It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the 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. 

 

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For this assessment the patient will be a 63 year old female with a cystocele, and chief complaint urinary incontinence. The rest of the info can be made up such as medical history meds labs just make it believable to the pt age and diagnosis. 

Comprehensive Patient Assessment

When completing practicum requirements in clinical settings, you and your Preceptor might complete several patient assessments in the course of a day or even just a few hours. This schedule does not always allow for a thorough discussion or reflection on every patient you have seen. As a future advanced practice nurse, it is important that you take the time to reflect on a comprehensive patient assessment that includes everything from patient medical history to evaluations and follow-up care. For this Assignment, you begin to plan and write a comprehensive assessment paper that focuses on one female patient from your current practicum setting.

By Day 7 of Week 9

This Assignment is due. It is highly recommended that you begin planning and working on this Assignment as soon as it is viable.

To prepare

· Reflect on your Practicum Experience and select a female patient whom you have examined with the support and guidance of your Preceptor.

· Think about the details of the patient’s background, medical history, physical exam, labs and diagnostics, diagnosis, treatment and management plan, as well as education strategies and follow-up care.

To complete

Write an 8- to 10-page comprehensive paper that addresses the following:

· Age, race and ethnicity, and partner status of the patient

· Current health status, including chief concern or complaint of the patient

· Contraception method (if any)

· Patient history, including medical history, family medical history, gynecologic history, obstetric history, and personal social history (as appropriate to current problem)

· Review of systems

· Physical exam

· Labs, tests, and other diagnostics

· Differential diagnoses

· Management plan, including diagnosis, treatment, patient education, and follow-up care

 

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You will design a patient education tool that can be used by nurses for teaching patients using computer applications. You will then present your tool to the class and explain the purpose, how you created it, reasoning for your choice of applications, and provide current evidence of the effectiveness of this patient education. This presentation is 5-10 minutes.

DUE DATE: 

Total Points: 200

Patient Education Project Tool Rubric – 100 points

  

Points

18-20

14-17

10-16

0

Comments

 

Use of Computer Applications

Creative,   innovative, effective use of computer applications

Effective use of computer   applications

Ineffective   use of computer use of applications

Lacking   use of computer applications

 

Organization

Extremely   well organized; logical format that was easy to follow; flowed smoothly from   one idea to another and cleverly conveyed; the organization enhanced the   effectiveness of the project

Well   organized; logical format that was easy to follow; flowed smoothly from one   idea to another and conveyed; the organization enhanced the effectiveness of   the project

Somewhat   organized; ideas were not presented coherently and transitions were not   always smooth, which at times distracted the audience

Choppy   and confusing; format was difficult to follow transitions of ideas were   abrupt and seriously distracted the audience

 

Content   Accuracy

100 % of   the facts are accurate 

99-90%   of the facts are accurate 

89-80%   of the facts are accurate

Fewer   than 80% of facts are accurate

 

Research

Went   above and beyond to research information; solicited material in addition to   what was provided; brought in personal ideas and information to enhance   project; and utilized variety of resources to make project effective

Did a   very good job of researching; utilized materials provided to their full   potential; solicited adequate resources to enhance project; at time took the   initiative to find information outside of school.

Used   the material provided in an acceptable manner, but did not consult any   additional resources

Did   not utilize resources effectively; did little or no fact gathering on the   topic

 

Creativity

Was   extremely clever and presented with originality; a unique approach that truly   enhanced the project

Was   clever at times; thoughtfully and uniquely presented

Added   a few original touches to enhance the project but did not incorporate them   throughout

Little   creative energy used during this project; was bland, predictable, and lacked   “zip”

 

Patient Education Project Class Presentation Rubric: 100 points

   

Points

18-20

14-17

10-13

5-9

0-4

Comments

 

Voice

Speaker uses appropriate pitch,   volume, and rate of speaking. Articulation excellent.

Hasty conversational style;   does not interfere with volume or articulation. Communication is unhampered.

Low volume; hasty   conversational style compromises articulation and communication.

Speech difficult to hear or   understand; communication is severely compromised.

Speaker is inaudible, and/or   speech is garbled, impeding communication.

 

Gestures and Audience Engagement

Eyes, hands, facial expression,   and body language all coordinate to support communication.

Eye contact is adequate. Facial and body language are neutral.

Eye contact and facial   expressions are minimal; gestures and body language distracting.

No eye contact; speaker is   stationary, or is supported by lectern.

No eye contact, speaker is   rigid, head down, or is unable to continue.

 

Speech Content

Introduction explains the   purpose of the tool, previews speech.

Body clearly explains how you   created it and the reasoning for choice of tools.

