Mrs. Williams is a 27-year-old female diagnosed with breast cancer. She is currently in pharmacy school. She does not have children, but hopes to have them someday. She has been tested and has a genetic predisposition for this disease.

What treatment options does she have?

What are the advantages and disadvantages of those treatment options?

What would you tell Mrs. Williams if she decided to refuse treatment?

Mrs. Williams really wants to have children before she starts treatment. What would
you educate her about? Why?

NUR2790 Professional Nursing III

Module 2 Discussion

Death and
Dying

Discuss the
term “clinical death,” especially with respect to when not to
initiate CPR. Discuss what is meant by a “peaceful death” and a
“good death,” including goals for End-Of-Life care. How would you
feel if you knew your patients did not want CPR but the family insisted on it?

Rasmussen NUR2790 All Modules Discussions Latest NUR2790 Professional Nursing NUR2790 Professional Nursing III Module 3 Discussion

Triage

Triage involves the rapid assessment and prioritization of patients. Compare the
three-tiered system of triage to the Mass Casualty Incident (MCI) triage
philosophy. Imagine that you are the Triage Nurse during an MCI. How will you
categorize the following patients using the MCI triage philosophy? Explain your
answer. Are there any ethical issues that should be considered?

10-year-old boy with massive head injury, no spontaneous breathing, BP 60 palp

22-year-old female with a close fracture of the left arm

60-year-old male with a laceration in the leg complaining of shortness of breath

15-year-old girl with glass embedded in the eyes

52-year-old male with a pulse of 30 and a blood pressure of 70/30

For your response, do you agree with your classmates’ opinions? What would you urge them
to consider when making the triage determination?

NUR2790 Professional Nursing III Module 4 Discussion

Gas Exchange

Mr. Nguyen is a 58-year-old patient that had septic shock and developed Acute Respiratory
Distress Syndrome. He is orally intubated and on a mechanical ventilator. He is
paralyzed and sedated.

What manifestations might you observe for a patient with ARDS?

What complications can Mr. Nguyen develop from being mechanically ventilated?

List priority nursing interventions to prevent complications associated with
ventilatory support.

What interventions can be implemented specifically to prevent the development of
Ventilator Acquired Pneumonia (VAP)?

You are orienting in the ICU, the nurse you are working with is not implementing the
VAP interventions. What would you do?

Rasmussen NUR2790 All Modules Discussions Latest NUR2790 Professional Nursing NUR2790 Professional Nursing III Module 5 Discussion

Artifact
vs. Dysrhythmia

Describe
the role of each component of the ECG in the heart’s contraction: the P wave,
the PR interval, the QRS complex, the ST segment, the T wave, and the QT
interval. What is the difference between artifact and dysrhythmia? How can you
reduce artifacts? What are some situations that can occur if artifact is not
reduced or eliminated?

You are
working in the Telemetry Unit. The nurse “watching” the monitors is
reading a magazine. She constantly turns off an alarm that looks a lot like
Ventricular Fibrillation. She tells you that it is not a dysrhythmia, it is
just artifact. What do you think about her actions? What is the worst case
scenario in this situation? What would you do?

NUR2790 Professional Nursing III

Module 6 Discussion

Prevention
of Shock

Your
patient is a 42-year-old female that arrives in the ED with complaints of fever
and not feeling well. She is currently undergoing chemotherapy for bladder
cancer. She has an indwelling urinary catheter with scant amount of dark, foul
smelling urine. She has a temperature of 102.2F, HR 136, BP 110/50 and RR 28.
She is allergic to penicillin and Sulfa.

What type
of shock is she experiencing?

What
interventions do you anticipate the doctor will order?

What can
you teach this patient about prevention of infection?

The doctor
orders Bactrim. What should you be concern about? Why?

NUR2790 Professional Nursing III

Module 7 Discussion

Modifiable
vs. Unmodifiable Risk Factors

Choose a
subject (it can be a former patient, a family member, or yourself) and identify
modifiable and nonmodifiable risk factors. Identify methods to prevent Coronary
Artery Disease (CAD) in the subject. What can you recommend to your classmates
subjects?

Rasmussen NUR2790 All Modules Discussions Latest NUR2790 Professional Nursing  NUR2790 Professional Nursing III Module 8 Discussion

The Patient
with Chronic Renal Failure

Mr. Rojas
is a 49-year-old patient with End Stage Renal Disease. He has a history of
hypertension and uncontrolled type 1 diabetes (since he was 12 years old). His
last Hemoglobin A1c was 12.8%. He is currently receiving hemodialysis three
times per week for three hours. He is in the hospital because he went into DKA
a few days ago when he had a stomach virus. He is asking you about renal
transplantation.

What are
the criteria to be placed in the transplant list?

What
options for transplantation does Mr. Rojas have?

What
recommendations can you give Mr. Rojas on treatment compliance?

What other
renal replacement therapies could Mr. Rojas be educated about?

What are
their advantages and disadvantages?

NUR2790 Professional Nursing III

Module 9 Discussion

Brain
Death: Ethical Considerations

Your
patient is a 23-year-old female with a history of headaches. This morning she
was experiencing a really bad headache as her boyfriend was driving her to the
university. He thought she was sleeping and by the time they got to the school,
45 minutes later, she was not waking up. She was diagnosed with a cerebral
aneurysm and you are taking care of her in the Neurological ICU.

What
testing do you expect to be performed to diagnose brain death?

What is the
procedure when a patient is determined to be brain dead?

Who should
approach the family about organ donation?

The family
is approached about organ donation. The patient indicated on her driver’s
license that she wanted to be an organ donor. Her mother refuses to consent for
organ donation.

Do you
think donation should happen anyway? Why or why not?

What will
be the ethical consequences of your decision?

NUR2790 Professional Nursing III

Module 10 Discussion

Ethical
Dilemma

For
patients with liver failure due to cirrhosis liver, transplantation may be the
only possible treatment.

How is the
care for the patient undergoing liver transplantation different from the care
of a regular surgical patient?

What
patient teaching is needed after a patient receives a liver transplant?

Should the
patient with alcoholic cirrhosis be a candidate for a liver transplant?

Should
government funds be used in the care of patients with cirrhosis who continue to
consume alcohol?

NUR2790 Professional Nursing III

Module 11 Discussion

Caring for
Self!

You have
learned a lot during your training to become a Registered Nurse. At this point
in your education, where do you see yourself as a nurse? What unit would you
like to work in and why?

To be able
to care for patients, you must be able to care for yourself. What are some
practices you plan to implement to help you care for yourself and why?