Journaling is an active learning technique that is meant to enhance reflective practice (Blake, 2005). Reflective practice involves looking back over what has happened in the practice setting in an ef

Journaling is an active learning technique that is meant to enhance reflective practice (Blake, 2005). Reflective practice involves looking back over what has happened in the practice setting in an effort to improve performance or to encourage professional growth (Ruth-Sahd, 2003).

Your Weekly Practicum Journal is:

• A personal, introspective subjective account that focuses on Healthy People 2020 and course objectives. You can include events that occurred, but be sure to describe your thoughts and feelings about those events. How did your perceptions change? What did you learn that was unexpected? Describe your thinking about your thoughts and feelings regarding the new learning you experienced. MY JOURNEY IS ON THE OAK ACADEMY PREKCARE SITE CHILDREN 4-5 YEARS OLD LOCATED IN CUMMING GA. 
• Connected to South University’s College of Nursing Conceptual Framework Pillars (Caring, Communication, Critical Thinking, Professionalism, and Holism)
• Connected to prior coursework and experiences through reflective analysis.
• Written in a scholarly, academic style using APA style format. Two or three sentences are not sufficient nor are daily logs/reports of activities.

To reflect on an information governance issue, inspired by an observation made in practice or on reading around the topic. Maximum 2,000 wordsPlease also refer to the lecture of reflection and the acc

To reflect on an information governance issue, inspired by an observation made in practice or on reading around the topic. Maximum 2,000 words

Please also refer to the lecture of reflection and the accompanying PowerPoint slides. 

You can only reflect on your own practice and this must be something related to health information governance (or a parallel issue with relevance to health information governance). It could be an incident from the past, made critical by something we discuss during the taught week or by something you read about governance.

As this is a form of ‘guided reflection’, it is recommended that you use the following headings and prompts for your paper based on Gibbs Reflective Cycle:

Model for academic reflective writing

1. Describe the situation/event

· Why was it important?

· How does it relate to IG?

1. Feelings

What were your thoughts and feelings/what were the good and bad points of the situation/event?

· Did it impact on others, and how?

· How did you feel at the time?

· What was your role?

1. The key issue

On the basis of 1 and 2, what is the main IG related issue emerging?

· Having identified the IG issue, it becomes possible to find suitable literature

1. Analysis

Making sense of the situation – a) What does the literature say about the issue and the situation? b) What are the legal and ethical perspectives. c) What alternatives were there?

1. Conclusion 

What have you learned a) about the issue, b) about yourself and c) about the best alternative way to manage the situation/event?

1. Action Plan

What would you do if the situation arose again ? What do you need to do to further develop yourself/your skills/your knowledge/ your practice?

Patient history: The patient has history of traumatic brain injury secondary to motor vehicle accident and with cognitive and physical deficits spasticity / hemiplegia of left side of the body.

Patient history: The patient has history of traumatic brain injury secondary to motor vehicle accident and with cognitive and physical deficits spasticity / hemiplegia of left side of the body.

Admission diagnosis: altered mental status.

Discharge diagnosis summary: AMS / possible acute toxic encephalopathy, and SIRs.

Ola was 40yrs he presented to the hospital with Altered mental status, he was lethargic and not following commands in hospital. She was admitted for AMS (altered mental status) .he was Keppra loaded as she appeared post-ictal . placed on seizure precaution with neuro checks overnight in the ICU and he improved and was transferred to floor. His mentation continued clear. Blood cultured drawn 12-22 returned positive for staph epidermidis times 2 -> most likely contaminant. He did meet SIRS(Systemic Inflammatory Response Syndrome) criteria with CBC < 4 and heart rate > 90, although upon review of his medical record his leukocytosis is chronic. he was given dose of vancomycin and BCx redrawn with NGTD -> ID evaluated patient and antibiotic were deescalated. TSH elevated normal T4.

Date: ________ Student Name: ____________________________ Clinical Site/Unit: ___________________________

Clinical Site Instructor:__ ____________________________Previous Shift Report: ____________________________

Client Initials: _______ Client age: _______   Gender: _____________ Height: __________ Weight: ______________

Allergies: ________________________________ Code Status: _________________ Transfer Status: ______________

Marital Status: _____________ Religion: _________________ Occupation: ___________________________________

Cultural Background: ____________________________     Primary Language: _______________________________

Diet/Nutrition: ____________________________   Activity: _______________________________ Fall Risk: Yes / No

Use of (type/amount/frequency): Alcohol: _____________ Tobacco (pack years): ______________________________

Medical Diagnosis(s):

Admitting Diagnoses to Acute Care Facility

1.____________________________________ 2.______________________________________

Primary Diagnoses for Admission to TCU/LTC

1._____________________________________ 2._____________________________________

3._____________________________________4._____________________________________

Secondary Diagnoses

                                                1.______________________________________ 2.____________________________________

3._______________________________________ 4.___________________________________

Surgical History 1.______________________________________ 2.___________________________________

                                                3._______________________________________ 4.___________________________________

Treatments: _______________________________  IV/Tubes/Ostomies: ______________________________________

Dressings/Wounds: (type & location) ___________________________________________________________________

Oxygen: (delivery method & amount) _______________________________ Dialysis: ___________________________

Recent LAB Results:

Why is this lab significant for this client’s condition? If the lab result was abnormal, include what the NURSE needs to monitor for or do related to the abnormal lab result under the significance column.

