Tag: Pathophysiology & Pharmacology

  • [Solved] STRENGTHS AND LIMITATIONS OF SECONDARY DATA SOURCES

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    find attached n use the rubrics **files (2)** – ## wk2epiassignment.docx – ## wk2assignrubrics.docx **## wk2epiassignment.docx** ![A close-up of a graph AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/strengths-and-limitations-of-secondary-data-sources-20963573) In this …

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    find attached n use the rubrics

    **files (2)**

    – ## wk2epiassignment.docx

    – ## wk2assignrubrics.docx

    **## wk2epiassignment.docx**

    ![A close-up of a graph AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/strengths-and-limitations-of-secondary-data-sources-20963573)

    In this information age, where data are readily accessible and there is both a great demand for accelerated research projects and strict limitations on research funding, using existing data makes sense. Data used in this way are called secondary data; they come in many forms and contain information on just about anything—depending on who collected the information in the first place, and why.

    As a health professional, you have access to a wide range of secondary data sources, including government agencies (such as, the Census Bureau or the Centers for Disease Control and Prevention) and private sources, including local health service providers. Global and international data are available from familiar sources, such as the World Health Organization and the United Nations. In addition, nearly every nation maintains statistics on social, economic, and environmental indicators, which contain a wealth of health information.
    As a member of the Walden community, you have access to the Inter-University Consortium for Political and Social Research (ICPSR), the world’s largest archival database of secondary data. You also have access to the Social Change Impact Report (SCIR) data sets—a Walden-owned database. There are also a number of sources and tutorials available to you through Walden’s Office of Research and Doctoral Quality.
    No matter the topic—be it vaccination rates, women’s access to mammography, or chronic lung disease—you can probably find an existing secondary data source related to the specific population health problem you are investigating. The next steps are to identify the variables in the data source that you would need to analyze to examine the association of interest and to assess the validity of the data source. For this Assignment, you delve into these issues in greater detail.

    RESOURCES

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/215573/modules/items/8999887)

    TO PREPARE:

    · Consider a variety of population health problems and then select one of professional interest on which to focus for this Assignment.

    · Explore three data sources (data sets) presented in the Learning Resources that could aid you in describing the population and magnitude of the problem you selected. Consider the strengths and limitations of each data source.

    THE ASSIGNMENT

    In 3–4 pages (not including title page and references), analyze the data sources you selected by addressing the following:

    · Briefly identify the population health problem you selected.

    · Identify each data set you selected.

    · Identify the variables in each data set you would need to examine the association of interest.

    · Assess the validity of each data set. Has it been used for prior studies/publications?

    · Explain challenges you might face as a researcher in identifying a proper data set or securing permission to use it.

    ## image1.jpeg

    **## wk2assignrubrics.docx**

    **NURS_8310_Week2_Assignment_Rubric**

    | | | |
    | — | — | — |
    | NURS_8310_Week2_Assignment_Rubric |
    | **Criteria** | **Ratings** | **Pts** |
    | This criterion is linked to a Learning OutcomeIn 3–4 pages (not including title page and references), analyze the data sources you selected by addressing the following: Briefly identify the population health problem you selected. | **20 to >17.0 ptsExcellent** The response accurately, clearly, and concisely identifies the selected population health problem.<br> <br>**17 to >15.0 ptsGood** The response accurately identifies the selected population health problem.<br> <br>**15 to >12.0 ptsFair** The response somewhat inaccurately or vaguely identifies the selected population health problem.<br> <br>**12 to >0 ptsPoor** The response inaccurately and vaguely identifies the selected population health problem, or it is missing. | 20 pts |
    | This criterion is linked to a Learning OutcomeIdentify each data set you selected. Identify the variables in each data set you would need to examine the association of interest. | **40 to >35.0 ptsExcellent** The response accurately, clearly, and concisely identifies each data set…. The response accurately, clearly, and concisely identifies the variables in each data set needed to examine the association of interest.<br> <br>**35 to >31.0 ptsGood** The response accurately identifies each data set…. The response accurately identifies the variables in each data set needed to examine the association of interest.<br> <br>**31 to >27.0 ptsFair** The response somewhat inaccurately or vaguely identifies each data set…. The response somewhat inaccurately or vaguely identifies the variables in each data set needed to examine the association of interest.<br> <br>**27 to >0 ptsPoor** The response inaccurately and vaguely identifies each data set, or it is missing…. The response inaccurately and vaguely identifies the variables in each data set needed to examine the association of interest, or it is missing. | 40 pts |
    | This criterion is linked to a Learning OutcomeAssess the validity of each data set. Has it been used for prior studies/publications? | **40 to >35.0 ptsExcellent** An accurate and detailed explanation of the validity of each data set is provided, including whether it has been used in prior studies/publications.<br> <br>**35 to >31.0 ptsGood** An accurate explanation of the validity of each data set is provided, including whether it has been used in prior studies/publications.<br> <br>**31 to >27.0 ptsFair** A somewhat inaccurate or vague explanation of the validity of each data set and whether it has been used in prior studies/publications is provided.<br> <br>**27 to >0 ptsPoor** An inaccurate and vague, or incomplete explanation of the validity of each data set and whether it has been used in prior studies/publications is provided, or it is missing. | 40 pts |
    | This criterion is linked to a Learning OutcomeExplain challenges you might face as a researcher in identifying a proper data set or securing permission to use it. | **35 to >31.0 ptsExcellent** An accurate and detailed explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**31 to >27.0 ptsGood** An accurate explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**27 to >24.0 ptsFair** A somewhat inaccurate or vague explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**24 to >0 ptsPoor** An inaccurate and vague explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided, or it is missing. | 35 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. | **5 to >4.0 ptsExcellent** Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.<br> <br>**4 to >3.5 ptsGood** Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.<br> <br>**3.5 to >3.0 ptsFair** Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<br> <br>**3 to >0 ptsPoor** Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion was provided. | 5 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and proper punctuation | **5 to >4.0 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**4 to >3.5 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**3.5 to >3.0 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**3 to >0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 5 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. | **5 to >4.0 ptsExcellent** Uses correct APA format with no errors.<br> <br>**4 to >3.5 ptsGood** Contains a few (1 or 2) APA format errors.<br> <br>**3.5 to >3.0 ptsFair** Contains several (3 or 4) APA format errors.<br> <br>**3 to >0 ptsPoor** Contains many (≥ 5) APA format errors. | 5 pts |

    Total Points: 150

    **## wk2assignrubrics.docx**

    **NURS_8310_Week2_Assignment_Rubric**

    | | | |
    | — | — | — |
    | NURS_8310_Week2_Assignment_Rubric |
    | **Criteria** | **Ratings** | **Pts** |
    | This criterion is linked to a Learning OutcomeIn 3–4 pages (not including title page and references), analyze the data sources you selected by addressing the following: Briefly identify the population health problem you selected. | **20 to >17.0 ptsExcellent** The response accurately, clearly, and concisely identifies the selected population health problem.<br> <br>**17 to >15.0 ptsGood** The response accurately identifies the selected population health problem.<br> <br>**15 to >12.0 ptsFair** The response somewhat inaccurately or vaguely identifies the selected population health problem.<br> <br>**12 to >0 ptsPoor** The response inaccurately and vaguely identifies the selected population health problem, or it is missing. | 20 pts |
    | This criterion is linked to a Learning OutcomeIdentify each data set you selected. Identify the variables in each data set you would need to examine the association of interest. | **40 to >35.0 ptsExcellent** The response accurately, clearly, and concisely identifies each data set…. The response accurately, clearly, and concisely identifies the variables in each data set needed to examine the association of interest.<br> <br>**35 to >31.0 ptsGood** The response accurately identifies each data set…. The response accurately identifies the variables in each data set needed to examine the association of interest.<br> <br>**31 to >27.0 ptsFair** The response somewhat inaccurately or vaguely identifies each data set…. The response somewhat inaccurately or vaguely identifies the variables in each data set needed to examine the association of interest.<br> <br>**27 to >0 ptsPoor** The response inaccurately and vaguely identifies each data set, or it is missing…. The response inaccurately and vaguely identifies the variables in each data set needed to examine the association of interest, or it is missing. | 40 pts |
    | This criterion is linked to a Learning OutcomeAssess the validity of each data set. Has it been used for prior studies/publications? | **40 to >35.0 ptsExcellent** An accurate and detailed explanation of the validity of each data set is provided, including whether it has been used in prior studies/publications.<br> <br>**35 to >31.0 ptsGood** An accurate explanation of the validity of each data set is provided, including whether it has been used in prior studies/publications.<br> <br>**31 to >27.0 ptsFair** A somewhat inaccurate or vague explanation of the validity of each data set and whether it has been used in prior studies/publications is provided.<br> <br>**27 to >0 ptsPoor** An inaccurate and vague, or incomplete explanation of the validity of each data set and whether it has been used in prior studies/publications is provided, or it is missing. | 40 pts |
    | This criterion is linked to a Learning OutcomeExplain challenges you might face as a researcher in identifying a proper data set or securing permission to use it. | **35 to >31.0 ptsExcellent** An accurate and detailed explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**31 to >27.0 ptsGood** An accurate explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**27 to >24.0 ptsFair** A somewhat inaccurate or vague explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**24 to >0 ptsPoor** An inaccurate and vague explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided, or it is missing. | 35 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. | **5 to >4.0 ptsExcellent** Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.<br> <br>**4 to >3.5 ptsGood** Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.<br> <br>**3.5 to >3.0 ptsFair** Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<br> <br>**3 to >0 ptsPoor** Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion was provided. | 5 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and proper punctuation | **5 to >4.0 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**4 to >3.5 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**3.5 to >3.0 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**3 to >0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 5 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. | **5 to >4.0 ptsExcellent** Uses correct APA format with no errors.<br> <br>**4 to >3.5 ptsGood** Contains a few (1 or 2) APA format errors.<br> <br>**3.5 to >3.0 ptsFair** Contains several (3 or 4) APA format errors.<br> <br>**3 to >0 ptsPoor** Contains many (≥ 5) APA format errors. | 5 pts |

    Total Points: 150

    **## wk2epiassignment.docx**

    ![A close-up of a graph AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/strengths-and-limitations-of-secondary-data-sources-20963573)

    In this information age, where data are readily accessible and there is both a great demand for accelerated research projects and strict limitations on research funding, using existing data makes sense. Data used in this way are called secondary data; they come in many forms and contain information on just about anything—depending on who collected the information in the first place, and why.

    As a health professional, you have access to a wide range of secondary data sources, including government agencies (such as, the Census Bureau or the Centers for Disease Control and Prevention) and private sources, including local health service providers. Global and international data are available from familiar sources, such as the World Health Organization and the United Nations. In addition, nearly every nation maintains statistics on social, economic, and environmental indicators, which contain a wealth of health information.
    As a member of the Walden community, you have access to the Inter-University Consortium for Political and Social Research (ICPSR), the world’s largest archival database of secondary data. You also have access to the Social Change Impact Report (SCIR) data sets—a Walden-owned database. There are also a number of sources and tutorials available to you through Walden’s Office of Research and Doctoral Quality.
    No matter the topic—be it vaccination rates, women’s access to mammography, or chronic lung disease—you can probably find an existing secondary data source related to the specific population health problem you are investigating. The next steps are to identify the variables in the data source that you would need to analyze to examine the association of interest and to assess the validity of the data source. For this Assignment, you delve into these issues in greater detail.

    RESOURCES

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/215573/modules/items/8999887)

    TO PREPARE:

    · Consider a variety of population health problems and then select one of professional interest on which to focus for this Assignment.

    · Explore three data sources (data sets) presented in the Learning Resources that could aid you in describing the population and magnitude of the problem you selected. Consider the strengths and limitations of each data source.

    THE ASSIGNMENT

    In 3–4 pages (not including title page and references), analyze the data sources you selected by addressing the following:

    · Briefly identify the population health problem you selected.

    · Identify each data set you selected.

    · Identify the variables in each data set you would need to examine the association of interest.

