(Answered) NR 603 WEEK 8: REFLECTION;Chamberlain College of Nursing

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This 8-week session provided a learning platform using specific course outcomes. The platform design enhanced knowledge and practice skills for many health issues encountered in the primary care set... ting. Students were challenged to plan medical management for neurological, pulmonary, cardiovascular, hematological, mental health and inflammatory disorders. Lastly, the course included the important factor of culture diversity issues. Exposing the need to approach treatment plans incorporating race, ethnicity, culture background and degree of proficiency with the English language. Program Outcome #4: Integrate professional values through scholarship and service in health care. (Professional identity) The studies and activities added to the layers from the previous sessions. The prepared FNP student interprets guidelines and studies correctly and then can offer help and assistance to the practicum healthcare team and patients. Week 1 compare then contrast a disorder and week 4 the APEA exam allowed the student to realize weaknesses. During clinical hours strengths were evident when applying knowledge and skill to patient care and contributing to the treatment plan. Using the technology of Cleveland Heart Lab, specific inflammatory markers in addition to traditional lipid testing provides meaningful information to determine the person’s cardiovascular risk. An example is taking the result and trending response to current medications, diet, and exercise. If the inflammatory markers and lipid results are not improving, treatment requires increasing the dose of the statin, adding omega and or niacin. Time dedicated to the complete understanding of DASH/Mediterranean diet and the amount of exercise to positively affect and lower the markers and lipids. A more specific case involved a patient that was referred for a sleep study. Detecting the need for the test was determined through the interview and constitutional systems assessment. It was liberating to recognize symptoms, discuss the health risk related to sleep apnea, and then probe the preceptor. Though not proficient at this point, I do possess individual thinking, acting, and feeling of an advanced practice nurse. MSN essential IV: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice. (Extraordinary Nursing) According to Thomas et al, 2017, within the quality competency area, the NP core competency “generates knowledge from clinical practice to improve practice and patient outcomes and applies clinical investigative skills to improve health outcomes.” The curriculum support of the competency includes “appraising evidence for application to practice (e.g., design, methods, tools, analysis), literature search methods, including, but not limited to, the PICO Model to define a clinical questions and search for the best clinical evidence.” (Thomas et al, 2017) Program graduates should display testimony of acquiring the skills necessary to bring evidencebased practice into the clinic with a basis of consistency. Week 6 switched the role of student to educator. Students were assigned a mental health disorder. The project enhanced identifying clinical practice guidelines, apply the patient’s HPI, analyze plan and act as the facilitator to promote active learning. My case study was derived from information surrounding substance This study source was downloaded by 100000860583932 from CourseHero.com on 01-28-2023 01:27:35 GMT -06:00 https://www.coursehero.com/collection/72083718/NR-603-Week-8-Reflection-1docx/ abuse disorder and not a patient encounter. However, later there was an opportunity to discuss with the preceptor what red flags does he consider when managing opioids. He provided the answer and then explained a recent risk benefit situation of a patient requesting a narcotic refill four days early. The patient’s circumstance, she is leaving for two weeks and her refill is available the day she leaves for her trip. The preceptor explained he would refill early, explain reasons to the pharmacist. Realistically she will need the medication to prevent losing ground with pain management and potential for withdrawal. Nonetheless if this became a routine request, the possibility of substance abuse would be assessed. Supporting evidenced based practice is synonymous practice at the practicum site. The example is the frequent theme for the site related to hypertension management. The clinical definition criteria from the JNC8 guidelines are used and pharmacological adjustments occur with comorbidities of diabetes and or chronic kidney disease. The threshold goals are determined by the patient’s home blood pressure log. I was impressed with the number of patient’s that are compliant with the log and the contribution for the log influencing decisions. The consistency and repetitiveness of applying the guidelines was an advantage for me as this is a primary learning method for me. Nurse Practitioner Core Competencies # 7/Health Delivery System Competencies: This core competency targets patient centered care, promote healing and disease prevention, and prevention of errors. A prepared heath care professional seeks to finds gaps within themselves, the team, and the flow of the practice. (IOM, 2003) The health care professional uses associations and specific group memberships to stay informed and updated concerning guideline revisions. The preceptor partners with other health care professionals such as cardiology, orthopedic and others to optimize the care of the patient. Notes from those providers are pulled into the patient’s record to facilitate the continuum of care in a safe, effective manner. An example for one of the core competencies describes the “needs of culturally diverse populations” section of the subset number 4. Daughter accompanies her mother (the patient) for a wellness visit to review lab results, health care risk and treatment plan. The patient is from Guatemala who speaks and understands minimal English. The daughter interprets and translates information. The student, daughter and patient need to understand the food staples for Guatemala to manage the patient’s diabetes. Because the site can schedule 30-60 min blocks of time per patient, the provider is able to provide detailed education. The student initially was challenged as to how to teach the Mediterranean Diet that is evidenced based practice. Using the CDC website specific for the Latino population, the patient and the daughter learned where to find helpful information. The daughter is experienced with and has a computer. They were both pleased to learn how easy it is to convert the content to Spanish with one “click”. Through this clinical event the student felt empowered to connect with a patient’s culture. The subset section number 7 states the nurse practitioner “collaborates in planning for transitions across the continuum of care.” More common is the continuum of care post hospital discharge and interaction with other health care professionals like oncology, rheumatology etc. Our area is still considered “moderate risk” for COVID 19. Patient presented with symptoms and a direct exposure from a family member. An O2 sat of 88%, associated shortness of breath, and rales bilaterally triggered the need for a higher level of care. Rapid antigen test performed and resulted positive. I was able to communicate information to the receiving hospital ED. Having the d [Show More]

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