Date          Test                     Normal Value                   Client Value                       Significance

_____WBC _     4.0—11.0           4.1 ________________________________________________________________ RBC           3.80 -5.40          4.95 ____________________________________________________________HEM_                    35.0 -47.0           37.5           _____________________________________________________________ MCV               80-100                   76     __

 MCH                  7-34                     22

_PLT                                                                                      238                  

HEMOGLOBIN 12-16                  11.1          __________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

Recent Diagnostic tests: (list X-rays, CT scans, MRIs, ECGs, Ultrasounds, Cardiac Catheterizations, etc.)

List the test, the test result, and include an explanation of the significance of the results in relation to the medical treatment, other diagnostics, and nursing considerations/interventions for your client. _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________

___________________________________________________________________________________________________

PATHOPHYSIOLOGY:

For the primary admitting diagnosis to the acute care facility and primary diagnosis for the TCU/LTC, provide a 3-5 sentence explanation of the pathophysiology of the problem. Then complete an ATI template for the above two diagnoses (2 total).  Use the “Active Learning Template: Systems Disorder” template from ATI Active Learning templates.  Complete, print, and attached to paperwork.

PATHOPHYSIOLOGY CONTINUED:

For the top two secondary diagnoses, write a 1-2 sentence explanation of pathophysiology of the diagnosis and explain how this secondary diagnosis may impact your client’s condition during this hospitalization. 

If your client is post-surgical, what problems or complications could possibly occur? What nursing assessments would you need to include in your post-operative or post-procedure monitoring

                                                        To be completed the day of clinical

Vital Signs

Pain: Pain is normal for him due to his TBI 8 out of 10

Neurological: The patient oriented times 4, his speech is clear and appropriate and slow .Head: No rashes , no lesion and symmetrical round. Pupils: PERRLA. Ears: no drainage, no lesion and hearing intact. Nose: clean, no drainage. Throat: moist intact, No JVD, no difficulty in swallowing, no lumps. Mouth: oral mucosa is pink and moist, no gum bleeding.

Cardiac Rate 88. Radial pulse: 2+ bilaterally equal. Chest pain: no chest pain. Peripheral Pulses: palpable present in all extremities. Edema: no edema.

Capillary refill: less than l second on finger and toes.

Respiratory: Respiration: even and relaxed. Respiratory rate: 16. Lung sounds: Breath sounds clear no crackles and wheezing. Cough : no cough . SOB: No.

Gastrointestinal: Abdomen: round and soft. Bowel sound: active times 4. Nausea and vomiting: not present. Pain:  no pain upon palpation. Last BM: This morning, usually once a day . Continent: continent.

Genitourinary: Urination: Q 2h . color: clear.  Dysuria: no pain. Continent: continent.

Integument: dry, no bruising, no broken. Color: appropriate for color. Wounds/ location: no wound. Dressing /location: no dressing. Upper extremities/ lower extremities: warm and moist, no bruises and wound  on top of toes , between the toes and heel.

Musculoskeletal: Strength of upper extremities: strong on left arm but the right arm is flaccid. Strength of lower extremities: strong on left leg but not right leg. Weakness: yes, paralysis  on right side of the body due TBI . Assist with transfers: yes, Hoyer devices use to transfer from bed to wheel chair.  Assistive device: wheel chair

BP_________   HR _________  RR _________ Temp ________ O2 Sat _______%  RA/LPM ________

Pain is normal for him due to his TBI

                                                                 PRN Medications List

                    Medication

(Include dose, time, route, & frequency)

       Classification

What nursing considerations should

you include with this medications?

Buspar  15mg

Baclofen 20mg

Cymbalta 30mg

Levetiracetam 1000mg

Omeprazole 20mg

Robafen 100mg /5ml

Senna 8.6mg

Tizanidine hcl 2mg

Xarelto 20mg

Oxycodone HCL 5mg

ibuprofen

Medication Data Sheet

List all scheduled medications for your shift

Drug Name and Classification, Normal Adult Dose, Route & Schedule

Indications for Use and Expected Actions

Side Effects/ Adverse Reactions

Drug and Food Interactions

Nursing Administration Considerations

Client education &

Evaluation of Medication Effectiveness

Ticagrelor

Atorvastin

Pantoprazole

Gabapentin 300mg(Neurontin).  

