The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control with sodium restriction. He current works at a catalog telephone center.

Objective Data

1. Height: 68 inches; Weight 134.5 kg
2. BP: 172/96, HR 88, RR 26
3. Fasting Blood Glucose: 146/mg/dL
4. Total Cholesterol: 250mg/dL
5. Triglycerides: 312 mg/dL
6. HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
2. Ranitidine (Zantac) 300 mg PO at bedtime.
3. Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

1. Assess each of Mr. C.’s functional health patterns using the information given. (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance.)
2. What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

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Professional Capstone and Practicum Reflective Journal and Scholarly Activities

Throughout the course, students will engage in weekly reflection and scholarly activities. These assignments are presented in Topic 1 to allow students to plan ahead, and incorporate the deliverables into the Individual Success Plan if they so choose.

The weekly reflective journals and scholarly activities will not be submitted in LoudCloud each week; a final, culminating submission will be due in Topic 10. No submission is required until Topic 10.

Professional Capstone and Practicum Reflective Journal

Students are required to maintain weekly reflective narratives throughout the course to combine into a final, course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course. This course-long journal assignment will be due in Topic 10.

In each week’s entry, you should reflect on the personal knowledge and skills gained throughout the Professional Capstone and Practicum course. Your entry should address a variable combination of the following, dependent on the specific practice immersion clinical experiences you encountered that week:

1. New practice approaches
2. Intraprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Population health concerns
6. The role of technology in improving health care outcomes
7. Health policy
8. Leadership and economic models
9. Health disparities

In the Topic 10 submission, each of the areas should be addressed in one or more of the weekly entries.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how they met competencies and course objectives.

Scholarly Activities

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

You are required to post one scholarly activity while you are in the BSN program, which should be documented by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

In Topic 10, you will submit a summary report of your scholarly activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.

AttachmentsNRS-490-RS-ScholarlyActivitySummary.docx 

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Literature Evaluation Table

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. Being able to articulate the information and successfully summarize relevant peer-reviewed articles in a scholarly fashion helps to support the student’s ability and confidence to further develop and synthesize the progressively more complex assignments that constitute the components of the course change proposal capstone project.

For this assignment, the student will provide a synopsis of eight peer-reviewed articles from nursing journals using an evaluation table that determines the level and strength of evidence for each of the eight articles. The articles should be current within the last 5 years and closely relate to the PICOT statement developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project. Use the “Literature Evaluation Table” resource to complete this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

https://lms-ugrad.gcu.edu/learningPlatform/content/content.lc?operation=viewContent&contentId=a16908a6-1de0-4c3c-be20-a91f70dcf6b2

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 Sustaining change can be difficult, as there are many variables that can affect implementation. One critical component of EBP is to ensure that practice change is part of an organization’s culture so it will continue to impact outcomes over time. Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers. 

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