A. Research and define the following terms as they relate to the legal and medical ethics presented in the story My Sister’s Keeper. These are the central issues needed to base a medical opinion about any case in court. (12 points)

Medical Ethics:

• Autonomy
• Veracity
• Fidelity
• Beneficence
• Non-maleficence
• Justice

B. Using these as 6 criterion, describe how each of these characteristics related back to the legal arguments and behaviors exhibited by the prosecuting and defense attorneys in this case.

C. Then, in two to three paragraphs, describe the moral, practical, and emotional complication of putting one child in unnecessary pain and danger for the well-being of another?

PHARM WEEK 5 QUIZ

 

Question 1

A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?

 

A.            A patient whose stage III pressure ulcer required intravenous antibiotics and a vacuum dressing

 

B.            A patient with a history of angina who experienced a non-ST wave myocardial infarction

 

C.            A patient who received treatment for kidney failure due to an overdose of acetaminophen

 

D.            A patient whose pulmonary embolism was treated with a heparin infusion

1 points

Question 2

A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that

 

A.            she will report this to the physician immediately.

 

B.            it may take up to 6 months for the drug to relieve her anxiety.

 

C.            optimum relief of anxiety usually occurs after 3 to 4 weeks of treatment.

 

D.            the drug is not going to work for her and the medication needs to be changed.

1 points

Question 3

A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of

 

A.            diabetic hyperlipidemia.

 

B.            increased intraocular pressure.

 

C.            seizure disorders.

 

D.            low blood pressure.

1 points

Question 4

A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask the patient if she is taking

 

A.            oxycodone (Percodan).

 

B.            secobarbital (Seconal).

 

C.            cimetidine (Zantac).

 

D.            meperidine (Demerol).

1 points

Question 5

A nurse is caring for a patient who has been admitted with acute cocaine intoxication. Which of the following vital signs would the nurse expect to find initially when assessing the patient?

 

A.            BP: 130/88, P: 92, R: 28

 

B.            Blood pressure (BP): 98/50, pulse (P): 120, respirations (R): 40

 

C.            BP: 170/98, P:110, R: 20

 

D.            BP: 150/90, P: 80, R: 16

1 points

Question 6

A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of

 

A.            no nursing action unless the patient experiences a “bad trip.”

 

B.            nonpharmacologic interventions combined with an exercise program.

 

C.            aggressive respiratory assistance

 

D.            drug therapy with bromocriptine (Parlodel).

1 points

Question 7

A patient is suffering from acute inhalant intoxication. The priority nursing intervention will be to

 

A.            assess the patient’s psychosocial status.

 

B.            administer oxygen therapy.

 

C.            provide an emesis basin.

 

D.            administer epinephrine.

1 points

Question 8

A 20-year-old man has begun treatment of the psychotic symptoms of schizophrenia using olanzapine (Zyprexa). Which of the following symptoms would be categorized as a negative symptom of schizophrenia?

 

A.            Visual hallucinations

 

B.            Auditory hallucinations

 

C.            Delusional thinking

 

D.            Lack of interest in normal activities

1 points

Question 9

A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient’s characteristics likely to influence possible treatment with phenytoin?

 

A.            The patient’s heavy alcohol use will compete with phenytoin for binding sites and he will require a higher-than-normal dose.

 

B.            The patient’s protein deficit will likely increase the levels of the free drug in his blood.

 

C.            Phenytoin is contraindicated within 48 hours of alcohol use due to the possibility of paradoxical effects.

 

D.            The patient will require oral phenytoin rather than intravenous administration.

1 points

Question 10

The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be

 

A.            “I’ll ask the nurse practitioner if the dosage can be increased.”

 

B.            “Continue the prescribed dose. It may take several days to work.”

 

C.            “I’ll ask the nurse practitioner if the haloperidol can be discontinued and another drug started.”

 

D.            “I’ll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol.”

1 points

Question 11

A patient who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by

 

A.            inhibiting the action of monoamine oxidase.

 

B.            increasing the effects of the neurotransmitter GABA.

 

C.            increasing the amount of serotonin available in the synapses.

 

D.            affecting the regulation of serotonin and norepinephrine in the brain.

1 points

Question 12

A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan

 

A.            has a shorter half-life than morphine.

 

B.            has less strength in each dose than do individual doses of morphine.

 

C.            causes the respiratory rate to decrease.

 

D.            combined with morphine, increases the physiologic action of the morphine.

1 points

Question 13

A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child’s face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered?

