Burn Victim Assessment Paper

Using the attached document (below), discuss the following:

1. The staff are following the Parkland Formula for fluid resuscitation. The client arrived at 0200 and was admitted at 0400. She weighs 110 pounds. Calculate her fluid requirement, using the Parkland formula. Explain the time intervals and amounts for each.
2. The client was sleeping when the fire started and managed to make her way out of the house through thick smoke. You are concerned about possible smoke inhalation. What assessment finding would corroborate this concern?
3. The client is in severe pain. What is the drug of choice for pain relief and how should it be given?
4. What nutritional requirements are necessary for the client’s burns to heal?
5. What measures are taken with the client to prevent infection? Burn Victim Assessment Paper

Module 06 Assignment
Multidimensional Care IV

Instructions
Submit your completed assignment by following the directions below. You must include 2-3 refences from scholarly sources and a reference list in APA format at the end of this document. Answers should be appropriately cited, in full sentences, and double-spaced per APA format. Please check the Course Calendar for specific due dates.
Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:
Jstudent_exampleproblem_101504

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Scenario
You are working the night shift on a medical-surgical unit. Your assignment includes a 19-year-old woman admitted early this morning. She has sustained burns over 30% of her body surface area, with partial-thickness burns on her legs and back.

Questions
Discuss the following:
1. The staff are following the Parkland Formula for fluid resuscitation. The client arrived at 0200 and was admitted at 0400. She weighs 110 pounds. Calculate her fluid requirement, using the 4 ml Parkland formula. Explain the time intervals and amounts for each.
A) Calculate Parkland formula amounts and rates:
Total fluid replacement for 1st 24 hours:
1st half of fluid replacement (1st 8 hours): Total volume:
Rate per hour:
2nd half of fluid replacement (next 16 hours): Total volume:
Rate per hour:
B) Why is this time interval important for rescue of the burn victim?

2. The client was sleeping when the fire started and managed to make her way out of the house through thick smoke. You are concerned about possible smoke inhalation. What assessment finding would corroborate this concern? Burn Victim Assessment Paper

3. The client is in severe pain. What is the drug of choice for pain relief and how should it be given? Are there any risks associated with these medications?

4. What nutritional requirements are necessary for the client’s burns to heal? What is the goal of nutrition therapy in post-burn care?

5. What measures are taken with the client suffering from burn injuries to prevent infection? What dressings may be used to prevent infection? Be sure to list and describe at least 3 types of dressings. Burn Victim Assessment Paper

 

Case Study: Assessment And Management Of Patients With Diabetes

 

1. Sallie Smith, 42 years of age, is newly diagnosed with type 2 diabetes. During the patient education, the patient asks the nurse, “What should I do if I am sick and can’t eat; should I still take my medicine for the diabetes?” (Learning Objective 10)

 

 

1. What management strategies should the nurse provide the patient to deal with “sick days?”

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2. Jerry Thomas is a 26-year-old type 1 diabetic. He was originally diagnosed at the age of 14, and currently manages his disease with an intensive regimen of insulin injections. Jerry is employed as a schoolteacher and soccer coach. He presents today with a 2-day history of vomiting and diarrhea. He has been closely monitoring his blood glucoses, and is using regular insulin for high blood glucose levels. He has only been able to tolerate liquids such as Gatorade, but today he is unable to even tolerate that, and comes to the clinic for evaluation of possible diabetic ketoacidosis (DKA). (Learning Objective 9) Case Study: Assessment And Management Of Patients With Diabetes

 

 

1. Describe the pathophysiology of DKA and why it occurs in patients with type 1 diabetes.

 

1. Based on the diagnosis of DKA, what assessment findings does the nurse correlate to this disorder?

 

425. The physician orders a complete metabolic panel, and Jerry’s blood glucose is 425. Other lab values include a serum sodium of 152, serum potassium of 3.0, and BUN of 64. What is your assessment of these results?

