Week 4: Transformational Nursing Leaders

Review Appendix A, Sections I–V in Finkelman (2016).

  1. Select one of the sections and share how your chief nurse executive demonstrates expertise in these competencies.  Your comments should be about the “highest nursing leader” in your organization. Typically this is the leader who represents nurses and nursing to the governing board.
  2. In your own words, explain the differences between a transactional nursing leader and a transformational nursing leader. What one is more like your Nurse Executive?
  3. Describe how the Nurse Executive “leads the charge” for transformational leadership in an organization where you work or have done prelicensure clinical experiences.

how many pregnancies a woman has had

 

GTPAL stand for: gravida, term, preterm, abortions, living

Gravida: how many pregnancies a woman has had. Term how many pregnancies delivered that have reached or surpassed 37 weeks.

Term: deliver at 37 or greater weeks

Preterm: how many pregnancies between 20-37 (actually 36 and 6/7) wks

Abortion: pregnancy loss at less than 20 weeks. Abortions may also be induced by physicians or spontaneously.

Living: how many children are living now?:

***Multiple births (twins, triplets and higher multiples) count as one birth

1. This is mom’s 1st pregnancy:

2. 2nd pregnancy and she had an AB at 8 wks for the 1st pregnancy

3. 3rd pregnancy. 1st pregnancy delivered at 38 and 2nd pregnancy was twins delivered at 29 wks. 1 of those children died.

4. 2nd pregnancy. Delivered twins at 37 wks both live pregnancy.

5. 3rd pregnancy. Delivered triplets at 28 wks and 2 of the babies survived. Had an elective AB at 6 wks.

6. This is a woman’s 5 pregnancies,  births at 41 week, 39 5/7 weeks, 38 6/7 and 36 5/7 weeks 1 induced abortion at 10 weeks , and 4 living children at this time.

7. a pregnant woman who carried one pregnancy to term with a surviving infant; carried one pregnancy to 35 weeks with surviving twins; carried one pregnancy to 9 weeks as an ectopic (tubal) pregnancy; and has 3 living children would have a GTPAL annotation of?

8. A woman who has given birth at term once and has had one miscarriage at 12 weeks would be recorded as?

Rubric:

This assignment is worth 5 points. 1 point for APA and style of paper.

.5 point for each of the eight cases. Partial points are not awarded if you get part of a case incorrect you get the whole case incorrect.  Use page 259 in your text book for further details. Explain your rationale. Demonstrations will be done in class.

The Impact Of Standardized Nursing Terminology

Among the Resources in this module is the Rutherford (2008) article Standardized Nursing Language: What Does It Mean for Nursing Practice? In this article, the author recounts a visit to a local hospital to view the recent implementation of a new coding system.

During the visit, one of the nurses commented to her, “We document our care using standardized nursing languages but we don’t fully understand why we do” (Rutherford, 2008, para. 1).

How would you respond to a comment such as this one?

To Prepare:

  • Review the concepts of informatics as presented in the Resources, particularly Rutherford, M. (2008) Standardized Nursing Language: What Does It Mean for Nursing Practice?
  • Reflect on the role of a nurse leader as a knowledge worker.
  • Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

In a 2- to 3-page paper, address the following:

  • Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies.
  • Describe the benefits and challenges of implementing standardized nursing terminologies in nursing practice. Be specific and provide examples.
  • Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the your school.

Resources:

Rutherford, M. A. (2008). Standardized nursing language: What does it mean for nursing practice? Online Journal of Issues in Nursing, 13(1), 1–12. doi:10.3912/OJIN.Vol13No01PPT05.

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)
  • Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

https://www.healthit.gov/sites/default/files/snt_final_05302017.pdf

Rubric:

In a 2- to 3-page paper, address the following:

·   Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies.
·   Describe the benefits and challenges of implementing standardized nursing terminologies in nursing practice. Be specific and provide examples.
·   Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the Walden Library.–

Levels of Achievement:  Excellent 77 (77%) – 85 (85%)    Good 68 (68%) – 76 (76%)    Fair 60 (60%) – 67 (67%)    Poor 0 (0%) – 59 (59%)

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

Case Study, Chapter 13, Fluid and Electrolytes: Balance and Disturbance

Case Study, Chapter 13, Fluid and Electrolytes: Balance and Disturbance

1. Mrs. Dean is 75-year-old woman admitted to the hospital for a small bowel obstruction. Her medical history includes hypertension. Mrs. Dean is NPO. She has a nasogastric (NG) tube to low continuous suction. She has an IV of 0.9% NS at 83 mL/hr. Current medications include furosemide 20 mg daily and hydromorphone 0.2 mg every 4 hours, as needed for pain. The morning electrolytes reveal serum potassium of 3.2 mEq/L.

  1. What are possible causes of a low potassium level?
  2. What action should the nurse take in relation to the serum potassium level?
  3. What clinical manifestations might the nurse assess in Mrs. Dean?

2. Conrad Jackson is a 28-year-old man who presents to the emergency department with severe fatigue and dehydration secondary to a 4-day history of vomiting. During the interview, he describes attending a family reunion and states that perhaps he “ate something bad.” Upon admission his vital signs are a temperature of 102.7°F, heart rate of 116 bpm, respiratory rate of 18 breaths/min, and blood pressure of 86/54 mm Hg. The nurse also notes the patient has dry mucous membranes and tenting of skin. The physician orders an IV to be started with 0.45% normal saline, and orders a serum electrolytes and an arterial blood gas.

The following results are returned from the laboratory:

Sodium (Na+)             150

Potassium (K+)           5.5

Chloride (Cl¯)             110

BUN                           42

Creatinine                    0.8

Glucose                       86

pH                               7.32

PaCO2                         35

HCO3¯                        20

PaO2                            90

O2 Sat                          98%

  1. What is your interpretation of this arterial blood gas sample?
  2. Explain the high potassium in this patient.
  3. Calculate the patient’s anion gap:
  4. What is the interpretation of this anion gap?