NR 325 Pre-Simulation – Carl Rogers

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

Nursing Education and Practice

In the realm of nursing education, delivering safe and effective patient care is of utmost importance. This paper examines nursing practice and explores the multiple dimensions of care outlined within the NCLEX-RN test plan. These dimensions encompass various aspects crucial for nursing competency, including a safe and effective care environment, management of care, safety and infection control, health promotion and maintenance, psychosocial integrity, and physiological integrity. Additional categories such as basic care and comfort, pharmacological and parenteral therapies, risk reduction, and physiological adaptation also play an essential role in this framework. The NCLEX-RN test plan is instrumental as a practice readiness guide, aligning nursing education with the core competencies required for professional nursing. This approach highlights the critical role of clinical self-assessment in professional growth, guiding nursing students toward personal and professional development.

NR 325 Pre-Simulation – Carl Rogers

Activity statements within the NCLEX-RN test plan are specifically designed to cover each element of nursing care, providing invaluable guidance to prepare individuals for the multifaceted demands of nursing practice. This research delves into the importance of these components, illustrating their contribution to fostering skilled, confident nursing practitioners. A unique clinical experience during a rotation at a medical-surgical unit highlighted the value of these competencies, especially when managing a patient recovering from clavicle surgery after a motorcycle accident. This experience enhanced my nursing skills, particularly in areas like physiological integrity and infection control. For example, I managed the patient’s postoperative pain, monitored vital signs, adhered to sterile techniques during dressing changes, and remained vigilant for any signs of infection.

Personal Growth and Future Goals

Through this clinical experience, I recognized areas for further development, particularly in health promotion and psychosocial integrity. Moving forward, I aim to improve in these aspects by educating patients on injury prevention and lifestyle adjustments (health promotion) and by enhancing my ability to assess and support their psychological well-being (psychosocial integrity). According to UWorld (n.d.), understanding the social and emotional influences on a patient’s health allows healthcare providers to offer holistic care, addressing both physical and mental needs. To further develop these skills, I plan to actively seek new clinical experiences that involve these client needs. Collaborating with experienced nurses in health promotion and psychosocial integrity will allow me to gain practical insights and mentorship. Embracing these strategies will shape me into a well-rounded nurse capable of handling diverse patient needs across various clinical settings.

NCLEX-RN Test Plan and Competency Development

The NCLEX-RN test plan delineates essential elements that support a secure and effective care environment, encompassing management of care, infection control, health promotion, psychosocial integrity, and physiological needs. Emphasizing these domains ensures aspiring nurses are prepared to deliver safe, effective care in varied healthcare environments. Developing competency in these areas is vital to maintaining patient well-being and preparing for the NCLEX-RN. A solid grasp of these domains supports future nurses in meeting patient care standards across healthcare settings and underpins the NCLEX-RN strategy.

NR 325 Pre-Simulation – Carl Rogers

Table 1: Key Components of NCLEX-RN Dimensions and Nursing Practice

References

NCSBN. (n.d.). 2023 NCLEX-RN test plan. Retrieved from https://www.ncsbn.org/publications/2023-nclex-rn-test-plan

NR 325 Pre-Simulation – Carl Rogers

UWorld. (n.d.). NCLEX-RN® Test Plan. UWorld Nursing. Retrieved from https://nursing.uworld.com/nclex-rn/test-plan

NR 325 Pre-Simulation – Carl Rogers

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

Scenario Overview

Carl Rogers, a 67-year-old African American male with a 20-year history of type II diabetes mellitus, was directly admitted to the medical unit from his physician’s office on Tuesday at 1530. He has a stage II non-healing ulcer on his right heel, and upon arrival, his admission paperwork was completed, and pain medication administered. Additional medical orders include a dressing change and insulin administration, which have yet to be implemented. This scenario takes place at 1700 on Tuesday.

