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Your patient C.S is 78 years old. Admitted to the nursing home you work at, with a diagnosis of dehydration. C.S., has been ordered to increase her oral fluid intake to 2500cc per day. When offering her a glass of water, she pushes away your hand and says “I hate water and I don’t drink it much”. You note that after one and a half days she has dry mucous membranes and poor skin turgor.

Your patient C.S is 78 years old – Admitted to the nursing home you work at

 

APPENDIX D
1.       APA Format with References
2.       No single word responses
3.       At least 100+ words for each response
4.       Give questions some thought and answer honestly and sincerely
5.       Students MUST complete questions for BOTH scenarios

Scenario 1:
Your patient C.S is 78 years old. Admitted to the nursing home you work at, with a diagnosis of dehydration. C.S., has been ordered to increase her oral fluid intake to 2500cc per day. When offering her a glass of water, she pushes away your hand and says “I hate water and I don’t drink it much”. You note that after one and a half days she has dry mucous membranes and poor skin turgor.

Questions:
1.            What should your assessment be on this patient? Explain in detail.

2.            After completing your assessment, what should your next step be? Be specific.

3.            Write 3 complete nursing diagnosis from above information. Include all 3 sections (NANDA, Related to (R/T) & Evidence based practice (EBP) & include 2 nursing interventions for each nursing diagnosis.

Scenario 2:

Ms. Cohen is hospitalized for repair of a fractured hip after a fall at home. She requires intravenous (IV) antibiotics after surgery. Shortly after the first dose she became restless and started picking at her IV line and frequently tried to get out of bed. Several restraint alternatives were attempt ed; but, because of her restlessness, she was successful at pulling out her IV line and getting out of bed. It becomes necessary to restrain Ms. Cohen.

Questions:
1. You know that a health care provider’s order is require d for the restraint. What are essential components of the restraint order?
2. Which assessments do you need to perform on Ms. Cohen while she is restrain ed?
3. The physician orders a belt restraint. Your assessment of Ms. Cohen the next day reveals that during the day she is alert and pleasantly confuse d but not attempting to get out of bed. Do you continue use of the restraint? Explain.

Li Chen is a 43-year-old, married, Chinese-American woman who comes for an evaluation for anxiety-related symptoms. She presents with excessive worry that she finds challenging to control and complaints of irritability, muscle tension, and difficulty falling asleep.

Li Chen is a 43-year-old married Chinese-American woman

Li Chen is a 43-year-old, married, Chinese-American woman who comes for an evaluation for anxiety-related symptoms. She presents with excessive worry that she finds challenging to control and complaints of irritability, muscle tension, and difficulty falling asleep.

She reports the anxiety symptoms are causing her difficulty caring for her two children. Also, she reports she has developed a fear of driving her car, which has limited her ability to shop, take her children to school, and her ability to see her family who live 20 minutes away. Additionallly, She tells you that every time she tries to drive, she experiences a feeling of extreme dread.

Her last menstrual period was three weeks ago. She reports a history of high blood pressure for which she takes Lisinopril 20 mg daily. She is 5’ 4” and 110 pounds.

Questions
From your perspective as Li’s psychiatric nurse practitioner, answer the following questions in a double-spaced paper (not including the reference page) and in APA format. Include at least three peer-reviewed, evidence-based references.

1-Identify one screening tool you could use when evaluating Li.
2-Articulate one DSM-5 diagnosis and at least one differential diagnosis for Li. Please match her symptoms with the corresponding DSM-5 criteria.
3-What interviewing techniques would be best used for Li?
4-Identify what lab work you would order for Li. Provide evidence to support your rationale.
5-What coping skills would you give Li? Would you refer her to therapy? If so, what type? Provide evidence to support your rationale.
6- Finally, Is Li in need of hospital stabilization? If so, what steps would you take to seek hospitalization? Would you involve her family? Why?

In this assignment, you will assess a current semi-direct or indirect nursing situation that is in need of change. Observe a healthcare environment, focusing on areas of the nursing process that are inefficient, unsafe, or problematic in nature.

A current semi-direct or indirect nursing situation that is in need of change

In this assignment, you will assess a current semi-direct or indirect nursing situation that is in need of change. Observe a healthcare environment, focusing on areas of the nursing process that are inefficient, unsafe, or problematic in nature. Diagnose the problem and choose a nursing change theory that suits the change(s) you want to make. Propose a detailed plan based on your chosen change theory, explaining how to implement change. Develop criteria to evaluate the effectiveness of the plan and include a timeline for your change proposal. Finally, reflect on how your change affects the nursing profession NUR204: Week 9 Assignment Page 1 `

Assignment: Change Paper
Assignment Overview In this assignment, you will assess a current semi-direct or indirect nursing situation that is in need of change. Observe a healthcare environment, focusing on areas of the nursing process that are inefficient, unsafe, or problematic in nature. Diagnose the problem and choose a nursing change theory that suits the change(s) you want to make. Propose a detailed plan based on your chosen change theory, explaining how to implement change. Develop criteria to evaluate the effectiveness of the plan and include a timeline for your change proposal. Finally, reflect on how your change affects the nursing profession.

