Fluid, Electrolyte, and Acid-Base Balance
1. You are a nurse who frequently cares for post-surgical patients in your hospital unit. Most of the medical-surgical patients have IV fluids infusing during their admission. Due to the frequent use of IV fluids on your floor, understanding fluid balance and electrolyte function is primary to your nursing practice. 
a. What conditions might lead to the development of hypovolemia?
b. How would the amount of patient fluid loss be determined?
c. Describe how hypovolemia and third-space fluid shifts correlate.
d. Outline the major difference between hypovolemia and third-space fluid shift.
e. Which conditions can result in third-space fluid shift?
2. You are a nurse in a nonsurgical cardiac unit caring for a 92-year-old patient who has two sons, 15 grandchildren, and 49 great-grandchildren. She lives in assisted living and has a history of congestive heart failure (CHF). She consistently struggles with balancing her fluids and electrolytes and has an affinity for dill pickles and sauerkraut. While hospitalized, she remains on a fluid restriction—much to her chagrin, as she loves ice cream. 
a. What within her history would indicate she was at risk for hypervolemia?
b. How would dill pickles and sauerkraut impact her fluid volume?

c. What body areas offer observational evidence of excessive interstitial extracellular fluid (ECF)?
d. Why would your patient be on a strict fluid restriction while hospitalized?
e. Outline nursing interventions used while a patient is on fluid restriction.

PLEASE follow the instructions. Answer each question in the order it appears and separately. This is the bibliography to guide you:

 1.Potter, P.A., &Perry, A. G. (2017). Fundamentals of Nursing: Concepts, Process, and Practice (9th ed.). St. Louis: MO:  Mosby. ISBN: 9780323327404.  

What do you do?

Do you change the documents?

Do you go back and confront your supervisor?

What is your decision and why did you make it?

What is your next course of action?

What other factors do you consider and what other actions do you take?

ANSWER ALL QUESTIONS

CASE ATTACHED BELOW

What ethical framework/Distributive Justice Theory best supports your decisions regarding the case and why?

Discussion Question 1

The COVID-19 Pandemic has presented the nation and health care organizations with an unforeseen emergency. This type of situation requires all health professionals to be leaders in their communities.

·  Review this article https://gacc.nifc.gov/cism/documents/leadership.pdf 

·  Review the ANA statement calling for a collaborative effort to respond to COVID-19 at this link https://www.nursingworld.org/news/news-releases/2020/american-nurses-association-calls-for-collaborative-effort-to-respond-to-the-coronavirus/

Answer these questions:

1. In your present health care organization how well prepared is the organization and the staff to respond to the pandemic?

2. What was the nursing leaders’ response to the crisis?

3. Relate the response to the theories you learned in this course and the Crisis Leadership article.

4. What else should be done to improve the response? What is the leader’s role in this improvement?

5. How are you responding to the pandemic as a health care professional and leader?

As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the  University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the  University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Clinical problem statement.
3. Purpose of the change proposal in relation to providing patient care in the changing health care system.
4. PICOT question.
5. Literature search strategy employed.
6. Evaluation of the literature.
7. Applicable change or nursing theory utilized.
8. Proposed implementation plan with outcome measures.
9. Discussion of how evidence-based practice was used in creating the intervention plan.
10. Plan for evaluating the proposed nursing intervention.
11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

PLEASE FOLLOW RUBRICS

 Background of clinical problem are clearly and logically presented. Relevant support and rationale are evident. 

 Clinical problem statement is clearly and logically presented. Relevant support and rationale are evident. 

 Purpose of the change proposal in relation to providing patient care in the changing health care system is logically presented. Relevant support and rationale are eviden 

 Topic and criteria are clearly and logically presented. Relevant support and rationale are evident. 

 Topic and criteria are clearly and logically presented. Relevant support and rationale are evident. 

 Evaluation of literature is clearly and logically presented. Relevant support and rationale are evident. 

 Change or nursing theory is logically presented. Relevant support and rationale are evident. 

Implementation plan and outcome measures are clearly and logically presented. Relevant support and rationale are evident.  

 Use of evidence-based practice in intervention plan is clearly and logically presented. Relevant support and rationale are evident. 

 Plan for evaluating proposed nursing intervention is clearly and logically presented. Relevant support and rationale are evident. 

 Potential barriers and plan to overcome barriers are clearly and logically presented. Relevant support and rationale are evident. 

 Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 

 Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 

 Writer is clearly in command of standard, written, academic English. 

After viewing your classmates’ presentations, describe some new things you learned about two different vulnerable populations 

Purpose 

The purpose of this assignment is to provide the student with an opportunity to explore the nurse practitioner (NP) practice requirements in his/her state of practice, NP competencies and leadership skills to develop a plan to support professional development. 