 

A.            Nicotine

 

B.            Cevimeline

 

C.            Atropine

 

D.            Acetylcholine

1 points

Question 14

A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in

 

A.            gastrointestinal distress.

 

B.            cognitive deficits.

 

C.            acute renal failure.

 

D.            liver damage.

1 points

Question 15

A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms?

 

A.            Amphetamines

 

B.            Opioids

 

C.            Benzodiazepines

 

D.            Sedative–hypnotic drugs

1 points

Question 16

A 59-year-old woman has presented to a clinic requesting a prescription for lorazepam (Ativan) in order to treat her recurrent anxiety. Her care provider, however, believes that a selective serotonin reuptake inhibitor (SSRI) would be more appropriate. What advantage do SSRIs have over benzodiazepines in the treatment of anxiety?

 

A.            SSRIs have a more rapid therapeutic effect.

 

B.            SSRIs require administration once per week, versus daily or twice daily with benzodiazepines.

 

C.            SSRIs generally have fewer adverse effects.

 

D.            SSRIs do not require serial blood tests during therapy.

1 points

Question 17

A 64-year-old-patient has been prescribed lorazepam (Ativan) because of increasing periods of anxiety. The nurse should be careful to assess for

 

A.            a history of current or past alcohol use.

 

B.            a diet high in fat.

 

C.            current nicotine use.

 

D.            a diet high in carbohydrates.

1 points

Question 18

Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?

 

A.            Restoration of normal sinus rhythm

 

B.            Resolution of respiratory acidosis

 

C.            Reduction of severe hypertension

 

D.            Increased level of consciousness

1 points

Question 19

A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient’s

 

A.            bowel patterns.

 

B.            urine specific gravity.

 

C.            skin integrity.

 

D.            core body temperature.

1 points

Question 20

A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient’s subsequent care, what nursing diagnosis should the nurse prioritize?

 

A.            Risk for Injury related to drug–drug interactions or drug–nutrient interactions

 

B.            Risk for Constipation related to decreased gastrointestinal peristalsis

 

C.            Risk for Ineffective Peripheral Tissue Perfusion related to cardiovascular effects of phenelzine

 

D.            Risk for Infection related to immunosuppressive effects of phenelzine

1 points

Question 21

A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)?

 

A.            A 20-year-old woman who will take the drug about once a week

 

B.            A 46-year-old man who receives an antidepressant and needs a sleep aid

 

C.            A 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep

 

D.            A 52-year-old woman who needs to fall asleep quickly and stay asleep all night

1 points

Question 22

A 26-year-old professional began using cocaine recreationally several months ago and has begun using the drug on a daily basis over the past few weeks. He has noticed that he now needs to take larger doses of cocaine in order to enjoy the same high that he used to experience when he first used the drug. A nurse should recognize that this pattern exemplifies

 

A.            drug tolerance.

 

B.            dependence.

 

C.            addiction.

 

D.            withdrawal.

1 points

Question 23

A postsurgical patient has been provided with a morphine patient-controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient’s concerns?

 

A.            “It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction.”

 

B.            “You don’t need to worry. It’s actually not true that you can get addicted to the medications we use in a hospital setting.”

 

C.            “It’s important that you accept that your current need to control your pain is more important than fears of becoming addicted.”

 

D.            “If you do become addicted, we’ll make sure to provide you with the support and resources necessary to help you with your recovery.”

1 points

Question 24

A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)

 

A.            The drug does not cause sleepiness in the morning.

 

B.            It is available in both quick-onset and continuous-release oral forms.

 

C.            The drug should not be used for longer than 1 month.

 

D.            It should be taken 1 hour to 90 minutes before going to bed.

 

E.            One of the most common adverse effects of the drug is headache.

1 points

Question 25

A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome?

 

A.            The patient develops yellowed sclerae and intense pruritis (itchiness).

 

B.            The patient demonstrates a significant increase in agitation after being given haloperidol.

 

C.            The patient develops muscle rigidity and a sudden, high fever.

 

D.            The patient complains of intense thirst and produces copious amounts of urine.

1 points

Question 26

A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that

 

A.            there is a risk of systemic absorption of the lidocaine through the patient’s traumatized skin.

 

B.            intravenous lidocaine may be preferable to topical application.

 

C.            lidocaine must be potentiated with another anesthetic in order to achieve pain control.

 

D.            pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site.

1 points

Question 27

Which of the following drugs used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work?

