Nursing research and evidence based practice with picot question

Today is week 1 day 2.  I need discussion question by Weds.  The picot question in this discussion question will be the question for the paper.  So I need discussion question complete and the 3 part paper.

Discussion: Nursing Research and Evidence-Based Practice

In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.

Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).

To prepare:                                                         

• Consider a recent clinical experience in which you were providing care for a patient.
• Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?
• What questions have you thought about in a particular area of care such as a procedure or policy?
• Review Chapter 2, pages 31–34 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.
• Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.
• Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.

By Day 3

Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.

Course Project: Part 1—Identifying a Researchable Problem

One of the most challenging aspects of EBP is to actually identify the answerable question.

—Karen Sue Davies

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.

In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.

To prepare:

• Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.
• Review the section beginning on page 75 of the course text, titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.
• Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.
• Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.
• Formulate a preliminary PICO question—one that is answerable—based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?

Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

• Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

To complete:

Write a 3- to 4-page paper that includes the following:

• A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice
• The 5 questions you have generated and a description of how you analyzed them for feasibility
• Your preliminary PICOT question and a description of each PICOT variable relevant to your question
• At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections

By Day 7

Submit your Project. It will also be a component of your Portfolio Assignment for this course, which is due by Day 7 of Week 10.

Reference:

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

2nd part

Course Project: Part 2—Literature Review

This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

To prepare:

• Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.
• Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.
• Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.
• Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

To complete:

Write a 3- to 4-page literature review that includes the following:

• A synthesis of what the studies reveal about the current state of knowledge on the question that you developed
  • Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.
• Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry
• Your literature review summary table with all references formatted in correct APA style

Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

By Day 7 of Week 5

This part of the Course Project is due. It will also be a component in your Portfolio Assignment in this course, which is due by Day 7 of Week 10.

3rd part

Course Project: Part 3—Translating Evidence Into Practice

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.

Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.

To prepare:

• Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?
• With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.
• Explore possible consequences of failing to adopt the evidence-based practice that you identified.
• Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

To complete:

In a 3- to 4-page paper:

• Restate your PICOT question and its significance to nursing practice.
• Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
• Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
• Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

By Day 7 of Week 10

This part of the Course Project is due. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course.

Note: In addition, include a 1-page summary of your project.

For this final iteration, you will need to:

• Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.
• Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

NURSING CASE STUDY NEEDED BY SUNDAY (6/25/207) 10AM

Due Date: Jul 02, 2017 23:59:59       Max Points: 200Details:

Write a 1,200-1,500 word analysis of “Case Study: Healing and Autonomy.” In light of the readings, be sure to address the following questions:

1. Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study?
2. Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?
3. According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case?
4. According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James?

Prepare this assignment according to the guidelines found in the APA Style Guide, 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.

BE SURE TO PROOF READ

Case Study: Healing and Autonomy

Mike and Joanne are the parents of James and Samuel, identical twins born eight years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’ condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own, or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.

The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.

Two days later the family returned, and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James kidneys had deteriorated such that his dialysis was now not a temporary matter, and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.

James’ nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’ brother Samuel.

Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney, or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? “This time around, it is a matter of life and death, what could require greater faith than that?” Mike reasons.

Advanced Medical Surgical Nursing Week 3 Quiz ( Chapters 33-40)

Question

Question 1

A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic. What response by the nurse instructor is best?

a. It is due to side effects of medications for bronchodilation.

b. It is from overactive bone marrow in response to chronic disease.

c. It combats the anemia caused by an increased metabolic rate.

d. It compensates for tissue hypoxia caused by lung disease.

Question 2

A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional assessment finding should the nurse expect?

a. Heart rate of 120 beats/min

b. Cool, clammy skin

c. Oxygen saturation of 90%

d. Respiratory rate of 8 breaths/min

Question 3

A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?

a.“I have been drinking more water than usual.”

b.“I am awakened by the need to urinate at night.”

c.“I must stop halfway up the stairs to catch my breath.”

d.“I have experienced blurred vision on several occasions.”

