NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Pre- and Post-Operative Care
“A wide range of illnesses and injuries may require treatment that includes some type of surgical intervention. Surgery may be planned or unplanned, major or minor, invasive or noninvasive, and may involve any body part or system”
—Pamela Lynn (2008).
As this quotation suggests, advanced practice nurses must be able to provide pre- and post-operative care to patients with various illnesses and injuries. Consider a 17-year-old patient who is injured in a car accident. The patient has severe burns on her legs, and several toes on her right foot require amputation. Her injuries are affecting multiple body systems. As an advanced practice nurse, how might you stabilize and prepare this patient for surgery? What areas of care will be your focus as the patient recovers from surgery?
This week, you examine and discuss limitations and challenges of clinical practice. Then, as you explore the role of the advanced practice nurse in perioperative settings, you examine strategies for assessing, diagnosing, and treating patients in pre- and post-operative care. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Learning Objectives
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By the end of this week, students will:
Analyze limitations and challenges of clinical practice
Evaluate pre- and post-operative care patients
Develop differential diagnoses for pre- and post-operative care patients
Develop treatment plans for pre- and post-operative care patients
Photo Credit: PhotoAlto/Odilon Dimier/PhotoAlto Agency RF Collections/Getty Images
Learning Resources
Required Readings
Colyar, M. R. (2015).
Advanced practice nursing procedures
(1st ed.). Philadelphia, PA: F. A. Davis Company.
Chapter 1, “Punch Biopsy”
Chapter 2, “Skin Biopsy”
Chapter 4, “Abscesses—Incision and Drainage Drainage (Furuncle, Felon, Paronychia, Pilonidal Cyst, Perianal Cyst)”
Chapter 7, “Burns—Debridement”
Chapter 8, “Digital Nerve Block”
Chapter 12, “Sebaceous Cyst Removal”
Chapter 17, “Soft Tissue Aspiration”
Chapter 21, “Subungual Hematoma Excision”
Chapter 22, “Suture Insertion”
Chapter 23, “Suture Selection”
Chapter 24, “Suture Removal”
Chapter 26, “Topical Hemostatic Agent Application”
Chapter 27, “Ulcer Debridement”
Doherty, G. M. (2015).
Current diagnosis and treatment: Surgery
(14th ed.). New York, NY: McGraw Hill. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Chapter 6, “Wound Healing”
Chapter 8, “Inflammation, Infection, & Antimicrobial Therapy in Surgery”
Chapter 9, “Fluid & Electrolyte Management & Acid-Base Disorders”
Chapter 10, “Surgical Metabolism & Nutrition”
Chapter 13, “Management of the Injured Patient”
Chapter 14, “Burns & Other Thermal Injuries”
Document:
i-Human Patients, Inc. (2014).
i-Human patients case player student manual.
Throughout this course, you will be required to complete case study assignments within i-Human Patients. This manual provides guidance on accessing and using these simulation. It is highly recommended that you explore the various training resources offered in this manual in preparation for the upcoming Assignments.Throughout this course, you will be required to complete case study assignments within i-Human Patients. This manual provides guidance on accessing and using these simulation. It is highly recommended that you explore the various training resources offered in this manual in preparation for the upcoming Assignments. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Required Media
Note:
You should have received an e-mail with your i-Human Patients login and password information. If you have not received this information, please contact your Instructor.
i-Human Patient Cases. (2014). Retrieved from https://ih2.i-human.com/users/sign_in
Vo, H. (2012).
Placement of central venous catheter—NEJM
[Video file]. Retrieved from https://www.youtube.com/watch?v=HE5QhsPRaPU
Optional Resources
University of Michigan Trauma Burn Center. (2015).
Fluid resuscitation.
Retrieved from http://www.traumaburn.org/referring/fluid.shtml
U.S. Department of Health & Human Services. (2014).
Burn triage and treatment: Thermal injuries.