Comparison of Long- and Short-Acting Insulin

1. Long-Acting Insulin:

Long-acting insulin primarily controls hyperglycemia for both type 1 and type 2 diabetic patients. It aids in maintaining blood glucose levels between meals and overnight. The onset for long-acting insulin ranges from 0.8 to 4 hours. Unlike other forms, long-acting insulin does not have a defined peak, reducing the risk of hypoglycemia due to the absence of peak action time (Lewis et al., 2017). The duration spans from 16 to 24 hours. Common types include glargine (Lantus), detemir (Levemir), and degludec (Tresiba).

2. Short-Acting Insulin:

Known as mealtime or bolus insulin, short-acting insulin has a quick onset of action, supporting meal absorption during food intake. The onset ranges from 30 minutes to an hour, with a peak time of 2 to 5 hours and a duration of 5 to 8 hours. Administered 30 to 45 minutes before a meal, it aligns with meal absorption and has a higher risk of hypoglycemia due to its longer duration of action.

NR 325 Pre-Simulation – Carl Rogers

Dietary Education for Type II Diabetes Mellitus

For individuals with Type II diabetes, maintaining a balanced diet is crucial. Weight management is often recommended, especially for those who are overweight or obese. A balanced intake of carbohydrates, fats, and protein is essential to help maintain blood glucose levels. Carbohydrates are an important source of energy, fiber, vitamins, and minerals, tailored individually to meet each patient’s needs. Fiber intake should ideally range from 25 to 30 grams per day. Fat intake, specifically trans-fat, should be minimized with cholesterol limited to 200 mg daily. Protein intake varies, but high-protein diets are typically discouraged for patients aiming for weight loss. Collaboration with a dietitian in meal planning enhances adherence, helping the patient establish realistic health goals (Lewis et al., 2017).

Wound Care Best Practices for Diabetic Foot Ulcers

Effective wound care for diabetic foot ulcers aims at promoting fast healing and preventing infection. Diabetic patients are at increased risk for complications, thus necessitating vigilant wound management. To prevent infection and subsequent complications like necrosis or amputation, wounds require regular, sterile dressing changes. Proper wound dimensions should be documented during initial assessment, establishing a baseline for monitoring healing progress. Hands should be washed, and gloves worn during care. Medicated dressings are sometimes prescribed to create a protective barrier and promote healing. Debridement may be necessary to remove dead tissue and support the growth of healthy tissue.

References

Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Harding, M. M. (2017). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (10th ed.). St. Louis: Elsevier.

NR 325 Pre-Simulation – Carl Rogers

Vallerand, A. H., Sanoski, C. A., & Deglin, J. H. (2017). Digoxin. Davis’s Drug Guide for Nurses (15th ed.). Philadelphia, Penn.: F.A. Davis.

Table 1: Comparison of Long- and Short-Acting Insulin

NR 325 Pre-Simulation – Carl Rogers

Table 2: Dietary Recommendations for Type II Diabetes

Table 3: Wound Care Best Practices

NR 325 Exam 2

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

Exam #2 Topics Review

1. Neurological Conditions

Head Injury

When managing a patient with a head injury, it is essential to anticipate seizures. Patients are generally placed on anticonvulsant medications as a preventative measure. Key signs and symptoms include cerebrospinal fluid (CSF) leakage and notable discoloration.

Increased Intracranial Pressure (ICP)

ICP management requires monitoring specific symptoms and positioning the patient with their head elevated at 30 degrees. Monitoring is typically achieved with specialized devices, and prompt management of these signs and symptoms is crucial to prevent further complications.

Stroke

Understanding the various types of strokes, including ischemic and hemorrhagic, is essential for providing effective management. Immediate CT scans help determine stroke type, guiding appropriate treatment interventions. Management includes maintaining a patent airway, conducting a swallow study, and using thrombolytic therapy where appropriate. Attention to left-sided versus right-sided strokes is also essential for tailored interventions.

Transient Ischemic Attack (TIA)

Often referred to as a “mini-stroke,” a TIA requires immediate management to prevent escalation.

Seizures

Seizure management includes understanding different types, implementing safety precautions, and providing medication therapy as appropriate. Specific considerations are necessary for managing seizure status epilepticus and determining suitable seizure medications based on patient needs.