Conclusion ties presentation   together.

Speech is prepared, organized   into an introduction, body, and conclusion, with minimal transitional   devices.

Speech is obviously prepared   and researched, but has no discernible intro, body, and/or conclusion and   lacks interlocking thoughts.

Speech has an impromptu effect,   with no discernible parts or transitions; is obviously poorly researched and   unprepared.

Speech is unprepared, not   researched, and is obviously an impromptu presentation.

 

Evidence Support

Research used from appropriate   sources

Research used, but not from   appropriate sources

.

No research support provided

 

Length of presentation

Presentation is 5-10 minutes in   length

Presentation is <5 minutes   or>10 minutes in length

  

You will design a patient education tool that can be used by nurses for teaching patients using computer applications. You will then present your tool to the class and explain the purpose, how you created it, reasoning for your choice of applications, and provide current evidence of the effectiveness of this patient education. This presentation is 5-10 minutes.

DUE DATE: 

Total Points: 200

Patient Education Project Tool Rubric – 100 points

  

Points

18-20

14-17

10-16

0

Comments

 

Use of Computer Applications

Creative,   innovative, effective use of computer applications

Effective use of computer   applications

Ineffective   use of computer use of applications

Lacking   use of computer applications

 

Organization

Extremely   well organized; logical format that was easy to follow; flowed smoothly from   one idea to another and cleverly conveyed; the organization enhanced the   effectiveness of the project

Well   organized; logical format that was easy to follow; flowed smoothly from one   idea to another and conveyed; the organization enhanced the effectiveness of   the project

Somewhat   organized; ideas were not presented coherently and transitions were not   always smooth, which at times distracted the audience

Choppy   and confusing; format was difficult to follow transitions of ideas were   abrupt and seriously distracted the audience

 

Content   Accuracy

100 % of   the facts are accurate 

99-90%   of the facts are accurate 

89-80%   of the facts are accurate

Fewer   than 80% of facts are accurate

 

Research

Went   above and beyond to research information; solicited material in addition to   what was provided; brought in personal ideas and information to enhance   project; and utilized variety of resources to make project effective

Did a   very good job of researching; utilized materials provided to their full   potential; solicited adequate resources to enhance project; at time took the   initiative to find information outside of school.

Used   the material provided in an acceptable manner, but did not consult any   additional resources

Did   not utilize resources effectively; did little or no fact gathering on the   topic

 

Creativity

Was   extremely clever and presented with originality; a unique approach that truly   enhanced the project

Was   clever at times; thoughtfully and uniquely presented

Added   a few original touches to enhance the project but did not incorporate them   throughout

Little   creative energy used during this project; was bland, predictable, and lacked   “zip”

 

Patient Education Project Class Presentation Rubric: 100 points

   

Points

18-20

14-17

10-13

5-9

0-4

Comments

 

Voice

Speaker uses appropriate pitch,   volume, and rate of speaking. Articulation excellent.

Hasty conversational style;   does not interfere with volume or articulation. Communication is unhampered.

Low volume; hasty   conversational style compromises articulation and communication.

Speech difficult to hear or   understand; communication is severely compromised.

Speaker is inaudible, and/or   speech is garbled, impeding communication.

 

Gestures and Audience Engagement

Eyes, hands, facial expression,   and body language all coordinate to support communication.

Eye contact is adequate. Facial and body language are neutral.

Eye contact and facial   expressions are minimal; gestures and body language distracting.

No eye contact; speaker is   stationary, or is supported by lectern.

No eye contact, speaker is   rigid, head down, or is unable to continue.

 

Speech Content

Introduction explains the   purpose of the tool, previews speech.

Body clearly explains how you   created it and the reasoning for choice of tools.

Conclusion ties presentation   together.

Speech is prepared, organized   into an introduction, body, and conclusion, with minimal transitional   devices.

Speech is obviously prepared   and researched, but has no discernible intro, body, and/or conclusion and   lacks interlocking thoughts.

Speech has an impromptu effect,   with no discernible parts or transitions; is obviously poorly researched and   unprepared.

Speech is unprepared, not   researched, and is obviously an impromptu presentation.

 

Evidence Support

Research used from appropriate   sources

Research used, but not from   appropriate sources

.

No research support provided

 

Length of presentation

Presentation is 5-10 minutes in   length

Presentation is <5 minutes   or>10 minutes in length 

 here is the other format.

You will design a patient education tool that can be used by nurses for teaching patients using computer applications. You will then present your tool to the class and explain the purpose, how you created it, reasoning for your choice of applications, and provide current evidence of the effectiveness of this patient education. This presentation is 5-10 minutes.

