Question
NUR2790 Professional Nursing III
Module 1 Discussion
Cancer Treatment Options
Mrs. Williams is a 27-year-old female diagnosed with breast cancer. She is currently in pharmacy school. She does not have children, but hopes to have them someday. She has been tested and has a genetic predisposition for this disease.
What treatment options does she have?
What are the advantages and disadvantages of those treatment options?
What would you tell Mrs. Williams if she decided to refuse treatment?
Mrs. Williams really wants to have children before she starts treatment. What would you educate her about? Why?
NUR2790 Professional Nursing III
Module 2 Discussion
Death and Dying
Discuss the term “clinical death,” especially with respect to when not to initiate CPR. Discuss what is meant by a “peaceful death” and a “good death,” including goals for End-Of-Life care. How would you feel if you knew your patients did not want CPR but the family insisted on it?
NUR2790 Professional Nursing III
Module 3 Discussion
Triage
Triage involves the rapid assessment and prioritization of patients. Compare the three-tiered system of triage to the Mass Casualty Incident (MCI) triage philosophy. Imagine that you are the Triage Nurse during an MCI. How will you categorize the following patients using the MCI triage philosophy? Explain your answer. Are there any ethical issues that should be considered?
10-year-old boy with massive head injury, no spontaneous breathing, BP 60 palp
22-year-old female with a close fracture of the left arm
60-year-old male with a laceration in the leg complaining of shortness of breath
15-year-old girl with glass embedded in the eyes
52-year-old male with a pulse of 30 and a blood pressure of 70/30
For your response, do you agree with your classmates’ opinions? What would you urge them to consider when making the triage determination?
NUR2790 Professional Nursing III
Module 4 Discussion
Gas Exchange
Mr. Nguyen is a 58-year-old patient that had septic shock and developed Acute Respiratory Distress Syndrome. He is orally intubated and on a mechanical ventilator. He is paralyzed and sedated.
What manifestations might you observe for a patient with ARDS?
What complications can Mr. Nguyen develop from being mechanically ventilated?
List priority nursing interventions to prevent complications associated with ventilatory support.
What interventions can be implemented specifically to prevent the development of Ventilator Acquired Pneumonia (VAP)?
You are orienting in the ICU, the nurse you are working with is not implementing the VAP interventions. What would you do?
NUR2790 Professional Nursing III
Module 5 Discussion
Artifact vs. Dysrhythmia
Describe the role of each component of the ECG in the heart’s contraction: the P wave, the PR interval, the QRS complex, the ST segment, the T wave, and the QT interval. What is the difference between artifact and dysrhythmia? How can you reduce artifacts? What are some situations that can occur if artifact is not reduced or eliminated?
You are working in the Telemetry Unit. The nurse “watching” the monitors is reading a magazine. She constantly turns off an alarm that looks a lot like Ventricular Fibrillation. She tells you that it is not a dysrhythmia, it is just artifact. What do you think about her actions? What is the worst case scenario in this situation? What would you do?
NUR2790 Professional Nursing III
Module 6 Discussion
Prevention of Shock
Your patient is a 42-year-old female that arrives in the ED with complaints of fever and not feeling well. She is currently undergoing chemotherapy for bladder cancer. She has an indwelling urinary catheter with scant amount of dark, foul smelling urine. She has a temperature of 102.2F, HR 136, BP 110/50 and RR 28. She is allergic to penicillin and Sulfa.
What type of shock is she experiencing?
What interventions do you anticipate the doctor will order?
What can you teach this patient about prevention of infection?
The doctor orders Bactrim. What should you be concern about? Why?
NUR2790 Professional Nursing III
Module 7 Discussion
Modifiable vs. Unmodifiable Risk Factors
Choose a subject (it can be a former patient, a family member, or yourself) and identify modifiable and nonmodifiable risk factors. Identify methods to prevent Coronary Artery Disease (CAD) in the subject. What can you recommend to your classmates subjects?
NUR2790 Professional Nursing III
Module 8 Discussion
The Patient with Chronic Renal Failure
Mr. Rojas is a 49-year-old patient with End Stage Renal Disease. He has a history of hypertension and uncontrolled type 1 diabetes (since he was 12 years old). His last Hemoglobin A1c was 12.8%. He is currently receiving hemodialysis three times per week for three hours. He is in the hospital because he went into DKA a few days ago when he had a stomach virus. He is asking you about renal transplantation.
What are the criteria to be placed in the transplant list?
What options for transplantation does Mr. Rojas have?
What recommendations can you give Mr. Rojas on treatment compliance?
What other renal replacement therapies could Mr. Rojas be educated about?
What are their advantages and disadvantages?
NUR2790 Professional Nursing III
Module 9 Discussion
Brain Death: Ethical Considerations
Your patient is a 23-year-old female with a history of headaches. This morning she was experiencing a really bad headache as her boyfriend was driving her to the university. He thought she was sleeping and by the time they got to the school, 45 minutes later, she was not waking up. She was diagnosed with a cerebral aneurysm and you are taking care of her in the Neurological ICU.
What testing do you expect to be performed to diagnose brain death?
What is the procedure when a patient is determined to be brain dead?
Who should approach the family about organ donation?
The family is approached about organ donation. The patient indicated on her driver’s license that she wanted to be an organ donor. Her mother refuses to consent for organ donation.
Do you think donation should happen anyway? Why or why not?
What will be the ethical consequences of your decision?
NUR2790 Professional Nursing III
Module 10 Discussion
Ethical Dilemma
For patients with liver failure due to cirrhosis liver, transplantation may be the only possible treatment.
How is the care for the patient undergoing liver transplantation different from the care of a regular surgical patient?
What patient teaching is needed after a patient receives a liver transplant?
Should the patient with alcoholic cirrhosis be a candidate for a liver transplant?
Should government funds be used in the care of patients with cirrhosis who continue to consume alcohol?
NUR2790 Professional Nursing III
Module 11 Discussion
Caring for Self!
You have learned a lot during your training to become a Registered Nurse. At this point in your education, where do you see yourself as a nurse? What unit would you like to work in and why?
To be able to care for patients, you must be able to care for yourself. What are some practices you plan to implement to help you care for yourself and why?