Meningitis

Key symptoms of meningitis require prompt attention. Management focuses on symptom control and specific tests, such as a lumbar puncture, to confirm the diagnosis.

Parkinson’s Disease

Parkinson’s disease presents with unique symptoms that require monitoring.

Alzheimer’s Disease

A form of dementia, Alzheimer’s disease is characterized by specific symptoms, and its management involves addressing memory loss and behavioral symptoms.

2. Other Conditions Affecting Brain and Nervous System

Intracranial Pressure (ICP)

Normal ICP values are essential for understanding increased pressure levels, which may be caused by edema. Management includes monitoring pressure and administering intracranial diuretics as needed.

Cranial Nerves

Knowledge of cranial nerves, their names, and functions is essential, as well as understanding the cerebellum’s role in balance, tested through the Romberg Test.

Myasthenia Gravis

Myasthenia gravis often leads to paralysis, and priority care includes performing Tensilon testing.

Amyotrophic Lateral Sclerosis (ALS)

ALS results in progressive muscle weakness and wasting. Care for ALS patients involves specific interventions to address priority needs.

Guillain-Barré Syndrome

Management focuses on priority care to address respiratory and muscle weakness symptoms.

Multiple Sclerosis (MS)

MS management involves understanding the unique presentation of the condition, appropriate treatment, and priority care measures.

Delirium

Patients with acute confusion present with specific symptoms that require careful management, with a focus on safety measures.

3. Gastrointestinal and Hepatic Conditions

Spinal Cord Injury

Different spinal cord injury levels, such as T12 and C9, affect patient outcomes differently. Management includes addressing complications and providing physical, occupational, and speech therapy.

Gallbladder Disease

Gallbladder inflammation and gallstones may necessitate surgical intervention. Post-operative care requires specific management to ensure patient recovery.

Pancreatitis

Both acute and chronic pancreatitis have distinct symptoms, with acute cases often associated with hypocalcemia. Chronic pancreatitis management involves lab value monitoring and priority care for patient stabilization.

Hepatitis

Understanding the types of hepatitis and their modes of transmission is crucial for effective disease management.

Cirrhosis of the Liver

Cirrhosis is an end-stage liver disease with incurable status. Patients may experience symptoms such as edema and weight gain. Medication and nutritional management are integral to care, along with addressing complications such as varices and bleeding.

Pancreatic Cancer

Risk factors for pancreatic cancer often include a history of chronic pancreatitis. Priority care measures aim to manage symptoms and support the patient’s overall quality of life.

Liver Cancer

Liver cancer requires risk factor assessment and specific priority care interventions.

NR 325 Exam 2

Table 1: Neurological Conditions

NR 325 Exam 2

References

American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.).

NR 325 Adult Health Final Exam Concept Reviews

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

Focused Gastrointestinal Physical Assessment Techniques

In conducting a focused gastrointestinal (GI) physical assessment, ensure the patient is in a supine position with knees slightly flexed and the head of the bed raised slightly. The patient should also empty their bladder before the assessment. The evaluation sequence is as follows:

• Inspection: Observe the abdomen for any skin changes, umbilicus positioning, symmetry, contour, concavity, or protuberance. Check for hernias, masses, and any observable movements.

• Auscultation: Auscultate before percussion and palpation. Use the stethoscope diaphragm for high-pitched sounds and the bell for lower pitches. Listen to all four quadrants, starting in the right lower quadrant (RLQ), for at least two minutes to determine if bowel sounds are normal, hypoactive, or hyperactive.

NR 325 Adult Health Final Exam Concept Reviews

• Percussion: This technique helps estimate liver size and detect fluid, distention, or masses. Start below the umbilicus at the right midclavicular line and percuss upwards to detect dullness. Move to the nipple line, percuss downwards, and listen for changes indicating the liver’s upper border.

