NUR 2790 Professional Nursing III

Module 1 Discussion

Cancer Treatment Options

Mrs. Williams is a 27-year-old female diagnosed with breast cancer. She is currently in pharmacy school. She does not have children, but hopes to have them someday. She has been tested and has a genetic predisposition for this disease.

What treatment options does she have?

What are the advantages and disadvantages of those treatment options?

What would you tell Mrs. Williams if she decided to refuse treatment?

Mrs. Williams really wants to have children before she starts treatment. What would you educate her about? Why?

NUR 2790 Professional Nursing III

Module 2 Discussion

Death and Dying

Discuss the term “clinical death,” especially with respect to when not to initiate CPR. Discuss what is meant by a “peaceful death” and a “good death,” including goals for End-Of-Life care. How would you feel if you knew your patients did not want CPR but the family insisted on it?

NUR 2790 Professional Nursing III

Module 3 Discussion

Triage

Triage involves the rapid assessment and prioritization of patients. Compare the three-tiered system of triage to the Mass Casualty Incident (MCI) triage philosophy. Imagine that you are the Triage Nurse during an MCI. How will you categorize the following patients using the MCI triage philosophy? Explain your answer. Are there any ethical issues that should be considered?

10-year-old boy with massive head injury, no spontaneous breathing, BP 60 palp

22-year-old female with a close fracture of the left arm

60-year-old male with a laceration in the leg complaining of shortness of breath

15-year-old girl with glass embedded in the eyes

52-year-old male with a pulse of 30 and a blood pressure of 70/30

For your response, do you agree with your classmates’ opinions? What would you urge them to consider when making the triage determination?

NUR 2790 Professional Nursing III

Module 4 Discussion

Gas Exchange

Mr. Nguyen is a 58-year-old patient that had septic shock and developed Acute Respiratory Distress Syndrome. He is orally intubated and on a mechanical ventilator. He is paralyzed and sedated.

What manifestations might you observe for a patient with ARDS?

What complications can Mr. Nguyen develop from being mechanically ventilated?

List priority nursing interventions to prevent complications associated with ventilatory support.

What interventions can be implemented specifically to prevent the development of Ventilator Acquired Pneumonia (VAP)?

You are orienting in the ICU, the nurse you are working with is not implementing the VAP interventions. What would you do?

NUR 2790 Professional Nursing III

Module 5 Discussion

Artifact vs. Dysrhythmia

Describe the role of each component of the ECG in the heart’s contraction: the P wave, the PR interval, the QRS complex, the ST segment, the T wave, and the QT interval. What is the difference between artifact and dysrhythmia? How can you reduce artifacts? What are some situations that can occur if artifact is not reduced or eliminated?

You are working in the Telemetry Unit. The nurse “watching” the monitors is reading a magazine. She constantly turns off an alarm that looks a lot like Ventricular Fibrillation. She tells you that it is not a dysrhythmia, it is just artifact. What do you think about her actions? What is the worst case scenario in this situation? What would you do?

NUR 2790 Professional Nursing III

Module 6 Discussion

Prevention of Shock

Your patient is a 42-year-old female that arrives in the ED with complaints of fever and not feeling well. She is currently undergoing chemotherapy for bladder cancer. She has an indwelling urinary catheter with scant amount of dark, foul smelling urine. She has a temperature of 102.2F, HR 136, BP 110/50 and RR 28. She is allergic to penicillin and Sulfa.

What type of shock is she experiencing?

What interventions do you anticipate the doctor will order?

What can you teach this patient about prevention of infection?

The doctor orders Bactrim. What should you be concern about? Why?

NUR 2790 Professional Nursing III

Module 7 Discussion

Modifiable vs. Unmodifiable Risk Factors

Choose a subject (it can be a former patient, a family member, or yourself) and identify modifiable and nonmodifiable risk factors. Identify methods to prevent Coronary Artery Disease (CAD) in the subject. What can you recommend to your classmates subjects?

NUR 2790 Professional Nursing III

Module 8 Discussion

The Patient with Chronic Renal Failure

Mr. Rojas is a 49-year-old patient with End Stage Renal Disease. He has a history of hypertension and uncontrolled type 1 diabetes (since he was 12 years old). His last Hemoglobin A1c was 12.8%. He is currently receiving hemodialysis three times per week for three hours. He is in the hospital because he went into DKA a few days ago when he had a stomach virus. He is asking you about renal transplantation.

What are the criteria to be placed in the transplant list?

What options for transplantation does Mr. Rojas have?

What recommendations can you give Mr. Rojas on treatment compliance?

What other renal replacement therapies could Mr. Rojas be educated about?

What are their advantages and disadvantages?

NUR 2790 Professional Nursing III

Module 9 Discussion

Brain Death Ethical Considerations

Your patient is a 23-year-old female with a history of headaches. This morning she was experiencing a really bad headache as her boyfriend was driving her to the university. He thought she was sleeping and by the time they got to the school, 45 minutes later, she was not waking up. She was diagnosed with a cerebral aneurysm and you are taking care of her in the Neurological ICU.

What testing do you expect to be performed to diagnose brain death?

What is the procedure when a patient is determined to be brain dead?

Who should approach the family about organ donation?

The family is approached about organ donation. The patient indicated on her driver’s license that she wanted to be an organ donor. Her mother refuses to consent for organ donation.

Do you think donation should happen anyway? Why or why not?

What will be the ethical consequences of your decision?