 

A.            Lorazepam (Ativan)

 

B.            Diazepam (Valium)

 

C.            Alprazolam (Xanax)

 

D.            Buspirone (BuSpar)

1 points

Question 28

A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?

 

A.            Liver function studies, pain intensity, and blood glucose level

 

B.            Pain intensity, respiratory rate, and level of consciousness

 

C.            Respiratory rate, seizure activity, and electrolytes

 

D.            Respiratory rate, pain intensity, and mental status

1 points

Question 29

A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to

 

A.            administer after diluting the drug with gabapentin in intravenous solution.

 

B.            inject very slowly, no faster than 100 mg/minute.

 

C.            inject the diazepam very quickly, 15 mg in 10 to15 seconds.

 

D.            avoid the small veins in the dorsum of the hand or the wrist.

1 points

Question 30

A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for

A.            increased secretions.

 

B.            facial flushing.

 

C.            dizziness

Episodic/Focused   SOAP Note Exemplar (pls use this template)
Focused   SOAP Note for a patient with chest pain

S.
CC: “Chest pain”
HPI: The patient is a 65 year old AA male who developed sudden onset of   chest pain, which began early this morning.  The pain is described as   “crushing” and is rated nine out of 10 in terms of intensity. The pain is   located in the middle of the chest and is accompanied by shortness of breath.   The patient reports feeling nauseous. The patient tried an antacid with   minimal relief of his symptoms.
PMH: Positive history of GERD and hypertension is controlled
FH: Mother died at 78 of breast cancer; Father at 75 of CVA.  No   history of premature cardiovascular disease in first degree relatives.
SH : Negative for tobacco abuse, currently or previously; consumes   moderate alcohol; married for 39 years
ROS
General–Negative for fevers,   chills, fatigue
Cardiovascular–Negative for   orthopnea, PND, positive for intermittent lower extremity edema
Gastrointestinal–Positive for   nausea without vomiting; negative for diarrhea, abdominal pain
Pulmonary–Positive for   intermittent dyspnea on exertion, negative for cough or   hemoptysis

O.

VS:   BP 186/102; P 94; R 22; T 97.8; 02 96% Wt 235lbs; Ht 70”

General–Pt appears diaphoretic and anxious

Cardiovascular–PMI is in the 5th inter-costal   space at the mid clavicular line. A grade 2/6 systolic decrescendo murmur is   heard best at the

second   right inter-costal space which radiates to the neck.

A   third heard sound is heard at the apex. No fourth heart sound or rub are   heard. No cyanosis, clubbing, noted, positive for bilateral 2+ LE edema is   noted.

Gastrointestinal–The abdomen is symmetrical   without distention; bowel

sounds   are normal in quality and intensity in all areas; a

bruit   is heard in the right para-umbilical area. No masses or

splenomegaly   are noted. Positive for mid-epigastric tenderness with deep palpation.

Pulmonary— Lungs are clear to   auscultation and percussion bilaterally

Diagnostic   results: EKG, CXR, CK-MB (support with evidenced and guidelines)

A.

Differential   Diagnosis:

1)   Myocardial Infarction (provide supportive documentation with evidence based   guidelines).

2)   Angina (provide supportive documentation with evidence based guidelines).

3)   Costochondritis (provide supportive documentation with evidence based   guidelines).

Primary   Diagnosis/Presumptive Diagnosis: Myocardial Infarction

P. This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

Case #2: 

CASE STUDY 2: Numbness and Pain A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

To Prepare

·  You will be assigned to a specific case study for this Case Study Assignment (Please see Above)

· Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format( as in exampler above) rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

· Review this week’s Learning Resources, and consider the insights they provide about the case study.

· Consider what history would be necessary to collect from the patient in the case study you were assigned.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

·

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided ( ABOVE). Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

Resource for references

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 7, “Mental Status”

  This chapter revolves around the mental status evaluation of an      individual’s overall cognitive state. The chapter includes a list of      mental abnormalities and their symptoms.

• ·Chapter 23, “Neurologic System”

  The authors of this chapter explore the anatomy and physiology of the      neurologic system. The authors also describe neurological examinations and      potential findings.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 4, “Affective Changes”
This chapter outlines how to identify the potential cause of affective changes in a patient. The authors provide a suggested approach to the evaluation of this type of change, and they include specific tools that can be used as part of the diagnosis.