• Palpation: Start with light palpation to assess tenderness, sensitivity, muscular resistance, masses, and swelling. Follow with deeper palpation for organ assessment and mass detection. Keep fingers together, use fingertip pads, depress the abdominal wall approximately 1 cm, and palpate all four quadrants, starting with the RLQ. Monitor for both verbal and non-verbal indications of discomfort.

NR 325 Adult Health Final Exam Concept Reviews

Endoscopic and Biopsy Procedures

Gastrointestinal Blood Studies

1. Amylase (Pancreas and Small Intestine): 40-140 U/L
2. Lipase (Pancreas): 0-160 U/L
3. Total Bilirubin (Liver, Gallbladder): 0.3-1.0 mg/dl
4. AST (Liver): 0-35 U/L
5. ALT (Liver): 4-36 U/L
6. PT (Warfarin-related clotting): 11-13.5 seconds
7. aPTT (Heparin-related clotting): 22-35 seconds
8. Cholesterol (Blood Vessels): Total cholesterol – less than 200 mg/dL; LDL – less than 100 mg/dL; HDL – 40 mg/dL or higher
9. Serum Ammonia (Production: Intestines, Kidneys; Consumption: Liver, Muscles): 6-47 mmol/L (10-80 mcg/dL)

NR 325 Adult Health Final Exam Concept Reviews

References

American Nurses Association. (2020). Nursing: Scope and Standards of Practice. 4th ed. Nursing Publishers.

NR 325 Care Plan 2 Diagnosis

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

Care Plan for Nursing Diagnoses and Patient Goals

This care plan addresses three main nursing diagnoses with specified goals, interventions, rationales, and evaluations. Each diagnosis is approached with a focus on patient comfort, skin integrity, and hygiene, aligning with the principles of end-of-life and supportive care. Given that the patient is a Ward of the State, the plan does not incorporate significant family involvement or patient education. Instead, the focus remains on providing high-quality, compassionate care to meet the patient’s needs.

Table 1: Nursing Diagnoses, Goals, Actions, and Evaluations

NR 325 Care Plan 2 Diagnosis

References

Deglin, J. H., & Vallerand, A. H. (2011). Davis’s drug guide for nurses (12th ed.). Philadelphia, PA: F.A. Davis.

Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., … Angus, D. C. (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8), 801-810. doi:10.1001/jama.2016.0287

NR 325 Care Plan 2 Diagnosis

Tromp, M., Hulscher, M., Bleeker-Rovers, C. P., Peters, L., van den Berg, D. T., Borm, G. F., … & Pickkers, P. (2010). The role of nurses in the recognition and treatment of patients with sepsis in the emergency department: A prospective before-and-after intervention study. International Journal of Nursing Studies, 47(12), 1464-1473.

NR 325 Week 3 Case Study

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

NR 325 Adult Health II – Case Study #1

Patient Profile

P.J., a 74-year-old female, presents with a complex medical history. She was recently discharged following a 14-day hospitalization for a gangrenous open cholecystectomy in which her gallbladder was removed. Postoperatively, P.J. experienced a bile leak due to gangrene that extended into the common bile duct. She has a history of diabetes and now reports diminished vision in her left eye, persisting for the last seven days. Her current medications include valsartan 160 mg/25 mg daily (ARB for hypertension), amitriptyline 25 mg daily (antidepressant), aspirin 81 mg daily (NSAID), and alprazolam 0.25 mg as needed every six hours for anxiety (benzodiazepine).

Subjective Data

P.J. describes her vision in the left eye as “fuzzy and distorted.” She states, “I survived that horrid ordeal with my gallbladder, and now I have trouble with my vision.” She is unmarried but has a supportive network of friends and caretakers.

Objective Data

• Physical Examination: Blood pressure 119/79 mmHg, pulse 82 beats/min, temperature 97.7°F, respirations 16 breaths/min.
• Mental Status: Alert and oriented to person, place, and time.
• Respiratory Examination: Diminished breath sounds in the bilateral lower lobes posteriorly, likely due to postoperative atelectasis. Potential early signs of pneumonia warrant further assessment for adequate oxygenation. Oxygen saturation is 96% on room air.

