DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders

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DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders – Step-by-Step Guide

The first step before starting to write the DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last few years and review each one for credibility. Ensure that you obtain the references in the required format, for example, in APA, to save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested in reading through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence collected from the research, and ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between paragraphs by using transition words and a flow of ideas.

How to Write the In-text Citations for DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders Instructions

Branching Exercise: Common Diseases And Disorders

For this Assignment, you will review the interactive media piece/branching exercise provided in the Learning Resources. As you examine the patient case, consider how you might assess and treat patients with the symptoms and conditions presented. Have a look at NRNP 6550 Week 1 Discussion – Medicolegal Impacts on Health Promotion.

To prepare:

  • Review the interactive media under Required Media: Branching exercise. This is provided in the Learning Resources.
  • Review the information provided in the case (patient presentation, vital signs, pmh, home meds, results of labs and diagnostics. With this information, critically think about what is happening with the patient.
  • Use your critical thinking skills and current guidelines to develop orders. Include additional labs/diagnostics, what needs repeated and followed up on. Medications that need to be ordered or changed.
The Assignment:
  • Using the required admission orders template found under the Learning Resources: Required Reading.
  • Develop a set of orders as the admitting provider.
  • Be sure to address each aspect of the order template
  • Write the orders as you would in the patient’s chart. Be specific. Do not leave room for the nurse to interpret your orders.
  • Do not assume anything has already been done/order. Use the information given. Example: If the case does not mention fluids were given, the patient did not receive fluids. You may have to start from scratch as if you are working in the ER. And you must provide orders if the patient needs to be admitted.
  • Make sure the order is complete and applicable to the patient.
  • Make sure you provide rationales for your labs and diagnostics and anything else you feel the need to explain. This should be done at the end of the order set – not included with the order.
  • Please do not write per protocol. We do not know what your protocol is and you need to demonstrate what is the appropriate standard of care for this patient.
  • A minimum of three current (within the last 5 years), evidenced based references are required.
By Day 7 of Week 9

Submit your completed Assignment by Day 7 of Week 9 in Module 5.

Scenario #5 68 year old female

BACKGROUND

A 68-year-old female is brought to the hospital from the acute rehabilitation facility with complaints of shortness of breath and productive cough for 1 week. She was started on ciprofloxin 3 days ago, but her symptoms have continued to worsen. Her past medical history includes hypertension, hypothyroidism. She underwent a right knee replacement 2 weeks ago. Current medications include lisinopril 10mg, levothyroxine 75mcg, rivaroxaban 10mg daily and ciprofloxacin 500mg Q12. Her current symptoms include fever, chills, productive cough with purulent green sputum, and worsening shortness of breath. She is allergic to morphine. The patient is a full code.

EXAM

  •  Current vital signs T 102.6 HR 92. RR 22 BP 128/82. O2 saturation is 96% on 4L of O2
  •  Chest x-ray shows consolidation in the right lower lobe
  •  CBC and CMP are all within normal limits

Decision Point One

Discontinue the ciprofloxin
Start levofloxin 750 mg IV every 24 hours

RESULTS OF DECISION POINT ONE

This patient meets the criteria for hospital acquired pneumonia (HAP) due to her surgery 2 weeks ago and inpatient stay at the rehabilitation facility. She is at risk of drug resistant bacteria and MRSA. Changing her antibiotic from one Fluoroquinolone to another would not provide enough antibacterial coverage for the HAP. A three drug combination for broad spectrum coverage should be initiated until culture and sensitivity report on her sputum is available and antibiotic deescalation can occur.

The patient’s culture and sensitivity report for sputum and blood culture is now available. Staph aureus grew from the sputum culture. Utilizing this information, what adjustments to the patients’ antibiotics would you make for admission?Antimicrobial chart of sputum and blood

Decision Point Two

Continue the piperacillin/tazobactam

RESULTS OF DECISION POINT TWO

  • Correct!
  • The sensitivity report indicates that the bacteria in the sputum and blood is sensitive to piperacillin/tazobactam. Continuing it and discontinuing the other antibiotics will still provide good coverage for this infection.

Decision Point Three

The patient should be admitted to the hospital and PICC placed.

Guidance to Student

Correct!

The patient is requiring oxygen to maintain her O2 saturation at the low normal range. The safest option for the patient is to admit her to make sure her oxygen requirements do not need increasing with further intervention. A PICC can be placed for antibiotic therapy.

DRNP 6566 Week 9 Assignment – Branching Exercise: Common Diseases And Disorders Example

Branching Exercise Scenario #5 68 year old female

Admission Orders

Primary Diagnosis: 

Hospital-acquired pneumonia (HAP) secondary to Staph. aureus infection.

