Clinical Judgment Essay

Clinical Judgment

Clinical Judgment is the process of integrating evidence-based practice, critical-thought, the Nursing Process, knowledge, skills, and attitudes, as well as application of theory to practice in order to promote safe, quality care to clients in all settings.

Don't use plagiarized sources. Get Your Custom Essay on
Clinical Judgment Essay
Just from $13/Page
Order Essay

Keeping that in mind, answer the following scenario:

You are the Charge Nurse in a large Urban Emergency Department (ED). You nursing staff include:

RN with 12 years of Trauma ED experience

New RN with 6 months ED experience

RN from the Medical Surgical floor with 8 years of experience

The following patients are in the ED, which patient will you give to each of the nurses and why?

A 76-year-old client who was involved in a motor vehicle accident and has hematuria.

A 38-year-old client with kidney stones complaining of severe pain.

A 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching.

An 80-year-old client that has not had a bowel movement for 4 days.

NUR2571 Professional Nursing II

Module 2 Discussion

Patient with Hyperkalemia

Mr. Sweet, 38 years old, is brought to the Emergency Department unresponsive. He has a history of Type 1 diabetes and has been sick for the last 3 days. On admission his Blood sugar is 532, Potassium is 7.2 and ABG results include pH 7.08, Bicarb 12, and CO2 28. His VS are HR 116, BP 107/64, RR 36 Deep and rapid, and Temp 101.5. Answer the following questions:

What interventions do expect to be ordered for Mr. Sweet? Why?

What type of acid-base disturbance does he have?

What do you think is Mr. Sweet’s Medical Diagnosis?

NUR2571 Professional Nursing II

Module 3 Discussion

Case Scenario Tuberculosis

Wilson is a 36-year-old migrant worker. He was admitted to the Hospital with a cough, unintended weight loss, and night sweats. He is staying with 6 friends in a one bedroom apartment near the strawberry field where he works. The ED physician suspects Tuberculosis (TB).

What diagnostic testing will the Provider order to confirm a diagnosis of TB?

What Isolation precautions do you expect to be put in place and why?

Describe the recommended treatment regimen for TB, including the rationale for combination drug therapy.

Identify the reason compliance to medication therapy is often a concern in the patient with TB.

What should be done for Wilson’s 6 roommates?

NUR2571 Professional Nursing II

Module 4 Discussion

I-SBAR-R Reporting

Think of a situation from clinical when the Provider needed to be informed of a change in patient condition. Using ISBARR write what you would report to the Provider. You can use the ISBARR form for guidance.

NUR2571 Professional Nursing II

Module 5 Discussion

Patient Teaching: Anticoagulants

Sandra is a 27-year-old female admitted with a possible Deep Vein Thrombosis (DVT). She smokes one pack per day and is on birth control. She has a history of hypertension and obesity. She is admitted to the hospital and placed on bedrest. Heparin drip is started per protocol. The Provider is anticipating on sending her home with Coumadin.

Can Sandra be placed on Coumadin and Heparin at the same time? Explain your answer.

Develop 3 teaching points important for Sandra to know about her medications regimen.

What questions would you ask Sandra to verify that she understand the 3 teaching points?

NUR2571 Professional Nursing II

Module 7 Discussion

Type 1 vs. Type 2 and Patient Education

Compare and contrast risk factors, age of onset, pathophysiology and clinical manifestations of Type 1 and Type 2 Diabetes. What do you think is the most important topic that must be taught to the diabetic patient and why?