Retrieved from http://www.remm.nlm.gov/burns.htm
Discussion Part I: Limitations and Challenges
From providing ongoing assessments to monitoring for complications and facilitating recovery, advanced practice nurses who care for patients in perioperative environments experience a unique set of limitations and challenges. Reflecting on your experiences in this complex and critical environment will help you develop your professional competency and prepare you for your future role as an advanced practice nurse. In this week’s Discussion, you consider limitations and challenges of clinical practice in perioperative care settings. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
To prepare:
Reflect on this week’s clinical experiences.
Consider one limitation or challenge you encountered.
Think about how you overcame this limitation or challenge and how this might affect your future practice in pre- and post-operative care settings.
By Day 3
Post
a description of at least one limitation or challenge you encountered during your clinical experience this week. Explain how you overcame this limitation or challenge and how this might affect your future practice.
Note:
If you refer to a patient in your Discussions or Assignments, be sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.
Read
a selection of your colleagues’ responses.
By Day 6
Respond
to
two colleagues
by sharing additional insights or alternative perspectives.
Discussion Part II: Pharmacology
Note:
To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
To prepare:
Read the following articles to enhance your knowledge of commonly prescribed medications:
Ando, S., Yasugi, D., Matsumoto, T., Kanata, S., & Kasai, K. (2014). Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia.
Psychiatry Clinical Neuroscience, 68
(9), 721.
Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia by Ando, S., et al in Psychiatry Clinical Neuroscience, 68(9). Copyright 2014 by John Wiley & Sons, Inc. Reprinted by permission of John Wiley & Sons, Inc., via the Copyright Clearance Center.
Dassanayake, T. L., Jones, A. L., Michie, P. T., Carter, G. L., McElduff, P., Stokes, B. J., & Whyte, I. M. (2012). Risk of road traffic accidents in patients discharged following treatment for psychotropic drug overdose: A self-controlled case series study in Australia.
CNS Drugs 26
(3), 269–276. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Note:
Retrieved from the Walden Library databases.
Kulick, D., & Deen, D. (2011). Specialized nutrition support.
American Family Physician, 83
(2), 173–183. Retrieved from http://www.aafp.org/afp/2011/0115/p173.html
Martini, D. I., Nacca, N., Haswell, D., Cobb, T., & Hodgman, M. (2015). Serotonin syndrome following metaxalone overdose and therapeutic use of a selective serotonin reuptake inhibitor.
Clinical Toxicology 53
(3), 185–187.
Serotonin syndrome following metaxalone overdose and therapeutic use of a selective serotonin reuptake inhibitor by Martini, D., in Clinical Toxicology, 53(3). Copyright 2015 by Informa Healthcare. Reprinted by permission of Informa Healthcare via the Copyright Clearance Center.
Robinson, A., & Wermeling, D. P. (2014). Intranasal naloxone administration for treatment of opioid overdose.
American Journal of Health-System Pharmacy, 71
(24), 2129–2135.
Note:
Retrieved from the Walden Library databases. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Thomas, D. R. (2013). Total parenteral nutrition (TPN). In
The Merck Manual Professional Edition.
Retrieved from http://www.merckmanuals.com/professional/nutritional_disorders/nutritional_support/total_parenteral_
All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.
KPhos, bicarb, calcium, magnesium
Iron, folic acid, B12
Diamox
Macrolides
Muinolones/mluoroquinolone
Cephalosporins, 4th and 5th generation
Aminoglycosides
Carbapenems
Lipopeptide
Tigecycline
Note:
When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
By Day 3
For this Discussion, address 1 of the following options:
Option 1
Post
a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose.
Option 2
Conduct an evidence-based drug search on the drug you selected and
post
an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?
Option 3
Post
an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Discuss a patient to whom you would prescribe this medication.
Note:
To be considered as one of your required responses, your pharmacology rationale must include a supporting reference.