Chapter 9, “Confusion in Older Adults”
This chapter focuses on causes of confusion in older adults, with an emphasis on dementia. The authors include suggested questions for taking a focused history as well as what to look for in a physical examination.

Chapter 13, “Dizziness”
Dizziness can be a symptom of many underlying conditions. This chapter outlines the questions to ask a patient in taking a focused history and different tests to use in a physical examination.

Chapter 19, “Headache”
The focus of this chapter is the identification of the causes of headaches. The first step is to ensure that the headache is not a life-threatening condition. The authors give suggestions for taking a thorough history and performing a physical exam.

Chapter 31, “Sleep Problems”
In this chapter, the authors highlight the main causes of sleep problems. They also provide possible questions to use in taking the patient’s history, things to look for when performing a physical exam, and possible laboratory and diagnostic studies that might be useful in making the diagnosis.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

• Chapter 2, “The Comprehensive History      and Physical Exam” (“Cranial Nerves and Their Function” and      “Grading Reflexes”) (Previously read in Weeks 1, 2, 3, and 5)

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical examination objective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Neurologic system: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Neurologic system: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Mental status: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Bearden , S. T., & Nay, L. B. (2011). Utility of EEG in differential diagnosis of adults with unexplained acute alteration of mental status. American Journal of Electroneurodiagnostic Technology, 51(2), 92–104.

This article reviews the use of electrocenographs (EEG) to assist in differential diagnoses. The authors provide differential diagnostic scenarios in which the EEG was useful.

Athilingam, P ., Visovsky, C., & Elliott, A. F. (2015). Cognitive screening in persons with chronic diseases in primary care: Challenges and recommendations for practice. American Journal of Alzheimer’s Disease & Other Dementias, 30(6), 547–558. doi:10.1177/1533317515577127

Sinclair , A. J., Gadsby, R., Hillson, R., Forbes, A., & Bayer, A. J. (2013). Brief report: Use of the Mini-Cog as a screening tool for cognitive impairment in diabetes in primary care. Diabetes Research and Clinical Practice, 100(1), e23–e25. doi:10.1016/j.diabres.2013.01.001

Roalf, D. R., Moberg, P. J., Xei, S. X., Wolk, D. A., Moelter, S. T., & Arnold, S. E. (2013). Comparative accuracies of two common screening instruments for classification of Alzheimer’s disease, mild cognitive impairment, and healthy aging. Alzheimer’s & Dementia, 9(5), 529–537. doi:10.1016/j.jalz.2012.10.001. Retrieved from http://www.alzheimersanddementia.com/article/S1552-5260(12)02463-6/abstract 

Complete this assessment fourth.

For this assessment, you will reflect on various aspects of your capstone experience. This will give you a chance to discuss elements of the project of which you are proud and aspects of the experience that will help you grow in your personal practice and nursing career.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 2: Make clinical and operational decisions based upon the best available evidence.
  • Reflect on how evidence and the literature were utilized to plan and implement a capstone project, as well as how project outcomes compared to initial predictions based on a review of the literature.
• Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
  • Reflect on the degree to which health care technology was successfully used in the capstone project to improve outcomes or communication to relevant stakeholders.
• Competency 5: Analyze the impact of health policy on quality and cost of care.
  • Reflect on how organizational and governmental health policy influenced the planning and implementation of a capstone project, as well as any contributions to policy development made by the project.
• Competency 8: Integrate professional standards and values into practice.
  • Reflect on personal and professional growth throughout the capstone project and the BSN program, with special attention to growth related to ethical care provision and demonstration of professional standards.
  • Communicate professionally and audibly, using proper grammar and current APA style.

Important: You must complete all of the assessments in order for this course.

Professional Context

BSN-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. After a patient care interaction, it is important to evaluate how well you addressed the criteria set for the nurse-patient interaction and consider future improvements. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

Preparation

This assessment requires you to prepare a 5–10 minute video reflection on your capstone clinical practicum experience. Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact [email protected] to request accommodations. If you are unable to record a video, please contact your faculty member as soon as possible to explore options for completing the assessment.

