Critical Thinking Questions

Description

In this exercise, you will put in to practice what you have learned in the previous modules. Read the THREE scenarios on the next pages and write a ½-1 page description of what could be a solution in each situation. Provide rationales for each solution.

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In this exercise, you will put in to practice what you have learned in the previous modules. Read
the THREE scenarios on the next pages and write a ½-1 page description of what could be a
solution in each situation. Provide rationales for each solution. Post your responses in the D2L
Assignment box. This assignment will count towards your participation grade.
Scenario #1:
A 72 year-old woman is being cared for at home after a heart attack. She is able to get out of bed
and use the bedside commode unaided, but she cannot do much more than that. Her husband and
adult children care for her on a daily basis. In general, they do a satisfactory job, except for the
fact that they will not empty the bucket on the commode. When the home health aide comes for
a visit, the bucket is always full and the room has the stench of feces and urine.
The home health nurse has been to the home and discussed this with the family on several
occasions. The patient does not seem to object to the stench. The family is adamant that this is
the job of the nurses.
You are the new home health nurse assigned to the patient. You have decided that this is a
problem with a solution. Approach the family with a new and fresh attitude toward the
problem. Keep in mind your legal, ethical, and personal responsibilities and limitations.
Scenario #2
A home care patient is experiencing pain secondary to surgery for right foot amputation. She
takes a liquid narcotic in suspension form. Her doctor ordered 2 teaspoons q. 4 hrs, PRN for
pain and gave orders to the home health nurse to titrate the dose to the patient’s pain level. The
nurse is to report on the patient’s pain level and response to the analgesics every week. Given
the patient’s condition and level of pain and previous response to analgesics, there is no fear of
addiction in this patient.
The nurse has explained the treatment plan to the patient, and she concurs with the analgesia
plan. However, the patient will not measure the amount of medication she takes each
time. Every time the nurse visits, the patient reports that she takes a “couple of swigs” and that it
relieves the pain. She does not see the need to make a detailed record of her use of medication
because the system she is using works.
Design a program that will be agreeable to this patient and still meet the nursing need of
documenting episodes of pain and how much medication was needed for relief of pain. You must
consider your legal and ethical role as a nurse and the ideal of patient autonomy.
Scenario #3
With the major emphasis in downsizing and restructuring health care to be financially successful,
issues of quality nursing care come up frequently. One common issue related to quality nursing
care is medication errors.
In a downsized work environment, medication errors may increase due to limited staffing with
licensed nursing personnel. Often staffing is just enough to be adequate or slightly below what is
necessary for safe and quality patient care.
You are a nursing supervisor, and you want to research a medication that was omitted during a
change of shift period. What questions are you going to ask? Who will you look to for
information? How will I know if a medication error is a result of a nursing colleague’s mistake
or a result of an understaffed nursing unit?

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References:

Nursing Standards

Nursing and Midwifery Board of Australia. (2018). Code of conduct for midwives. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Clinical Guidelines

Guideline Adaption Committee. (2016). Clinical practice guidelines and principles of care for people with dementia. NHMRC Partnership Centre for Dealing with Cognitive and Related Function Decline in Older People. https://cdpc.sydney.edu.au/wp-content/uploads/2019/06/CDPC-Dementia-Guidelines_WEB.pdf

Living Guideline

Stroke Foundation. (2022). Australian and New Zealand living clinical guidelines for stroke management – chapter 1 of 8: Pre-hospital care. https://app.magicapp.org/#/guideline/NnV76E

Evidence-based practice

BMJ Best Practice

Goldfarb, S., & Josephson, M. (2020). Cystic fibrosis. BMJ Best Practice. https://bestpractice.bmj.com/

Schub, T., & Cabrera, G. (2018). Bites: Head lice [Evidence-based care sheet]. Cinahl Information Systems. https://www.ebscohost.com

Beyea, S. C., & Slattery, M. J. (2006). Evidence-based practice in nursing: A guide to successful implementation. http://www.hcmarketplace.com/supplemental/3737_browse.pdf

JBI: Evidence summary

Swe, K. K. (2022). Blood glucose levels: Self-monitoring [Evidence summary]. JBI EBP Database. https://jbi.global

JBI: Best practice information sheet

Bellman, S. (2022). Experiences of living with juvenile idiopathic arthritis [Best practice information sheet]. JBI EBP Database, 24(1), 1-4.

Cochrane Database of Systematic Reviews

Srijithesh, P. R., Aghoram, R., Goel, A., & Dhanya, J. (2019). Positional therapy for obstructive sleep apnoea. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010990.pub2

Drug Information

Codeine. (2023, January). In Australian medicines handbook. Retrieved February 2, 2023, from https://amhonline.amh.net.au

Colorado State University. (2011). Why assign WID tasks? http://wac.colostate.edu/intro/com6a1.cfm

 

Dartmouth Writing Program. (2005). Writing in the social sciences. http://www.dartmouth.edu/~writing/materials/student/soc_sciences/write.shtml

Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice? [Abstract]. Online Journal of Issues in Nursing, 13(1). http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Health-IT/StandardizedNursingLanguage.html

Wagner, D. (n.d.). Why writing matters in nursing. https://www.svsu.edu/nursing/programs/bsn/programrequirements/whywritingmatters/

Writing in nursing: Examples. (n.d.). http://www.technorhetoric.net/7.2/sectionone/inman/examples.html

Perth Children’s Hospital. (2022, April). Appendicitis [Emergency Department Guidelines]. Child and Adolescent Health Service. https://www.pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Appendicitis

Department of Health. (n.d.). Who is being active in Western Australia? https://ww2.health.wa.gov.au/Articles/U_Z/Who-is-being-active-in-Western-Australia

Donaldson, L. (Ed.). (2017, May 1). Healthier, fairer, safer: The global health journey 2007-2017. World Health Organisation. https://www.who.int/publications/i/item/9789241512367

NCBI Bookshelf

Rodriguez Ziccardi, M., Goyal, G., & Maani, C. V. (2020, August 10). Atrial flutter. In Statpearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540985/

Royal Perth Hospital. (2016). Procedural management: Pre and post (24-48 hours) NPS. Canvas. https://courses.ecu.edu.au

 

 

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