Question 4

A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk for the development of left-sided heart failure?

a. A 36-year-old woman with aortic stenosis

b. A 42-year-old man with pulmonary hypertension

c. A 59-year-old woman who smokes cigarettes daily

d. A 70-year-old man who had a cerebral vascular accident

Question 5

A client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it works. What response by the nurse is best?

a. “It inhibits thrombin.”

b. “It inhibits fibrinogen.”

c. “It thins your blood.”

d. “It works against vitamin K.”

Question 6

A client undergoing hemodynamic monitoring after a myocardial infarction has a right atrial pressure of 0.5 mm Hg. What action by the nurse is most appropriate?

a. Level the transducer at the phlebostatic axis.

b. Lay the client in the supine position.

c. Prepare to administer diuretics.

d. Prepare to administer a fluid bolus.

Question 7

A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition?

a. Sinus tachycardia

b. Speech alterations

c. Fatigue

d. Dyspnea with activity

Question 8

A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best?

a.“Do you have trouble affording your medications?”

b.“Most people with hypertension do not have symptoms.”

c.“You are lucky; most people get severe morning headaches.”

d.“You need to take your medicine or you will get kidney failure.”

Question 9

A client received tissue plasminogen activator (t-PA) after a myocardial infarction and now is on an intravenous infusion of heparin. The client’s spouse asks why the client needs this medication. What response by the nurse is best?

a.“The t-PA didn’t dissolve the entire coronary clot.”

b.“The heparin keeps that artery from getting blocked again.”

c.“Heparin keeps the blood as thin as possible for a longer time.”

d.“The heparin prevents a stroke from occurring as the t-PA wears off.”

Question 10

The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning?

a. Cholesterol: 126 mg/dL

b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL

c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL

d. Triglycerides: 198 mg/dL

Question 11

A hospitalized client has a platelet count of 58,000/mm3. What action by the nurse is best?

a. Encourage high-protein foods.

b. Institute neutropenic precautions.

c. Limit visitors to healthy adults.

d. Place the client on safety precautions.

Question 12

A client is in the hospital after suffering a myocardial infarction and has bathroom privileges. The nurse assists the client to the bathroom and notes the client’s O2 saturation to be 95%, pulse 88 beats/min, and respiratory rate 16 breaths/min after returning to bed. What action by the nurse is best?

a. Administer oxygen at 2 L/min.

b. Allow continued bathroom privileges.

c. Obtain a bedside commode.

d. Suggest the client use a bedpan

Question 13

A nurse is working with a client who takes atorvastatin (Lipitor). The client’s recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?

a. Ask if the client eats grapefruit.

b. Assess the client for dehydration.

c. Facilitate admission to the hospital.

d. Obtain a random urinalysis.

Question 14

While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. Which action should the nurse take next?

a. Assess for symptoms of left-sided heart failure.

b. Document this as a normal finding.

c. Call the health care provider immediately.

d. Transfer the client to the intensive care unit.

Question 15

The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates the client is managing this condition well with diet?

a. A 4-ounce steak, French fries, iceberg lettuce

b. Baked chicken breast, broccoli, tomatoes

c. Fried catfish, cornbread, peas

d. Spaghetti with meat sauce, garlic bread

Question 16

A client is in shock and the nurse prepares to administer insulin for a blood glucose reading of 208 mg/dL. The spouse asks why the client needs insulin as the client is not a diabetic. What response by the nurse is best?

a. “High glucose is common in shock and needs to be treated.”

b. “Some of the medications we are giving are to raise blood sugar.”

c. “The IV solution has lots of glucose, which raises blood sugar.”

d. “The stress of this illness has made your spouse a diabetic.”

