Clinical Judgment is the process of integrating evidence-based practice, critical-thought, the Nursing Process, knowledge, skills, and attitudes, as well as application of theory to practice in order to promote safe, quality care to clients in all settings.

Keeping that in mind, answer the following scenario:

You are the Charge Nurse in a large Urban Emergency Department (ED). You nursing staff include:

1. RN with 12 years of Trauma ED experience
2. New RN with 6 months ED experience
3. RN from the Medical Surgical floor with 8 years of experience

The following patients are in the ED, which patient will you give to each of the nurses and why?

1. A 76-year-old client who was involved in a motor vehicle accident and has hematuria.
2. A 38-year-old client with kidney stones complaining of severe pain.
3. A 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching.
4. An 80-year-old client that has not had a bowel movement for 4 days.

 

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DUE TODAY! 

At least 150-word response to each question. Each response must have at least 1 Reference within the past 5 years. APA format, no plagiarism. 

 

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Nursing 

 

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Read Chapter 4

1-which of the following behaviors may be (1) ethical but illegal, (2) legal but unethical, (3) illegal and unethical, and (4) legal and ethical. 

A. Working in a clinic that performs abortions 

b. Respecting the wishes of a client suffering from ALS that he be permitted to die with dignity and not placed on “breathing machines”

c. Respecting the health surrogate’s wishes regarding termination of life support of her friend 

d. Observing a coworker take out two tablets of oxycodone as ordered for pain management for his patient but keeping one for himself, administering only one tablet to the patient. 

2-differentiate among the following: deontological theories, utilitarianism, and principlism. 

3-what do you think about health-care professionals disclosing information to clients about a poor prognosis, even though the information may cause severe distress.

4-What do they think about health-care professionals disclosing information to clients against family wishes? 

5. You see a colleague use another nurse’s password to access the medication administration system and take out a narcotic. What would you do? 

6.Your colleague’s child fell and was brought to the emergency department. She comes back up to the unit and tells you that they cleaned and debrided the wound, and she needs to change the dressings twice a day using a wet to dry method. You see her go into the supply system and remove the dressings and saline using a patient’s identification number. What would you do?

7. You are caring for a patient who has a terminal disease. He asks you if he is dying. Would you tell him? If yes, how? If no, what might you say? . 

8-You are administering hydromorphone to a patient. The patient asks you what you are administering. Would you tell the patient about the medication?

 

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Read Chapter 6 & 7

APA FORMAT AND REFERENCE

1. Discuss the importance of effective communication in the personal relationship, the therapeutic relationship, and the relationship within the interprofessional health-care team.

2. What similarities and differences can you identify among the above interactions? 

3. Explain the concept of congruence between verbal and nonverbal communication.

4. There are many pitfalls to electronic communication. Identify a situation in which an electronic form of communication may result in a miscommunication. What other method of communication would have been more effective? 

5. How have you seen ISBAR used during your clinical experiences? 

6- Develop a hand-off report for yourself. Include items that you believe are pertinent for safe and effective nursing care. Refer to the information in the chapter for creating this report form. Using the information from the chapter, determine the effectiveness of the system currently in use on your unit for communicating shift-to-shift reports. 

7-Dr. Roberts comes into the nurses’ station demanding, “Where are Mr. Adams’s lab reports? I ordered these stat, and they’re not here! Who’s responsible for this patient?” How would you, as the nurse, respond? 

8-Explain the concept of accountability in delegation. What are the legal ramifications of accountability in delegation?

9. Dennie and Elias arrive in the unit for the 7:00 p.m. to 7:00 a.m. shift. Both nurses completed orientation 4 weeks ago. They find that they will be the only two RNs on the floor that night. There is a census of 48 clients. The remaining staff consists of two NAPs/UAPs and one LPN. What are the responsibilities of the RN, NAP/UAP, and LPN? Can Dennie and Elias effectively delegate client care tasks and care safely for all 48 clients? Use the Delegation Tree to make your decisions.

10. Discuss the differences between direct delegation and indirect delegation. 

1. You have to observe delegation procedures in your assigned unit:

A-What considerations does the RN take into account when delegating patient care? 

2-You have to look at the unit census and prioritize the patient care:

A- Give the rationale foryour choices.

3.Answer the following questions during your clinical experiences:

a. What specific tasks did your patients require that you might have been able to delegate?

b. How effective was your nurse/preceptor in delegating tasks to others? 

c. How did your nurse/preceptor ensure that the tasks were completed safely and appropriately?

 

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