NUR2571 Professional Nursing II

Module 8 Discussion

The Older Adult

A nurse at the local Senior Center made the following notation about a client: A 74-year-old female client wearing eyeglasses with bifocal lenses and hearing aid in her left ear. Walks with a shuffling gait, using a cane for support. Wearing house slippers and housedress. States, “My other doctor says I should have my eyes looked at by an expert. It’s been a while, and my eyes seem to be acting up lately. I can’t see so good anymore.” The client states that she takes medication for “sugar” and her blood pressure and has worn glasses for years with the last prescription changed about 3 years ago. “I was a seamstress for many years and quit when I couldn’t see to thread the needles anymore-just in time too. These new materials are too hard to work with!” Denies using any eye drops. Describes vision changes as difficulty seeing well at night, especially if trying to read. Uses a magnifying glass to help when reading. No eye pain or discharge, although eyes sometimes feel “dry and scratchy,” with the left eye being worse than the right. Admits to rubbing eyes but without relief.

Develop a Plan of Care for this patient that includes:

2 Nursing Diagnosis

2 goals for each Nursing Diagnosis

Interventions with rationales

NUR2571 Professional Nursing II

Module 10 Discussion

Bariatric Surgery Patient

EJ is a 28-year-old female. She is being admitted for Gastric Bypass Surgery. She is 5’6” and 265 pounds. She has a history of Diabetes and hypertension, she is not on medications at the time.

What client education topics are important to reinforce for this client?

How will this client’s diet be advanced?

What complications can occur after this surgery?

What is Dumping Syndrome and what are some interventions to help prevent its development?

NUR2571 Professional Nursing II

Module 1 Assignment

Bowel and Urinary Disorders

Complete the comparison tables on urinary disorders and bowel disorders.

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

Comparison of Urinary Elimination Disorders:

Stress Incontinence

Benign Prostatic Hypertrophy

Pyelonephritis

Pathophysiology

Etiology

Clinical Manifestations

Interventions

Comparison of Bowel Elimination Disorders:

Diarrhea

Bowel Obstruction

Hemorrhoids

Pathophysiology

Etiology

Clinical Manifestations

Interventions

NUR2571 Professional Nursing II

Module 2 Assignment

Fluid/electrolyte disturbances and ABG interpretation

Complete the Fluid disturbance table and answer the following ABGs (Arterial Blood Gases).

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

Comparison of Fluid Deficit and Fluid Overload

Fluid Deficit

Fluid Overload

Definition

Causes/Risk Factors

Clinical Manifestations (including laboratory data)

Collaborative Management (Interventions)

NUR2571 Professional Nursing II

Module 3 Assignment

Respiratory Disease

Complete the Respiratory Diseases comparison table.

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

Comparison of Respiratory Disorders:

Asthma

Emphysema

Chronic Bronchitis

Pneumonia

Pathophysiology

Etiology/Population at Risk

Clinical Manifestations including Laboratory data

Typical Nursing Diagnosis

Interventions

NUR2571 Professional Nursing II

Module 4 Assignment

Concept Map-Hypertension

Develop and Concept Map, using the form provided, on the following patient. Include Diagnostic data and medical orders that you expect to be ordered on the patient.

T.J., a 30-year-old African American client, is in his last year of law school and is clerking for a prestigious law firm. He and his fiancé plan to marry as soon as he graduates. During the last week he has had four dizzy spells and a headache at the base of his skull upon awakening for the last 2 days. His father has a history of hypertension, so T.J. is aware that his symptoms may indicate high blood pressure. On his way home from work, T.J. stops by the clinic and asks the nurse to check his blood pressure. The nursing assessment yields the following data.

Subjective data: States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content. T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having hypertension because he does not want to take medication.

Objective data: T 98.6°F(37°C), AP 78 beats/min, R 16 breaths/min, BP 142/92 mm Hg, Wt 190 lbs (optimum weight 160). No edema noted in hands, feet, or legs.

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

NUR2571 Professional Nursing II

Module 5 Assignment

Medications affecting Coagulation

Please go through and fill out the table on Medications affecting Coagulation. If need be go back on previous lectures or your textbook for resources to help you complete the assignment.