NR 325 Week 3 Case Study

Table of Potential Causes of Blurry Vision, Focused Assessment, and Diagnostic and Dietary Interventions

Case Study Progress

Following an ophthalmologist consult, P.J.’s initial eye exam reveals a scar in the central macular area, indicating age-related macular degeneration (AMD). The ophthalmologist recommends preventing further vision loss with photodynamic therapy.

1. Early Signs of Age-Related Macular Degeneration (AMD)

• Early signs of AMD include blurry or distorted central vision, difficulty in recognizing faces, and the need for brighter light when reading.

2. Risk Factors for Macular Degeneration

• Known risk factors include smoking, hypertension, female gender, short body stature, family history, a diet deficient in carotene and vitamin E, and prolonged sun exposure.

3. Diet-Related Teaching for AMD Prevention

• P.J. should consume foods rich in antioxidants, carotene, vitamin E, vitamin C, and vitamin B12, such as leafy greens, eggs, nuts, whole grains, fruits, and vegetables.

NR 325 Week 3 Case Study

NR 325 Adult Health II – Case Study #2

Patient Profile

S.H. is a 25-year-old male presenting to the emergency department with severe vertigo and vomiting lasting for one day. He reports recurrent vertigo spells accompanied by right-sided tinnitus for the past month. He becomes nauseous upon attempting to sit up, experiences worsened vertigo with head movement, and has been crawling out of bed to avoid falls. S.H. currently complains of nausea.

Subjective Data

• Reports that vertigo is exacerbated with head movement, accompanied by nausea.
• S.H. has a history of tinnitus on the right side with increased severity of vertigo symptoms.

Objective Data

• Physical Examination: Blood pressure 139/72 mmHg, pulse 90 beats/min, temperature 97.7°F, respirations 22 breaths/min.
• Neurological Findings: Spontaneous nystagmus in the right eye.
• Vomiting and Diaphoresis: Two episodes of vomiting within the last 30 minutes, intermittent diaphoresis.

Diagnostic Studies

• Audiogram: Severe sensorineural hearing loss at 35.0 dB, with low-frequency impairment in the right ear.
• Weber Test: Right-sided sensorineural hearing loss.

Discussion Questions

1. Definition of Vertigo vs. Dizziness

• Vertigo refers to a sensation of spinning, where the patient feels as if the room is moving around them. Dizziness, by contrast, is a feeling of unsteadiness without the sensation of movement.

2. Potential Diagnosis for S.H.

• Based on the symptoms, including vertigo, tinnitus, and sensorineural hearing loss, S.H. likely has Ménière’s disease.

3. Additional Diagnostic Tests for Vertigo

• Additional tests may include the Romberg test, MRI, CT scan, and vestibular function testing.

4. Causes and Risk Factors of Ménière’s Disease

• Causes include trauma, viral infections, and potential genetic predisposition.

5. Priority Nursing Diagnoses for S.H.

• The primary concern is safety, as S.H. is at high risk of falling due to severe vertigo and associated symptoms.

6. Discharge Teaching for S.H.

• S.H. should be cautioned about the sedative effects of prochlorperazine and diazepam and advised to avoid activities requiring alertness, such as operating heavy machinery, until his symptoms stabilize.

NR 325 Week 3 Case Study

NR 325 Week 3 Acute Kidney Injury CAE PNCI Medical Surgical

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

Acute Kidney Injury (AKI): Pathophysiological Changes, Diagnostic Differentiation, and Management

Pathophysiology of Acute Kidney Injury

Acute kidney injury (AKI) represents a sudden decline in kidney function, often due to an obstruction that disrupts normal urine flow. When urine outflow is blocked, it causes reflux into the renal pelvis, ultimately compromising kidney function. Bilateral ureteral obstruction specifically leads to hydronephrosis, which causes kidney dilation and increases hydrostatic pressure and tubular blockage, progressively reducing kidney efficiency. If this obstruction is cleared within 48 hours, recovery of kidney function is possible; however, prolonged blockage can cause tubular atrophy and irreversible kidney fibrosis. Additionally, severe ischemia disrupts the basement membrane and destroys portions of the tubular epithelium.