Note:
For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Submission and Grading Information
Grading Criteria
Week 2 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 2 Discussion
Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients
The perioperative period is critical for surgical patients. Whether patients require fluid and electrolyte management, pain management, or treatment for infections or surgical complications, advanced practice nurses must be able to provide safe and effective care. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat patients who require pre- and post-operative care. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
To prepare:
Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients in pre- and post-operative care.
Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Identify three to five possible conditions to consider in a differential diagnosis for the patient.
Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
Develop a treatment plan for each patient that includes health promotion and patient education strategies for pre- and post-operative care patients.
To complete:
As you interact with this week’s i-Human patient, complete the assigned case study. As you interact with this week’s i-Human patients, complete the assigned case studies. For guidance on using i-Human, refer to the
i-Human Patients Case Player Student Manual
in the Week 2 Learning Resources.
By Day 7
This Assignment is due.
Grading Information
Week 2 i-Human Rubric
Week in Review
This week
you analyzed the unique set of limitations and challenges when providing safe and effective care in perioperative environments for pre-and-post operative patients. You also developed differential diagnoses and treatment plans for these patients. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Next week
you will explore the assessment and care of pre- and post-operative patients with conditions specifically related to the head, neck, esophagus, and diaphragm, and examine strategies for assessment, diagnosis, and treatment.
NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Application_Rubric
Novice
Emerging
Proficient
HPI Statement
0
(0%)
– 5
(5%)
Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills
6
(6%)
– 10
(10%)
Well written HPI statement but may be missing 1-2 key components from the history
11
(11%)
– 15
(15%)
Clearly written HPI statement with comprehensive information gathering from case questions.
Objective testing and physical exam
0
(0%)
– 5
(5%)
Poorly written physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis. Includes 3 or more inappropriate exams or tests.
6
(6%)
– 10
(10%)
Well written physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis. May include 1-2 unnecessary exams or tests.
11
(11%)
– 15
(15%)
Clearly written physical examination covering all critical components of a focus exam. Tests that are ordered are appropriate for patient and cost effective.
Assessment
0
(0%)
– 10
(10%)
Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components. Priority list may be out of order. Primary diagnosis may be wrong.
11
(11%)
– 19
(19%)
Well written differential diagnoses. May be missing 1-2 critical components. Correct primary diagnosis identified.
20
(20%)
– 25
(25%)
Clearly written differential diagnoses. Primary diagnosis identified.
Plan for patient
0
(0%)
– 15
(15%)
Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.
16
(16%)
– 25
(25%)
Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.
26
(26%)
– 30
(30%)
Clearly written plan covering all critical components for patient’s final diagnosis.
Clinical Questions
0
(0%)
– 10
(10%)
Correctly answered 0-69% of the clinical question
11
(11%)
– 13
(13%)
Correctly answered 70-89% of the clinical question
14
(14%)
– 15
(15%)
Correctly answered 90-100% of the clinical questions
NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Discussion_Rubric
Outstanding Performance
Excellent Performance
Competent Performance
Proficient Performance
Room for Improvement
Main Posting:
Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
44
(44%)
– 44
(44%)
Thoroughly responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
supported by at least 3 current, credible sources
40
(40%)
– 43
(43%)
Responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
75% of post has exceptional depth and breadth
supported by at least 3 credible references.NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
35
(35%)
– 39
(39%)
Responds to most of the discussion question(s)
is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
50% of post has exceptional depth and breadth
supported by at least 3 credible references
31
(31%)
– 34
(34%)
Responds to some of the discussion question(s)
one to two criteria are not addressed or are superficially addressed
is somewhat lacking reflection and critical analysis and synthesis
somewhat represents knowledge gained from the course readings for the module.
post is cited with fewer than 2 credible references
0
(0%)
– 30
(30%)
Does not respond to the discussion question(s)
lacks depth or superficially addresses criteria
lacks reflection and critical analysis and synthesis
does not represent knowledge gained from the course readings for the module.
