Nursing pediatrics case study

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Case study #1: Young Infant with Tetralogy of Fallot Defect

 

Jake is a 6 week old male infant hospitalized with the diagnosis of Tetralogy of Fallot (TOF). He was seen at the pediatrician’s office because Jake’s mother was worried that he was not gaining weight and was having difficulty sucking on the bottle during feedings. He is admitted with a diagnosis of TOF and CHF.

 

1. You are the admitting nurse and do a complete physical assessment on Jake. The following are your findings. Please explain if these are expected or unexpected and why.

Assessment findings:

Apical pulse: 165; Respiratory rate: 66; Lung sounds/respiratory rate, effort, Accessory muscle use status; Heart sounds: gallop rhythm; Weak suck; Capillary refill longer than three seconds; Weight: 3.1kg.

 

 

 

2. You implement care interventions to improve cardiovascular functioning. Provide a rationale for the following care interventions that are incorporated into Jake’s plan of care and are shared with his parents:

a.      Anticipate needs to limit crying

b.      Plan morning care using the cluster care approach

c.      Digoxin 16mcg PO b.i.d. Hold if apical heart rate is less than 110 beats per minute

d.      Simi-Fowler position with the head of the bed at a 30 to 45 degree angle

e.      Daily weights on scale #2 at 7 A.M.

f.       Oral feeding every 3 hours using a large-hole nipple with the child in an upright position. (If complete volume of feed has not been taken in fifteen minutes, administer the remaining volumes of the formula via nasogastric tube over fifteen minutes).

g.      Strict hand washing

h.      Temperature assessment and clothing to maintain infant’s baseline temperature.

 

 

3. You enter Jake’s room and find him to have circumoral cyanosis, a sweaty forehead, and a heart rate of 260 beats/minute, and he is limp. Describe your nursing actions beginning with most important to ensure Jake’s physical safety.

 

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Essay two to three pages

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Based upon your reading of Dr. Christina Sommers’ article on Virtue Ethics and & the video lecture by Tamar Gendler on the same topic, write a 2 to 3 page essay (double-spaced; MS doc file or rtf) answering the questions given in the instructions.  You must support your analysis with at least two short quotations from the reading and/or video, properly notated.   Proper MLA or APA in text citations are required.  Each quotation must be no more than 40 words.  Topic Instructions are given below.

Instructions:

Based upon your reading of Dr. Christina Sommers’ article on Virtue Ethics & the video lecture by Tamar Gendler on the same, write a 2 to 3 page essay (double-spaced) on what virtue ethics is and how each of these philosophers explains it.   You will need to answer the following questions: According to Sommers, what is the main problem today and what is her basic answer both in terms of content and scope?  And then, from the lecture by Dr. Gendler, explain how we can turn normative commitments into descriptive laws and what does it mean to do that, according to her explanation of Aristotle’s virtue ethics (video link)?  Do you think it is fair to say that virtue ethics, as Tamar Gendler explains this moral theory, is a type of human programming and, if so, does this view challenge or undercut the idea of good human behavior as a matter of choice rather than response without thought?   Explain.  Do you think this approach of Professor Gendler to how virtue ethics becomes part of us goes along with Professor Sommers’ thesis on what is needed in schools today or not?  Explain.  Finally, what part of Christina Sommers’ analysis and proposal you find convincing, if any, and what part of it, if any, do you find questionable?

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microbial growth

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You will be the expert: Imagine you are teaching a class on controlling microbial growth in the environment. To test your students, you will present them with a scenario including a site and some probable microbes present. They must design a strategy to eliminate harmful microbes from the area.

In this discussion, each student should present a scenario for analysis by his or her classmates, and propose an answer to another classmate’s scenario. Be as creative as you can!

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Wk 4 – Signature Assignment: Health Care Manager Interview

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Assignment Content

  1. In this assignment you’ll examine the role of a health care manager regarding ethical issues and decision-making. You’ll have the opportunity to practice your professional skills in conducting interviews and communication, in general. Being able to have professional conversations with all stakeholders in an organization, including managers at various levels, is an important skill to have as a health care manager.

    Research a health care facility (pharmacy, medical office, nursing home, hospital). Become familiar with the company, including the mission, vision, and goals of the company.

    Select a leadership position at the facility – for example, a supervisor, manager, director, vice president, compliance officer, or similar.

    Use the Health Care Leadership Interview Questionnaire to conduct an interview with the person you selected.

    Write a 700-word summary of your interview. Title your assignment “Health Care Manager Interview.” Note: Double-space the interview responses and use proper grammar and sentence structure.

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W12 DQ ANP 650

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Instructions for Answer to 2 Question

1- After Each DQ (question), write down references

2- 300 minimum words for every DQ, you can go up to 800 words but answer should be complete.