    · Assess the validity of each data set. Has it been used for prior studies/publications?

    · Explain challenges you might face as a researcher in identifying a proper data set or securing permission to use it.

    ## image1.jpeg

    **## wk2assignrubrics.docx**

    **NURS_8310_Week2_Assignment_Rubric**

    | | | |
    | — | — | — |
    | NURS_8310_Week2_Assignment_Rubric |
    | **Criteria** | **Ratings** | **Pts** |
    | This criterion is linked to a Learning OutcomeIn 3–4 pages (not including title page and references), analyze the data sources you selected by addressing the following: Briefly identify the population health problem you selected. | **20 to >17.0 ptsExcellent** The response accurately, clearly, and concisely identifies the selected population health problem.<br> <br>**17 to >15.0 ptsGood** The response accurately identifies the selected population health problem.<br> <br>**15 to >12.0 ptsFair** The response somewhat inaccurately or vaguely identifies the selected population health problem.<br> <br>**12 to >0 ptsPoor** The response inaccurately and vaguely identifies the selected population health problem, or it is missing. | 20 pts |
    | This criterion is linked to a Learning OutcomeIdentify each data set you selected. Identify the variables in each data set you would need to examine the association of interest. | **40 to >35.0 ptsExcellent** The response accurately, clearly, and concisely identifies each data set…. The response accurately, clearly, and concisely identifies the variables in each data set needed to examine the association of interest.<br> <br>**35 to >31.0 ptsGood** The response accurately identifies each data set…. The response accurately identifies the variables in each data set needed to examine the association of interest.<br> <br>**31 to >27.0 ptsFair** The response somewhat inaccurately or vaguely identifies each data set…. The response somewhat inaccurately or vaguely identifies the variables in each data set needed to examine the association of interest.<br> <br>**27 to >0 ptsPoor** The response inaccurately and vaguely identifies each data set, or it is missing…. The response inaccurately and vaguely identifies the variables in each data set needed to examine the association of interest, or it is missing. | 40 pts |
    | This criterion is linked to a Learning OutcomeAssess the validity of each data set. Has it been used for prior studies/publications? | **40 to >35.0 ptsExcellent** An accurate and detailed explanation of the validity of each data set is provided, including whether it has been used in prior studies/publications.<br> <br>**35 to >31.0 ptsGood** An accurate explanation of the validity of each data set is provided, including whether it has been used in prior studies/publications.<br> <br>**31 to >27.0 ptsFair** A somewhat inaccurate or vague explanation of the validity of each data set and whether it has been used in prior studies/publications is provided.<br> <br>**27 to >0 ptsPoor** An inaccurate and vague, or incomplete explanation of the validity of each data set and whether it has been used in prior studies/publications is provided, or it is missing. | 40 pts |
    | This criterion is linked to a Learning OutcomeExplain challenges you might face as a researcher in identifying a proper data set or securing permission to use it. | **35 to >31.0 ptsExcellent** An accurate and detailed explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**31 to >27.0 ptsGood** An accurate explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**27 to >24.0 ptsFair** A somewhat inaccurate or vague explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**24 to >0 ptsPoor** An inaccurate and vague explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided, or it is missing. | 35 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. | **5 to >4.0 ptsExcellent** Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.<br> <br>**4 to >3.5 ptsGood** Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.<br> <br>**3.5 to >3.0 ptsFair** Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<br> <br>**3 to >0 ptsPoor** Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion was provided. | 5 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and proper punctuation | **5 to >4.0 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**4 to >3.5 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**3.5 to >3.0 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**3 to >0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 5 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. | **5 to >4.0 ptsExcellent** Uses correct APA format with no errors.<br> <br>**4 to >3.5 ptsGood** Contains a few (1 or 2) APA format errors.<br> <br>**3.5 to >3.0 ptsFair** Contains several (3 or 4) APA format errors.<br> <br>**3 to >0 ptsPoor** Contains many (≥ 5) APA format errors. | 5 pts |

    Total Points: 150

    **## wk2epiassignment.docx**

    ![A close-up of a graph AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/strengths-and-limitations-of-secondary-data-sources-20963573)

    In this information age, where data are readily accessible and there is both a great demand for accelerated research projects and strict limitations on research funding, using existing data makes sense. Data used in this way are called secondary data; they come in many forms and contain information on just about anything—depending on who collected the information in the first place, and why.

    As a health professional, you have access to a wide range of secondary data sources, including government agencies (such as, the Census Bureau or the Centers for Disease Control and Prevention) and private sources, including local health service providers. Global and international data are available from familiar sources, such as the World Health Organization and the United Nations. In addition, nearly every nation maintains statistics on social, economic, and environmental indicators, which contain a wealth of health information.
    As a member of the Walden community, you have access to the Inter-University Consortium for Political and Social Research (ICPSR), the world’s largest archival database of secondary data. You also have access to the Social Change Impact Report (SCIR) data sets—a Walden-owned database. There are also a number of sources and tutorials available to you through Walden’s Office of Research and Doctoral Quality.
    No matter the topic—be it vaccination rates, women’s access to mammography, or chronic lung disease—you can probably find an existing secondary data source related to the specific population health problem you are investigating. The next steps are to identify the variables in the data source that you would need to analyze to examine the association of interest and to assess the validity of the data source. For this Assignment, you delve into these issues in greater detail.

    RESOURCES

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/215573/modules/items/8999887)

    TO PREPARE:

    · Consider a variety of population health problems and then select one of professional interest on which to focus for this Assignment.

    · Explore three data sources (data sets) presented in the Learning Resources that could aid you in describing the population and magnitude of the problem you selected. Consider the strengths and limitations of each data source.

    THE ASSIGNMENT

    In 3–4 pages (not including title page and references), analyze the data sources you selected by addressing the following:

    · Briefly identify the population health problem you selected.

    · Identify each data set you selected.

    · Identify the variables in each data set you would need to examine the association of interest.

    · Assess the validity of each data set. Has it been used for prior studies/publications?

    · Explain challenges you might face as a researcher in identifying a proper data set or securing permission to use it.

    ## image1.jpeg

    **## wk2assignrubrics.docx**

    **NURS_8310_Week2_Assignment_Rubric**

    | | | |
    | — | — | — |
    | NURS_8310_Week2_Assignment_Rubric |
    | **Criteria** | **Ratings** | **Pts** |
    | This criterion is linked to a Learning OutcomeIn 3–4 pages (not including title page and references), analyze the data sources you selected by addressing the following: Briefly identify the population health problem you selected. | **20 to >17.0 ptsExcellent** The response accurately, clearly, and concisely identifies the selected population health problem.<br> <br>**17 to >15.0 ptsGood** The response accurately identifies the selected population health problem.<br> <br>**15 to >12.0 ptsFair** The response somewhat inaccurately or vaguely identifies the selected population health problem.<br> <br>**12 to >0 ptsPoor** The response inaccurately and vaguely identifies the selected population health problem, or it is missing. | 20 pts |
    | This criterion is linked to a Learning OutcomeIdentify each data set you selected. Identify the variables in each data set you would need to examine the association of interest. | **40 to >35.0 ptsExcellent** The response accurately, clearly, and concisely identifies each data set…. The response accurately, clearly, and concisely identifies the variables in each data set needed to examine the association of interest.<br> <br>**35 to >31.0 ptsGood** The response accurately identifies each data set…. The response accurately identifies the variables in each data set needed to examine the association of interest.<br> <br>**31 to >27.0 ptsFair** The response somewhat inaccurately or vaguely identifies each data set…. The response somewhat inaccurately or vaguely identifies the variables in each data set needed to examine the association of interest.<br> <br>**27 to >0 ptsPoor** The response inaccurately and vaguely identifies each data set, or it is missing…. The response inaccurately and vaguely identifies the variables in each data set needed to examine the association of interest, or it is missing. | 40 pts |
    | This criterion is linked to a Learning OutcomeAssess the validity of each data set. Has it been used for prior studies/publications? | **40 to >35.0 ptsExcellent** An accurate and detailed explanation of the validity of each data set is provided, including whether it has been used in prior studies/publications.<br> <br>**35 to >31.0 ptsGood** An accurate explanation of the validity of each data set is provided, including whether it has been used in prior studies/publications.<br> <br>**31 to >27.0 ptsFair** A somewhat inaccurate or vague explanation of the validity of each data set and whether it has been used in prior studies/publications is provided.<br> <br>**27 to >0 ptsPoor** An inaccurate and vague, or incomplete explanation of the validity of each data set and whether it has been used in prior studies/publications is provided, or it is missing. | 40 pts |
    | This criterion is linked to a Learning OutcomeExplain challenges you might face as a researcher in identifying a proper data set or securing permission to use it. | **35 to >31.0 ptsExcellent** An accurate and detailed explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**31 to >27.0 ptsGood** An accurate explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**27 to >24.0 ptsFair** A somewhat inaccurate or vague explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided.<br> <br>**24 to >0 ptsPoor** An inaccurate and vague explanation of potential challenges as a researcher in identifying a proper data set or securing permission to use it is provided, or it is missing. | 35 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. | **5 to >4.0 ptsExcellent** Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.<br> <br>**4 to >3.5 ptsGood** Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.<br> <br>**3.5 to >3.0 ptsFair** Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<br> <br>**3 to >0 ptsPoor** Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion was provided. | 5 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and proper punctuation | **5 to >4.0 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**4 to >3.5 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**3.5 to >3.0 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**3 to >0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 5 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. | **5 to >4.0 ptsExcellent** Uses correct APA format with no errors.<br> <br>**4 to >3.5 ptsGood** Contains a few (1 or 2) APA format errors.<br> <br>**3.5 to >3.0 ptsFair** Contains several (3 or 4) APA format errors.<br> <br>**3 to >0 ptsPoor** Contains many (≥ 5) APA format errors. | 5 pts |

    Total Points: 150

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    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Blood Transfusion

    1. Which findings from the present problem are most important and noticed by the nurse as clinically significant?

    Most Important Findings Clinical Significance

    Procedural Safety Principles: Blood Administration

    2. What will you do if you have not performed blood administration in the clinical setting?

    3. If the nurse was going to administer another unit of packed red blood cells (PRBC), what supplies does the nurse

    need to gather?

    4. Review and summarize essential steps and knowledge the nurse will apply to administer the remainder of this
    transfusion safely.

    5. What will the nurse communicate to educate the patient or family about the need for this procedure and what to
    expect?

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Evaluation

    6. You collect the following assessment data. Make a clinical judgment for each finding by placing an "x" in the
    appropriate column if the finding is expected or unexpected.

    Assessment Finding Expected Unexpected
    T: 98.2 F/36.8 C (oral)
    P: 108 (regular)
    R: 25 (regular)
    BP: 128/83
    O2 sat: 88% RA
    Appears anxious
    Breathing rapidly
    Skin is cool and clammy

    7. Is the overall status of the patient:

    a. Improved
    b. Declined
    c. No change

    8. Complete the table below for each home medication.

    Medication Pharm. Class Mechanism of Action Expected Outcome
    Metoprolol

    Lisinopril

    Furosemide

    Ferrous gluconate

    Potassium chloride

    9. Which home medication(s) that were not taken would have the greatest impact on his current status?

    Medication Rationale

    Lucy Myers

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    10. Calculate the patient's total intake and output, then interpret the significance of your findings.
    Intake and Output Clinical Significance

    11. What clinical data is most important and must be recognized as clinically significant by the nurse?

    Most Important Data Clinical Significance

    12. To interpret the clinical data collected, list at least two possible problems for this patient. Which problem is the

    priority?
    Possible Problems Priority Problem Pathophysiology of Priority Problem

    13. After evaluating the patient, identify the current nursing priority and which action(s) the nurse should take. List

    interventions by priority and the expected outcome.
    Nursing Priority
    Priority Intervention(s) Rationale Expected Outcome

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    14. Recognizing a potential problem, you use Identify-Situation-Background-Assessment-Recommendation (ISBAR)
    to update the provider. Summarize what you would communicate for an ISBAR report.