Venlafaxine 75mg ( Effexor)

.

NURSING PROCESS

Write 2 complete Nursing Diagnoses based on your client problems you noted on your assessment for this day.

Nursing Diagnosis #1:

___________________________________________________________________________________________________

Client Goal: ________________________________________________________________________________________

List 2 priority nursing interventions related to this diagnosis with the rationale for each intervention.

1.       _______________________________________________________________________________________________

Rationale: _________________________________________________________________________________________

Outcome Assessment: ________________________________________________________________________________

2: _________________________________________________________________________________________________

Rationale: _________________________________________________________________________________________

Outcome Assessment: ________________________________________________________________________________

Nursing Diagnosis #2:

__________________________________________________________________________________________________

Client Goal: ________________________________________________________________________________________

List 2 priority nursing interventions related to this diagnosis with the rationale for each intervention.

1.       ______________________________________________________________________________________________

Rationale: _________________________________________________________________________________________

Outcome Assessment: ________________________________________________________________________________

2. ________________________________________________________________________________________________

Rationale: ________________________________________________________________________________________

Outcome Assessment: ________________________________________________________________________________

Documentation by exception of head to toe assessment:

SBAR communication:

S:

B:

A:

R:

Notes:

Student self-evaluation of clinical performance:

Please describe any procedures/skills you performed/ observed during the clinical experience. Also, include your assessment of how well the day went.

Post-Clinical Education:

Provide the group with education on a topic you learned about preparing for your client/clinical packet.  For example a medical diagnosis, intervention, medication, lab value, treatment method, etc.  Use this space to write your speaking notes and reference(s).

Case Study Week 8A 63 years old obese female presents with 4 to 5 months history of mid-epigastric pain that is worse after eating. She is unable to identify any specific foods that may be triggering

Case Study Week 8

A 63 years old obese female presents with 4 to 5 months history of mid-epigastric pain that is worse after eating. She is unable to identify any specific foods that may be triggering the symptoms. She denies excessive gas, denies regurgitation of food or a water brash. She has normal daily bowel movements but states that sometimes her stools are very dark. She denies nausea and vomiting. She has no previous history of these symptoms and they are becoming disruptive in her daily life. She has been taking TUMs, “like they are candy.”

Past Medical History: surgical menopause at age 35 secondary to endometriosis, hypertension (HTN), diabetes mellitus Type II, morbid obesity, dyslipidemia. Surgical History: T&A as child, total abdominal hysterectomy with bilateral salpingo-oophorectomy, appendectomy, cholecystectomy. Her medication regimen includesPremarin 0.625mg q day, lisinopril 10mg q day, metformin 500mg bid, and atorvastatin 40mg q HS. VS: BP 145/94, P 90, R 18, T 98.2. The patient’s height is 5’4” and her weight is 225lbs., consequently her BMI is 38.6.  Physical examination is within normal limits.

Questions for response:

1. What additional history would you like for this patient?

2. If you plan to start drug treatment today

a. what is your choice, the dose, and the duration of the treatment?

b. what are some alternatives to this choice

c. what is your rationale for this choice

3. What risk factors for this patient will guide your choice?

4. Are there any major drug-to-drug interactions, side effects or adverse reactions to this drug?

5. Provide patient education regarding the use of this drug. Besides drug therapy, are there any other interventions you would consider or recommend?

References less than 5 years and at least 6. no less than 2 pages

Create a power point presentation that explores the security threats that infectious diseases can create for the Kingdom of Saudi Arabia. Research a disease that is a threat of becoming pandemic and h

Create a power point presentation that explores the security threats that infectious diseases can create for the Kingdom of Saudi Arabia. Research a disease that is a threat of becoming pandemic and harming the population. Research the policies that the Ministry of Health have in place to prevent such an occurrence.

Create a power point presentation that is 7-8 slides in length, not including the title slide or the reference slides. Place your discussion in the speaker notes , which should contain at least 100 words on each slide. Reference at least six academic articles.

Please use the following headings in your presentation:

• Title Slide
• Introduction
• The Infectious Disease Threat
• Public Health Initiatives
• Security Initiatives
• Potential Political, Social, and Economic Disruptions
• Resources Needed
• Conclusion
• References

Your presentation should meet the following requirements:

1. Be 7-8 slides in length, not including the title or reference slides.
2. Be formatted according to APA writing guidelines.
3. Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
4. Remember to utilize headings to organize the content in your work.
5. Provide a cited images to the title page and others for the slides 
6. No plagiarism
7. The references should be not more than 5 years back ago