contains only 1 or no credible references
Main Posting:
Writing
NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
6
(6%)
– 6
(6%)
Written clearly and concisely
Contains no grammatical or spelling errors
Fully adheres to current APA manual writing rules and style
5.5
(5.5%)
– 5.5
(5.5%)
Written clearly and concisely
May contain one or no grammatical or spelling error
Adheres to current APA manual writing rules and style
5
(5%)
– 5
(5%)
Written concisely
May contain one to two grammatical or spelling error
Adheres to current APA manual writing rules and style
4.5
(4.5%)
– 4.5
(4.5%)
Written somewhat concisely
May contain more than two spelling or grammatical errors
Contains some APA formatting errors
0
(0%)
– 4
(4%)
Not written clearly or concisely
Contains more than two spelling or grammatical errors
Does not adhere to current APA manual writing rules and style
Main Posting:
Timely and full participation
10
(10%)
– 10
(10%)
Meets requirements for timely and full participation
posts main discussion by due date
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
Does not meet requirement for full participation
First Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9
(9%)
– 9
(9%)
Response exhibits critical thinking and application to practice settings
responds to questions posed by faculty
the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives
8.5
(8.5%)
– 8.5
(8.5%)
Response exhibits critical thinking and application to practice settings
7.5
(7.5%)
– 8
(8%)
Response has some depth and may exhibit critical thinking or application to practice setting
6.5
(6.5%)
– 7
(7%)
Response is on topic, may have some depth
0
(0%)
– 6
(6%)
Response may not be on topic, lacks depth
First Response:
Writing
6
(6%)
– 6
(6%)
Communication is professional and respectful to colleagues
Response to faculty questions are fully answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English
5.5
(5.5%)
– 5.5
(5.5%)
Communication is professional and respectful to colleagues
Response to faculty questions are answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English
5
(5%)
– 5
(5%)
Communication is mostly professional and respectful to colleagues
Response to faculty questions are mostly answered if posed
Provides opinions and ideas that are supported by few credible sources
Response is written in Standard Edited English
4.5
(4.5%)
– 4.5
(4.5%)
Responses posted in the discussion may lack effective professional communication
Response to faculty questions are somewhat answered if posed
Few or no credible sources are cited
0
(0%)
– 4
(4%)
Responses posted in the discussion lack effective
Response to faculty questions are missing
No credible sources are cited
First Response:
Timely and full participation
5
(5%)
– 5
(5%)
Meets requirements for timely and full participation
posts by due date
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
Does not meet requirement for full participation
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9
(9%)
– 9
(9%)
Response exhibits critical thinking and application to practice settings * responds to questions posed by faculty
the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives
NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
8.5
(8.5%)
– 8.5
(8.5%)
Response exhibits critical thinking and application to practice settings
7.5
(7.5%)
– 8
(8%)
Response has some depth and may exhibit critical thinking or application to practice setting
6.5
(6.5%)
– 7
(7%)
Response is on topic, may have some depth
0
(0%)
– 6
(6%)
Response may not be on topic, lacks depth
Second Response:
Writing
6
(6%)
– 6
(6%)
Communication is professional and respectful to colleagues
Response to faculty questions are fully answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English
5.5
(5.5%)
– 5.5
(5.5%)
Communication is professional and respectful to colleagues
Response to faculty questions are answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English
5
(5%)
– 5
(5%)
Communication is mostly professional and respectful to colleagues
Response to faculty questions are mostly answered if posed
Provides opinions and ideas that are supported by few credible sources
Response is written in Standard Edited English
4.5
(4.5%)
– 4.5
(4.5%)
Responses posted in the discussion may lack effective professional communication
Response to faculty questions are somewhat answered if posed
Few or no credible sources are cited
0
(0%)
– 4
(4%)
Responses posted in the discussion lack effective
Response to faculty questions are missing
No credible sources are cited.NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper
Second Response:
Timely and full participation
5
(5%)
– 5
(5%)
Meets requirements for timely and full participation
Posts by due date
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
Does not meet requirement for full participation
NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Paper