    I identify Specify who you are/where you work.

    • Yourself: name/position/location

    • Patient: name/age/gender

    S situation What is the problem/reason for contact?

    Concise summary of primary problem:

    B background If urgent, state concern. Provide concise/relevant history

    • Primary problem/diagnosis:

    • Day of admission/post-op day #:

    • Relevant past medical history:

    • Relevant treatments/interventions:

    A assessment Assessment of the situation using the most important clinical data.

    State your concern by communicating
    concerning clinical data:

    • Vital signs

    • Nursing assessment

    • Lab/diagnostic results

    Trend of most important clinical data
    (stable-increasing/decreasing):

    R recommendation Request specific advice/interventions. Clarify expectations.

    • Nurse suggestions to advance the plan
    of care:

    • What do you recommend?

    • Repeat and state back new
    orders/confirm plan of care:

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    15. Identify the rationale for each provider order and its expected outcome.

    Provider Orders Rationale Expected Outcome
    Furosemide 40 mg IV push

    Discontinue blood
    transfusion

    Apply oxygen to maintain
    oxygen saturation >92%

    Dosage Calculation: Furosemide 40 mg IV push

    Medication

    Time frame to
    Administer

    Show Work Volume to Administer

    16. Which findings are expected if the nursing and medical intervention(s) were effective?

    Expected Findings Rationale

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    17. The nurse has implemented the medical and nursing plan of care. One hour later, you collect the following
    assessment data below.
    For each finding, make a clinical judgment by placing an "x" in the appropriate column if the patient's
    condition has improved, has not changed, or has declined.

    Assessment Finding Improved No Change Declined
    Urine output: 750 mL
    HR: 89/minute
    RR: 18/minute non-labored
    BP: 124/80
    O2 sat: 96% room air
    Crackles persist in bases but are not as pronounced
    Resting comfortably appears less anxious

    18. Is the overall status of the patient:

    a. Improved
    b. No change
    c. Declined

    Documentation
    Write a concise nurse's note to document what was most important in the medical record.

    Nurse Reflection
    To strengthen your clinical judgment skills, reflect on your knowledge and the decisions made caring for this patient by
    answering the reflection questions below.
    Reflection Question Nurse Reflection
    As you worked through this
    simulation, how did it make you
    feel?

    What did you already know and do
    well on this simulation?

    What areas do you need to
    develop/improve?

    What did you learn? How will you
    apply what was learned to improve
    patient care?

    Lucy Myers

    01. Most Important Findings: History of heart failure
    Iron deficiency anemia
    low hemoglobin
    02. Clinical Significance: low hemoglobin needs blood tranfusion
    Heart failure can cause breath difficulties

    03. 2: As a student nurse I can not administrater blood alone without supervision, so I will ask charge nurse and also look at the hospital policy.
    04. need to gather: I will need gloves, vital sign machine, blood tubing with fliter, IV pump and normal saline
    05. transfusion safely: Check prescriptions for allergy, expiration, virefied orders with second nurse check vitals before blood tranfusion monitor patient during tranfusion watch for side inffect and decumention.
    06. expect: Educate patient that blood tranfusion will help with their hemonglobin, they should wash and report these symptoms; shortness of breath, and chest pain.
    07. Assessment Finding:
    08. ExpectedT 982 F368 C oral: x
    09. UnexpectedT 982 F368 C oral:
    10. ExpectedP 108 regular:
    11. UnexpectedP 108 regular: x
    12. ExpectedR 25 regular:
    13. UnexpectedR 25 regular: x
    14. ExpectedBP 12883: x
    15. UnexpectedBP 12883:
    16. ExpectedO2 sat 88 RA:
    17. UnexpectedO2 sat 88 RA: x
    18. ExpectedAppears anxious:
    19. UnexpectedAppears anxious: x
    20. ExpectedBreathing rapidly:
    21. UnexpectedBreathing rapidly: x
    22. ExpectedSkin is cool and clammy:
    23. UnexpectedSkin is cool and clammy: x
    24. Medication:
    25. Pharm ClassMetoprolol: Beta blocker
    26. Mechanism of ActionMetoprolol: reduce heart rate
    27. Expected OutcomeMetoprolol: lower heart rate
    28. Pharm ClassLisinopril: ACE inhabitor
    29. Mechanism of ActionLisinopril: lower BP
    30. Expected OutcomeLisinopril: lower BP
    31. Pharm ClassFurosemide: loop diuretic
    32. Mechanism of ActionFurosemide: Increase urine output
    33. Expected OutcomeFurosemide: reduce fluid retention
    34. Pharm ClassFerrous gluconate: iron suppliment
    35. Mechanism of ActionFerrous gluconate: Provide essential iron
    36. Expected OutcomeFerrous gluconate: prevention of iron deficiency enemia
    37. Pharm ClassPotassium chloride: electrolyte suppliment
    38. Mechanism of ActionPotassium chloride: replaces potassium
    39. Expected OutcomePotassium chloride: prevention of hypokalemia
    40. MedicationRow1: furosemide
    41. RationaleRow1: Furosemide, because it causes fliud build up
    42. Intake and OutputRow1: Blood tranfusion
    43. Clinical SignificanceRow1: excess fluid causes respiratory issue, like SOB
    44. Most Important DataRow1: Heart failure and rapid breathing
    45. Clinical SignificanceRow1_2: fluid overload
    46. Possible ProblemsRow1: fluid overload
    rapid breathing
    47. Priority ProblemRow1: fluid overload
    48. Pathophysiology of Priority ProblemRow1: excess fluid build-up place critical strain on the heart.
    49. Nursing Priority:
    50. Priority InterventionsRow1: Improving breathing
    51. RationaleRow1_2: administrater furosemide, notify provider and applying oxygen,
    52. Expected OutcomeRow1: improving breathing
    53. I identify:
    54. Specify who you arewhere you workYourself namepositionlocation Patient nameagegender: Nurse Lucy Myers, RN nurse on the medicine floor

    PT. is Andre Ronaine, 64yrs male PT.
    55. S situation:
    56. What is the problemreason for contactConcise summary of primary problem: Rapid breathing during tranfusion
    57. B background:
    58. If urgent state concern Provide conciserelevant historyPrimary problemdiagnosis Day of admissionpostop day Relevant past medical history Relevant treatmentsinterventions: History of heart failure, Iron deficiency anemia and low hemoglobin
    Admited this morning
    date of adnission, N/A
    Heart failure
    Tranfusion
    59. A assessment:
    60. Assessment of the situation using the most important clinical dataState your concern by communicating concerning clinical data Vital signs Nursing assessment Labdiagnostic results Trend of most important clinical data stableincreasingdecreasing: Pluse is 108, rispiratory 25 and O2 is 88%

    PT. vital signs

    Iron deficiency and low hemoglobin
    61. R recommendation:
    62. Request specific adviceinterventions Clarify expectationsNurse suggestions to advance the plan of care What do you recommend Repeat and state back new ordersconfirm plan of care: Give diuretics

    Give furosemide

    Continue to monitor Pt vitals
    63. Provider Orders:
    64. RationaleFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: To eliminate fluid overload

    Stop more overload

    To increase oxygen level
    65. Expected OutcomeFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: Enhance rispiration

    66. Administer: 1-2 minutes
    67. Show Work: 40mg/100mg =0.4×10=4ml
    68. Expected FindingsRow1: O2 level>92
    rapid breathing
    69. RationaleRow1_3: To improve gas exchange

    70. Assessment Finding_2:
    71. ImprovedUrine output 750 mL: x
    72. No ChangeUrine output 750 mL:
    73. DeclinedUrine output 750 mL:
    74. ImprovedHR 89minute: x
    75. No ChangeHR 89minute:
    76. DeclinedHR 89minute:
    77. ImprovedRR 18minute nonlabored: x
    78. No ChangeRR 18minute nonlabored:
    79. DeclinedRR 18minute nonlabored:
    80. ImprovedBP 12480: x
    81. No ChangeBP 12480:
    82. DeclinedBP 12480:
    83. ImprovedO2 sat 96 room air: x
    84. No ChangeO2 sat 96 room air:
    85. DeclinedO2 sat 96 room air:
    86. ImprovedCrackles persist in bases but are not as pronounced: x
    87. No ChangeCrackles persist in bases but are not as pronounced:
    88. DeclinedCrackles persist in bases but are not as pronounced:
    89. ImprovedResting comfortably appears less anxious: x
    90. No ChangeResting comfortably appears less anxious:
    91. DeclinedResting comfortably appears less anxious:
    92. Write a concise nurses note to document what was most important in the medical record: Furosimide IV push was administrater to pt. during blood transfusion, Pt experienced rapid breathing.
    93. Reflection Question:
    94. Nurse Reflection: It was somehow challenging
    95. Nurse ReflectionWhat did you already know and do well on this simulation: regonizing and understanding some the problem
    96. Nurse ReflectionWhat areas do you need to developimprove: monitoring for adverse effects
    97. Nurse ReflectionWhat did you learn How will you apply what was learned to improve patient care: I have learned that monitoring the patient closely and washing up for symptoms like, chest pain and shortness of breath it’s very essential.
    for patient care
    98. Text1: 4 ml

    **IMG_6870.jpeg**

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    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/screenshot2026-01-26at4-00-32pm-png-10508727)

    **Screenshot2026-01-26at4.00.32PM.png**

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    **## BloodTransfusiondone.pdf**

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Blood Transfusion

    1. Which findings from the present problem are most important and noticed by the nurse as clinically significant?

    Most Important Findings Clinical Significance

    Procedural Safety Principles: Blood Administration

    2. What will you do if you have not performed blood administration in the clinical setting?

    3. If the nurse was going to administer another unit of packed red blood cells (PRBC), what supplies does the nurse

    need to gather?

    4. Review and summarize essential steps and knowledge the nurse will apply to administer the remainder of this
    transfusion safely.

    5. What will the nurse communicate to educate the patient or family about the need for this procedure and what to
    expect?

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Evaluation

    6. You collect the following assessment data. Make a clinical judgment for each finding by placing an "x" in the
    appropriate column if the finding is expected or unexpected.

    Assessment Finding Expected Unexpected
    T: 98.2 F/36.8 C (oral)
    P: 108 (regular)
    R: 25 (regular)
    BP: 128/83
    O2 sat: 88% RA
    Appears anxious
    Breathing rapidly
    Skin is cool and clammy

    7. Is the overall status of the patient:

    a. Improved
    b. Declined
    c. No change

    8. Complete the table below for each home medication.

    Medication Pharm. Class Mechanism of Action Expected Outcome
    Metoprolol

    Lisinopril

    Furosemide

    Ferrous gluconate

    Potassium chloride

    9. Which home medication(s) that were not taken would have the greatest impact on his current status?

    Medication Rationale

    Lucy Myers

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    10. Calculate the patient's total intake and output, then interpret the significance of your findings.
    Intake and Output Clinical Significance

    11. What clinical data is most important and must be recognized as clinically significant by the nurse?

    Most Important Data Clinical Significance

    12. To interpret the clinical data collected, list at least two possible problems for this patient. Which problem is the

    priority?
    Possible Problems Priority Problem Pathophysiology of Priority Problem

    13. After evaluating the patient, identify the current nursing priority and which action(s) the nurse should take. List

    interventions by priority and the expected outcome.
    Nursing Priority
    Priority Intervention(s) Rationale Expected Outcome

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    14. Recognizing a potential problem, you use Identify-Situation-Background-Assessment-Recommendation (ISBAR)
    to update the provider. Summarize what you would communicate for an ISBAR report.

    I identify Specify who you are/where you work.

    • Yourself: name/position/location

    • Patient: name/age/gender

    S situation What is the problem/reason for contact?

    Concise summary of primary problem:

    B background If urgent, state concern. Provide concise/relevant history

    • Primary problem/diagnosis:

    • Day of admission/post-op day #:

    • Relevant past medical history:

    • Relevant treatments/interventions:

    A assessment Assessment of the situation using the most important clinical data.

