Identify the one that you think is most likely and explain why.

Discussion WK 3

· Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

· Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

· Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

· Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

· Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.

· Review the posttest for the case study.

Post a response to the following:

· Provide the case number in the subject line of the Discussion thread.

· List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.

· Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

· Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.

· List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.

· List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.

Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

To Prepare:

Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.

Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)

Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.
In the Discussion for this module, you considered the interaction of nurse informaticists with other specialists to ensure successful care. How is that success determined?

Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is measured. Measuring patient outcomes results in the generation of data that can be used to improve results. Nursing informatics can have a significant part in this process and can help to improve outcomes by improving processes, identifying at-risk patients, and enhancing efficiency.

To Prepare:

Review the concepts of technology application as presented in the Resources.

Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

Describe the project you propose.

Identify the stakeholders impacted by this project.

Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.

Identify the technologies required to implement this project and explain why.

Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

Explain how the American Nurses Association Scope and Standards of Practice and Code of Ethics serve as a foundation for nursing practice and health promotion. (COs 1, 2, and 4)

Scope and Standards of Nursing Practice

According the text book The American Nurses Association’s Nursing: Scope and Standards of Practice (3rd ed.) discusses integrating the art and science of nursing. Describe how science and art are synthesized in the practice of nursing.

The course outcomes to meet include:

-Examine the roles and responsibilities of the professional nurse related to promoting health and wellness. (COs 1, 2, and 3)

-Explain how the American Nurses Association Scope and Standards of Practice and Code of Ethics serve as a foundation for nursing practice and health promotion. (COs 1, 2, and 4)

-Compare and contrast the nursing process and clinical reasoning. (COs 1, 2, and 3)

-Apply knowledge of the nursing role to promoting healthy behaviors in others. (COs 2 and 3)

-Describe how the nursing process is utilized to promote the health of individuals and families. (COs 1 and 2)

Nursing is a complex profession that combines art and science. I believe that it is one of the few jobs that have this gift. Every day we touch the lives of a diverse population. There are fundamental standards and codes we must abide. While upholding these standards, we must continue to educate ourselves and show compassion to our patients (Potter, Perry, Stockert, & Hall, 2017). As with other disciplines, we hear of stories about how individuals stray from the oath or pledge they took to care for those in need. When we no longer function in the role of a nurse who promotes health and wellness, we bring harm to those who we are charged with caring. As you develop your nursing craft at mixing art and science of nursing, consider the implications of not being able to manage both of these aspects of nursing successfully. Take a look at this 2 min video:

Link to the video: https://www.youtube.com/watch?v=8PZNl6vix8Q

What additional tests, if needed, could be done to determine the cause of AKI?

Mrs. Davies is a 70-year-old white woman who presented to the emergency department because of a 4-day history of increased shortness of breath and generalized weakness. Mrs. Davies stated that she has been able to do her daily chores at home independently, but for the last few days it was getting difficult for her to get around and that she needed to take frequent breaks because she was short of breath and had no energy. She has a long history of heart failure, diabetes mellitus type 2, and hypertension. She is admitted with a tentative diagnosis of acute kidney injury (AKI).

Subjective Data

Has been having headaches on and off, with nausea and dizziness

Reported that she hadn’t been taking her medications regularly at home because of ‘forgetfulness’

Has not been urinating a lot

Feels ‘puffy’ in her legs and hands

Objective Data

Physical Examination

Blood pressure 178/96, pulse 110, temperature 98.9° F, respirations 24

Alert and oriented to person, place, and time

Mild jugular venous distention

Fine crackles in bilateral lower lobes

Heart rate regular, no murmurs

Bowel sounds normoactive and present in all four quadrants

2+ edema bilateral lower extremities and hands

Diagnostic Studies

Echocardiogram shows decreased left ventricular function

Urinalysis: Urine dark yellow and cloudy, protein 28 mg/dL, negative for glucose and ketones, positive for casts, red blood cells and white blood cells

24-hour urine output = 380 mL

Laboratory Tests:

Hemoglobin 8 g/dL

Hematocrit 23.8%

RBC 2.57 million/mm3

WBC 4.7 mm3

Sodium 132 mEq/L

Potassium 5.2 mEq/L

Calcium 9 mg/dL

BUN 36 mg/dL

Creatinine 4.9 mg/dL

BNP 182 pg/mL

Question 1

Interpret Mrs. Davies’s laboratory test results and describe their significance.

Question 2

What is the most likely cause of Mrs. Davies’s AKI?