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

Medications affecting coagulation

Coumadin

Heparin

Lovenox

Mode of Action

Indications

Dosage/Route

Side Effects

Labs to Monitor

Antidote

Patient teaching

NUR2571 Professional Nursing II

Module 6 Assignment

Inflammatory Diseases

Complete the comparison table for Inflammatory Diseases.

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

Comparison of Inflammatory Disease:

Rheumatoid Arthritis

Systemic Lupus Erythematosus

Ulcerative Colitis

Pathophysiology

Etiology

Clinical Manifestations

Common Laboratory Tests

Treatment

NUR2571 Professional Nursing II

Module 7 Assignment

Acute Complications of Diabetes

Comparison of Acute Complications of Diabetes:

Hypoglycemia

Diabetic Ketoacidosis

Hyperosmolar Hyperglycemic Nonketotic syndrome

Clinical Manifestations

Diagnostic Data

Interventions

Patient Teaching

NUR2571 Professional Nursing II

Module 8 Assignment

Otitis Media

An 8-year-old girl comes to your ambulatory care clinic with complaints of left ear pain for the past 3 days. She had respiratory infection a week ago. On physical examination, the tympanic membrane is bulging.

Answer the following questions:

What else should you ask the client?

What teaching would you reinforce to prevent the recurrence of otitis media?

What expected outcomes would be specific to this situation?

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

NUR2571 Professional Nursing II

Module 9 Assignment

Seizures

An older client was recently discharged from the hospital for evaluation of seizure activity. His history reveals that he has late-stage Alzheimer’s disease, Parkinson’s disease, hypertension, and type II diabetes mellitus, which is controlled by diet. He lives at home, where his wife and daughter take care of him. His discharge medications include phenytoin (Dilantin), 100 mg BID; hydrochlorothiazide (HydroDIURIL), 50 mg QD; levodopa (Sinemet), 25/100 TID; and haloperidol (Haldol), 1 mg before bed. The client has been referred for home care nursing follow-up.

Questions:

On the initial home visit by the nurse, what assessments should be made?

The wife and daughter need teaching about his antiepileptic medication. What teaching should be included?

During the initial home visit, the client experiences a generalized seizure. What action should the nurse take?

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

NUR2571 Professional Nursing II

Module 10 Assignment

Exemplars

Fill out the Alteration in Metabolism Exemplar Table.

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

Alterations in Metabolism

Obesity

Hyperthyroid

Hypothyroid

Pathophysiology

Risk Factors

Assessment Findings (including Labs)

Possible Nursing Diagnosis

Interventions (including Medications)

NUR2571 Professional Nursing II

Course Project

Course Project-Clinical Question

Clinical Question – Formulate a clinical question using the PICOT format.

P: Patient Population

I: Intervention or area on Interest

C: Comparison intervention or group

O: Outcome

T: Time

Ex: “In acute care hospitals (patient population), how does having a rapid response team (intervention) compared with not having a response team (comparison) affect the number of cardiac arrests (outcome) during a three-month period (time)?”

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

Reference Page

Turn in a reference page in APA format. You must use three (3) or more relevant sources; to ensure the readings are relevant and current, the selected peer reviewed article must have been written within the past three (3) years.

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

Paper Submission

Your paper for the course project should be a 2-3 page APA paper (not including title page and the reference page) that describes the clinical problem and the following:

Reason for choosing this topic

The PICOT question

Possible integration of the evidenced that you found in clinical practice

Methods to evaluate the effectiveness of implementation

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

Staff Development PowerPoint

Your staff development PPT presentation will include the information from your written paper in 10-12 slides (including a title and reference slide in APA format). Make sure to include speaker notes at the bottom of your slide to explain the content of your slide.

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

What Will You Get?

We provide professional writing services to help you score straight A’s by submitting custom written assignments that mirror your guidelines.

Premium Quality

Get result-oriented writing and never worry about grades anymore. We follow the highest quality standards to make sure that you get perfect assignments.

Experienced Writers

Our writers have experience in dealing with papers of every educational level. You can surely rely on the expertise of our qualified professionals.