    State your concern by communicating
    concerning clinical data:

    • Vital signs

    • Nursing assessment

    • Lab/diagnostic results

    Trend of most important clinical data
    (stable-increasing/decreasing):

    R recommendation Request specific advice/interventions. Clarify expectations.

    • Nurse suggestions to advance the plan
    of care:

    • What do you recommend?

    • Repeat and state back new
    orders/confirm plan of care:

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    15. Identify the rationale for each provider order and its expected outcome.

    Provider Orders Rationale Expected Outcome
    Furosemide 40 mg IV push

    Discontinue blood
    transfusion

    Apply oxygen to maintain
    oxygen saturation >92%

    Dosage Calculation: Furosemide 40 mg IV push

    Medication

    Time frame to
    Administer

    Show Work Volume to Administer

    16. Which findings are expected if the nursing and medical intervention(s) were effective?

    Expected Findings Rationale

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    17. The nurse has implemented the medical and nursing plan of care. One hour later, you collect the following
    assessment data below.
    For each finding, make a clinical judgment by placing an "x" in the appropriate column if the patient's
    condition has improved, has not changed, or has declined.

    Assessment Finding Improved No Change Declined
    Urine output: 750 mL
    HR: 89/minute
    RR: 18/minute non-labored
    BP: 124/80
    O2 sat: 96% room air
    Crackles persist in bases but are not as pronounced
    Resting comfortably appears less anxious

    18. Is the overall status of the patient:

    a. Improved
    b. No change
    c. Declined

    Documentation
    Write a concise nurse's note to document what was most important in the medical record.

    Nurse Reflection
    To strengthen your clinical judgment skills, reflect on your knowledge and the decisions made caring for this patient by
    answering the reflection questions below.
    Reflection Question Nurse Reflection
    As you worked through this
    simulation, how did it make you
    feel?

    What did you already know and do
    well on this simulation?

    What areas do you need to
    develop/improve?

    What did you learn? How will you
    apply what was learned to improve
    patient care?

    Lucy Myers

    01. Most Important Findings: History of heart failure
    Iron deficiency anemia
    low hemoglobin
    02. Clinical Significance: low hemoglobin needs blood tranfusion
    Heart failure can cause breath difficulties

    03. 2: As a student nurse I can not administrater blood alone without supervision, so I will ask charge nurse and also look at the hospital policy.
    04. need to gather: I will need gloves, vital sign machine, blood tubing with fliter, IV pump and normal saline
    05. transfusion safely: Check prescriptions for allergy, expiration, virefied orders with second nurse check vitals before blood tranfusion monitor patient during tranfusion watch for side inffect and decumention.
    06. expect: Educate patient that blood tranfusion will help with their hemonglobin, they should wash and report these symptoms; shortness of breath, and chest pain.
    07. Assessment Finding:
    08. ExpectedT 982 F368 C oral: x
    09. UnexpectedT 982 F368 C oral:
    10. ExpectedP 108 regular:
    11. UnexpectedP 108 regular: x
    12. ExpectedR 25 regular:
    13. UnexpectedR 25 regular: x
    14. ExpectedBP 12883: x
    15. UnexpectedBP 12883:
    16. ExpectedO2 sat 88 RA:
    17. UnexpectedO2 sat 88 RA: x
    18. ExpectedAppears anxious:
    19. UnexpectedAppears anxious: x
    20. ExpectedBreathing rapidly:
    21. UnexpectedBreathing rapidly: x
    22. ExpectedSkin is cool and clammy:
    23. UnexpectedSkin is cool and clammy: x
    24. Medication:
    25. Pharm ClassMetoprolol: Beta blocker
    26. Mechanism of ActionMetoprolol: reduce heart rate
    27. Expected OutcomeMetoprolol: lower heart rate
    28. Pharm ClassLisinopril: ACE inhabitor
    29. Mechanism of ActionLisinopril: lower BP
    30. Expected OutcomeLisinopril: lower BP
    31. Pharm ClassFurosemide: loop diuretic
    32. Mechanism of ActionFurosemide: Increase urine output
    33. Expected OutcomeFurosemide: reduce fluid retention
    34. Pharm ClassFerrous gluconate: iron suppliment
    35. Mechanism of ActionFerrous gluconate: Provide essential iron
    36. Expected OutcomeFerrous gluconate: prevention of iron deficiency enemia
    37. Pharm ClassPotassium chloride: electrolyte suppliment
    38. Mechanism of ActionPotassium chloride: replaces potassium
    39. Expected OutcomePotassium chloride: prevention of hypokalemia
    40. MedicationRow1: furosemide
    41. RationaleRow1: Furosemide, because it causes fliud build up
    42. Intake and OutputRow1: Blood tranfusion
    43. Clinical SignificanceRow1: excess fluid causes respiratory issue, like SOB
    44. Most Important DataRow1: Heart failure and rapid breathing
    45. Clinical SignificanceRow1_2: fluid overload
    46. Possible ProblemsRow1: fluid overload
    rapid breathing
    47. Priority ProblemRow1: fluid overload
    48. Pathophysiology of Priority ProblemRow1: excess fluid build-up place critical strain on the heart.
    49. Nursing Priority:
    50. Priority InterventionsRow1: Improving breathing
    51. RationaleRow1_2: administrater furosemide, notify provider and applying oxygen,
    52. Expected OutcomeRow1: improving breathing
    53. I identify:
    54. Specify who you arewhere you workYourself namepositionlocation Patient nameagegender: Nurse Lucy Myers, RN nurse on the medicine floor

    PT. is Andre Ronaine, 64yrs male PT.
    55. S situation:
    56. What is the problemreason for contactConcise summary of primary problem: Rapid breathing during tranfusion
    57. B background:
    58. If urgent state concern Provide conciserelevant historyPrimary problemdiagnosis Day of admissionpostop day Relevant past medical history Relevant treatmentsinterventions: History of heart failure, Iron deficiency anemia and low hemoglobin
    Admited this morning
    date of adnission, N/A
    Heart failure
    Tranfusion
    59. A assessment:
    60. Assessment of the situation using the most important clinical dataState your concern by communicating concerning clinical data Vital signs Nursing assessment Labdiagnostic results Trend of most important clinical data stableincreasingdecreasing: Pluse is 108, rispiratory 25 and O2 is 88%

    PT. vital signs

    Iron deficiency and low hemoglobin
    61. R recommendation:
    62. Request specific adviceinterventions Clarify expectationsNurse suggestions to advance the plan of care What do you recommend Repeat and state back new ordersconfirm plan of care: Give diuretics

    Give furosemide

    Continue to monitor Pt vitals
    63. Provider Orders:
    64. RationaleFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: To eliminate fluid overload

    Stop more overload

    To increase oxygen level
    65. Expected OutcomeFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: Enhance rispiration

    66. Administer: 1-2 minutes
    67. Show Work: 40mg/100mg =0.4×10=4ml
    68. Expected FindingsRow1: O2 level>92
    rapid breathing
    69. RationaleRow1_3: To improve gas exchange

    70. Assessment Finding_2:
    71. ImprovedUrine output 750 mL: x
    72. No ChangeUrine output 750 mL:
    73. DeclinedUrine output 750 mL:
    74. ImprovedHR 89minute: x
    75. No ChangeHR 89minute:
    76. DeclinedHR 89minute:
    77. ImprovedRR 18minute nonlabored: x
    78. No ChangeRR 18minute nonlabored:
    79. DeclinedRR 18minute nonlabored:
    80. ImprovedBP 12480: x
    81. No ChangeBP 12480:
    82. DeclinedBP 12480:
    83. ImprovedO2 sat 96 room air: x
    84. No ChangeO2 sat 96 room air:
    85. DeclinedO2 sat 96 room air:
    86. ImprovedCrackles persist in bases but are not as pronounced: x
    87. No ChangeCrackles persist in bases but are not as pronounced:
    88. DeclinedCrackles persist in bases but are not as pronounced:
    89. ImprovedResting comfortably appears less anxious: x
    90. No ChangeResting comfortably appears less anxious:
    91. DeclinedResting comfortably appears less anxious:
    92. Write a concise nurses note to document what was most important in the medical record: Furosimide IV push was administrater to pt. during blood transfusion, Pt experienced rapid breathing.
    93. Reflection Question:
    94. Nurse Reflection: It was somehow challenging
    95. Nurse ReflectionWhat did you already know and do well on this simulation: regonizing and understanding some the problem
    96. Nurse ReflectionWhat areas do you need to developimprove: monitoring for adverse effects
    97. Nurse ReflectionWhat did you learn How will you apply what was learned to improve patient care: I have learned that monitoring the patient closely and washing up for symptoms like, chest pain and shortness of breath it’s very essential.
    for patient care
    98. Text1: 4 ml

    **IMG_6870.jpeg**

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    **## BloodTransfusiondone.pdf**

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Blood Transfusion

    1. Which findings from the present problem are most important and noticed by the nurse as clinically significant?

    Most Important Findings Clinical Significance

    Procedural Safety Principles: Blood Administration

    2. What will you do if you have not performed blood administration in the clinical setting?

    3. If the nurse was going to administer another unit of packed red blood cells (PRBC), what supplies does the nurse

    need to gather?

    4. Review and summarize essential steps and knowledge the nurse will apply to administer the remainder of this
    transfusion safely.

    5. What will the nurse communicate to educate the patient or family about the need for this procedure and what to
    expect?

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Evaluation

    6. You collect the following assessment data. Make a clinical judgment for each finding by placing an "x" in the
    appropriate column if the finding is expected or unexpected.

    Assessment Finding Expected Unexpected
    T: 98.2 F/36.8 C (oral)
    P: 108 (regular)
    R: 25 (regular)
    BP: 128/83
    O2 sat: 88% RA
    Appears anxious
    Breathing rapidly
    Skin is cool and clammy

    7. Is the overall status of the patient:

    a. Improved
    b. Declined
    c. No change

    8. Complete the table below for each home medication.

    Medication Pharm. Class Mechanism of Action Expected Outcome
    Metoprolol

    Lisinopril

    Furosemide

    Ferrous gluconate

    Potassium chloride

    9. Which home medication(s) that were not taken would have the greatest impact on his current status?

    Medication Rationale

    Lucy Myers

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    10. Calculate the patient's total intake and output, then interpret the significance of your findings.
    Intake and Output Clinical Significance

    11. What clinical data is most important and must be recognized as clinically significant by the nurse?

    Most Important Data Clinical Significance

    12. To interpret the clinical data collected, list at least two possible problems for this patient. Which problem is the

    priority?
    Possible Problems Priority Problem Pathophysiology of Priority Problem

    13. After evaluating the patient, identify the current nursing priority and which action(s) the nurse should take. List

    interventions by priority and the expected outcome.
    Nursing Priority
    Priority Intervention(s) Rationale Expected Outcome

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    14. Recognizing a potential problem, you use Identify-Situation-Background-Assessment-Recommendation (ISBAR)
    to update the provider. Summarize what you would communicate for an ISBAR report.

    I identify Specify who you are/where you work.

    • Yourself: name/position/location

    • Patient: name/age/gender

    S situation What is the problem/reason for contact?

    Concise summary of primary problem:

    B background If urgent, state concern. Provide concise/relevant history

    • Primary problem/diagnosis:

    • Day of admission/post-op day #:

    • Relevant past medical history:

    • Relevant treatments/interventions:

    A assessment Assessment of the situation using the most important clinical data.

    State your concern by communicating
    concerning clinical data:

    • Vital signs

    • Nursing assessment

    • Lab/diagnostic results

    Trend of most important clinical data
    (stable-increasing/decreasing):

    R recommendation Request specific advice/interventions. Clarify expectations.

    • Nurse suggestions to advance the plan
    of care:

    • What do you recommend?

    • Repeat and state back new
    orders/confirm plan of care:

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    15. Identify the rationale for each provider order and its expected outcome.

