Reflective Discussion A key learning experience I had during this course was a comprehensive head-to-toe examination of an elderly patient with numerous chronic illnesses in my practicum environment. I went into the encounter with the intention of adhering to the…
Neurobiology of Sleep and Wakefulness A dynamic process between arousal-promoting and sleep-promoting systems mediates sleep and wakefulness. The ascending reticular activating system actively maintains wakefulness, which consists of cholinergic projections from the pedunculopontine and laterodorsal tegmentum, and monoaminergic input from…
Enhanced Project Measures Worksheet Trigger to Develop QI Initiative The trigger of this quality improvement (QI) initiative is the endemic level of uncontrolled type 2 diabetes in adult patients in the outpatient clinical environment. Lots of patients still come to…
Change Concepts Worksheet Improving Diabetic Patient Education to Reduce Hospital Readmissions A change concept is a general notion or approach to change that is useful in developing specific ideas for improvement. In the column to the right, “Ideas”, for each…
Case Studies – Alexandra and Carolyn The ethical situations faced by advanced practice nurses are often complicated and require them to balance between legal requirements, the autonomy of patients, and clinical judgment. The case studies with Alexi and Carolyn, which…
Unexplained Lymphadenopathy One of the most valuable concepts that I have gained in this article is the importance of categorizing the lymphadenopathy as localized or generalized early in the assessment process. This distinction reduces potential causes and guides the proper…
Sickle Cell Vaso-Occlusive Crisis Patient Information Initials: A.B. Age: 22 years Sex: Male Race/Ethnicity: African American Source and Reliability: The patient provided the history. Reliability is good; the patient was alert, oriented, and consistent in reporting symptoms. Subjective: Chief Complaint…
Right Leg Pain Following Octreotide Use Patient Information: Initials:D. Gender: Male Chief Complaint: Right leg pain Past Medical History: History of stomach mass, ascites, prediabetes Social History: Lives alone, no family support, unable to work due to medical condition, applying…
Response to Kelvin Jernigan Hi Kelvin, Your assessment was comprehensive and clinically reasonable, especially in the way in which you related the abnormal vital signs and physical findings of the patient to acute decompensated heart failure. Your clinical judgment and…
Abnormal Findings Requiring Further Investigation Several observations in this older adult obviously vary from those that would be anticipated in a healthy person and should be reviewed immediately. His heart rate is fast, and this is accompanied by quick breathing…