Adult Health II

RUA: Practice Readiness Paper Guidelines

Purpose

The student will review the current NCLEX-RN® test plan and reflect on areas of opportunity and strategies to assist the student in the transition to practice. The student will assess clinical learning against the activity statements within the test plan and determine next steps to seek out new opportunities in future clinical experiences.

Course outcomes: This assignment enables the student to meet the following course outcomes:

1. Provide effective professional nursing care for adult patients and their families in acute care settings using the nursing process. (PO 1)

2. Participate in health maintenance and health restoration activities as members of the health care team. (PO 2)

3. Demonstrate effective communication skills necessary for collaboration with other health team members and for providing professional nursing care to adult patients and their families. (PO 3)

4. Apply critical thinking strategies to make good clinical decisions in the adult patient clinical setting. (PO 4)

5. Assume responsibility and accountability for identifying own personal, educational, and professional goals. (PO 5)

6. Relate knowledge and principles of legal, ethical, and professional standards to clinical practice in the acute care setting, with adult patients and their families. (PO 6)

7. Exhibit behaviors consistent with professional nursing roles and responsibilities while providing cost-effective nursing care to individuals and families. (PO 7)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 100 points

Preparing the assignment

Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

1. Write a 3-4-page summary paper (not including the title page or reference page) using APA format.

2. Include the following sections (detailed criteria listed below and in the Grading Rubric).

A. Introduction- 20 points/20 %

1. Offers a detailed description for the purpose of the paper.

2. Summarizes the 4 client need categories and sub-categories.

3. Describes why using the NCLEX-RN® test plan to guide practice readiness is important.

4. Explains why clinical self-assessment is important.

5. Describes how the activity statements help prepare you for practice.

B. Clinical Experience Reflection and Plan – 50 points/50%

1. Describes a unique clinical experience that you have encountered in the clinical setting.

2. Identifies 2 client need categories and 2 activity statements for each category that you had the opportunity to practice in the described experience.

3. Identifies the 2 client need categories and 2 activity statements for each category that you need more practice with in your future clinical experiences.

4. Provides a rationale for why these categories and activity statements were selected for seeking out new opportunities for practice.

5. Discusses 3 strategies you will use in your future clinical experiences to seek out practice opportunities.

C. Conclusion – 20 points/20%

1. Restates the purpose of the paper.

2. Summarizes the main points of the paper.

3. Offers final impression of why the NCLEX- RN® test plan is important.

4. Avoids presenting new information.

D. APA Style and Organization– 10 points/10%

1. References are submitted with assignment. 

2. Uses current APA format and is free of errors. 

3. Grammar and mechanics are free of errors. 

4. Paper is 3-4 pages, excluding title and reference pages. 

5. At least two (2) scholarly, primary sources from the last 5 years, excluding the textbook, are provided. 

Adult Health II

RUA: Practice Readiness Paper Guidelines

Adult Health II

RUA: Practice Readiness Paper Guidelines

Adult Health II RUA: Practice Readiness Paper Guidelines © 2023 Chamberlain University. All Rights Reserved 1

Adult Health II RUA: Practice Readiness Paper Guidelines © 2023 Chamberlain University. All Rights Reserved 2

Grading Rubric: Criteria are met when the student’s application of knowledge demonstrates achievement of the listed outcomes.
 

Assignment Section and  Required Criteria  (Points possible/% of total points available)	Highest Level of Performance	High Level of Performance	Satisfactory Level of Performance	Unsatisfactory Level of Performance	Section Not Included
Introduction (20 Points/20% Points)	20 points	18 points	15 points	8 points	0 points
Required criteria.  1. Offers a detailed description for the purpose of the paper. 2. Summarizes the 4 client need categories and sub-categories. 3. Describes why using the NCLEX-RN® test plan to guide practice readiness is important. 4. Explains why clinical self-assessment is important. 5. Describes how the activity statements help prepare you for practice.	Includes 5 requirements for section.	Includes 4 requirements for section.	Includes 3 requirements for section.	Includes 2 or fewer requirements for section.	No requirements for this section presented.
Clinical Experience Reflection and Plan  (50 Points/50 % Points)	50 points	44 points	38 points	19 points	0 points
Required criteria 1. Describes a unique clinical experience that you have encountered in the clinical setting. 2. Identifies 2 client need categories and 2 activity statements that you had the opportunity to practice in the described experience. 3. Identifies the 2 client need categories and 2 activity statements for each category that you need more practice with in your future clinical experiences. 4. Provides a rationale for why these categories and activity statements were selected for seeking out new opportunities to practice. 5. Discusses 3 strategies you will use in your future clinical experiences to seek out practice opportunities.	Includes 5 requirements for section.	Includes 4 requirements for section.	Includes 3 requirements for section.	Includes 2 or fewer requirements for section.	No requirements for this section presented.