Question 17

The nurse gets the hand-off report on four clients. Which client should the nurse assess first?

a. Client with a blood pressure change of 128/74 to 110/88 mm Hg

b. Client with oxygen saturation unchanged at 94%

c. Client with a pulse change of 100 to 88 beats/min

d. Client with urine output of 40 mL/hr for the last 2 hours

Question 18

A nurse cares for a client with right-sided heart failure. The client asks, “Why do I need to weigh myself every day?” How should the nurse respond?

a. “Weight is the best indication that you are gaining or losing fluid.”

b. “Daily weights will help us make sure that you’re eating properly.”

c. “The hospital requires that all inpatients be weighed daily.”

d. “You need to lose weight to decrease the incidence of heart failure.”

Question 19

A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate?

a. “Make certain that your bath water is warm.”

b.“Avoid straining while having a bowel movement.”

c.“Limit your intake of caffeinated drinks to one a day.”

d.“Avoid strenuous exercise such as running.”

Question 20

A nurse is caring for a client after surgery. The client’s respiratory rate has increased from 12 to 18 breaths/min and the pulse rate increased from 86 to 98 beats/min since they were last assessed 4 hours ago. What action by the nurse is best?

a. Ask if the client needs pain medication.

b. Assess the client’s tissue perfusion further.

c. Document the findings in the client’s chart.

d. Increase the rate of the client’s IV infusion.

Question 21

An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?

a. “I get short of breath when I climb stairs.”

b. “I see halos floating around my head.”

c. “I have trouble remembering things.”

d. “I have lost weight over the past month.”

Question 22

The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?

a. Clopidogrel (Plavix)

b. Enoxaparin (Lovenox)

c. Reteplase (Retavase)

d. Warfarin (Coumadin)

Question 23

A nurse assesses a client’s electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation?

a. The client has hyperkalemia causing irregular QRS complexes.

b. Ventricular tachycardia is overriding the normal atrial rhythm.

c. The client’s chest leads are not making sufficient contact with the skin.

d. Ventricular and atrial depolarizations are initiated from different sites.

Question 24

A nurse caring for a client with sickle cell disease (SCD) reviews the client’s laboratory work. Which finding should the nurse report to the provider?

a. Creatinine: 2.9 mg/dL

b. Hematocrit: 30%

c. Sodium: 147 mEq/L

d. White blood cell count: 12,000/mm3

Question 25

A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

a. An 86-year-old man with a history of asthma

b. A 32-year-old Asian-American man with colorectal cancer

c. A 45-year-old American Indian woman with diabetes mellitus

d. A 53-year-old postmenopausal woman who is on hormone therapy

Question 26

A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene?

a. Assessing blood pressure in both upper extremities

b. Auscultating the carotid arteries for any bruits

c. Classifying capillary refill of 4 seconds as normal

d. Palpating both carotid arteries at the same time

Question 27

A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?

a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg

b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min

c. Oxygen saturation increased from 88% to 96%

d. Pulse decreased from 100 beats/min to 80 beats/min

Question 28

A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client’s medication administration record to prevent a common complication of this condition?

a. Sotalol (Betapace)

b. Warfarin (Coumadin)

c. Atropine (Sal-Tropine)

d. Lidocaine (Xylocaine)

Question 29

A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?

a. Document the finding in the chart.

b. Initiate external pacing.

c. Assess the client’s medications.

d. Administer 1 mg of atropine.

Question 30

A client presents to the emergency department in sickle cell crisis. What intervention by the nurse takes priority?

a. Administer oxygen.

b. Apply an oximetry probe.

c. Give pain medication.

d. Start an IV line.

Question 31

A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure?

a.“I sleep with four pillows at night.”

b.“My shoes fit really tight lately.”

c.“I wake up coughing every night.”

d.“I have trouble catching my breath.”

Question 32

A nursing student is caring for a client who had a myocardial infarction. The student is confused because the client states nothing is wrong and yet listens attentively while the student provides education on lifestyle changes and healthy menu choices. What response by the faculty member is best?

a.“Continue to educate the client on possible healthy changes.”

b.“Emphasize complications that can occur with noncompliance.”

c.“Tell the client that denial is normal and will soon go away.”

d.“You need to make sure the client understands this illness.”