Complete the following preparatory activities:

• If necessary, set up and test your microphone or headset per the manufacturer instructions.
• Practice using the equipment to ensure the audio quality is sufficient.
• Consult the Campus resource Using Kaltura [PDF] for guidance on recording and uploading your assessment in the courseroom.
• Begin developing your reflection. Some questions you might address in your reflection video are:
  • What were your most important outcomes or findings?
  • What challenges did you overcome throughout your project?
  • How did your initial research and evidence base help you plan and execute your capstone project?
  • How were the outcomes similar to and different from your expectations?
  • How did you feel your professional product turned out?
  • What impacts of the implementation of your professional product did you observe?
  • To what degree were you successful in using technology in your capstone project?
  • How did organizational or governmental health policy impact the way in which you approached your project?
  • What contributions did you make to your organization’s policies throughout the course of your project?
  • In which areas do you feel you grew the most?
  • How will your learning affect your professional practice and ability to implement ethical care in accordance with professional codes of conduct?
  • What would you do differently if you could do the capstone project or program again?
  • What accomplishment are you most proud of, within the context of the capstone or the program as a whole?
• Examine your capstone project through the lens of your initial plan and literature review.

Instructions

Use Kaltura to record a 5–10 minute video reflection addressing the following scoring guide grading criteria. Please study the scoring guide carefully so you know what is needed for a distinguished score:

• Reflect on how evidence and the literature were utilized to plan and implement a capstone project, as well as how project outcomes compared to initial predictions based on a review of the literature.
• Reflect on the degree to which health care technology was successfully used to improve outcomes or communication to relevant stakeholders in the capstone project.
• Reflect on how organizational and governmental health policy influenced the planning and implementation of a capstone project as well as any contributions to policy development that the project made.
• Reflect on personal and professional growth throughout the capstone project and the BSN program, paying special attention to growth related to the provision of ethical care and demonstration of professional standards.
• Communicate audibly and professionally, using proper grammar and including a reference list formatted in current APA style.

Important Note: You do not need to submit the transcript of your video, but do address each scoring guide criterion in the video, including a discussion of authors in the literature who support the ideas presented. Please submit a separate APA-formatted reference list for the resources discussed in your reflection.

Additional Requirements

• References: Cite a minimum of three scholarly and/or authoritative sources to support your assertions.
• APA style and format: Submit, along with the video, a separate references page that follows APA style and formatting guidelines. Refer to the APA Module as needed.

Portfolio Prompt: Remember to save the assessment to your ePortfolio. After you complete your program you may want to consider leveraging your Portfolio as part of a job search or other demonstration of your academic competencies.

Reference

Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos – An innovative and creative approach to assessment. Sciedu International Journal of Higher Education, 7(4). Retrieved from http://www.sciedu.ca/journal/index.php/ijhe/article/view/13820

Based on the information in this video, Meridian Diagnostics Inc. decided to produce an enzyme-linked immunosorbent assay (EIA test kit) to screen for presence of Salmonella heidelberg, so patients who became sickened, could be diagnosed quickly and treated. Patient blood samples could be tested for presence of the S. heidelberg bacteria as opposed to other Genera and species of bacteria.

1. With this information, by constructing a 2-by-2 table, calculate the predictive-value positive and predictive-value negative of the EIA in a hypothetical population of 1,000,000 blood donors. Using a separate 2-by-2 table, calculate PVP and PVN for a population of 1000 ill patients. Assume that the actual prevalence of S. heidelberg among blood donors is 0.04% (0.0004) and that of people who ate Foster’s chicken is 10.0% (0.10).

2. Do you think that the EIA is a good screening test for the hospital? Why or why not?

3. Do you think that the EIA performs well enough to justify using the test outcomes in court cases? Why or why not?

4. If sensitivity and specificity remain constant, what is the relationship of prevalence to predictive-value positive and predictive-value negative?

Given their success with the EIA for S. heidelberg, Meridian Diagnostics decided to perfect their design, and use it to produce an EIA to test for E. coli O157 H7.

5. With this information, by constructing a 2-by-2 table, calculate the predictive-value positive and predictive-value negative of the EIA in a hypothetical population of 500,000 blood donors. Using a separate 2-by-2 table, calculate PVP and PVN for a population of 600 ill patients. Assume that the actual prevalence of E. coli among blood donors is 0.02% (0.0002) and that of people who ate Jack-In-the-Box hamburgers is 15.0% (0.15).

Link for homework

https://www.pbs.org/wgbh/frontline/film/trouble-with-chicken/