Conclusion  (20 Points/20 % Points)	20 points	18 points	15 points	8 points	0 points
Required criteria 1. Restates the purpose of the paper. 2. Summarizes the main points of the paper. 3. Offers final impression of why the NCLEX- RN® test plan is important. 4. Avoids presenting new information.	Includes 4 requirements for section.	Includes 3 requirements for section.	Includes 2 requirements for section.	Includes 1 requirement for section.	No requirements for this section presented .
APA Style and Organization (10 Points/10% Points)	10 points	9 points	8 points	4 points	0 points
Required criteria  1. References are submitted with assignment.  2. Uses appropriate APA format and is free of errors.  3. Grammar and mechanics are free of errors.  4. Paper is 3-4 pages, excluding title and reference pages.  5. At least two (2) scholarly, primary sources from the last 5 years, excluding the textbook, are provided.	Includes 5 requirements for section.	Includes 4 requirements for section.	Includes 3 requirements for section.	Includes 2 or fewer requirements for section.	No requirements for this section presented.
Total Points Possible = 100 points

 

Adult Health II RUA: Practice Readiness Paper Guidelines © 2023 Chamberlain University. All Rights Reserved 4

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Please provide positive comments with reference to each paragraph. Thanks

1-Cognitive techniques are a group of tools that psychotherapists use to give the patient the opportunity to identify and modify thought patterns and beliefs that guide the way we interpret situations and determine our feelings and emotions regarding these events. 

2-Exposure Therapy: Exposure therapy is a logical and progressive strategy of facing perceived or avoided situations, entities, or thoughts. Controlled exposure helps people face and manage their concerns, reducing distress and improving coping skills. Exposure treatment is crucial to treating phobias, PTSD, OCD, and other anxiety disorders 

Unit 3 Discussion – ICD-10 Codes. Due 7-25-23. 1000words. 4 references

1. Why is accurate coding using the ICD-10-CM important?

2. Use your lecture materials to determine what ICD-10 Codes to assign for this patient encounter.

3. In paragraph form, construct a discussion that supports the Codes you identified. 

4. In the discussion explore how the ICD-10 Codes that you assigned impact third party payor reimbursement for this visit.

5. Summarize an article that pertains to ICD-10-CM

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria.

Chief Complaint:

Older sister reports – “Our mother died three weeks ago and we lost our father several months ago. I think that my sister was depressed and just wanted to be with them.”

History of Present Illness:

31-year-old female who was brought to the hospital by ambulance. She was found slumped over in her car in front of the funeral home where memorial services for both her father and mother had recently been held. On the seat beside her were two empty bottles of sleeping pills, a Bible opened to Psalm 23, and a note that read
: “I am going to be with mom and dad. It is just too sad being here anymore without them. I love you all and you will be in my prayers.” When she was found by the funeral home director her hair was oily and unkempt and she smelled as if she had not bathed in a long time. She was wearing a dirty orange T-shirt and jeans.

PMH:

Depression when she was a junior in HS which led to psychiatric admissions at 15 and 19 years of age. For these admissions she was treated with antidepressants and psychotherapy. Length of stay for both admissions was approximately 5 weeks. At age 19, following a suicide attempt, she met her first husband in the psych ward of the hospital. Diagnosed with bipolar disorder 6 years ago.

Information from Sister:

Older sister reports ‘hard life’. Reports both parents were alcoholics. Parents would go to bars almost every night and leave the 8 children in the care. The children were eventually removed from the home. Some of the children went to the Catholic girls’ home others were placed in “horrible” foster homes where they were subjected to physical and sexual abuse.

Reports numerous siblings, including the patient, have been through several detoxification centers for alcohol abuse.

Patient is in her second marriage with 3 daughters – 2 from the first marriage and 1 from the current marriage.

Reports that after having her third baby the patient went into a ‘terrible depression’. The patient was under the care of a psychiatrist for this depression and was placed on an anti-depressant after about 3 months of being under the psychiatrist’s care. After 3 weeks of being on this anti-depressant the patient is reported as having gotten ‘really weird’; patient was staying up all night pacing around her house and talking to people on the phone, she would go on shopping sprees for 2-3 days at a time and max out all her credit cards. The patient finally crashed and was taken to the hospital by her family and it was during this admission, 6 years ago, that the patient was diagnosed with bipolar disorder. Sister reports the patient has been on Lithium since being diagnosed with bipolar disorder.

Reports their father had been sick for a while so his death was not unexpected. However, their mother went downhill fast and the patient is reported to not cope well with the mother’s illness/death.

Reports the patient hadn’t been eating lately with noted weight loss. Additionally, the sister reports the patient had been smoking and drinking ‘more than usual’ lately.

