NUR 540 Module Four Short Paper Guidelines and Rubric Overview: In your final project, you will be asked to make clinical decisions for a patient.

NUR 540 Module Four Short Paper Guidelines and Rubric Overview: In your final project, you will be asked to make clinical decisions for a patient. This short paper will help you practice clinical decision making on a disorder of the respiratory system. You will explain the rationale for a patient’s physical symptoms, analyze risk factors relevant to treatment decisions for promoting patient outcomes, and identify the use of patient-care technologies that are appropriate for diagnostic testing. Consider the following case study:

A 58-year-old, self-employed communications consultant has smoked a pack a day for more than 30 years. He has a 10-year history of asthma/chronic bronchitis and congestive heart failure. He is 5 feet 11 inches tall and weighs 370 pounds. He routinely takes a diuretic and pulmonary medications. The following information is obtained from the medical record:

 Diagnosis: COPD exacerbation secondary to bronchitis and right-sided CHF with newly diagnosed irregular rhythm.

 Presenting signs and symptoms: Cough productive of brownish-green phlegm, ankle swelling, orthopnea (six pillows to help with sleep), dyspnea (on walking one block), and fever and chills.

 Relevant diagnostic testing (consider all other lab results normal): o Na = 139, K = 3.8, glucose = 99, BUN = 21, creatinine = 1.6, WBC = 5,600, theophylline level = 5.7 ug/ml, BNP 780. o ABGs on room air: pH = 7.32, pCO2 = 57, pO2 = 57, HCO3 = 30, SaO2 saturation = 81%. o Chest x-ray: borderline cardiomegaly, infiltrates to right middle lobe of lungs. o Current vitals as follows: BP 134/58 (L. arm, sitting), RR 26, pulse 116, temp 37.1°C. The telemetry monitor shows this reading:

Atrial Fibrillation (Burns, 2011)

Reference

Burns, E. (2011). Atrial fibrillation. Licensed under Creative Commons Attribution-NonCommercial ShareAlike 4.0 International License on Lifeinthefastlane.com. Retrieved from https://lifeinthefastlane.com/ecg-library/atrial-fibrillation/

Prompt: From a pathophysiological perspective, write a short paper in which you address the following questions related to the respiratory system:

 Briefly explain the rationale for the patient’s physical symptoms based on the information provided.

 Explain one to three treatment decisions for this patient based on evidence-based research.

 Analyze some risk factors relevant to the treatment decisions for promoting better patient outcomes.

 In addressing clinical decision making as a future graduate nurse, discuss the current diagnostic test results. What additional patient-care technologies would you recommend based on these results?

Guidelines for Submission: Your short paper should be submitted as a Word document with 12-point Times New Roman font, double spacing, and one-inch margins. The paper should be a minimum of 2 pages in length. Support your paper with relevant peer-reviewed sources, cited according to APA style.

Rubric

Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value

Rationale Explains the rationale for the patient’s physical symptoms

Explains the rationale for the patient’s physical symptoms, but explanation is cursory or illogical or contains inaccuracies

Does not explain the rationale for the patient’s physical symptoms

22.5

Treatment Decisions

Identifies at least one treatment decision based on evidence-based research

Identifies at least one treatment decision based on evidence-based research, but decisions are unclear or illogical or contain inaccuracies

Does not identify at least one treatment decision based on evidence-based research

22.5

Risk Factors Analyzes risk factors relevant to the treatment decisions for promoting better patient outcomes

Analyzes risk factors relevant to the treatment decisions for promoting better patient outcomes, but analysis is unclear or illogical or contains inaccuracies

Does not analyze risk factors relevant to the treatment decisions for promoting better patient outcomes

22.5

Diagnostic Testing and Patient-Care

Technologies

Discusses the current diagnostic test results and recommends appropriate patient-care technologies

Discusses the current diagnostic test results and recommends patient-care technologies, but recommendations are unclear or illogical or contain inaccuracies

Does not discuss the current diagnostic test results or recommend patient-care technologies

22.5

Articulation of Response

Paper is free of errors of organization and grammar

Paper contains errors of organization and grammar, but they are limited enough so that the paper can be understood

Paper contains errors of organization and grammar, making the paper difficult to understand

10

Total 100%