walden nurs6560 week 10 discussion latest 2017 october

Week 10 discussion

Discussion Part I:
Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery

This week, you study neurologic and orthopedic conditions
with plastic surgery considerations. Both neurologic and orthopedic conditions
are seen in the trauma areas of the hospital. These conditions encompass
cardiovascular, pulmonary, and metabolic aspects of care in the ICU. For this
Discussion, focus on adolescent patients, and consider potential diagnoses,
treatment, and/or referral options for the patients in the following 3 case
studies.

Case Study 1: A 17-year-old male was celebrating his
birthday with friends and alcohol. At one point he jumped into the hotel pool
three stories below, hitting the side of the pool with his chest. EMS arrived
and packaged him with spinal support. He arrives in the ER with breathing
difficulty, chest pain, GCS 10, and O2 sat of 94%. You do initial assessment in
the first 10 minutes and find that his chest is asymmetric for breathing and
contusions are noted all over his chest. His CXR shows multiple rib fractures
on both sides and pulmonary contusions. His cervical spine is stable in a
collar. His thoracic and lumbar films are negative for fractures. In the next
hours, what are your priorities, and what plan would you have for this patient
as he moves to the ICU? At what stage of development is he, and how does that
affect his care?

Case Study 2: A 13-year-old female restrained passenger of a
vehicle was involved in an MVA at 60 mph on the highway. The vehicle
experienced a frontal impact. The patient arrived in the ER with closed
fractures of the left tibia and fibula with angulation, dislocation of the
right ankle, multiple pelvic fractures, and femur fracture on the left side.
Her BP is 92/54 with pulse of 130. What is your plan for this patient, and what
are the considerations to prevent further morbidity? At what stage of
development is she, and how does that impact her care?

Case Study 3: A 19-year-old male private in the U.S. Air
Force was driving with friends when they dared him to “surf the car.” He fell
off the roof of the car while it was moving at a speed of approximately 40 mph.
He landed face first. He is now in the ICU with a closed head injury. His
intracranial pressure is elevated, and his pupillary response is slowing. At
this time, what medications do you recommend, and what other medical treatments
do you recommend? In addition, after the acute situation is controlled and the
patient awakens, what medication do you use for his agitation?

To prepare:

Review and select 1 of the 3 provided case studies. Analyze
the patient information.

Consider a differential diagnosis for the patient in the
case study you selected. Think about the most likely diagnosis for the patient.

Think about a treatment and management plan for the patient.
Be sure to consider appropriate dosages for any recommended pharmacologic
and/or nonpharmacologic treatments.

Consider strategies for educating patients and families on
the treatment and management of the trauma care.

Post on or before Day 3 an explanation of the differential
diagnosis for the patient in the case study you selected. Explain which is the
most likely diagnosis for the patient and why. Include an explanation of unique
characteristics of the disorder you identified as the primary diagnosis. Then,
explain a treatment and management plan for the patient, including appropriate
dosages for any recommended treatments. Finally, explain strategies for
educating patients and families on the treatment and management of neurologic
and orthopedic conditions.

Read a selection of your colleagues’ responses.

Respond on or before Day 6 to at least two of your
colleagues on 2 different days in both of the ways listed below. Respond to
colleagues who selected different case studies from yours.

Describe how culture might affect the diagnosis, management,
and follow-up care of patients with the neurological, orthopedic, or plastics
disorders your colleagues discussed.

Based on your personal and/or professional experiences,
expand on your colleagues’ postings by providing additional insights or
different perspectives.?

Discussion Part II: Pharmacology

To prepare:

Read the following articles to enhance your knowledge of
commonly prescribed medications:

Family Practice Notebook. (2015). Nonsteroidal
anti-inflammatory. Retrieved from
http://www.fpnotebook.com/Pharm/Analgesic/NnstrdlAntInflmtry.htm

Press, C. D. (2013, September 10). Infiltrative
administration of local anesthetic agents. Retrieved from
http://emedicine.medscape.com/article/149178-overview

All of the following groups of medications are commonly
prescribed in the acute care setting. Choose one of the topics below to
discuss. If it is a medication group, select a specific drug within that group.
(This is a good way for you to prepare for clinical practice, because you will
get to know the drugs you will prescribe for patients.). Focus your discussion
on the hospital or ICU setting and IV usage.

Glycopeptides

Oxazolidinones (Bs)

Monobactams

Ansamycins

Metronidazole

Lincosamides (Bs)

Tinidazole

Lidocaine

Marcaine

NSAIDs

Note: When sharing your initial post, select a topic that
has not yet been discussed. If all topics have been discussed, then you may
select that topic again, but select a different drug within the medication
group.

For this Discussion, address 1 of the following options.
Post by Day 3:

Option 1: Post a description of a patient you have taken
care of (inpatient as an RN, or as an NP student) who has been prescribed the
medication you selected. Include the scenario, indication, dosing,
complications, and outcome. Then explain whether or not you would have ordered
the same drug and same dose.

Option 2: Conduct an evidence-based drug search on the drug
you selected and post an explanation of any possible issues. Are there any drug
interactions? Any black box warnings? To what type of patient would you
prescribe this medication?

Option 3: Post an explanation of the properties of the drug
you selected, including usages and dosing in the hospital or ICU. Describe a
patient you would prescribe this medication to.

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