    Provider Orders Rationale Expected Outcome
    Furosemide 40 mg IV push

    Discontinue blood
    transfusion

    Apply oxygen to maintain
    oxygen saturation >92%

    Dosage Calculation: Furosemide 40 mg IV push

    Medication

    Time frame to
    Administer

    Show Work Volume to Administer

    16. Which findings are expected if the nursing and medical intervention(s) were effective?

    Expected Findings Rationale

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    17. The nurse has implemented the medical and nursing plan of care. One hour later, you collect the following
    assessment data below.
    For each finding, make a clinical judgment by placing an "x" in the appropriate column if the patient's
    condition has improved, has not changed, or has declined.

    Assessment Finding Improved No Change Declined
    Urine output: 750 mL
    HR: 89/minute
    RR: 18/minute non-labored
    BP: 124/80
    O2 sat: 96% room air
    Crackles persist in bases but are not as pronounced
    Resting comfortably appears less anxious

    18. Is the overall status of the patient:

    a. Improved
    b. No change
    c. Declined

    Documentation
    Write a concise nurse's note to document what was most important in the medical record.

    Nurse Reflection
    To strengthen your clinical judgment skills, reflect on your knowledge and the decisions made caring for this patient by
    answering the reflection questions below.
    Reflection Question Nurse Reflection
    As you worked through this
    simulation, how did it make you
    feel?

    What did you already know and do
    well on this simulation?

    What areas do you need to
    develop/improve?

    What did you learn? How will you
    apply what was learned to improve
    patient care?

    Lucy Myers

    01. Most Important Findings: History of heart failure
    Iron deficiency anemia
    low hemoglobin
    02. Clinical Significance: low hemoglobin needs blood tranfusion
    Heart failure can cause breath difficulties

    03. 2: As a student nurse I can not administrater blood alone without supervision, so I will ask charge nurse and also look at the hospital policy.
    04. need to gather: I will need gloves, vital sign machine, blood tubing with fliter, IV pump and normal saline
    05. transfusion safely: Check prescriptions for allergy, expiration, virefied orders with second nurse check vitals before blood tranfusion monitor patient during tranfusion watch for side inffect and decumention.
    06. expect: Educate patient that blood tranfusion will help with their hemonglobin, they should wash and report these symptoms; shortness of breath, and chest pain.
    07. Assessment Finding:
    08. ExpectedT 982 F368 C oral: x
    09. UnexpectedT 982 F368 C oral:
    10. ExpectedP 108 regular:
    11. UnexpectedP 108 regular: x
    12. ExpectedR 25 regular:
    13. UnexpectedR 25 regular: x
    14. ExpectedBP 12883: x
    15. UnexpectedBP 12883:
    16. ExpectedO2 sat 88 RA:
    17. UnexpectedO2 sat 88 RA: x
    18. ExpectedAppears anxious:
    19. UnexpectedAppears anxious: x
    20. ExpectedBreathing rapidly:
    21. UnexpectedBreathing rapidly: x
    22. ExpectedSkin is cool and clammy:
    23. UnexpectedSkin is cool and clammy: x
    24. Medication:
    25. Pharm ClassMetoprolol: Beta blocker
    26. Mechanism of ActionMetoprolol: reduce heart rate
    27. Expected OutcomeMetoprolol: lower heart rate
    28. Pharm ClassLisinopril: ACE inhabitor
    29. Mechanism of ActionLisinopril: lower BP
    30. Expected OutcomeLisinopril: lower BP
    31. Pharm ClassFurosemide: loop diuretic
    32. Mechanism of ActionFurosemide: Increase urine output
    33. Expected OutcomeFurosemide: reduce fluid retention
    34. Pharm ClassFerrous gluconate: iron suppliment
    35. Mechanism of ActionFerrous gluconate: Provide essential iron
    36. Expected OutcomeFerrous gluconate: prevention of iron deficiency enemia
    37. Pharm ClassPotassium chloride: electrolyte suppliment
    38. Mechanism of ActionPotassium chloride: replaces potassium
    39. Expected OutcomePotassium chloride: prevention of hypokalemia
    40. MedicationRow1: furosemide
    41. RationaleRow1: Furosemide, because it causes fliud build up
    42. Intake and OutputRow1: Blood tranfusion
    43. Clinical SignificanceRow1: excess fluid causes respiratory issue, like SOB
    44. Most Important DataRow1: Heart failure and rapid breathing
    45. Clinical SignificanceRow1_2: fluid overload
    46. Possible ProblemsRow1: fluid overload
    rapid breathing
    47. Priority ProblemRow1: fluid overload
    48. Pathophysiology of Priority ProblemRow1: excess fluid build-up place critical strain on the heart.
    49. Nursing Priority:
    50. Priority InterventionsRow1: Improving breathing
    51. RationaleRow1_2: administrater furosemide, notify provider and applying oxygen,
    52. Expected OutcomeRow1: improving breathing
    53. I identify:
    54. Specify who you arewhere you workYourself namepositionlocation Patient nameagegender: Nurse Lucy Myers, RN nurse on the medicine floor

    PT. is Andre Ronaine, 64yrs male PT.
    55. S situation:
    56. What is the problemreason for contactConcise summary of primary problem: Rapid breathing during tranfusion
    57. B background:
    58. If urgent state concern Provide conciserelevant historyPrimary problemdiagnosis Day of admissionpostop day Relevant past medical history Relevant treatmentsinterventions: History of heart failure, Iron deficiency anemia and low hemoglobin
    Admited this morning
    date of adnission, N/A
    Heart failure
    Tranfusion
    59. A assessment:
    60. Assessment of the situation using the most important clinical dataState your concern by communicating concerning clinical data Vital signs Nursing assessment Labdiagnostic results Trend of most important clinical data stableincreasingdecreasing: Pluse is 108, rispiratory 25 and O2 is 88%

    PT. vital signs

    Iron deficiency and low hemoglobin
    61. R recommendation:
    62. Request specific adviceinterventions Clarify expectationsNurse suggestions to advance the plan of care What do you recommend Repeat and state back new ordersconfirm plan of care: Give diuretics

    Give furosemide

    Continue to monitor Pt vitals
    63. Provider Orders:
    64. RationaleFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: To eliminate fluid overload

    Stop more overload

    To increase oxygen level
    65. Expected OutcomeFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: Enhance rispiration

    66. Administer: 1-2 minutes
    67. Show Work: 40mg/100mg =0.4×10=4ml
    68. Expected FindingsRow1: O2 level>92
    rapid breathing
    69. RationaleRow1_3: To improve gas exchange

    70. Assessment Finding_2:
    71. ImprovedUrine output 750 mL: x
    72. No ChangeUrine output 750 mL:
    73. DeclinedUrine output 750 mL:
    74. ImprovedHR 89minute: x
    75. No ChangeHR 89minute:
    76. DeclinedHR 89minute:
    77. ImprovedRR 18minute nonlabored: x
    78. No ChangeRR 18minute nonlabored:
    79. DeclinedRR 18minute nonlabored:
    80. ImprovedBP 12480: x
    81. No ChangeBP 12480:
    82. DeclinedBP 12480:
    83. ImprovedO2 sat 96 room air: x
    84. No ChangeO2 sat 96 room air:
    85. DeclinedO2 sat 96 room air:
    86. ImprovedCrackles persist in bases but are not as pronounced: x
    87. No ChangeCrackles persist in bases but are not as pronounced:
    88. DeclinedCrackles persist in bases but are not as pronounced:
    89. ImprovedResting comfortably appears less anxious: x
    90. No ChangeResting comfortably appears less anxious:
    91. DeclinedResting comfortably appears less anxious:
    92. Write a concise nurses note to document what was most important in the medical record: Furosimide IV push was administrater to pt. during blood transfusion, Pt experienced rapid breathing.
    93. Reflection Question:
    94. Nurse Reflection: It was somehow challenging
    95. Nurse ReflectionWhat did you already know and do well on this simulation: regonizing and understanding some the problem
    96. Nurse ReflectionWhat areas do you need to developimprove: monitoring for adverse effects
    97. Nurse ReflectionWhat did you learn How will you apply what was learned to improve patient care: I have learned that monitoring the patient closely and washing up for symptoms like, chest pain and shortness of breath it’s very essential.
    for patient care
    98. Text1: 4 ml

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    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Blood Transfusion

    1. Which findings from the present problem are most important and noticed by the nurse as clinically significant?

    Most Important Findings Clinical Significance

    Procedural Safety Principles: Blood Administration

    2. What will you do if you have not performed blood administration in the clinical setting?

    3. If the nurse was going to administer another unit of packed red blood cells (PRBC), what supplies does the nurse

    need to gather?

    4. Review and summarize essential steps and knowledge the nurse will apply to administer the remainder of this
    transfusion safely.

    5. What will the nurse communicate to educate the patient or family about the need for this procedure and what to
    expect?

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Evaluation

    6. You collect the following assessment data. Make a clinical judgment for each finding by placing an "x" in the
    appropriate column if the finding is expected or unexpected.

    Assessment Finding Expected Unexpected
    T: 98.2 F/36.8 C (oral)
    P: 108 (regular)
    R: 25 (regular)
    BP: 128/83
    O2 sat: 88% RA
    Appears anxious
    Breathing rapidly
    Skin is cool and clammy

    7. Is the overall status of the patient:

    a. Improved
    b. Declined
    c. No change

    8. Complete the table below for each home medication.

    Medication Pharm. Class Mechanism of Action Expected Outcome
    Metoprolol

    Lisinopril

    Furosemide

    Ferrous gluconate

    Potassium chloride

    9. Which home medication(s) that were not taken would have the greatest impact on his current status?

    Medication Rationale

    Lucy Myers

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    10. Calculate the patient's total intake and output, then interpret the significance of your findings.
    Intake and Output Clinical Significance

    11. What clinical data is most important and must be recognized as clinically significant by the nurse?

    Most Important Data Clinical Significance

    12. To interpret the clinical data collected, list at least two possible problems for this patient. Which problem is the

    priority?
    Possible Problems Priority Problem Pathophysiology of Priority Problem

    13. After evaluating the patient, identify the current nursing priority and which action(s) the nurse should take. List

    interventions by priority and the expected outcome.
    Nursing Priority
    Priority Intervention(s) Rationale Expected Outcome

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    14. Recognizing a potential problem, you use Identify-Situation-Background-Assessment-Recommendation (ISBAR)
    to update the provider. Summarize what you would communicate for an ISBAR report.

    I identify Specify who you are/where you work.

    • Yourself: name/position/location

    • Patient: name/age/gender

    S situation What is the problem/reason for contact?

    Concise summary of primary problem:

    B background If urgent, state concern. Provide concise/relevant history

    • Primary problem/diagnosis:

    • Day of admission/post-op day #:

    • Relevant past medical history:

    • Relevant treatments/interventions:

    A assessment Assessment of the situation using the most important clinical data.

    State your concern by communicating
    concerning clinical data:

    • Vital signs

    • Nursing assessment

    • Lab/diagnostic results

    Trend of most important clinical data
    (stable-increasing/decreasing):

    R recommendation Request specific advice/interventions. Clarify expectations.

    • Nurse suggestions to advance the plan
    of care:

    • What do you recommend?

    • Repeat and state back new
    orders/confirm plan of care:

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    15. Identify the rationale for each provider order and its expected outcome.

    Provider Orders Rationale Expected Outcome
    Furosemide 40 mg IV push

    Discontinue blood
    transfusion

    Apply oxygen to maintain
    oxygen saturation >92%

    Dosage Calculation: Furosemide 40 mg IV push

    Medication

    Time frame to
    Administer

    Show Work Volume to Administer

    16. Which findings are expected if the nursing and medical intervention(s) were effective?

    Expected Findings Rationale

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    17. The nurse has implemented the medical and nursing plan of care. One hour later, you collect the following
    assessment data below.
    For each finding, make a clinical judgment by placing an "x" in the appropriate column if the patient's
    condition has improved, has not changed, or has declined.