Assignment Details:

Perform the following tasks:
Complete the reading assignment and the interactive lesson before attempting this assignment.
Assess a current semi-direct or indirect nursing situation that is in need of change. Observe your healthcare environment, focusing on areas of nursing process that are inefficient, unsafe, or problematic in nature.
Diagnose the problem and choose a nursing change theory that suits the change you want to make.

Propose a detailed plan based on your chosen change theory, explaining how to implement change.

Develop criteria to evaluate the effectiveness of the plan and include a timeline for your change proposal.

Reflect on how your change affects the nursing profession.

Write a 3-5 page paper following the criteria below:  your paper should include primary sources and include at least two peer-reviewed nursing journal articles.

Citations should be in your own words and not direct quotes.  Include a title page, running head, appropriate headings, and reference page. The paper should be double spaced, written in Times New Roman, 12-point font, follow APA style format, and cite all sources correctly.

Include the proper file naming convention: NUR204_wk9_assn_jsmith_mmddyyy. Grading:

Criteria Excellent (3pts) Good (2pts) Needs Improvement (1pt)
Research – Cited 4 or more reliable sources. – Sufficient information provided to support topic. – Research in-depth, revealing new insight.

– Cited 4 or more reliable sources. – Adequate information provided to support topic. – Research is superficial.

– Missing citations or unreliable sources used. – Information does not support research topic. – Research is not relevant to paper.

NUR204: Week 9 Assignment Page 2

Content – Appropriate topic is chosen that relates directly to the nursing process. – Proposed plan contains specific ideas for change. – Change theory is included and proposal follows theory. – Timeline is included for change proposal. – Reflection is provided.

– Appropriate topic is chosen that relates directly to the nursing process. – Proposed plan is included but missing specifics. – Change theory is included and proposal follows theory. – Timeline is incomplete – Reflection is not relevant to nursing process.

– Inappropriate topic is chosen that is unrelated to nursing process. – Proposed plan is inconsistent and missing specifics. – Change theory is missing or inappropriate. Plan does not follow theory. – Timeline is missing. – Reflection is missing.

Grammar/Spelling – Consistent and appropriate writing style. – No spelling/grammar errors. – Length is 3-5 pages using Times New Roman, 12-point font

– Writing is consistent and appropriate. – Grammar/spelling errors are minor. – Length is less than 3 pages or Times New Roman, 12-point font not used.

– Writing is inconsistent and inappropriate. – Significant grammar/spelling errors. – Length less than 3 pages or Times New Roman, 12-point font not used.

References/APA – All sources properly cited using APA format. – Includes title page, running head, page numbers, proper paragraphs, and reference page.

– All sources properly cited using APA format with minor errors (punctuation). – Includes title page, running head, page numbers, and reference page with minor errors in paragraph format.

– Sources not cited correctly. – Missing elements such as title page, running head, and reference page.

This is a paper that is focusing on The Nicole Mary Smith ethical and legal issues in nursing. The paper also provides additional information to use in writing the assignment paper.

The Nicole Mary Smith ethical and legal issues in nursing

An Essay on Ethical and Legal issues in nursing
Instructions to Write the Essay
An essay to be written on Ethical and Legal issues in nursing based on the case study given below.  This assessment has a weighting of 40%.
You need to consider:

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The legal and ethical concerns that the situation in the scenario raises.
The possible actions or inactions that could be taken and also the implications of those actions.
You do not need to provide the ‘right’ answers, what you will be assessed on is your ability to determine the implications of different actions or inactions from a legal and ethical perspective.
Firstly, think of the possible courses of action (or inaction) that could be taken and then consider, do any ethical theories support (or not) the actions that you discuss?

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Secondly, which ethical principles, doctrines or concepts apply to the actions/inactions put forward and if so, how?
Thirdly, do any of the ethical principles conflict with each other or with the law?
Fourthly, which torts or other legal concerns apply to your suggested actions/inactions?
Consider the Code of Conduct, Code of Ethics and RN Standards of Practice (2016), how do they apply to this situation?

The Nicole Mary Smith ethical and legal issues in nursing

Scenario:
On 18th January 2020, Nicole Mary Smith (pseudonym) was admitt to the Emergency department of a private hospital with the chief complaints of abdominal pain, poor appetite, and urinary symptoms. Upon review by the Emergency physician, she was admitt to the surgical ward for further investigations and symptom management. The patient is an 86-year old woman, who lives in an assisted living facility. Her daughter and also her grandson live in a nearby suburb and often visit her. During the preceding two weeks, Nicole’s condition has drastically deteriorated. Her daughter appears to be anxious and has narrated her struggle to manage the visits to the hospital and her work and family responsibilities. The visiting Oncologist has refereed Nicole to the palliative care team after the initial diagnosis of metastatic ovarian cancer.

You are the registered nurse looking after Nicole. You entered the room to administer pain relief, the patient’s daughter approaches you and says, “Why do you keep bothering us, do not give her any injections; she is going to die anyway”. She goes on, “I just cannot wait for all of this to be over; I have my own family to look after”. You realize her concerns and try to reassure her. However, you been new to palliative care and are finding the situation challenging.
Write an academic essay on Ethical and also legal issues in nursing, specific to the given scenario. Additionally, provide supporting evidence to your claims and include recommendations to improve future practice.