Activity Learning Outcomes 

Through this assignment, the student will demonstrate the ability to: 

1. Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care. (CO1)  
2. Analyze essential skills needed to lead within the context of complex systems. (CO3) 
3. Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings. (CO4) 

 Requirements: 

1. The APN Professional Development Plan paper is worth 200 points and will be graded on the quality of the content, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric. 
2. Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer and Grammarly tools when creating your assignment. 
3. Follow the directions below and the grading criteria located in the rubric closely. Any questions about this paper may be posted under the Q & A Forum or emailed to your faculty. 
4. The length of the paper should be 5-8 pages, excluding title page and reference page(s). 
5. Support ideas with a minimum of 3 scholarly resources. Scholarly resources do not include your textbook. You may need to use more than 3 scholarly resources to fully support your ideas. 
6. You may use first person voice when discussing information specific to your personal practice or skills.  
7. Current edition APA format is required with both a title page and reference page(s). Use the following as Level 1 headings to denote the sections of your paper (Level 1 headings use upper- and lower-case letters and are bold and centered): 
   • APN Professional Development Plan (This is the paper introduction. In APA format, a restatement of the paper title, centered and not bold serves as the heading of the introduction section) 
   • APN Scope of Practice 
   • Nurse Practitioner (NONPF) Core Competencies  
   • Leadership Skills 
   • Conclusion 

Directions: 

1. Introduction: Provide an overview of what will be covered in the paper. Introduction should include general statements on scope of practice, competencies, and leadership, and identification of the purpose of the paper. 
2. APN Scope of Practice: Research the Nurse Practice Act and APN scope of practice guidelines for the state in which you intend to practice after graduation. Describe the educational, licensure, and regulatory requirements for that state in your own words. Identify whether your state allows full, limited, or restricted NP practice. Discuss NP prescriptive authority in your state. Provide support from at least one scholarly source. Source may be the regulatory body that governs nursing practice in your state. 
3. Nurse Practitioner (NONPF) Core Competencies: Review the NONPF Core Competencies. Describe two competency areas you believe to be personal strengths and two competency areas in which you have opportunities for growth. Discuss two scholarly activities you could do during the master’s program to help yourself achieve NP competencies. Provide support from at least one scholarly source. Source may be NONPF Core Competencies document provided via the link in the week 2 readings. 
4. Leadership Skills: Analyze three leadership skills required to lead as an NP within complex systems. Describe two strategies you could use to help you develop NP leadership skills. Provide support from at least one scholarly source. Textbooks are not considered scholarly sources. 
5. Conclusion: Provide a conclusion, including a brief summary of what you discussed in the paper. 

 APA Formatting   

Formatting follows current edition APA Manual guidelines for  

1. title page 
2. running head 
3. body of paper (including citations and headings) 
4. reference page 

 Writing Mechanics  

Writing mechanics follow the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual. The length of the paper is at least 5 pages but no more than 8 pages.  

• Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
• Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.

Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.

 Develop a 5-6 slide PowerPoint presentation that covers the ethical implications of social media in healthcare. Be sure to address email communication, texting, and Facebook (at a minimum) and provide the “pros/cons” of using each in healthcare (from the perspective of the healthcare provider). 

In 500 words, describe the components necessary to create an effective professional identity and explain why professional networks are essential for professional development. 

Prepare this assignment according to the APA guidelines found in the APA Style Guide. PLEASE BE SURE TO TO READ THE ATATCHED APA 7TH EDITION GUIDE AND BE SURE TO USE THAT FORMAT.

Answer the following questions in three well-developed paragraphs (450-500 words) using APA formatting, integrating two evidence-based resources to include clinical practice guidelines as well as the course textbook. Pain Management Case Study

As an Advanced Nurse Practitioner (ANP), you are working in an urgent care setting. TC comes to the clinic with a work-related injury to the right shoulder. The patient rates the pain 8 on a scale of 0–10. The patient is unable to perform any ROM to the shoulder. There is no neck pain.

What pieces of the holistic assessment are missing from this scenario?

1. As a healthcare provider, what else do you need to understand about this patient related to pain management?
2. Describe the process of rational drug choice for this case study. In your process, discuss your thought processing of anti-inflammatory agents, topical agents, and narcotics.
3. Include in your response the teaching you would provide to TC.
4. What is meant by the DEA Drug Classification Schedule? Explain each category/classification.

Course textbook is :  Woo, Terri Moser and Robinson, Marylou V. (2020). Pharmacotherapeutics for Advanced Practice Nurse Prescribers. (5th ed.) Philadelphia, PA: F.A. Davis Company. 

RUBRIC: 

Discussion Question Rubric

Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Note: The value of each of the criterion on this rubric represents a point range. (example: 17-0 points)

Discussion Question Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsQuality of Initial PostProvides clear examples supported by course content and references.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

All instruction requirements noted.

40 pointsComponents are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints.

Meets all requirements within the discussion instructions.

Cites two references.

35 pointsComponents are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development.

Is missing one component/requirement of the discussion instructions.

Cites one reference, or references do not clearly support content.

Most instruction requirements are noted.

31 pointsAbsent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No references cited.

Missing several instruction requirements.

Submits post late.

27 points40Peer Response PostOffers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

2 points5Total Points100