    Assessment Finding Improved No Change Declined
    Urine output: 750 mL
    HR: 89/minute
    RR: 18/minute non-labored
    BP: 124/80
    O2 sat: 96% room air
    Crackles persist in bases but are not as pronounced
    Resting comfortably appears less anxious

    18. Is the overall status of the patient:

    a. Improved
    b. No change
    c. Declined

    Documentation
    Write a concise nurse's note to document what was most important in the medical record.

    Nurse Reflection
    To strengthen your clinical judgment skills, reflect on your knowledge and the decisions made caring for this patient by
    answering the reflection questions below.
    Reflection Question Nurse Reflection
    As you worked through this
    simulation, how did it make you
    feel?

    What did you already know and do
    well on this simulation?

    What areas do you need to
    develop/improve?

    What did you learn? How will you
    apply what was learned to improve
    patient care?

    Lucy Myers

    01. Most Important Findings: History of heart failure
    Iron deficiency anemia
    low hemoglobin
    02. Clinical Significance: low hemoglobin needs blood tranfusion
    Heart failure can cause breath difficulties

    03. 2: As a student nurse I can not administrater blood alone without supervision, so I will ask charge nurse and also look at the hospital policy.
    04. need to gather: I will need gloves, vital sign machine, blood tubing with fliter, IV pump and normal saline
    05. transfusion safely: Check prescriptions for allergy, expiration, virefied orders with second nurse check vitals before blood tranfusion monitor patient during tranfusion watch for side inffect and decumention.
    06. expect: Educate patient that blood tranfusion will help with their hemonglobin, they should wash and report these symptoms; shortness of breath, and chest pain.
    07. Assessment Finding:
    08. ExpectedT 982 F368 C oral: x
    09. UnexpectedT 982 F368 C oral:
    10. ExpectedP 108 regular:
    11. UnexpectedP 108 regular: x
    12. ExpectedR 25 regular:
    13. UnexpectedR 25 regular: x
    14. ExpectedBP 12883: x
    15. UnexpectedBP 12883:
    16. ExpectedO2 sat 88 RA:
    17. UnexpectedO2 sat 88 RA: x
    18. ExpectedAppears anxious:
    19. UnexpectedAppears anxious: x
    20. ExpectedBreathing rapidly:
    21. UnexpectedBreathing rapidly: x
    22. ExpectedSkin is cool and clammy:
    23. UnexpectedSkin is cool and clammy: x
    24. Medication:
    25. Pharm ClassMetoprolol: Beta blocker
    26. Mechanism of ActionMetoprolol: reduce heart rate
    27. Expected OutcomeMetoprolol: lower heart rate
    28. Pharm ClassLisinopril: ACE inhabitor
    29. Mechanism of ActionLisinopril: lower BP
    30. Expected OutcomeLisinopril: lower BP
    31. Pharm ClassFurosemide: loop diuretic
    32. Mechanism of ActionFurosemide: Increase urine output
    33. Expected OutcomeFurosemide: reduce fluid retention
    34. Pharm ClassFerrous gluconate: iron suppliment
    35. Mechanism of ActionFerrous gluconate: Provide essential iron
    36. Expected OutcomeFerrous gluconate: prevention of iron deficiency enemia
    37. Pharm ClassPotassium chloride: electrolyte suppliment
    38. Mechanism of ActionPotassium chloride: replaces potassium
    39. Expected OutcomePotassium chloride: prevention of hypokalemia
    40. MedicationRow1: furosemide
    41. RationaleRow1: Furosemide, because it causes fliud build up
    42. Intake and OutputRow1: Blood tranfusion
    43. Clinical SignificanceRow1: excess fluid causes respiratory issue, like SOB
    44. Most Important DataRow1: Heart failure and rapid breathing
    45. Clinical SignificanceRow1_2: fluid overload
    46. Possible ProblemsRow1: fluid overload
    rapid breathing
    47. Priority ProblemRow1: fluid overload
    48. Pathophysiology of Priority ProblemRow1: excess fluid build-up place critical strain on the heart.
    49. Nursing Priority:
    50. Priority InterventionsRow1: Improving breathing
    51. RationaleRow1_2: administrater furosemide, notify provider and applying oxygen,
    52. Expected OutcomeRow1: improving breathing
    53. I identify:
    54. Specify who you arewhere you workYourself namepositionlocation Patient nameagegender: Nurse Lucy Myers, RN nurse on the medicine floor

    PT. is Andre Ronaine, 64yrs male PT.
    55. S situation:
    56. What is the problemreason for contactConcise summary of primary problem: Rapid breathing during tranfusion
    57. B background:
    58. If urgent state concern Provide conciserelevant historyPrimary problemdiagnosis Day of admissionpostop day Relevant past medical history Relevant treatmentsinterventions: History of heart failure, Iron deficiency anemia and low hemoglobin
    Admited this morning
    date of adnission, N/A
    Heart failure
    Tranfusion
    59. A assessment:
    60. Assessment of the situation using the most important clinical dataState your concern by communicating concerning clinical data Vital signs Nursing assessment Labdiagnostic results Trend of most important clinical data stableincreasingdecreasing: Pluse is 108, rispiratory 25 and O2 is 88%

    PT. vital signs

    Iron deficiency and low hemoglobin
    61. R recommendation:
    62. Request specific adviceinterventions Clarify expectationsNurse suggestions to advance the plan of care What do you recommend Repeat and state back new ordersconfirm plan of care: Give diuretics

    Give furosemide

    Continue to monitor Pt vitals
    63. Provider Orders:
    64. RationaleFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: To eliminate fluid overload

    Stop more overload

    To increase oxygen level
    65. Expected OutcomeFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: Enhance rispiration

    66. Administer: 1-2 minutes
    67. Show Work: 40mg/100mg =0.4×10=4ml
    68. Expected FindingsRow1: O2 level>92
    rapid breathing
    69. RationaleRow1_3: To improve gas exchange

    70. Assessment Finding_2:
    71. ImprovedUrine output 750 mL: x
    72. No ChangeUrine output 750 mL:
    73. DeclinedUrine output 750 mL:
    74. ImprovedHR 89minute: x
    75. No ChangeHR 89minute:
    76. DeclinedHR 89minute:
    77. ImprovedRR 18minute nonlabored: x
    78. No ChangeRR 18minute nonlabored:
    79. DeclinedRR 18minute nonlabored:
    80. ImprovedBP 12480: x
    81. No ChangeBP 12480:
    82. DeclinedBP 12480:
    83. ImprovedO2 sat 96 room air: x
    84. No ChangeO2 sat 96 room air:
    85. DeclinedO2 sat 96 room air:
    86. ImprovedCrackles persist in bases but are not as pronounced: x
    87. No ChangeCrackles persist in bases but are not as pronounced:
    88. DeclinedCrackles persist in bases but are not as pronounced:
    89. ImprovedResting comfortably appears less anxious: x
    90. No ChangeResting comfortably appears less anxious:
    91. DeclinedResting comfortably appears less anxious:
    92. Write a concise nurses note to document what was most important in the medical record: Furosimide IV push was administrater to pt. during blood transfusion, Pt experienced rapid breathing.
    93. Reflection Question:
    94. Nurse Reflection: It was somehow challenging
    95. Nurse ReflectionWhat did you already know and do well on this simulation: regonizing and understanding some the problem
    96. Nurse ReflectionWhat areas do you need to developimprove: monitoring for adverse effects
    97. Nurse ReflectionWhat did you learn How will you apply what was learned to improve patient care: I have learned that monitoring the patient closely and washing up for symptoms like, chest pain and shortness of breath it’s very essential.
    for patient care
    98. Text1: 4 ml

    **IMG_6870.jpeg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/img-6870-jpeg-10508713)

    **IMG_6870.jpeg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/img-6870-jpeg-10508713)

    **## BloodTransfusiondone.pdf**

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Blood Transfusion

    1. Which findings from the present problem are most important and noticed by the nurse as clinically significant?

    Most Important Findings Clinical Significance

    Procedural Safety Principles: Blood Administration

    2. What will you do if you have not performed blood administration in the clinical setting?

    3. If the nurse was going to administer another unit of packed red blood cells (PRBC), what supplies does the nurse

    need to gather?

    4. Review and summarize essential steps and knowledge the nurse will apply to administer the remainder of this
    transfusion safely.

    5. What will the nurse communicate to educate the patient or family about the need for this procedure and what to
    expect?

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Evaluation

    6. You collect the following assessment data. Make a clinical judgment for each finding by placing an "x" in the
    appropriate column if the finding is expected or unexpected.

    Assessment Finding Expected Unexpected
    T: 98.2 F/36.8 C (oral)
    P: 108 (regular)
    R: 25 (regular)
    BP: 128/83
    O2 sat: 88% RA
    Appears anxious
    Breathing rapidly
    Skin is cool and clammy

    7. Is the overall status of the patient:

    a. Improved
    b. Declined
    c. No change

    8. Complete the table below for each home medication.

    Medication Pharm. Class Mechanism of Action Expected Outcome
    Metoprolol

    Lisinopril

    Furosemide

    Ferrous gluconate

    Potassium chloride

    9. Which home medication(s) that were not taken would have the greatest impact on his current status?

    Medication Rationale

    Lucy Myers

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    10. Calculate the patient's total intake and output, then interpret the significance of your findings.
    Intake and Output Clinical Significance

    11. What clinical data is most important and must be recognized as clinically significant by the nurse?

    Most Important Data Clinical Significance

    12. To interpret the clinical data collected, list at least two possible problems for this patient. Which problem is the

    priority?
    Possible Problems Priority Problem Pathophysiology of Priority Problem

    13. After evaluating the patient, identify the current nursing priority and which action(s) the nurse should take. List

    interventions by priority and the expected outcome.
    Nursing Priority
    Priority Intervention(s) Rationale Expected Outcome

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    14. Recognizing a potential problem, you use Identify-Situation-Background-Assessment-Recommendation (ISBAR)
    to update the provider. Summarize what you would communicate for an ISBAR report.

    I identify Specify who you are/where you work.

    • Yourself: name/position/location

    • Patient: name/age/gender

    S situation What is the problem/reason for contact?

    Concise summary of primary problem:

    B background If urgent, state concern. Provide concise/relevant history

    • Primary problem/diagnosis:

    • Day of admission/post-op day #:

    • Relevant past medical history:

    • Relevant treatments/interventions:

    A assessment Assessment of the situation using the most important clinical data.

    State your concern by communicating
    concerning clinical data:

    • Vital signs

    • Nursing assessment

    • Lab/diagnostic results

    Trend of most important clinical data
    (stable-increasing/decreasing):

    R recommendation Request specific advice/interventions. Clarify expectations.

    • Nurse suggestions to advance the plan
    of care:

    • What do you recommend?

    • Repeat and state back new
    orders/confirm plan of care:

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    15. Identify the rationale for each provider order and its expected outcome.

    Provider Orders Rationale Expected Outcome
    Furosemide 40 mg IV push

    Discontinue blood
    transfusion

    Apply oxygen to maintain
    oxygen saturation >92%

    Dosage Calculation: Furosemide 40 mg IV push

    Medication

    Time frame to
    Administer

    Show Work Volume to Administer

    16. Which findings are expected if the nursing and medical intervention(s) were effective?

    Expected Findings Rationale

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    17. The nurse has implemented the medical and nursing plan of care. One hour later, you collect the following
    assessment data below.
    For each finding, make a clinical judgment by placing an "x" in the appropriate column if the patient's
    condition has improved, has not changed, or has declined.

    Assessment Finding Improved No Change Declined
    Urine output: 750 mL
    HR: 89/minute
    RR: 18/minute non-labored
    BP: 124/80
    O2 sat: 96% room air
    Crackles persist in bases but are not as pronounced
    Resting comfortably appears less anxious

    18. Is the overall status of the patient:

    a. Improved
    b. No change
    c. Declined

    Documentation
    Write a concise nurse's note to document what was most important in the medical record.

