Patient Background: Maria, a 45-year-old female, presents to the emergency room with symptoms of severe dehydration following prolonged vomiting and diarrhea. Her lab results indicate the following:

• Serum sodium: Elevated (hypernatremia)
• Urine output: Low
• Heart rate: Elevated (tachycardia)
• Blood pressure: Low (hypotension)

The attending physician has ordered an IV to address Maria’s dehydration and stabilize her condition. Three IV solutions are available for consideration:

1. 0.45% saline (hypotonic)
2. 0.9% saline (isotonic)
3. 3% saline (hypertonic)

Your task is to analyze the situation, considering how each IV solution would interact with Maria’s cells and overall condition, and recommend the best choice.

 

A 32-year-old patient diagnosed with Obsessive-Compulsive Disorder (OCD) and Bipolar Disorder presents with recurring intrusive thoughts related to cleanliness and compulsive hand-washing. They report periods of heightened energy and impulsivity alternating with depressive episodes. Current treatment includes mood stabilizers lithium and exposure-response prevention therapy for OCD.

General directions for the discussion:

There are two (2) questions for this discussion. Please choose one of the questions for your initial posting.

You are required to respond to at least one of your peers. You must respond to a different discussion question than the one you have answered.

You are also required to include a word count in parentheses (your question response must be between 300-500 words), excluding the original question and references. This word count is part of the Discussion Board Rubric.

Please note that there are two dates listed on the Course Schedule. The first is the due date for the initial posting and the second the completion date for the threaded response.

The due date listed here is for full completion of the module, including the threaded discussion. The DB be monitored to verify that the initial posting was completed on the date listed on the schedule.

Discussion Board 2 Questions

1. Select an article on your Supplemental Reading list in Module 1.2 and answer the following questions:

• How is the concept defined?
• What is the empirical referent for the concept? Suggest ways the concept might be measured in your clinical setting. If the authors did not suggest ways of measuring the concept, create ways of measuring the concept based on the defining attributes of the concept.
• What other information helps to illuminate the concept? e.g. case examples or exemplars, antecedents, consequences, synthesis, contrast.
• What did the particular method of concept analysis add to your understanding of the concept? In other words, justify the use of the method — or consider how a different concept analysis method might have provided a different picture of the concept.
• Provide an example of this concept from your practice. How does the conceptualization of the concept fit with your experience?
• Does the concept analysis begin to suggest propositions or testable hypotheses? For instance, could you begin to say something like “This concept occurs when . . .” or “When this concept is present, then . . .”? Give examples, if possible. In other words, consider how this concept analysis might be the beginning of a theory.

1. Considering the various levels of abstraction (Metaparadigm, Philosophy, Conceptual Model, Grand Theory, Middle Range Theory, Practice Theory), which do you see as most appropriate to your nursing practice? Why? Or could you argue for a time and place for each level of abstraction?