 

1. Explain why it is important for Jerry to continue to take his insulin even though his oral intake is decreased. Case Study: Assessment And Management Of Patients With Diabetes

 

 

The DNP Project: Data Management, Project Management And Ethical Issues

Data Management Plan

The data management plan articulates the outcome measure analysis to determine if the translation of the 4AT is effective in impacting restraint usage at the practicum site. The level of data outcome is ratio level (number of restraints). It is ratio level because it contains a true “0” value (no restraints). The planned analysis will include descriptive statistics (n, %) to measure the compliance of nurses and others using the 4AT by gathering daily paper forms of the assessment tool of all the admitted patients. The n, % of admitted patients that were assessed would be computed. To measure the compliance of nurses to document delirium in nursing care plans once associated risks are identified, descriptive statistics (n, %) will be computed. Assess barriers and comfort level of staff using the new 4AT, which will be queried and recorded by the DNP student during scheduled staff meetings and interviews, a qualitative content analysis of the staff statements about barriers will be conducted and categorized into themes. Comfort level will be presented using descriptive statistics (n, %) for the comfort levels of high, moderate, and low comfort regarding using the new 4AT.  The DNP Project: Data Management, Project Management And Ethical Issues

To examine restraint use, the average daily restraint episodes will be compared between pre and post using an independent samples t-test. This test allows for a comparison of two independent groups (pre/post) on a continuous outcome (number of daily restraint episodes).  IBM SPSS version 28 will be used to conduct the independent t-test with a significance level of p < .05. Additionally, the restraint use rate per 1,000 inpatient days will be computed and presented for the pre and post intervention. A percentage change calculation will be presented for the rate comparison at pre and post intervention. Descriptive statistics and inferential statistical analyses will be presented in narrative and chart format.

Project Management Plan and Gantt Chart

The implementation of the 4AT will be implemented over 10 weeks. The detailed project proposal, planning, data management and analysis, and dissemination plan can be found in the 32-week Gant chart (Appendix C).

Pre-Implementation Phase

The 4AT will be part of the daily charting of nursing staff. The DNP student must assess and review the SJMC delirium process and protocols during the pre-implementation phase. The DNP student will meet with stakeholders and unit staff to ensure multidisciplinary involvement for the implementation of the 4AT. The DNP student will also prepare educational resources and set-up meetings with stakeholders for the entirety of the project.

Week One of Implementation

Pre-implementation data collection will consist of restraint usage for patients in 4West within the since January 1st, 2022. Information session on the implementation of 4AT will be held. The DNP student will train the staff and 4AT champions to lead the other staff during the implementation phase. Weekly discussions will be held with hospital leaderships, stakeholders, and members of the multidisciplinary team to ensure effective communication between DNP student and the implementation team related to weekly assessment and updates during the implementation stage. Educational seasons to the implementation staff will also include proper utilization and documentation of the 4AT form, and re-education will be planned as needed.

Week Two through Nine of Implementation

The implementation of the 4AT will occur during weeks two through nine. The DNP student will gather and assure completion of the delirium form daily for eight weeks of all the admitted patients in 4West. The project champions will also ensure the completion of the organizational restraint form per patient per event and online document restraint usage via Google document daily. If identified as at-risk or positive delirium, the DNP student will perform chart audits to ensure utilization of nursing care plans and identification of risk factors or precipitating factors that will prompt a follow-up with hospitalists or specialist providers. The DNP student will meet with the 4AT champions and have weekly discussions every Wednesday to receive feedbacks and modifications as needed. In week nine, the DNP student will conduct scheduled meetings and interviews of nursing staff and supervisors of 4West on barriers encountered with the utilization of the 4AT. In the same week, the DNP student will also gather data regarding the comfort levels of using the 4AT in the unit.

Week Ten through Eleven

Post-intervention data collection and analysis will occur from week ten through eleven. In week ten, the DNP student will compile all the data from week two through nine and provide the Statistician all necessary information for analyzes. Week Eleven will involve dissemination of information to stakeholders and wrap-up with staff. Week Eleven will also involve the discussion for sustainability in the organization.

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DNP Project Budget

Expenses

The creation of a detailed budget for the DNP project is an essential strategy for effective progression and risk management of the project. Expenses include salary and benefits, supplies, services, statistician, and project manager. The DNP student will need to allocate 1000 hours with a rate of $0 per hour, which will lead to zero salary and expenses. The project mentor will also allocate around 400 hours for zero cost. The supplies and services are covered by the organization. The statistician will cost around $500 in the analyses and evaluation of data for the project. The DNP Project: Data Management, Project Management And Ethical Issues

Revenue Sources

Revenue sources include hospital sources and the DNP student. The hospital will be covering supplies, services, and overhead costs. The DNP will cover the necessary hours needed for completing the project in addition to paying for the statistician, which will be around $500. The revenue is equal to the total expenses of the project.

