S.S. Acute Lymphocytic Leukemia Case Study
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
S.S. Acute Lymphocytic Leukemia Case Study
S.S., a 63-yr-old white woman with acute lymphocytic leukemia, has been receiving chemotherapy on an outpatient basis. She completed her third treatment 5 days ago and has been experiencing nausea and vomiting for 2 days despite using ondansetron (Zofran). She was initially admitted to the clinical unit but was transferred to the ICU for close monitoring after becoming severely hypotensive overnight. Her most recent blood pressure was 98/50, HR 82 and regular, O2 saturation 95% on 2 L via nasal cannula, RR 22 and regular.
Discussion Questions
Priority Decision: After receiving report, which patient should you see first? Provide your rationale.
Collaboration: Which morning tasks should you delegate to the UAP (select all that apply)?
Take BP readings on S.S.
Perform respiratory assessment on G.N.
Document strict intake and output on S.S.
Provide oral care around the endotracheal tube for J.N.
Titrate S.S.’s IV infusion rate based on her BP reading.
Priority Decision and Collaboration: When you enter J.N.’s room, the ventilator alarms are going off. The UAP had just finished providing oral care, and she tells you that J.N. has become increasingly agitated within the last 5 minutes. Which initial action would be most appropriate?
Suction J.N.’s endotracheal tube.
Have the UAP stay with J.N. while you obtain IV sedation for him.
Ask the UAP to describe exactly what she did when she was providing oral care.
Assess the ventilator to identify what alarm is going off and to make sure all connections are secure.
Case Study Progression
J.N.’s ventilator tubing became disconnected. You quickly reconnect his tubing, and as he settles down his oxygenation improves. You ask the UAP to obtain vital signs on your other patients while you begin a more thorough assessment of J.N.
During your assessment of J.N., you note gray-white patches on the inside of his mouth. You recognize these as most likely caused by
Candida albicans.
poor oral hygiene.
Coccidioides immitis.
irritation from recent mouth care.
G.N.’s family asks you why surgery was performed on his leg wound. Your response is based on the knowledge that debridement (select all that apply)
is used to remove infected tissue.
is used to remove nonviable tissue.
prepares the wound bed for healing.
can be accomplished only in surgery.
is necessary in any burn wound involving the skin.
S.S.’s morning laboratory results reveal a serum potassium level of 2.8 mEq/L. You notify the health care provider and obtain an order for IV potassium. During infusion of the potassium replacement, you prioritize assessment of S.S.’s
bowel function.
cardiac rhythm.
muscle strength.
level of consciousness.
Priority Decision: As the day continues, you find that you are getting busy. Which nursing task should be your priority?
Changing the sterile dressings on G.N.’s leg wounds
Performing routine suctioning of J.N.’s endotracheal tube
Starting a 500-mL fluid bolus to S.S., whose most recent BP is 76/42
Calling the hospital chaplain to speak with S.S., who is upset over her condition
Priority Decision: Which medication should you administer first?
Daily subcutaneous enoxaparin to G.N.
IV Bactrim, ordered twice daily, to J.N.
IV proton pump inhibitor, ordered twice daily, to S.S.
As needed IV morphine to G.N., who reports pain at a level 9 (1 to 10 scale)
Management Decision: While sitting at the computer charting your patients’ morning assessments, you overhear the UAP telling a nursing student that J.N. deserves what he got because HIV is God’s way of punishing those who sin. Your most appropriate response would be to
report the UAP’s actions to the supervisor.
ask the UAP to keep her opinions to herself.
ignore the conversation because it does not affect patient care.
talk to the UAP and student about keeping personal feelings separate from patient care.
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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