Assignment File(s)

• Patient Education Project and Presentation [Word Document]

Rubric

NM 208 Patient Education Project ToolNM 208 Patient Education Project ToolCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeUse of Computer Applications20.0 to >17.0 ptsHigh ProficiencyCreative, innovative, effective use of computer applications17.0 to >14.0 ptsModerately High ProficiencyEffective use of computer applications14.0 to >10.0 ptsProficient PointsIneffective use of computer use of applications10.0 to >0 ptsLow-Level Proficiency/Non-ProficientLacking use of computer applications20.0 pts
This criterion is linked to a Learning OutcomeOrganization20.0 to >17.0 ptsHigh ProficiencyExtremely well organized; logical format that was easy to follow; flowed smoothly from one idea to another and cleverly conveyed; the organization enhanced the effectiveness of the project17.0 to >14.0 ptsModerately High ProficiencyWell organized; logical format that was easy to follow; flowed smoothly from one idea to another and conveyed; the organization enhanced the effectiveness of the project14.0 to >10.0 ptsProficient PointsSomewhat organized; ideas were not presented coherently and transitions were not always smooth, which at times distracted the audience10.0 to >0 ptsLow-Level Proficiency/Non-ProficientChoppy and confusing; format was difficult to follow transitions of ideas were abrupt and seriously distracted the audience20.0 pts
This criterion is linked to a Learning OutcomeContent Accuracy20.0 to >17.0 ptsHigh Proficiency100 % of the facts are accurate17.0 to >14.0 ptsModerately High Proficiency99-90% of the facts are accurate14.0 to >10.0 ptsProficient Points89-80% of the facts are accurate10.0 to >0 ptsLow-Level Proficiency/Non-ProficientFewer than 80% of facts are accurate20.0 pts
This criterion is linked to a Learning OutcomeResearch20.0 to >17.0 ptsHigh ProficiencyWent above and beyond to research information; solicited material in addition to what was provided; brought in personal ideas and information to enhance project; and utilized variety of resources to make project effective17.0 to >14.0 ptsModerately High ProficiencyDid a very good job of researching; utilized materials provided to their full potential; solicited adequate resources to enhance project; at time took the initiative to find information outside of school.14.0 to >10.0 ptsProficient PointsUsed the material provided in an acceptable manner, but did not consult any additional resources10.0 to >0 ptsLow-Level Proficiency/Non-ProficientDid not utilize resources effectively; did little or no fact gathering on the topic20.0 pts
This criterion is linked to a Learning OutcomeCreativity20.0 to >17.0 ptsHigh ProficiencyWas extremely clever and presented with originality; a unique approach that truly enhanced the project17.0 to >14.0 ptsModerately High ProficiencyWas clever at times; thoughtfully and uniquely presented14.0 to >10.0 ptsProficient PointsAdded a few original touches to enhance the project but did not incorporate them throughout10.0 to >0 ptsLow-Level Proficiency/Non-ProficientLittle creative energy used during this project; was bland, predictable, and lacked “zip”20.0 pts
Total Points: 100.0PreviousNext

 

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You will design a patient education tool that can be used by nurses for teaching patients using computer applications. You will then present your tool to the class and explain the purpose, how you created it, reasoning for your choice of applications, and provide current evidence of the effectiveness of this patient education. This presentation is 5-10 minutes.

Assignment File(s)

• Patient Education Project and Presentation [Word Document]