Table 1

Budget

EXPENSES

REVENUE

Direct

Billing

500

Salary and benefits

0

Grants

0

Supplies

0

Institutional budget support

0

Services

0

Statistician

500

Indirect

0

Overhead

0

Total Expenses

500

Total Revenue

500

Ethical Issues and Considerations

The DNP project proposal will be submitted to Chamberlain University’s IRB for predetermination process, and implementation of the project will commence once the project receives the approval letter. Additionally, the DNP student has obtained permission to conduct the project per facility IRB committee (Appendix D). Patient safety and protection will be the main focus of this project. The participants will be protected during this project, as their 4AT scores and restraint usage will be collected without identifying data, and scores will be reported in cumulative form and will be stored in a password-protected computer file in an encrypted format for seven years. The project does not require any informed consent from the participants and participants are informed of resources available to answer questions or concerns via phone call with confidentially in mind. The DNP Project: Data Management, Project Management And Ethical Issues

 

Please do all questions and answer them in its entirety: Please cite your references

1. How can aging affect nutrition in the older adult?

2.What are some factors that are utilized to determine caloric intake of older adults.?

3. What are some basic life -sustaining needs of the older adult?

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4.What are some health challenges related needs of the older (aging) adult.?

5.What are some laws governing Gerontological Nursing Practice?

6. What are some legal risks in Gerontological Nursing

7.Why are there increased Risk of Adverse Reaction as it relates to Medication Usages in the older Adult.

8.What are some intervention necessary to address  threat to safety, life and well-being in the older clients.

9. What are some Impact of Aging on Environment Safety and Function.

10. What are some possible Mental Health issues which Amy affect the older adult?

Assignment: Assessing and Diagnosing Patients with Neurocognitive and Neurodevelopmental Disorders

Photo Credit: Getty Images

Neurodevelopmental disorders begin in the developmental period of childhood and may continue through adulthood. They may range from the very specific to a general or global impairment, and often co-occur (APA, 2013). They include specific learning and language disorders, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, and intellectual disabilities. Neurocognitive disorders, on the other hand, represent a decline in one or more areas of prior mental function that is significant enough to impact independent functioning. They may occur at any time in life and be caused by factors such brain injury; diseases such as Alzheimer’s, Parkinson’s, or Huntington’s; infection; or stroke, among others.

For this Assignment, you will assess a patient in a case study who presents with a neurocognitive or neurodevelopmental disorder.

To Prepare:

• Review this week’s Learning Resources and consider the insights they provide. Consider how neurocognitive impairments may have similar presentations to other psychological disorders.
• Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
• By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.
• Identify at least three possible differential diagnoses for the patient. Assignment: Assessing and Diagnosing Patients with Neurocognitive and Neurodevelopmental Disorders

By Day 7 of Week 10

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:

• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment?
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

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Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK10Assgn+last name first initial. (extension)” as the name.
• Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission. Assignment: Assessing and Diagnosing Patients with Neurocognitive and Neurodevelopmental Disorders

Note: choose 1 Case Study

 

Week 10 Neurocognitive and Neurodevelopmental Disorders

Training Title 48

Name: Sarah Higgins

Gender: female

Age: 9 years old

T- 97.4 P- 62 R 14 95/60 Ht 4’5 Wt 63lbs

Background: no history of treatment, developmental milestones met on time, vaccinations up

to date. Sleeps 9hrs/night, meals are difficult as she has hard time sitting for meals, she does

get proper nutrition per PCP.

Symptom Media. (Producer). (2017). Training title 48 [Video}

https://video-alexanderstreet-com.eu1.proxy.openathens.net/watch/training-title-48

 

Training Title 50

Name: Harold Griffin

Gender: male

Age:58 years old

T- 98.8 P- 86 R 18 134/88 Ht 5’11 Wt 180lbs

Background:

Has bachelor’s degree in engineering. He is homosexual and dates casually, never married, no

children. Has one younger sister. Sleeps 4-6 hours, appetite good. Denied legal issues; MOCA

27/30 difficulty with attention and delayed recall; ASRS-5 20/24; denied hx of drug use; enjoys

one scotch drink on the weekends with a cigar. Allergies Morphine; history HTN blood pressure

controlled with losartan 100mg daily, angina prescribed ASA 81mg po daily, metoprolol 25mg

twice daily. Hypertriglyceridemia prescribed fenofibrate 160mg daily, has BPH prescribed

tamsulosin 0.4mg po bedtime.

Symptom Media. (Producer). (2017).

https://video-alexanderstreet-com.eu1.proxy.openathens.net/watch/training-title-50