On-Time Delivery

Your deadline is our threshold for success and we take it very seriously. We make sure you receive your papers before your predefined time.

24/7 Customer Support

Someone from our customer support team is always here to respond to your questions. So, hit us up if you have got any ambiguity or concern.

Complete Confidentiality

Sit back and relax while we help you out with writing your papers. We have an ultimate policy for keeping your personal and order-related details a secret.

Authentic Sources

We assure you that your document will be thoroughly checked for plagiarism and grammatical errors as we use highly authentic and licit sources.

Moneyback Guarantee

Still reluctant about placing an order? Our 100% Moneyback Guarantee backs you up on rare occasions where you aren’t satisfied with the writing.

Order Tracking

You don’t have to wait for an update for hours; you can track the progress of your order any time you want. We share the status after each step.

image

Areas of Expertise

Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.

Areas of Expertise

Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.

image

Trusted Partner of 9650+ Students for Writing

From brainstorming your paper's outline to perfecting its grammar, we perform every step carefully to make your paper worthy of A grade.

Preferred Writer

Hire your preferred writer anytime. Simply specify if you want your preferred expert to write your paper and we’ll make that happen.

Grammar Check Report

Get an elaborate and authentic grammar check report with your work to have the grammar goodness sealed in your document.

One Page Summary

You can purchase this feature if you want our writers to sum up your paper in the form of a concise and well-articulated summary.

Plagiarism Report

You don’t have to worry about plagiarism anymore. Get a plagiarism report to certify the uniqueness of your work.

Free Features $66FREE

  • Most Qualified Writer $10FREE
  • Plagiarism Scan Report $10FREE
  • Unlimited Revisions $08FREE
  • Paper Formatting $05FREE
  • Cover Page $05FREE
  • Referencing & Bibliography $10FREE
  • Dedicated User Area $08FREE
  • 24/7 Order Tracking $05FREE
  • Periodic Email Alerts $05FREE
image

Our Services

Join us for the best experience while seeking writing assistance in your college life. A good grade is all you need to boost up your academic excellence and we are all about it.

  • On-time Delivery
  • 24/7 Order Tracking
  • Access to Authentic Sources
Academic Writing

We create perfect papers according to the guidelines.

Professional Editing

We seamlessly edit out errors from your papers.

Thorough Proofreading

We thoroughly read your final draft to identify errors.

image

Delegate Your Challenging Writing Tasks to Experienced Professionals

Work with ultimate peace of mind because we ensure that your academic work is our responsibility and your grades are a top concern for us!

Check Out Our Sample Work

Dedication. Quality. Commitment. Punctuality

It May Not Be Much, but It’s Honest Work!

Here is what we have achieved so far. These numbers are evidence that we go the extra mile to make your college journey successful.

0+

Happy Clients

0+

Words Written This Week

0+

Ongoing Orders

0%

Customer Satisfaction Rate
image

Process as Fine as Brewed Coffee

We have the most intuitive and minimalistic process so that you can easily place an order. Just follow a few steps to unlock success.

See How We Helped 9000+ Students Achieve Success

image

We Analyze Your Problem and Offer Customized Writing

We understand your guidelines first before delivering any writing service. You can discuss your writing needs and we will have them evaluated by our dedicated team.

  • Clear elicitation of your requirements.
  • Customized writing as per your needs.

We Mirror Your Guidelines to Deliver Quality Services

We write your papers in a standardized way. We complete your work in such a way that it turns out to be a perfect description of your guidelines.

  • Proactive analysis of your writing.
  • Active communication to understand requirements.
image
image

We Handle Your Writing Tasks to Ensure Excellent Grades

We promise you excellent grades and academic excellence that you always longed for. Our writers stay in touch with you via email.

  • Thorough research and analysis for every order.
  • Deliverance of reliable writing service to improve your grades.
Place an Order Start Chat Now
image