Status/Condition

Guarded – this is due to the patient’s ongoing oxygen requirement and pulmonary infection

Code Status: 

Full code

Allergies: 

No known allergies to medications or food

Admit to Unit: 

High dependency unit for close monitoring of vitals and respiratory status

Activity Level:

Activity as tolerated by the patient while monitoring her oxygen saturation

Diet: 

Regular diet

IV Fluids: 

  • Normal saline 1L IV slow infusion in 24 hours and adjust after BUN results
  • Critical Drips
  • No critical drips are required at this time

Respiratory:

  • Administer oxygen through a nasal cannula at a flow rate of 4 liters per minute, adjusting as necessary to ensure that oxygen saturation remains at or above 92%.
  • Promote the use of incentive spirometer on an hourly basis during waking hours to help prevent the occurrence of atelectasis (Harris, 2023).
  • Chest physiotherapy may be beneficial in facilitating the clearance of respiratory secretions.

Medications

  • Piperacillin/Tazobactam at a dosage of 4.5 grams administered IV every six hours (Evans et al., 2021).
  • Acetaminophen 1 gram intravenously every eight hours for the management of fever.
  • Lisinopril 10MG orally daily
  • Levothyroxine is also to be continued at a daily oral dose of 75 micrograms
  • Rivaroxaban 10 milligrams orally daily to maintain anticoagulation.

Nursing Orders

  • Vital signs should be recorded every four hours.
  • Monitor the intake and output to ensure proper fluid balance.
  • A daily weight assessment is necessary to evaluate the patient’s fluid status.
  • The respiratory status must be assessed every four hours and as needed, focusing on the work of breathing and lung sounds.
  • To facilitate easier breathing, the head of the bed should be elevated to an angle of 30 to 45 degrees.
  • For skin care, the patient should be turned and repositioned every two hours to prevent the development of pressure injuries (Harris, 2023).
  • The patient should be encouraged to use the restroom every four to six hours, with assistance provided as required.

Follow-Up Lab Tests:

  • CXR on day 3 in assessing the condition does not improve
  • A daily complete blood count (CBC) to evaluate the white blood cell count and detect any indications of infection.
  • A comprehensive metabolic panel (CMP) should be conducted daily to assess renal function, particularly in the context of antibiotic administration
  • One-time C-reactive protein (CRP) levels should be measured every 48 hours to track inflammation.
  • A follow-up chest X-ray should be conducted within 48 to 72 hours to assess any potential improvement.
  • If there is no observed improvement or if the respiratory condition deteriorates, a CT scan of the chest should be considered.

Consults:

  • An Infectious Disease consultation is recommended to provide insights on the appropriate duration of antibiotic therapy and to explore potential strategies for further de-escalation (Wunderink et al., 2020).
  • A Pulmonologist consultation in case of a deterioration in respiratory status or if there is a requirement for enhanced pulmonary support.

Patient Education and Health Promotion

  • It is essential to educate the patient about the significance of adhering to the full course of antibiotics to avert the possibility of recurrence.
  • Guidance should be provided on the correct utilization of incentive spirometry to enhance respiratory function.
  • The patient should be educated on the signs and symptoms of a deteriorating infection, such as heightened shortness of breath or elevated fever, emphasizing the importance of reporting these symptoms without delay.

Discharge Planning and Required Follow-Up Care:

  • Discharge planning should commence at an early stage, taking into account the potential necessity for home health services should the patient continue to require oxygen.
  • Arrange a follow-up appointment with the primary care provider within one week following discharge.

References

Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., … Levy, M. (2021). Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Critical Care Medicine, 49(11), e1063–e1143. https://doi.org/10.1097/ccm.0000000000005337

Harris, C. (2023). Adult-gerontology acute care practice guidelines (C. Harris, Ed.). Springer Publishing. https://doi.org/10.1891/9780826170057

Wunderink, R. G., Srinivasan, A., Barie, P. S., Chastre, J., Dela Cruz, C. S., Douglas, I. S., Ecklund, M., Evans, S. E., Evans, S. R., Gerlach, A. T., Hicks, L. A., Howell, M., Hutchinson, M. L., Hyzy, R. C., Kane-Gill, S. L., Lease, E. D., Metersky, M. L., Munro, N., Niederman, M. S., … Weiss, C. H. (2020). Antibiotic stewardship in the intensive care unit. An official American thoracic society workshop report in collaboration with the AACN, CHEST, CDC, and SCCM. Annals of the American Thoracic Society, 17(5), 531–540. https://doi.org/10.1513/annalsats.202003-188st