    Nurse Reflection
    To strengthen your clinical judgment skills, reflect on your knowledge and the decisions made caring for this patient by
    answering the reflection questions below.
    Reflection Question Nurse Reflection
    As you worked through this
    simulation, how did it make you
    feel?

    What did you already know and do
    well on this simulation?

    What areas do you need to
    develop/improve?

    What did you learn? How will you
    apply what was learned to improve
    patient care?

    Lucy Myers

    01. Most Important Findings: History of heart failure
    Iron deficiency anemia
    low hemoglobin
    02. Clinical Significance: low hemoglobin needs blood tranfusion
    Heart failure can cause breath difficulties

    03. 2: As a student nurse I can not administrater blood alone without supervision, so I will ask charge nurse and also look at the hospital policy.
    04. need to gather: I will need gloves, vital sign machine, blood tubing with fliter, IV pump and normal saline
    05. transfusion safely: Check prescriptions for allergy, expiration, virefied orders with second nurse check vitals before blood tranfusion monitor patient during tranfusion watch for side inffect and decumention.
    06. expect: Educate patient that blood tranfusion will help with their hemonglobin, they should wash and report these symptoms; shortness of breath, and chest pain.
    07. Assessment Finding:
    08. ExpectedT 982 F368 C oral: x
    09. UnexpectedT 982 F368 C oral:
    10. ExpectedP 108 regular:
    11. UnexpectedP 108 regular: x
    12. ExpectedR 25 regular:
    13. UnexpectedR 25 regular: x
    14. ExpectedBP 12883: x
    15. UnexpectedBP 12883:
    16. ExpectedO2 sat 88 RA:
    17. UnexpectedO2 sat 88 RA: x
    18. ExpectedAppears anxious:
    19. UnexpectedAppears anxious: x
    20. ExpectedBreathing rapidly:
    21. UnexpectedBreathing rapidly: x
    22. ExpectedSkin is cool and clammy:
    23. UnexpectedSkin is cool and clammy: x
    24. Medication:
    25. Pharm ClassMetoprolol: Beta blocker
    26. Mechanism of ActionMetoprolol: reduce heart rate
    27. Expected OutcomeMetoprolol: lower heart rate
    28. Pharm ClassLisinopril: ACE inhabitor
    29. Mechanism of ActionLisinopril: lower BP
    30. Expected OutcomeLisinopril: lower BP
    31. Pharm ClassFurosemide: loop diuretic
    32. Mechanism of ActionFurosemide: Increase urine output
    33. Expected OutcomeFurosemide: reduce fluid retention
    34. Pharm ClassFerrous gluconate: iron suppliment
    35. Mechanism of ActionFerrous gluconate: Provide essential iron
    36. Expected OutcomeFerrous gluconate: prevention of iron deficiency enemia
    37. Pharm ClassPotassium chloride: electrolyte suppliment
    38. Mechanism of ActionPotassium chloride: replaces potassium
    39. Expected OutcomePotassium chloride: prevention of hypokalemia
    40. MedicationRow1: furosemide
    41. RationaleRow1: Furosemide, because it causes fliud build up
    42. Intake and OutputRow1: Blood tranfusion
    43. Clinical SignificanceRow1: excess fluid causes respiratory issue, like SOB
    44. Most Important DataRow1: Heart failure and rapid breathing
    45. Clinical SignificanceRow1_2: fluid overload
    46. Possible ProblemsRow1: fluid overload
    rapid breathing
    47. Priority ProblemRow1: fluid overload
    48. Pathophysiology of Priority ProblemRow1: excess fluid build-up place critical strain on the heart.
    49. Nursing Priority:
    50. Priority InterventionsRow1: Improving breathing
    51. RationaleRow1_2: administrater furosemide, notify provider and applying oxygen,
    52. Expected OutcomeRow1: improving breathing
    53. I identify:
    54. Specify who you arewhere you workYourself namepositionlocation Patient nameagegender: Nurse Lucy Myers, RN nurse on the medicine floor

    PT. is Andre Ronaine, 64yrs male PT.
    55. S situation:
    56. What is the problemreason for contactConcise summary of primary problem: Rapid breathing during tranfusion
    57. B background:
    58. If urgent state concern Provide conciserelevant historyPrimary problemdiagnosis Day of admissionpostop day Relevant past medical history Relevant treatmentsinterventions: History of heart failure, Iron deficiency anemia and low hemoglobin
    Admited this morning
    date of adnission, N/A
    Heart failure
    Tranfusion
    59. A assessment:
    60. Assessment of the situation using the most important clinical dataState your concern by communicating concerning clinical data Vital signs Nursing assessment Labdiagnostic results Trend of most important clinical data stableincreasingdecreasing: Pluse is 108, rispiratory 25 and O2 is 88%

    PT. vital signs

    Iron deficiency and low hemoglobin
    61. R recommendation:
    62. Request specific adviceinterventions Clarify expectationsNurse suggestions to advance the plan of care What do you recommend Repeat and state back new ordersconfirm plan of care: Give diuretics

    Give furosemide

    Continue to monitor Pt vitals
    63. Provider Orders:
    64. RationaleFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: To eliminate fluid overload

    Stop more overload

    To increase oxygen level
    65. Expected OutcomeFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: Enhance rispiration

    66. Administer: 1-2 minutes
    67. Show Work: 40mg/100mg =0.4×10=4ml
    68. Expected FindingsRow1: O2 level>92
    rapid breathing
    69. RationaleRow1_3: To improve gas exchange

    70. Assessment Finding_2:
    71. ImprovedUrine output 750 mL: x
    72. No ChangeUrine output 750 mL:
    73. DeclinedUrine output 750 mL:
    74. ImprovedHR 89minute: x
    75. No ChangeHR 89minute:
    76. DeclinedHR 89minute:
    77. ImprovedRR 18minute nonlabored: x
    78. No ChangeRR 18minute nonlabored:
    79. DeclinedRR 18minute nonlabored:
    80. ImprovedBP 12480: x
    81. No ChangeBP 12480:
    82. DeclinedBP 12480:
    83. ImprovedO2 sat 96 room air: x
    84. No ChangeO2 sat 96 room air:
    85. DeclinedO2 sat 96 room air:
    86. ImprovedCrackles persist in bases but are not as pronounced: x
    87. No ChangeCrackles persist in bases but are not as pronounced:
    88. DeclinedCrackles persist in bases but are not as pronounced:
    89. ImprovedResting comfortably appears less anxious: x
    90. No ChangeResting comfortably appears less anxious:
    91. DeclinedResting comfortably appears less anxious:
    92. Write a concise nurses note to document what was most important in the medical record: Furosimide IV push was administrater to pt. during blood transfusion, Pt experienced rapid breathing.
    93. Reflection Question:
    94. Nurse Reflection: It was somehow challenging
    95. Nurse ReflectionWhat did you already know and do well on this simulation: regonizing and understanding some the problem
    96. Nurse ReflectionWhat areas do you need to developimprove: monitoring for adverse effects
    97. Nurse ReflectionWhat did you learn How will you apply what was learned to improve patient care: I have learned that monitoring the patient closely and washing up for symptoms like, chest pain and shortness of breath it’s very essential.
    for patient care
    98. Text1: 4 ml

    **IMG_6870.jpeg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/img-6870-jpeg-10508713)

    **## BloodTransfusiondone.pdf**

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Blood Transfusion

    1. Which findings from the present problem are most important and noticed by the nurse as clinically significant?

    Most Important Findings Clinical Significance

    Procedural Safety Principles: Blood Administration

    2. What will you do if you have not performed blood administration in the clinical setting?

    3. If the nurse was going to administer another unit of packed red blood cells (PRBC), what supplies does the nurse

    need to gather?

    4. Review and summarize essential steps and knowledge the nurse will apply to administer the remainder of this
    transfusion safely.

    5. What will the nurse communicate to educate the patient or family about the need for this procedure and what to
    expect?

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    Evaluation

    6. You collect the following assessment data. Make a clinical judgment for each finding by placing an "x" in the
    appropriate column if the finding is expected or unexpected.

    Assessment Finding Expected Unexpected
    T: 98.2 F/36.8 C (oral)
    P: 108 (regular)
    R: 25 (regular)
    BP: 128/83
    O2 sat: 88% RA
    Appears anxious
    Breathing rapidly
    Skin is cool and clammy

    7. Is the overall status of the patient:

    a. Improved
    b. Declined
    c. No change

    8. Complete the table below for each home medication.

    Medication Pharm. Class Mechanism of Action Expected Outcome
    Metoprolol

    Lisinopril

    Furosemide

    Ferrous gluconate

    Potassium chloride

    9. Which home medication(s) that were not taken would have the greatest impact on his current status?

    Medication Rationale

    Lucy Myers

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    10. Calculate the patient's total intake and output, then interpret the significance of your findings.
    Intake and Output Clinical Significance

    11. What clinical data is most important and must be recognized as clinically significant by the nurse?

    Most Important Data Clinical Significance

    12. To interpret the clinical data collected, list at least two possible problems for this patient. Which problem is the

    priority?
    Possible Problems Priority Problem Pathophysiology of Priority Problem

    13. After evaluating the patient, identify the current nursing priority and which action(s) the nurse should take. List

    interventions by priority and the expected outcome.
    Nursing Priority
    Priority Intervention(s) Rationale Expected Outcome

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    14. Recognizing a potential problem, you use Identify-Situation-Background-Assessment-Recommendation (ISBAR)
    to update the provider. Summarize what you would communicate for an ISBAR report.

    I identify Specify who you are/where you work.

    • Yourself: name/position/location

    • Patient: name/age/gender

    S situation What is the problem/reason for contact?

    Concise summary of primary problem:

    B background If urgent, state concern. Provide concise/relevant history

    • Primary problem/diagnosis:

    • Day of admission/post-op day #:

    • Relevant past medical history:

    • Relevant treatments/interventions:

    A assessment Assessment of the situation using the most important clinical data.

    State your concern by communicating
    concerning clinical data:

    • Vital signs

    • Nursing assessment

    • Lab/diagnostic results

    Trend of most important clinical data
    (stable-increasing/decreasing):

    R recommendation Request specific advice/interventions. Clarify expectations.

    • Nurse suggestions to advance the plan
    of care:

    • What do you recommend?

    • Repeat and state back new
    orders/confirm plan of care:

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    15. Identify the rationale for each provider order and its expected outcome.

    Provider Orders Rationale Expected Outcome
    Furosemide 40 mg IV push

    Discontinue blood
    transfusion

    Apply oxygen to maintain
    oxygen saturation >92%

    Dosage Calculation: Furosemide 40 mg IV push

    Medication

    Time frame to
    Administer

    Show Work Volume to Administer

    16. Which findings are expected if the nursing and medical intervention(s) were effective?

    Expected Findings Rationale

    Nursing Skills & Reasoning

    © 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
    form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

    17. The nurse has implemented the medical and nursing plan of care. One hour later, you collect the following
    assessment data below.
    For each finding, make a clinical judgment by placing an "x" in the appropriate column if the patient's
    condition has improved, has not changed, or has declined.

    Assessment Finding Improved No Change Declined
    Urine output: 750 mL
    HR: 89/minute
    RR: 18/minute non-labored
    BP: 124/80
    O2 sat: 96% room air
    Crackles persist in bases but are not as pronounced
    Resting comfortably appears less anxious

    18. Is the overall status of the patient:

    a. Improved
    b. No change
    c. Declined

    Documentation
    Write a concise nurse's note to document what was most important in the medical record.

    Nurse Reflection
    To strengthen your clinical judgment skills, reflect on your knowledge and the decisions made caring for this patient by
    answering the reflection questions below.
    Reflection Question Nurse Reflection
    As you worked through this
    simulation, how did it make you
    feel?

    What did you already know and do
    well on this simulation?

    What areas do you need to
    develop/improve?

    What did you learn? How will you
    apply what was learned to improve
    patient care?