Rubric

NM 208 Patient Education Project ToolNM 208 Patient Education Project ToolCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeUse of Computer Applications20.0 to >17.0 ptsHigh ProficiencyCreative, innovative, effective use of computer applications17.0 to >14.0 ptsModerately High ProficiencyEffective use of computer applications14.0 to >10.0 ptsProficient PointsIneffective use of computer use of applications10.0 to >0 ptsLow-Level Proficiency/Non-ProficientLacking use of computer applications20.0 pts
This criterion is linked to a Learning OutcomeOrganization20.0 to >17.0 ptsHigh ProficiencyExtremely well organized; logical format that was easy to follow; flowed smoothly from one idea to another and cleverly conveyed; the organization enhanced the effectiveness of the project17.0 to >14.0 ptsModerately High ProficiencyWell organized; logical format that was easy to follow; flowed smoothly from one idea to another and conveyed; the organization enhanced the effectiveness of the project14.0 to >10.0 ptsProficient PointsSomewhat organized; ideas were not presented coherently and transitions were not always smooth, which at times distracted the audience10.0 to >0 ptsLow-Level Proficiency/Non-ProficientChoppy and confusing; format was difficult to follow transitions of ideas were abrupt and seriously distracted the audience20.0 pts
This criterion is linked to a Learning OutcomeContent Accuracy20.0 to >17.0 ptsHigh Proficiency100 % of the facts are accurate17.0 to >14.0 ptsModerately High Proficiency99-90% of the facts are accurate14.0 to >10.0 ptsProficient Points89-80% of the facts are accurate10.0 to >0 ptsLow-Level Proficiency/Non-ProficientFewer than 80% of facts are accurate20.0 pts
This criterion is linked to a Learning OutcomeResearch20.0 to >17.0 ptsHigh ProficiencyWent above and beyond to research information; solicited material in addition to what was provided; brought in personal ideas and information to enhance project; and utilized variety of resources to make project effective17.0 to >14.0 ptsModerately High ProficiencyDid a very good job of researching; utilized materials provided to their full potential; solicited adequate resources to enhance project; at time took the initiative to find information outside of school.14.0 to >10.0 ptsProficient PointsUsed the material provided in an acceptable manner, but did not consult any additional resources10.0 to >0 ptsLow-Level Proficiency/Non-ProficientDid not utilize resources effectively; did little or no fact gathering on the topic20.0 pts
This criterion is linked to a Learning OutcomeCreativity20.0 to >17.0 ptsHigh ProficiencyWas extremely clever and presented with originality; a unique approach that truly enhanced the project17.0 to >14.0 ptsModerately High ProficiencyWas clever at times; thoughtfully and uniquely presented14.0 to >10.0 ptsProficient PointsAdded a few original touches to enhance the project but did not incorporate them throughout10.0 to >0 ptsLow-Level Proficiency/Non-ProficientLittle creative energy used during this project; was bland, predictable, and lacked “zip”20.0 pts
Total Points: 100.0PreviousNext

 

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 Instructions

The purpose of this assignment is to apply knowledge of reliable and valid information sources to patient education in clinical nursing practice and to evaluate patient educational materials posted on the internet.

The assignment for this week consists of 3-5 page paper evaluating consumer/patient health information on the web. You will be required to find a website that is designed to provide health information to the consumer/patient and analyze it according to the criteria described below. You are required to report your analysis in a formal course paper.

   Choose a health topic/issue in which you want to educate your patient/consumer/family about (diabetes, heart failure, teenage pregnancy, depression, etc…) and briefly describe in your paper :
       An explanation of your health topic/issue and why you selected it (Significance of the topic/issue selected).

   Find an internet source that is designed to provide information/education about your selected health topic/issue and analyze the following:

       describe the website (main title, information)
       describe the overall impression about the design of the website (organization, easiness of finding information, easiness to read, table of content/index, colors, font, does it look professional).
       Who is sponsoring the website?
       How often is the site updated? When was the site created? Was it updated recently?
       Does it state that the content is not medical advice?
       Who is the intended audience? Does the site have a clear target audience? Is the information presented appropriate to the target population?

   How credible are the information presented:

       Is there any evidence that the author of the web information has some authority in the field about which she or he is providing information? Who is responsible for the information? What are the author’s credentials? Is a mechanism in place for you to contact the author?
       Are there clues that the author/s are biased? For example, is he/she selling or promoting a product? Is the author taking a personal stand on a social/political issue or is the author being objective ? Bias is not necessarily “bad,” but the connections should be clear.
       Does the information have a complete list of works cited, which reference credible, authoritative sources? Is the information valid and supported by evidence? Are omissions noted? Is the author’s point of view objective and unbiased?
       Is the information accurate? Any inconsistencies, inaccuracies, errors, false information, etc…
       Are there links that point to additional, valuable resources with minimum effort?

   Adequacy:

       Over all, does the site provide consumer/patient education? is the education adequate or does the consumer have to go somewhere else to find answers about the topic?

   Sophistication of the information:

       Is this source too elementary, too technical, too advanced, or just right?
       Is the purpose of the site clearly stated? Does the site match its purpose? Is the site intended to educate or sell?

   Submit a 3-5 page analysis paper following APA format (include title page, running head, introduction, headings, Summary paragraph, reference page, in-text citation). You need to include at least 5 reliable and current (within the last 5 years) references of which at least 3 journal articles.

Supporting Materials:

   Medical Library Association (2019). Find good health informationLinks to an external site.. [Website]. Retrieved from https://www.mlanet.org/resources/userguide.html.
   Montecino, V. (1998). Criteria to evaluate the credibility of WWW resourcesLinks to an external site.. [Website]. Retrieved from http://mason.gmu.edu/~montecin/web-eval-sites.htm. 

 

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