What is risk

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What is risk

Assigment .Apa seven . All instructions attached.

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Using the input and suggestions from the peer-edited first draft, write the final version of your research paper in 2,500 and 3,000 words.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.  Use your chosen peer-reviewed journal for in-text citations and references.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

Dehydration

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due 10-12-23@10am

nursing: ethical dilemma

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attached

30D again

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 30 D again

THEORIES discussion

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EXPLORING MIDDLE RANGE THEORIES AND FRAMING PRACTICE ISSUES

week 4

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Your patient is a 23-year-old female. She presents with coughing and wheezing which she stated started about three weeks ago. She is currently 25 weeks pregnant. Her last prenatal visit was one month ago in another state. She has an appointment with the prenatal care provider next week, however her respiratory symptoms brought her to your office today.

History – Chickenpox as a child. Asthma as a child, diagnosed at age 8 for which she used a SABA when needed. She has not had the need to use an inhaler since she was 19. She takes only her prenatal vitamin. No other acute or chronic problems. She advises you that she is up to date on all immunizations except she has not had a flu shot (it is October).
Social – Non-smoker, no drug use. She relocated to your state two weeks ago to get away from an abusive domestic situation. She has no support network in this area and has not yet found employment. She has no medical insurance.

HPA – Non-productive cough x 3 weeks. Wheezing audible from across the room. She states it is like this all day and wakes her from sleep every night. She reports that she is fatigued even in the morning. No other complaints.

PE/ROS – Pt appears disheveled but clean. Wheezing in all lung fields. T 98, P 82 regular, R 28 no stridor. FH 130 regular. The remainder of the exam is WNL.

02 98% and FEV 70%

Directions:

1. Construct a narrative document of 4-5 pages (not including cover page or reference page)

2. Diagnose the patient based on the above findings and provide your rationale for how you arrived at the diagnosis.

3. Develop a treatment plan specifically for this patient, pharmacologic and non-pharmacologic.

4. Describe community resources (using your own community) currently available in your state/city to support this patient.

5. Provide a communication plan that you will use to ensure the patient is an active participant in the treatment plan. Refer to therapeutic communication concepts.

6. Utilize national standards, your pharm and/or patho book, and medical or advanced practice professional sources. Do not use patient-facing sources or general nursing texts.

7. Use references to support your concepts. Utilize correct APA formatting (7th edition) and mechanics of professional communication.

Before finalizing your work, you should:

·
Read the Assignment description carefully (as displayed above);

·
Consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary.

Your writing assignment should:

· Follow the conventions of 
Standard American English (correct grammar, punctuation, mechanics, etc.);

· Be 
well organized, logical, and 
unified, as well as 
original and insightful;

· Utilize correct APA formatting, 7th edition.

· Submit to, and review results of Turnitin. Purdue University Global Student Conduct policy as it relates to plagiarism will be adhered to in this course.

Rubric Title: MN553 Unit 4 Assignment Rubric

Assignment Criteria

Level III

Level II

Level I

Not Present

Criteria 1

Level III Max Points

Points: 10

Level II Max Points

Points: 8

Level I Max Points

Points: 6

Not Present

0 Points

Diagnosing the patient

· An accurate diagnosis with correct staging is provided

· Rationale for arrival at the diagnosis with support from national guidelines is provided

· An accurate diagnosis is provided with staging that may not be correct

· Rationale for the diagnosis is provided without support

· An accurate diagnosis is provided with staging that may not be correct

· Rationale for the diagnosis is provided without support

· Does not meet the criteria

Criteria 2

Level III Max Points

Points: 10

Level II Max Points

Points: 8

Level I Max Points

Points: 6

Not Present

0 Points

Providing pharmacologic intervention

· Correct medications are prescribed to treat the diagnosis

· Rational for medications prescribed adheres to national guidelines

·

· 50% of correct medications are prescribed

· Rational to support prescribed medications is provided and adheres to national guidelines

· Less than 50% of the correct medications are prescribed

· Rational to support the prescribed medications is not present or does not adhere to national guidelines

· Does not meet the criteria

Criteria 3

Level III Max Points

Points: 5

Level II Max Points

Points:

Level I Max Points

Points:

Not Present

0 Points

Providing non-pharmacologic interventions

· Five or more non-pharmacologic interventions are provided

· Three or four non-pharmacologic interventions are noted

One or two non-pharmacologic interventions

· Does not meet the criteria

Criteria 4

Level III Max Points

Points: 10

Level II Max Points

Points: 7

Level I Max Points

Points: 0

Not Present

0 Points

Writing a communication plan

· A communication plan which includes principles of therapeutic communication is developed

· A communication plan that does not include principles of therapeutic communication is developed

