Clinical Reasoning Report
Task Description
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Task Description
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Write a 2- to 3- page paper that addresses the following:
· Describe available preventive services that providers might recommend for patients at risk for the selected cancer
· Explain how the factors you selected might impact decisions related to preventive services.
· Describe drug treatment options for patients diagnosed with the type of cancer you selected. Explain the short-term and long-term implications of these treatments.
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Question
Question 1 A 45-year-old man who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the patient to
Question 2 A 55-year-old man’s hypertension has not responded adequately to his current medication regimen consisting or an ACE inhibitor, a beta-blocker and a thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which of the following nursing actions?
Question 3 A nurse has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The nurse suspects that these signs or symptoms are
Question 4 A nurse is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin.Because the patient has a history of severe renal disease, the nurse will assess for which of the following?
Question 5 A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by
Question 6 An expected outcome for a patient who has just taken sublingual nitroglycerin should be
Question 7 A clinic nurse has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to
Question 8 A 39-year-old African-American male is 25 pounds overweight and has been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be
Question 9 A nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which of the following signs or symptoms would the nurse attribute to being a common adverse effect of this medication?
Question 10 Several months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient’s cholesterol levels. Consequently, the patient has been prescribed cholestyramine. The nurse should recognize that this drugs achieves its therapeutic effect by
Question 11 A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments?
Question 12 A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When preparing for administration of the drug, the nurse will
Question 13 A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin?
Question 14 A nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients?
Question 15 A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient s heart rate, the nurse should prioritize assessment of the patient’s
Question 16 A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?
Question 17 A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
Question 18 A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention?
Question 19 A patient has been prescribed lovastatin for a high cholesterol level. The nurse’s teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it
Question 20 A nurse is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the nurse to monitor?
Question 21 A nurse explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for
Question 22 A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.)
Question 23 Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?
Question 24 A nurse has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely
Question 25 A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication
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I am very much enjoying the author’s voice in “Bioethics: A Primer for Christians.” I am probably one of the only non-Christians in this class, so I find Meilaender’s style approachable and his explanations of the Christian religion easy to follow and understand. I appreciate the preface where he says “all are welcome and invited to listen in.” I am grateful for this opportunity to learn more about the Christian religion, as the majority of my patients in west Michigan are of this faith! I like that he points out the revisions he has made over time as science has changed over the years. I think it is important to continually examine individual beliefs and be open to changes in perspective without compromising core values and beliefs. Healthy, respectful discussions with our peers are essential in these changing times.
“We need not, I think, fear that seeking medical help necessarily demonstrates lack of trust or faith on our part. Rather, it indicates only that we trust God to care for us mediately – through the love and concern of others” (Meilaender, 2013). I think this is a beautiful statement on the analysis of disease and healing. God can present Himself in indirect ways, such as through the healing hands of a doctor or nurse. If a patient is struggling with a diagnosis, going to the hospital for modern treatment does not mean they do not have faith in God. Just as people rely on their church communities for emotional and spiritual support, they can come to the hospital with physical symptoms and be treated without judgment from other people. As nurses, if we try to see each patient as God sees them, no matter who they are or what they may have done in life, we truly are serving these people and their families.
I’ve had people I just met hug me and thank me for what I do when they find out I’m an oncology nurse. This surprised me early on in my career, but then the person would go on to tell me a story of someone close to them who had cancer. People associate us with healing, and sometimes a hug from a stranger can be just the sign someone needs that God is watching over them.
Meilaender, G. (2013). Bioethics: a primer for Christians. Grand Rapids, MI: W.B. Eerdmans Pub. Co.
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Details:
The IOM Future of Nursing report calls for an increase in leadership from nurses at all levels. One way nurses demonstrate their role as a leader, is through public policy change. A leader does not always carry an official title or position, but demonstrates leadership through the work and the stance the leader takes to make a change for the good of others. Nurses have been noted by the Gallop poll year after year as the most trusted professionals.
This assignment requires thought about a public policy that is needed or needs to be changed that relates to nursing, health care, or the public. Policy changes can occur by working with members of your legislature, and state or national nurses associations, to introduce a new bill and/or change to a current law in your state or federal government.
Examples of public policy includes any component of the current legislation governing health care, Medicare Part D, Medicaid, nursing regulation, medication technicians, etc.
In 750-1,000 words, propose a health policy change (that is currently a bill, a law, or may not exist at all) at the state or federal level that you believe needs to change and why.