Family Hx:

Paternal grandmother – depression

Two maternal aunts – bipolar disorder

Mother and father – alcohol abuse

Father died from pancreatic cancer

Mother died from heart failure

3 living brothers, 3 living sisters, one deceased brother who had an AMI at age 34

Social Hx:

Divorced and remarried

Worked as a nurse’s aid and health insurance claims adjuster

Attends church regularly

Smoked 1ppd for 15 years

History of alcohol abuse with several DWI violations

History of IV drug use, not in the last 10 years

ROS:

Information from sister:

Neuro – history of migraine headaches since late teens, takes Imitrex prn

SIGECAPS:

Sister reports: at times the patient is up all night – particularly when bipolar symptoms not well controlled, the patient seemed to be more depressed since the loss of their mother, does not believe the patient felt guilty surviving parents, patient has been not been attentive to her personal hygiene, the patient appeared to be obsessing on parental loss, patient appeared to be losing weight and therefore suspect she was not eating well, patient seemed to not be engaging in typical daily activities; patient had not expressed having suicidal ideations, had not expressed homicidal ideations

Medications:

Lithium 600mg po Q AM and 600mg po Q HS

Sumatriptan 50-200mg po PRN

Allergies:

ASA – swelling of face

Physical Examination:

General – lethargic and slow to respond to questions; BP 110/72, P 66, RR 12, T 97.0, SpO2 on RA 95%, Ht 66 in, Wt 135 lbs, BMI 21.8

Integument – skin pale, warm, dry; good turgor; several cystic lesions on chin; no rashes, ecchymoses or petechiae noted

HEENT – Head is normocephalic and atraumatic, pupils dilated with sluggish reaction to light, TMs gray and shiny bilateral, nares patent without discharge noted, no tonsillar enlargement, moist mucous membranes

Neck – supple without adenopathy, no thyromegaly

Lungs – CTA

Breasts – deferred

Cardiovascular – heart with RRR without murmur/gallop, multiple varicosities noted bilateral lower extremities

Abdomen – soft, non-distended, active bowel sounds, non-tender, no organomegaly

Genitalia/Rectum – deferred

Musculoskeletal – no major limitations of ROM or gross abnormalities noted

Neurologic – oriented to person, DTRs 2+ and equal bilateral, no localizing signs, CN II- XII grossly intact

Diagnostics – Na 139 meq/L, K 3.7 meq/L, Cl 108 meq/L, HCO3 23 meq/L, Bun 10 mg/dL, Cr 0.7 mg/dL, fasting Glu 102 mg/dL, Ca 8.7 mg/dL, PO4 3.2 mg/dL, Protein 4.8 g/dL, Mg 2.0 mg/dL, AST 33 IU/L, ALT 20 IU/L, GGT 82 IU/L, Alb 2.9 g/dL, TSH 4.1, Vit B12 203 pg/mL, Hgb 12.2 g/dL, HCT 36.8 %;

Lithium 0.08meq/L

Urine dipstick – 6.3 pH, SG 1.021, all other parameters negative

Assessment:

You will be evaluating the subjective and objective data sets to determine the diagnoses for this patient encounter.

Plan:

The plan cannot be developed until the diagnoses are assigned.

 

Theoretical Models of Nursing Leadership

You  are the nurse manager on a busy medical-surgical unit. You have been  requested to attend a hospital administration meeting with your Chief  Nursing Officer (CNO) and the hospital Chief Financial Officer. The CNO  explains that nurse−patient staffing ratios on every unit are being  increased, and your ratios must also increase by 1-2 patients on both  the day and night shift. The CNO assures you this is a temporary issue  due to the seasonal high census, and this decision is not open for  debate. You are shocked and don’t know how to respond initially.

Question #1

Using the Theory of Emotional Intelligence: Page 56

a) Describe how you will demonstrate self-management and social competence to regulate your emotions in this scenario?

b) Discuss how you will respond to your CNO by using this leadership theory.

Question #2

a)  Determine how you will present the new nurse−patient staffing ratios to  your nursing staff by using the Theory of Quantum Leadership.

Guidelines

1. Initial post:  Respond to the discussion questions posted in Discussion board by  Monday (11:59pm)  must be at least 150 to 200 words in length to earn  credit for the assignment
2. Peer response: Each Student must respond to at least (2) other students‘ INITIAL post (must be at least 100 words in length by Wednesday (11:59pm) to earn credit for the assignment
3. The initial and response posts  must each have a minimum of two (2) outside references (i.e., textbook,  medical/nursing resources, etc.) to earn credit for assignment
4. Cite your references APA 7th 
5. To see grading rubric, click on the 3-dot menu on the top-right side of screen