Module 05 Written Assignment – Concepts for Clinical Judgment

Module 05 Content

1. Read the article “Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing” by Christine Tanner, which is linked below:

   Link to article

   In at least three pages, answer the following questions:

   1. What do you feel are the greatest influences on clinical judgment? Is it experience, knowledge, or a combination of those things?
   2. In your opinion, what part does intuition play in clinical judgment? How do you think you’ll be able to develop nursing intuition?
   3. Additional sources are not required but if they are used, please cite them in APA format.

      Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

      Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:

 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. 

*Fill in the concept map attached below; that’s all, and you can add a reference one or two below the map 

Darlene, age 32 years, has been having back pain for a number of years, ever since suffering a compressed L2 disc as the result of a motor vehicle accident that led to surgery and extensive physiotherapy. Now she is missing time from work as a secretary because of constant pain. Darlene has been referred to you for chronic pain.

1. As the nurse practitioner working with Darlene, what aspects of disorders of pain are important to understand?
2. How would you effectively manage Darlene’s pain at this time?

Instructions: discussion post, 1 page is long enough. APA format. Has to have 3 references. 

Create a PowerPoint slide show with notes pages discussing their PICOT question, literature review, and recommendations for change.

In a PowerPoint Presentation, address the following.

1.
Title Slide

2.
Introduction (1 slide): Slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered.

3.
Practice Issue (1-3 slides)
: Describe the area of interest and practice issue/problem related to NP practice selected in week 2. Explain why the issue/concern is important to nurse practitioner practice and its impact on health outcomes. Provide speaker notes. Provide scholarly references to support your ideas.

4.
PICOT Question (1 slide)
: Provide the PICOT question developed in week 2. Describe each element of your PICOT question in one or two sentences, being sure to address all the following:

1.
P-Population and problem – What is the nursing practice concern or problem and whom does it affect?

2.
I–Intervention – What evidence-based solution for the problem would you like to apply?

3.
C–Comparison – What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or alternative solutions.

4.
O–Outcome – Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome.

5.
T–Time frame – What is the Timeframe involved for the EBP initiative or the target date of completion?

5.
Literature review (2-4 slides):Summarize the literature review completed in week 5. Discuss themes and special concerns. Discuss any unique insight or perspective offered from the literature. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented.

6.
Recommendations (3 slides):

1. Slide 1: Identify the evidence-based recommendation for the identified practice change. Speaker’s notes should fully explain the recommended change and rationale for the change. Provide support from scholarly references to support the recommendation.

2. Slide 2: Identify the key stakeholders impacted by the recommended change. Speaker’s notes add detail.

3. Slide 3: Analyze the recommendation in terms of fit, feasibility, and appropriateness as discussed by Dang and Dearholt (2018), Ch. 8. Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.

7.
Conclusion: (1 slide)Slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.

8.
References: Reference elements provided in APA format, may use bullets. Hanging indents not required.

For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs.  

Case: An elderly widow who just lost her spouse. 

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: 

• Metformin 500mg BID 
• Januvia 100mg daily 
• Losartan 100mg daily 
• HCTZ 25mg daily 
• Sertraline 100mg daily 

Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86