· Does not meet the criteria

· Does not meet the criteria

Criteria 5

Level III Max Points

Points: 10

Level II Max Points

Points: 7

Level I Max Points

Points: 4

Not Present

0 Points

Community Resources

· Three or more local community resources are provided

· Two local community resources are provided

· One local community resource is provided or:

· Resources are provided but they are not local to the community

· Does not meet the criteria

Criteria 6

Level III Max Points

Points: 10

Level II Max Points

Points: 8

Level I Max Points

Points: 6

Not Present

0 Points

College-level academic writing

· Professional, peer-reviewed, advanced practice references are used

· Grammar and mechanics of writing demonstrate graduate level work

· Adheres to page number requirements

· The majority of references used are professional, peer-reviewed and advanced practice

· Errors in grammar or mechanics of writing are present but do not interfere with readability

· Adheres to page number requirements

· The majority of references used are professional, peer-reviewed and advanced practice

· Errors in grammar or mechanics of writing are present but do not interfere with readability

· Does not adhere to page number requirements

· Does not meet the criteria

Maximum Total Points

55

44

33

0

Minimum Total Points

45 points minimum

34 points minimum

1 point minimum

0

pm2 m2 writeen

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summit the complete question

Case Study 3

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 Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition Adolescent With Diabetes Mellitus (DM) Case Studies The patient, a 16-year-old high-school football player, was brought to the emergency room in a coma. His mother said that during the past month he had lost 12 pounds and experienced excessive thirst associated with voluminous urination that often required voiding several times during the night. There was a strong family history of diabetes mellitus (DM). The results of physical examination were essentially negative except for sinus tachycardia and Kussmaul respirations. Studies Results Serum glucose test (on admission), p. 227 1100 mg/dL (normal: 60–120 mg/dL) Arterial blood gases (ABGs) test (on admission), p. 98 pH 7.23 (normal: 7.35–7.45) PCO2 30 mm Hg (normal: 35–45 mm Hg) HCO2 12 mEq/L (normal: 22–26 mEq/L) Serum osmolality test, p. 339 440 mOsm/kg (normal: 275–300 mOsm/kg) Serum glucose test, p. 227 250 mg/dL (normal: 70–115 mg/dL) 2-hour postprandial glucose test (2-hour PPG), p. 230 500 mg/dL (normal: <140 mg/dL) Glucose tolerance test (GTT), p. 234 Fasting blood glucose 150 mg/dL (normal: 70–115 mg/dL) 30 minutes 300 mg/dL (normal: <200 mg/dL) 1 hour 325 mg/dL (normal: <200 mg/dL) 2 hours 390 mg/dL (normal: <140 mg/dL) 3 hours 300 mg/dL (normal: 70–115 mg/dL) 4 hours 260 mg/dL (normal: 70–115 mg/dL) Glycosylated hemoglobin, p. 238 9% (normal: <7%) Diabetes mellitus autoantibody panel, p. 186 insulin autoantibody Positive titer >1/80 islet cell antibody Positive titer >1/120 glutamic acid decarboxylase antibody Positive titer >1/60 Microalbumin, p. 872 <20 mg/L Diagnostic Analysis The patient’s symptoms and diagnostic studies were classic for hyperglycemic ketoacidosis associated with DM. The glycosylated hemoglobin showed that he had been hyperglycemic over the last several months. The results of his arterial blood gases (ABGs) test on admission indicated metabolic acidosis with some respiratory compensation. He was treated in the Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 2 emergency room with IV regular insulin and IV fluids; however, before he received any insulin levels, insulin antibodies were obtained and were positive, indicating a degree of insulin resistance. His microalbumin was normal, indicating no evidence of diabetic renal disease, often a late complication of diabetes. During the first 72 hours of hospitalization, the patient was monitored with frequent serum glucose determinations. Insulin was administered according to the results of these studies. His condition was eventually stabilized on 40 units of Humulin N insulin daily. He was converted to an insulin pump and did very well with that. Comprehensive patient instruction regarding selfblood glucose monitoring, insulin administration, diet, exercise, foot care, and recognition of the signs and symptoms of hyperglycemia and hypoglycemia was given. Critical Thinking Questions 1. Why was this patient in metabolic acidosis? 2. Do you think the patient will eventually be switched to an oral hypoglycemic agent? 3. How would you anticipate this life changing diagnosis is going to affect your patient according to his age and sex? 4. The parents of your patient seem to be confused and not knowing what to do with this diagnoses. What would you recommend to them? 

Discussion

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  1. What was your biggest “take away” from any/all of the simulations?
  2. What did you find most challenging from the simulations? 
  3. How is what you learned from the assignments applicable to the medical field?
  4. Give examples of how such knowledge can affect your direct patient care.