    Lucy Myers

    01. Most Important Findings: History of heart failure
    Iron deficiency anemia
    low hemoglobin
    02. Clinical Significance: low hemoglobin needs blood tranfusion
    Heart failure can cause breath difficulties

    03. 2: As a student nurse I can not administrater blood alone without supervision, so I will ask charge nurse and also look at the hospital policy.
    04. need to gather: I will need gloves, vital sign machine, blood tubing with fliter, IV pump and normal saline
    05. transfusion safely: Check prescriptions for allergy, expiration, virefied orders with second nurse check vitals before blood tranfusion monitor patient during tranfusion watch for side inffect and decumention.
    06. expect: Educate patient that blood tranfusion will help with their hemonglobin, they should wash and report these symptoms; shortness of breath, and chest pain.
    07. Assessment Finding:
    08. ExpectedT 982 F368 C oral: x
    09. UnexpectedT 982 F368 C oral:
    10. ExpectedP 108 regular:
    11. UnexpectedP 108 regular: x
    12. ExpectedR 25 regular:
    13. UnexpectedR 25 regular: x
    14. ExpectedBP 12883: x
    15. UnexpectedBP 12883:
    16. ExpectedO2 sat 88 RA:
    17. UnexpectedO2 sat 88 RA: x
    18. ExpectedAppears anxious:
    19. UnexpectedAppears anxious: x
    20. ExpectedBreathing rapidly:
    21. UnexpectedBreathing rapidly: x
    22. ExpectedSkin is cool and clammy:
    23. UnexpectedSkin is cool and clammy: x
    24. Medication:
    25. Pharm ClassMetoprolol: Beta blocker
    26. Mechanism of ActionMetoprolol: reduce heart rate
    27. Expected OutcomeMetoprolol: lower heart rate
    28. Pharm ClassLisinopril: ACE inhabitor
    29. Mechanism of ActionLisinopril: lower BP
    30. Expected OutcomeLisinopril: lower BP
    31. Pharm ClassFurosemide: loop diuretic
    32. Mechanism of ActionFurosemide: Increase urine output
    33. Expected OutcomeFurosemide: reduce fluid retention
    34. Pharm ClassFerrous gluconate: iron suppliment
    35. Mechanism of ActionFerrous gluconate: Provide essential iron
    36. Expected OutcomeFerrous gluconate: prevention of iron deficiency enemia
    37. Pharm ClassPotassium chloride: electrolyte suppliment
    38. Mechanism of ActionPotassium chloride: replaces potassium
    39. Expected OutcomePotassium chloride: prevention of hypokalemia
    40. MedicationRow1: furosemide
    41. RationaleRow1: Furosemide, because it causes fliud build up
    42. Intake and OutputRow1: Blood tranfusion
    43. Clinical SignificanceRow1: excess fluid causes respiratory issue, like SOB
    44. Most Important DataRow1: Heart failure and rapid breathing
    45. Clinical SignificanceRow1_2: fluid overload
    46. Possible ProblemsRow1: fluid overload
    rapid breathing
    47. Priority ProblemRow1: fluid overload
    48. Pathophysiology of Priority ProblemRow1: excess fluid build-up place critical strain on the heart.
    49. Nursing Priority:
    50. Priority InterventionsRow1: Improving breathing
    51. RationaleRow1_2: administrater furosemide, notify provider and applying oxygen,
    52. Expected OutcomeRow1: improving breathing
    53. I identify:
    54. Specify who you arewhere you workYourself namepositionlocation Patient nameagegender: Nurse Lucy Myers, RN nurse on the medicine floor

    PT. is Andre Ronaine, 64yrs male PT.
    55. S situation:
    56. What is the problemreason for contactConcise summary of primary problem: Rapid breathing during tranfusion
    57. B background:
    58. If urgent state concern Provide conciserelevant historyPrimary problemdiagnosis Day of admissionpostop day Relevant past medical history Relevant treatmentsinterventions: History of heart failure, Iron deficiency anemia and low hemoglobin
    Admited this morning
    date of adnission, N/A
    Heart failure
    Tranfusion
    59. A assessment:
    60. Assessment of the situation using the most important clinical dataState your concern by communicating concerning clinical data Vital signs Nursing assessment Labdiagnostic results Trend of most important clinical data stableincreasingdecreasing: Pluse is 108, rispiratory 25 and O2 is 88%

    PT. vital signs

    Iron deficiency and low hemoglobin
    61. R recommendation:
    62. Request specific adviceinterventions Clarify expectationsNurse suggestions to advance the plan of care What do you recommend Repeat and state back new ordersconfirm plan of care: Give diuretics

    Give furosemide

    Continue to monitor Pt vitals
    63. Provider Orders:
    64. RationaleFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: To eliminate fluid overload

    Stop more overload

    To increase oxygen level
    65. Expected OutcomeFurosemide 40 mg IV push Discontinue blood transfusion Apply oxygen to maintain oxygen saturation 92: Enhance rispiration

    66. Administer: 1-2 minutes
    67. Show Work: 40mg/100mg =0.4×10=4ml
    68. Expected FindingsRow1: O2 level>92
    rapid breathing
    69. RationaleRow1_3: To improve gas exchange

    70. Assessment Finding_2:
    71. ImprovedUrine output 750 mL: x
    72. No ChangeUrine output 750 mL:
    73. DeclinedUrine output 750 mL:
    74. ImprovedHR 89minute: x
    75. No ChangeHR 89minute:
    76. DeclinedHR 89minute:
    77. ImprovedRR 18minute nonlabored: x
    78. No ChangeRR 18minute nonlabored:
    79. DeclinedRR 18minute nonlabored:
    80. ImprovedBP 12480: x
    81. No ChangeBP 12480:
    82. DeclinedBP 12480:
    83. ImprovedO2 sat 96 room air: x
    84. No ChangeO2 sat 96 room air:
    85. DeclinedO2 sat 96 room air:
    86. ImprovedCrackles persist in bases but are not as pronounced: x
    87. No ChangeCrackles persist in bases but are not as pronounced:
    88. DeclinedCrackles persist in bases but are not as pronounced:
    89. ImprovedResting comfortably appears less anxious: x
    90. No ChangeResting comfortably appears less anxious:
    91. DeclinedResting comfortably appears less anxious:
    92. Write a concise nurses note to document what was most important in the medical record: Furosimide IV push was administrater to pt. during blood transfusion, Pt experienced rapid breathing.
    93. Reflection Question:
    94. Nurse Reflection: It was somehow challenging
    95. Nurse ReflectionWhat did you already know and do well on this simulation: regonizing and understanding some the problem
    96. Nurse ReflectionWhat areas do you need to developimprove: monitoring for adverse effects
    97. Nurse ReflectionWhat did you learn How will you apply what was learned to improve patient care: I have learned that monitoring the patient closely and washing up for symptoms like, chest pain and shortness of breath it’s very essential.
    for patient care
    98. Text1: 4 ml

    **IMG_6870.jpeg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/img-6870-jpeg-10508713)

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  • [Solved] Nursing nur507 assignment

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  • [Solved] NI-week 8- module 4

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    In-depth study guidance and analytical solution covering NI-week 8- module 4.

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  • [Solved] Identify the most commonly prescribed agents in the major drug classes.

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    Identify the most commonly prescribed agents in the major drug classes.

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    Identify the most commonly prescribed agents in the major drug classes.

  • [Solved] DNP-EVI-IVA

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    As a DNP, you have been asked to identify why the patients that are undergoing surgery are complaining that pain experienced after a surgical procedure has not been managed adequately. The patients' need of narcotics is around the clock until the pain subsides. The lack of staff in the surgical floo…

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    As a DNP, you have been asked to identify why the patients that are undergoing surgery are complaining that pain experienced after a surgical procedure has not been managed adequately. The patients' need of narcotics is around the clock until the pain subsides. The lack of staff in the surgical floor is a problem the institution has been dealing with for the last year and the problem still has not been corrected. The patient’s satisfaction is compromised, and the nurse patient ratio is high.  **Step 1: Identify the problem -** **Cultivate a spirit of inquiry** Explain, in your own words, what is the problem?  What are the data and sources that validate the problem?

    – Safety
    – Quality indicators
    – Practice observations
    – Patient satisfaction
    – Other

    Why is the problem is relevant?   What is the current practice?

    1. **Create the clinical question utilizing the PICOT format -** **Ask clinical questions utilizing the PICOT format**

    P = Patient Population  I = Intervention or issue  C = Comparison Intervention or Status  O = Outcome  T = Timeframe to accomplish the O  Final Clinical Question: _________________________________________

    1. **Searching for the best evidence**

    The student will look at the different databases to search for the strongest evidence that will be used to answer the clinical question.

    1. **Critically appraise the evidence – Summarize the evidence**

    The student will evaluate the evidence and will choose the ones that will help to answer the clinical question. They will create a summary of the best information found and synthesize the findings.

    1. **Integrate the evidence with clinical expertise**

    – Develop best evidence recommendations
    – Create an action plan
    – Implement action plan

    1. **Reports results to stakeholders**

    – Create a report to the stakeholders

    1. **Disseminate findings**

    – Hospital administration meeting – PowerPoint

    **General Instructions**

    1. Remember that your work must be original and must not contain material copied from books or the internet, has to be not greater than 10% of plagiarism or AI text.
    2. 9 pages
    3. References within the past 5 years and with DOI#
    4. FORMAT APA, double-spaced, in a Times New Roman, Arial, or Courier New font, with a font size of 12.

    – Pay attention to grammar rules (spelling and syntax).
    – When citing the work of other authors, include citations and references using APA style to respect their intellectual property and avoid plagiarism.

    DUE DATE MARCH 4 , 2026

  • [Solved] DNP-EVI

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    As a DNP, you have been asked to identify why the patients that are undergoing surgery are complaining that pain experienced after a surgical procedure has not been managed adequately. The patients' need of narcotics is around the clock until the pain subsides. The lack of staff in the surgical floo…

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    Assignment Prompt & Instructions

    As a DNP, you have been asked to identify why the patients that are undergoing surgery are complaining that pain experienced after a surgical procedure has not been managed adequately. The patients' need of narcotics is around the clock until the pain subsides. The lack of staff in the surgical floor is a problem the institution has been dealing with for the last year and the problem still has not been corrected. The patient’s satisfaction is compromised, and the nurse patient ratio is high.

    **Step 1: Identify the problem -** **Cultivate a spirit of inquiry**

    Explain, in your own words, what is the problem?

    What are the data and sources that validate the problem?

    – Safety
    – Quality indicators
    – Practice observations
    – Patient satisfaction
    – Other

    Why is the problem is relevant?

    What is the current practice?

    1. **Create the clinical question utilizing the PICOT format -** **Ask clinical questions utilizing the PICOT format**

    P = Patient Population

    I = Intervention or issue

    C = Comparison Intervention or Status

    O = Outcome

    T = Timeframe to accomplish the O

    Final Clinical Question: _________________________________________

    1. **Searching for the best evidence**

    The student will look at the different databases to search for the strongest evidence that will be used to answer the clinical question.

    1. **Critically appraise the evidence – Summarize the evidence**

    The student will evaluate the evidence and will choose the ones that will help to answer the clinical question. They will create a summary of the best information found and synthesize the findings.

    1. **Integrate the evidence with clinical expertise**

    – Develop best evidence recommendations
    – Create an action plan
    – Implement action plan

    1. **Reports results to stakeholders**

    – Create a report to the stakeholders

    1. **Disseminate findings**

    – Hospital administration meeting – PowerPoint

    **General Instructions**

    1. Remember that your work must be original and must not contain material copied from books or the internet, has to be not greater than 10% of plagiarism or AI text.
    2. 9 pages
    3. References within the past 5 years and with DOI#
    4. FORMAT APA, double-spaced, in a Times New Roman, Arial, or Courier New font, with a font size of 12.

    – Pay attention to grammar rules (spelling and syntax).
    – When citing the work of other authors, include citations and references using APA style to respect their intellectual property and avoid plagiarism.

    DUE DATE MARCH 4 , 2026

  • [Solved] Education

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    In-depth study guidance and analytical solution covering Education.

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    Assignment Prompt & Instructions

    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.