Question 33

A client is receiving an infusion of tissue plasminogen activator (t-PA). The nurse assesses the client to be disoriented to person, place, and time. What action by the nurse is best?

a. Assess the client’s pupillary responses.

b. Request a neurologic consultation.

c. Stop the infusion and call the provider.

d. Take and document a full set of vital signs.

Question 34

A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to start an IV. Which fluid choice is best?

a.0.45% normal saline

b.0.9% normal saline

c. Dextrose 50% (D50)

d. Lactated Ringer’s solution

Question 35

A student is caring for a client who suffered massive blood loss after trauma. How does the student correlate the blood loss with the client’s mean arterial pressure (MAP)?

a. It causes vasoconstriction and increased MAP.

b. Lower blood volume lowers MAP.

c. There is no direct correlation to MAP.

d. It raises cardiac output and MAP.

Question 36

A client has a serum ferritin level of 8 ng/mL and microcytic red blood cells. What action by the nurse is best?

a. Encourage high-protein Foods.

b. Perform a Hemoccult test on the client’s stools.

c. Offer Frequent oral care.

d. Prepare to administer cobalamin (vitamin B12).

Question 37

A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation?

a. A 45-year-old who takes an aspirin daily

b. A 50-year-old who is post coronary artery bypass graft surgery

c. A 78-year-old who had a carotid endarterectomy

d. An 80-year-old with chronic obstructive pulmonary disease

Question 38

A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When the client requests pain medication, what action by the nurse is best?

a. Give the client pain medication if it is time for another dose.

b. Instruct the client not to request pain medication too early.

c. Request the provider leave a prescription for a placebo.

d. Tell the client it is too early to have more pain medication.

Question 39

A nurse is caring for a client after surgery who is restless and apprehensive. The unlicensed assistive personnel (UAP) reports the vital signs and the nurse sees they are only slightly different from previous readings. What action does the nurse delegate next to the UAP?

a. Assess the client for pain or discomfort.

b. Measure urine output from the catheter.

c. Reposition the client to the unaffected side.

d. Stay with the client and reassure him or her.

Question 40

A nurse is assessing a dark-skinned client for pallor. What action is best?

a. Assess the conjunctiva of the eye.

b. Have the client open the hand widely.

c. Look at the roof of the client’s mouth.

d. Palpate for areas of mild swelling.

NSG 5522 Family Nursing: Theory, Research, and Practice

Good morning, Are you able to complete the assignment below due on Thursday 01/28/2016?

Thanks,

NSG 5522 Family Nursing: Theory, Research, and Practice

Genogram/Ecomap Assignment

Purpose: Genograms provide a quick and useful context in which to evaluate an individual’s health risks. Eco-maps are important because, when fully completed, they serve as a tool to highlight different the relationships and human resources in the person’s life. These resources and the information about each relationship then serve as a starting point when addressing the featured person’s needs.

Course Objective: Compare and contrast a variety of theoretical frameworks to understanding dynamics within families.

Directions:

• Choose a family (for this assignment this can be your own family)
• Refer to the Boxs and Figures in your text in developing a family genogram and eco map.
• Use the symbols posted in the Figure in your text
• Include birth/death dates, relationships, and health problems/risks
• Complete an in depth analysis of the information gained in the genogram and eco map.
  • In writing up your analysis use high quality/scholarly writing skills.
  • Use references more than 2 references less than 5 years and peer review
  • Due date 01/26/2017
  • 5-6 pages in APA formatFigures from my text book below:Book reference:Kaakinen, J.R., Gedaly-Duff,V. Coehlo, D.P., & Hanson, S.M.H. (2015). Family health care nursing: Theory, practice and research (5th ed.). Philadelphia: FA Davis.NOVA SOUTHEASTERN UNIVERSITYCOLLEGE OF NURSING NSG 5522 Family Nursing: Theory, Research, and PracticeGenogram/Ecomap RubricThis assignment is due according to the date posted on the Assignments and Activities Schedule.