Resources:
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
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Topic – Transient ischemic attack
Your discussion thread title should be the name of the disorder. If possible, you should choose a disorder that has not been chosen by a peer. You can complete your initial post using bullet points or a short answer.
In your initial post, discuss the following questions about your chosen disorder:
· Concept and Etiology: How does the disease affect the endocrine and neural body systems in particular? How does it deviate from the definition of health discussed in Module One?
· Classification: How is the disease classified?
· Clinical Manifestations (Symptoms and Signs): What are the symptoms and signs of the disease or disorder? Be sure you understand the difference between symptoms (subjective) and signs (objective).
· Diagnostic Tests: What are some additional diagnostic tests that can be done to illuminate the diagnosis? For example, when you injure your ankle, they take an X-ray to determine if it is broken or sprained.
Support your answer with relevant resources.
chose two different disorder that are similar to this one – Compare and contrast your chosen disorder with this one. What are their similarities and differences?
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Write a 250-500 word analysis of “Case Study: Fetal Abnormality.” Be sure to address the following questions:
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
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As a nurse leader, you need to have the skills and knowledge to collaborate and communicate with those who plan for and manage change. This capacity is valuable in any health care setting and for many different types of change. Furthermore, it is essential to be able to evaluate a change effort and determine if it is promoting improved outcomes and making a positive difference within the department or unit, or for the organization as a whole.
To prepare:
Post a summary of a specific change within an organization and describe the impact of this change on your role and responsibilities. Explain the rationale for the change, and whether or not the intended outcomes have been met. Assess the management of the change, and propose suggestions for how the process could have been improved.
Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
- Review Chapter 7, “Strategic and Operational Planning”
- Chapter 8, “Planned Change”
This chapter explores methods for facilitating change and the theoretical underpinnings of implementing effective change
McAlearney, A., Terris, D., Hardacre, J., Spurgeon, P. Brown, C., Baumgart, A., Nyström, M. (2014). Organizational coherence in health care organizations: Conceptual guidance to facilitate quality improvement and organizational change. Quality Management in Health Care, 23(4), 254–267 doi: 10.1097/QMH.0b013e31828bc37d
An international group of investigators explored the issues of organizational culture and Quality Improvement (QI) in different health care contexts and settings. The aim of the research was to examine if a core set of organizational cultural attributes are associated with successful QI systems.
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management – UK, 20(1), 32–37. doi: 10.7748/nm2013.04.20.1.32.e1013
Retrieved from the Walden Library databases.
Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. The Journal of Nursing Administration, 43(2), 69–72. doi:10.1097/NNA.0b013e31827f20a9
Retrieved from the Walden Library databases.
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I need complete 2-3 pages paper on the following assignment. HALF PAGE LENGTH IS NOT ACCEPTED. Must address the all steps properly. Must include 3 credible references cited in APA. Must provide 100% original work.
DO NOT PROVIDE THE PREVIOUSLY USED WORK.
DO NOT WRITE QUESTIONS IN ANSWER!
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#1 discussion
Caring determines what matters to a person. It underlies a wide range of interactions, from parental love to friendship, from caring for one’s work to caring for one’s pet to caring for and about one’s patients. Nursing in my opinion consists of a caring relationship that requires the individual to not only care for the patient but also the family and their communities. It requires medical knowledge, technical skills and empathy. A lack of empathy can influence their health and well-being. Possessing the ability to assess a patient needs and determine what type of care or intervention is needed to improve the clients’ health, person, and environment is the art of nursing. A nurse must realize that the patient is not the only person that they are caring for, they care for the whole family as well. We must make certain that the families’ needs are met as well as the patients for the best recovery for our actual patient. Majority of these family members are in a tough, stressful situation, it is our job to help them through it and keep their stress levels at the minimum. The patient’s environment plays a major role in their recovery, keeping it clean and stress free is the best way to keep them on the right path to recovery. As we know, there are so many different beliefs and cultures that impact the care we provide to our patients. An advanced practice nurse must provide care according to the patients beliefs and religion as well as social class and education level. This can be difficult at times, but it makes the patient satisfied with their stay and leads to a quicker recovery since they are able to relax instead of stressing out over their wishes and needs not being met. This could be as simple as following a patients request on diet restrictions due to religious views, making certain they do not deliver foods to the patient that are on their list.
Essential VIII is the essential that defines nursing care in my opinion. This essential recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations (AACN Master’s Essentials).
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