3- 2-3 Peer Reviewed/ scholarly references for each question

4- References should be within 4 years

5- I am in acute care nurse practitioner program.

6- The response to the DQ is expected to be a minimum of 300 words. A minimum of two peer reviewed/ scholarly  resources are expected. These need to be appropriate for a clinical professional to guide decisions about patient care. If a textbook is used for one of these responses, the other needs to be journal or professional-level website. The references need to be correctly formatted, as do the citations for those references.  “ Question words” don’t count towards 300 minimum count”

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Evidence-Based Practice Change Process

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  1. Identify a clinical topic and related nursing practice issue you think needs to be changed.
  2. Locate a systematic review on your topic from the CCN Library databases. Be sure this involves nursing actions.
  3. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.
  4. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).
  5. Work on a portion of the process each week, as the illustration unfolds.

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Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

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Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
  • Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
  • Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
  • Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
  • Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
  • Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

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Nursing homework help

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 InstructionsCreate a teaching tool to promote breastfeeding. The material created to educate new mothers on breastfeeding will influence the mother’s decision to breastfeed, including duration, based on the quality and content of the teaching.

Assignment RequirementsYour teaching tool will be a trifold and must include this relevant content for a mother considering the risks and benefits of breastfeeding a newborn.

  • Explain how breast milk is formed in the mammary glands and the physiology of breast milk
  • Include two 2020 National Health Goals related to newborn nutrition to support breast feeding as the best choice. See the link below:
    • https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health
  • Discuss the advantages of breastfeeding related to immunities transferred to the newborn
  • Describe three additional benefits of breast feeding with supporting rationales
  • Include at least two supporting resources
  • Document must be written

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Essay

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Directions

Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.

  1. Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity (Links to an external site.)
  2. View a short tutorial with tips for completing this assignment: Evidence-Based Practice Change Process Assignment Tutorial (Links to an external site.) or by reading the transcript (Links to an external site.).
  3. Download the EBP Change Process form (Links to an external site.) during Week 1. The use of this specific form is REQUIRED 
  4. Identify a clinical topic and related nursing practice issue you think needs to be changed.
  5. Locate a systematic review on your topic from the CCN Library databases. Be sure this involves nursing actions.
  6. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.
  7. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).
  8. Work on a portion of the process each week, as the illustration unfolds.

Best Practices

  • Please reach out to your instructor for feedback or assistance with your PICOT question as needed.
  • Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.
  • Please see the grading criteria and rubrics on this page.
  • Please use your browser’s File setting to save or print this page.

Scholarly Sources and Citations

  • Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed.
  • Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!

**Academic Integrity**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

Rubric

Week 6: EBP Change Process Assignment Grading RubricWeek 6: EBP Change Process Assignment Grading RubricCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeSelected Systematic ReviewA systematic review from the CCN Library databases was selected, identified, and was appropriate for the selected nursing change process.25 ptsOne systematic review from the CCN Library databases was identified and was clearly appropriate.22 ptsA systematic review was selected from the CCN Library databases and was mostly appropriate for a nursing change process.20 ptsA systematic review was selected from the CCN Library databases and was fairly appropriate for a nursing change process.10 ptsA systematic review was selected, but not from the CCN Library databases and/or was not appropriate for this assignment.0 ptsNo systematic review selected or used.25 pts
This criterion is linked to a Learning OutcomeStar Point 1 (Discovery)The topic, nursing practice issue, rationale and scope of the problem were clearly identified and described.25 ptsStar Point 1 elements in the first column were thoroughly addressed.22 ptsStar Point 1 elements in the first column were mostly well addressed.20 ptsStar Point 1 was missing one element in the first column or one lacked detail.10 ptsStar Point 1 was missing more than one element in the first column and others lacked detail.0 ptsThe ACE Star Model Star Point 1 was not completed.25 pts
This criterion is linked to a Learning OutcomeStar Point 2 (Summary)The NURSING practice problem, NURSING related PICOT question, a systematic review from any database in the Chamberlain Library, and other optional references, evidence summary, strength, and solutions, are listed and described.35 ptsStar Point 2 elements in the first column were thoroughly addressed.31 ptsStar Point 2 elements in the first column were mostly well addressed.28 ptsStar Point 2 was missing one element in the first column or one lacked detail.13 ptsStar Point 2 was missing more than one element in the first column and others lacked detail. or were inappropriate.0 ptsThe ACE Star Model Star Point 2 was not completed.35 pts
This criterion is linked to a Learning OutcomeStar Point 3 (Translation)Care standards, practice guidelines, or protocols; stakeholders and their roles and responsibilities; the nursing role; rationale for including certain stakeholders, and cost analysis plan are addressed.35 ptsStar Point 3 elements in the first column were thoroughly addressed.31 ptsStar Point 3 elements in the first column were mostly well addressed.28 ptsStar Point 3. was missing one element in the first column or one lacked detail.13 ptsStar Point 3 was missing more than one element in the first column and others lacked detail.0 ptsThe ACE Star Model Star Point 3 was not completed.35 pts
This criterion is linked to a Learning OutcomeStar Point 4 (Implementation)Permission process, education plan, timeline, measurable outcomes, forms, resources, and stakeholder meetings, are addressed.35 ptsStar Point 4 elements in the first column were thoroughly addressed.31 ptsStar Point 4 elements in the first column were mostly well addressed28 ptsStar Point 4 was missing one element in the first column or one lacked detail.13 ptsStar Point 4 was missing more than one element in the first column and others lacked detail.0 ptsThe ACE Star Model Star Point 4 was not completed.35 pts
This criterion is linked to a Learning OutcomeStar Point 5 (Evaluation)Reporting results, process and next steps are addressed.35 ptsStar Point 5 elements in the first column were thoroughly addressed.31 ptsStar Point 5 elements in the first column were mostly well addressed28 ptsStar Point 5 was missing one element in the first column or one lacked detail.13 ptsStar Point 5 was missing more than one element in the first column and others lacked detail.0 ptsThe ACE Star Model Star Point 5 was not completed.35 pts
This criterion is linked to a Learning OutcomePresentationInformation was presented clearly and thoughts were well organized and logical.20 ptsInformation was presented clearly and thoughts were well organized and logical throughout.18 ptsInformation was presented clearly and thoughts were mainly organized and logical throughout.16 ptsInformation was presented clearly and thoughts were somewhat organized and logical throughout.8 ptsInformation was not consistently clear and/or was not consistently organized and logical.0 ptsInformation was disorganized and difficult to understand.20 pts
This criterion is linked to a Learning OutcomeMechanics/APAThe systematic review and any other scholarly resources were properly listed in APA format.
The writing includes error free grammar and spelling, and complete sentence structure.15 ptsExcellent mechanics and APA formatting with minimal errors in grammar, spelling, and sentence structure.13 ptsGood mechanics and formatting considering the elements listed in the first column12 ptsFair mechanics and formatting considering the elements listed in the first column6 ptsPoor mechanics and formatting considering the elements listed in the first column0 ptsVery poor mechanics and formatting such that information is difficult to read.15 pts
This criterion is linked to a Learning OutcomeAssignment Form Used0 pts0 points deductedCorrect assignment form used0 pts22.5 points (10%) deductedIncorrect form used resulting in point deduction0 pts
This criterion is linked to a Learning OutcomeLate Deduction0 pts0 points deductedSubmitted on time0 ptsNot submitted on time – Point deduction1 day late =11.25 deduction; 2 days=22.5 deduction; 3 days=33.75 deduction; 4 days =45 deduction; 5 days = 56.25 deduction; 6 days =67.5 deduction; 7 days =78.75 deduction; Score of 0 if more than 7 days late0 pts
Total Points: 225PreviousNext

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Week 6 Assignment: Check-Up 3

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Required Resources
Read/review the following resources for this activity:

  • Textbook: Chapter 16, 17
  • Lesson
  • Minimum of 2 scholarly sources  (in addition to course text)

Instructions
For this Check-Up, you are acting as a counselor. You will find in your career that often you will need to provide more than medical advice: sometimes you have to provide emotional support as well. In this case, you need to counsel your patient, about what he suspects he is experiencing.

Henok is a 55-year-old male. He was born in Addis Ababa, Ethiopia but has lived in the American South for the last 30 years. He has had a successful life as an industrial engineer, and has made a very lucrative living. Henok got married when he was 45 years old and had twin boys when he was 47. He loves his wife and twin boys, but he is starting to feel restless and anxious and isn’t sure why. He signed up for a skydiving trip with his friends two weeks ago and loved it. Now he wants to buy a motorcycle. He has come to you because he is experiencing chest pains. His EKG is normal, and all his bloodwork is normal. Everything points to him being physically healthy.

You ask a few questions and find out the following information:

  • He hasn’t been sleeping well.
  • He thinks he is a failure.
  • He recently had his black hair bleached blonde,
  • He bought a beach house and hasn’t told his wife yet.
  • He got the phone number of a female coworker to meet for drinks, but he felt guilty and threw it in the trashcan right away.
  • He has found himself missing his late father.

Your job:

  1. Tell Henok what you think is going on (1-2 paragraphs)
  2. Tell Henok how you think he can best overcome these feelings (2-4 paragraphs)
  3. Make a referral for Henok (1 paragraph)
  4. Provide some encouragement for Henok (this is your conclusion)
  5. How did you reach these conclusions? What research helped you arrive at the decisions that you did?

Writing Requirements (APA format)

  • Length: 2.5-3 pages (not including title page or reference page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page (minimum of 2 outside scholarly sources in addition to course text)

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