NUR 2790 Professional Nursing III

Module 10 Discussion

Ethical Dilemma

For patients with liver failure due to cirrhosis liver, transplantation may be the only possible treatment.

How is the care for the patient undergoing liver transplantation different from the care of a regular surgical patient?

What patient teaching is needed after a patient receives a liver transplant?

Should the patient with alcoholic cirrhosis be a candidate for a liver transplant?

Should government funds be used in the care of patients with cirrhosis who continue to consume alcohol?

NUR 2790 Professional Nursing III

Module 11 Discussion

Caring for Self!

You have learned a lot during your training to become a Registered Nurse. At this point in your education, where do you see yourself as a nurse? What unit would you like to work in and why?

To be able to care for patients, you must be able to care for yourself. What are some practices you plan to implement to help you care for yourself and why?

NUR 2790 Professional Nursing III

Module 1 Assignment

Cancer Symptoms and their Management

Cancer treatment is very aggressive in nature. The treatment can lead to symptoms that range from uncomfortable to life-threatening. Complete the Cancer Symptoms Management Table. Do not forget to include complementary alternative therapy that may help in symptom management.

Cancer Symptoms and their Management:

Symptom Clinical Manifestations (including Diagnostics) Possible Nursing Diagnosis Interventions (including Medications and complementary alternative therapy)
Anemia
Neutropenia
Thrombocytopenia
Neuropathy
Cognitive disorders
Chemo Induced Nausea (CIN)
Mucositis
Alopecia
Pain

NUR 2790 Professional Nursing III

Module 2 Assignment

End-of-Life Care Concept Map

Mr. Rivera is a 72-year-old patient with end stage COPD who is in the care of Hospice. He has a history of smoking, hypertension, obesity, and type 2 Diabetes. He is on Oxygen 2L per nasal cannula around the clock. His wife and 2 adult children help with his care. Develop a concept map for Mr. Rivera. Consider the patients Ethnic background (he and his family are from Mexico) and family dynamics. Please use the concept map form provided.

NUR 2790 Professional Nursing III

Module 3 Assignment

Phases of Burn Injury

A burn injury can severely affect a patient’s physical and emotional well-being. As a nurse you may be in charge of taking care of a patient during any of the three phases of burns. Please complete the Phases of Burn Injury table to better understand the needs of a burn patient and ways to meet those needs.

Phases of Burn Injury: Patient Care

Resuscitation Acute Rehab
Time Period:
Goals:
Nursing Dx:
Assessment:
Interventions:

NUR 2790 Professional Nursing III

Module 4 Assignment

Gas Exchange Exemplars

Comparison of Gas Exchange Exemplars:

Pneumothorax Tension Pneumothorax Flail Chest Hemothorax Acute Respiratory Failure
Pathophysiology
Etiology
Clinical Manifestations
Interventions

NUR 2790 Professional Nursing III

Module 5 Assignment

Case Study

A 60-year-old male patient is admitted with chest pain to the telemetry unit where you work. While having a bowel movement on the bedside commode, the patient becomes short of breath and diaphoretic. The ECG waveform shows bradycardia.

What other assessment findings should you anticipate?

Why does this patient probably have bradycardia?

Does this dysrhythmia need treatment? Why or why not? What intervention would you implement first?

What is the drug treatment and dosage of choice for symptomatic bradycardia? How does this drug increase heart rate?

NUR 2790 Professional Nursing III

Module 6 Assignment

Types of Shock

It is very important to differentiate between the different types of shock since treatment may depend on this. Complete the Comparison Table on the different types of shock.

NUR 2790 Professional Nursing III

Module 7 Assignment

Cardiovascular Exemplars

Comparison of Cardiovascular Exemplars:

Angina Acute Myocardial Infarction
Pathophysiology
Etiology
Assessment Findings (including Diagnostics)
Nursing Diagnosis
Interventions (including meds and Surgical interventions)

NUR 2790 Professional Nursing III

Module 8 Assignment

Fluid and Electrolyte Exemplars

Comparison of Fluid Electrolyte Exemplars:

SIADH Diabetes Insipidus Acute Renal Failure Chronic Renal Failure
Pathophysiology
Etiology
Clinical Manifestations including Laboratory data
Interventions
Possible Complications

NUR 2790 Professional Nursing III

Module 9 Assignment

Stroke Concept Map

Please use the concept map to plan care for Mr. Jackson. Mr. Jackson is a 38-year-old African American that presents with an altered level of consciousness (ALOC). He has been having headaches for the last three months but due to a hectic work schedule he has not been able to go to see his medical practitioner. During his last visit two years ago, his blood pressure was slightly elevated, but he never followed up. Upon arrival to the ED a CT scan is completed and it shows a large bleed near the frontal lobe. What should Mr. Jackson’s plan of care include?

NUR 2790 Professional Nursing III

Module 10 Assignment

Concept Map

Your patient is a 52-year-old male with a history of smoking and alcohol abuse. He presents to the ED with complaints of “my skin looks yellow, my stomach hurts, and I feel nauseous”. He is taken to CT and a tumor near the pancreas is observed. It appears to be blocking the common bile duct. Develop a plan of care for the patient. Use the attached concept map.

NUR 2790 Professional Nursing III

Module 11 Assignment

Write a 1-2 page paper about some of the Best Practices you have learned about during this course. How will these practices improve patient’s outcomes? You must use APA and have at least three references less than three years old to support your choices.