2 nursing discussion questions

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2 Posts: should be substantive (approximately 200-300 words in length for each discussion the least). In your substantive post you are encouraged to use references (you may use your textbook); show evidence of critical thinking as it applies to the concepts. At least One reference on each discussion. number each discussion separately as 1 and 2.

Initial Substantive Posts: Your initial post should be substantive (approximately 200-300 words in length for each discussion). In your substantive post you are encouraged to use references (you may use your textbook); show evidence of critical thinking as it applies to the concepts. At least One reference on each discussion.

1.
Personal Philosophy in the Context of Nursing

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How does your personal philosophy fit with the context of nursing? Does it fit? How do nursing, person, environment, and health fit into your philosophy?

2.
Reflections on Troubling Clinical Experiences

Think about a clinical experience that was troubling to you. Reflect on what bothered you about the experience. What could you have done differently? What were the reasons behind your actions? Try to create and clarify meaning or a new understanding of the particular situation.

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Below is an example of a substantive discussion post (This content is not from this course):

Neutropenia is a decrease in circulating neutrophils in the nonmarginal pool, which constitutes 4-5% of total body neutrophil stores (Braden, 2016). Something that should be investigated is the underlying cause for the neutropenia. Knowing what would point myself as the nurse in the direction to educate the patient and would help the physician in treating the condition. The likelihood of having complication from neutropenia are very high as usually the reason for neutropenia is overwhelming infection.

Common presenting symptoms of neutropenia include the following: (Braden, 2016)

· Low-grade fever

· Sore mouth

· Odynophagia

· Gingival pain and swelling

· Skin abscesses

· Recurrent sinusitis and otitis

· Symptoms of pneumonia (eg, cough, dyspnea)

· Perirectal pain and irritation

Diagnosing neutropenis is realatively easy as the doctor would need to order a complete blood cell count, differencial white blood cell count, and a peripheral smear that is to be reviewed by a pathologist. Other causes of neutropenia, in the absence of overwhelming infection, may be (1) decreased neutrophil production or ineffective granulopoiesis, (2) reduced neutrophil survival, and (3) abnormal neutrophil distribution and sequestration. Hematologic disorders that cause ineffective or decreased production include hypoplastic or aplastic anemia, megaloblastic anemias, leukemia, or drug-/toxin-induced neutropenia (Huether, 2012). Educating patient on the way to care for ones self at home is very important. Making sure that the patient takes all of their antibiotics and committing to keeping their follow up appointment is very important to her recovery.

General measures to be taken in patients with neutropenia include the following: (Braden, 2016)

· Remove any offending drugs or agents in cases involving drug exposure: If the identity of the causative agent is not known, stop administration of all drugs until the etiology is established

· Use careful oral hygiene to prevent infections of the mucosa and teeth

· Avoid rectal temperature measurements and rectal examinations

· Administer stool softeners for constipation

· Use good skin care for wounds and abrasions: Skin infections should be managed by someone with experience in the treatment of infection in neutropenic patients

Braden, C. (2016, February 26). 
Neutropenia. Retrieved from MedScape: http://emedicine.medscape.com/article/204821-overview

Huether, S., & McCance, K. (2012). 
Understanding Pathophysiology (5th ed.). [https://bookshelf.vitalsource.com/#/books/978-0-323-07891-7/cfi/0!/4/2/4/4@0:65.4]. Retrieved from 
https://bookshelf.vitalsource.com/#/books

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