Question 3

What additional tests, if needed, could be done to determine the cause of AKI?

Question 4

What are the priority nursing diagnoses to address the concern of fluid retention?

Question 5

What are the priority nursing interventions for these nursing diagnoses?

How will attending/participating in this scholarly activity help you grow as a nurse?

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.

Submit, as the assignment, a summary report of the scholarly activity, including who, what, where, when and any relevant take-home points. Include the appropriate program competencies associated with the scholarly activity as well as future professional goals related to this activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.

While APA format 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.

You are not required to submit this assignment to LopesWrite.

Scholarly Activity Summary

This document describes the scholarly activity elements that should be included in a five paragraph summary. You may use this resource to help guide the preparation of the Scholarly Activities assignment, due in Topic 10.

Overview

This section consists of a single paragraph that succinctly describes the scholarly activity that you attended/participated in, the target market for the activity, and the benefit of the activity to you.

Problem

This section consists of either a short narrative or a list of bullet points that concisely identifies the problems the scholarly activity is designed to solve. Educate: What is the current state of the activity topic? Explain why this is a problem, and for whom is it a problem? Inspire: What could a nurse achieve by participating in the scholarly activity? Use declarative sentences with simple words to communicate each point. Less is more.

Solution

This section consists of either a short paragraph or a list of bullet points that concisely describes the solution to a proposed practice problem that the scholarly activity addressed and how it addresses the problem outlined in the previous section.

Opportunity

This section consists of short paragraphs that define the opportunity that the scholarly activity is designed to capture. It is important to cover the objectives and goals that were met. How will attending/participating in this scholarly activity help you grow as a nurse?

Program Competencies Addressed

This section consists of a list of program competencies that were addressed in this scholarly activity. Please use the list from the ISP.

NOTE: The plan that I want you to compile for me would state that I attended a meeting conference at San Antonio State Hospital (SASH) with a Psychiatrist and discussed the action plan for patients with intellectual disabilities

What can you do to be more effective as a leader?

Top of Form

Bottom of Form

Assignment Content

Top of Form

Perform a comparative analysis of five contemporary leadership approaches, including:

o Situational leadership

o Transactional leadership

o Transformational leadership

o Servant leadership

Use the Contemporary Leadership Matrix in Appendix B of the Example Paper to compare each approach on the following domains:

o Description

o Primary characteristics

o Strengths

o Criticisms

o Discipline-specific applications

Submit the Example Paper with:

o a properly formatted title page,

o the revised Historical Leadership section,

o properly formatted references,

o the matrix from Week 1 in Appendix A, and

o the matrix on Contemporary Leadership in Appendix B.

Discussions 1

Assessments

II. Working with others

B. Leadership and Team Skills

1. What’s my leadership style?

2. What was your score on the “concern for people” and “concern for task” dimensions of the What’s my Leadership Style Assessment? Explain how your score promotes or fails to promote effective leadership. What can you do to be more effective as a leader?

3. In your daily work life, what leadership strengths or talents do you rely on most? What is the result or outcome of using these strengths?

Discussions 2

This activity centers on one of the most prominent leaders in the world: the US president.

1) Using chapters 4-11 of Northouse, choose the leadership style you believe best characterizes President Trump.

2) Discuss and substantiate your choice with examples of his behavior you believe are best aligned with your choice. Include two additional peer-reviewed sources to your remarks.

· Caution! This is an exercise in critical thinking, not political proselytizing.

· Avoid emotional statements aimed at forwarding a political cause – or starting inappropriate political bantering.

· Stick with your sources to substantiate your claim. You can add substantiating links via video messages if you like.

Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

Understanding family structure and style is essential to patient and family care. Conducting a family interview and needs assessment gathers information to identify strengths, as well as potential barriers to health. This information ultimately helps develop family-centered strategies for support and guidance.

This family health assessment is a two-part assignment. The information you gather in this initial assignment will be utilized for the second assignment in Topic 3.

Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following:

Values/Health Perception

Nutrition

Sleep/Rest

Elimination

Activity/Exercise

Cognitive

Sensory-Perception

Self-Perception

Role Relationship

Sexuality

Coping

Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview.

Upon completion of the interview, write a 750-1,000-word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment.

Include the following in your paper:

Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment.

Summarize the overall health behaviors of the family. Describe the current health of the family.

Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified.

Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria

Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.

To Prepare:

Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.

Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”

Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.

Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples