NUR2790 Professional Nursing III –Residential and Online All Modules Discussions

Module 1 Discussion

Cancer Treatment Options

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 – Residential and Online

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?

NUR2790 Professional Nursing III –Residential and Online

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 –Residential and Online

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?

NUR2790 Professional Nursing III –Residential and Online

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 –Residential and Online

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 –Residential and Online

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?

NUR2790 Professional Nursing III –Residential and Online

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 –Residential and Online

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 –Residential and Online

Module 1 Discussion

Cancer Treatment Options

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?