Classification of AKI: Prerenal, Intrarenal, and Postrenal

AKI is categorized based on the causative factor: prerenal, intrarenal, and postrenal. Prerenal AKI is often due to hypovolemia (dehydration, hemorrhage), decreased cardiac output (heart failure, myocardial infarction), or reduced vascular resistance (shock, neurologic injury). Intrarenal causes involve nephrotoxins like aminoglycosides or contrast media, infections such as acute pyelonephritis, and conditions like lupus. Postrenal causes include obstructions from benign prostatic hyperplasia, calculi, or neuromuscular disorders. Common signs and symptoms of AKI include oliguria, shortness of breath, peripheral edema, chest pain, fatigue, and, in severe cases, seizures or coma.

Electrolyte and Fluid Imbalances in AKI

AKI often disrupts electrolyte balance, causing abnormalities like hyperkalemia, hyponatremia, and hypocalcemia. Hyperkalemia, often due to renal insufficiency or metabolic acidosis, presents with muscle weakness, bradycardia, and dysrhythmias. Hyponatremia may result from dehydration or fluid overload, causing confusion, dry mucous membranes, and headache. Hypocalcemia is linked to elevated phosphorus levels secondary to decreased glomerular filtration rate, with symptoms including tetany and tingling around the mouth or extremities.

NR 325 Week 3 Acute Kidney Injury CAE PNCI Medical Surgical

Table 1: Overview of AKI Characteristics, Causes, Symptoms, and Management

Management and Treatment of AKI

Managing AKI involves treating the underlying cause and closely monitoring fluid balance, electrolyte levels, and kidney function. Fluid administration can promote perfusion, with oral diuretics or IV fluids as needed. Electrolyte disturbances are managed with specific treatments like IV insulin to address hyperkalemia or sodium bicarbonate for acidosis. Dialysis may be necessary for severe cases, particularly if conservative measures do not stabilize the patient. Sodium polystyrene sulfonate enemas may be used to treat hyperkalemia by replacing potassium with sodium in the intestines.

NR 325 Week 3 Acute Kidney Injury CAE PNCI Medical Surgical

Nursing actions in dialysis include using aseptic techniques, avoiding compression of the access site, and monitoring for complications like hypotension or disequilibrium syndrome. Patient education covers the importance of hand hygiene, infection prevention, and adherence to prescribed medications. For those with MRSA, isolation and careful wound care are crucial to minimize the risk of spreading infection within healthcare settings.

References

• Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. (2012). KDIGO clinical practice guideline for acute kidney injury. Kidney International Supplements, 2(1), 1-138.
• National Institute for Health and Care Excellence. (2019). Acute kidney injury: Prevention, detection and management. NICE Guideline.

NR 325 Week 3 Acute Kidney Injury CAE PNCI Medical Surgical

• Thomas, R., & Balogun, R. A. (2018). Dialysis modalities: An evidence-based review. Clinics in Chest Medicine, 39(3), 557–566. https://doi.org/10.1016/j.ccm.2018.04.009

NR 325 Week 2 Clinical Reflection

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

Week 2 Clinical Reflection

This week in clinical was a remarkable experience that allowed me to engage closely with a complex patient case. My patient had a history of multiple health issues, including atrial fibrillation, which significantly affected her heart rate and created challenges in stabilizing her SPO2 levels post-surgery. Although this patient had not required oxygen support before, she became oxygen-dependent after her surgery, highlighting the intricate ways in which past health issues can lead to unexpected complications. Observing how these factors intertwined to impact her recovery deepened my understanding of patient care and the importance of monitoring for secondary issues following procedures.

My assigned nurse this week was very supportive and dedicated to teaching, offering me the opportunity to shadow her across various patient interactions. Under her guidance, I gained hands-on experience with essential tasks, including bathing a patient, discharging a patient, and transferring another patient between rooms. I was also able to assist with medication administration, observing the process of pulling medications and participating in the discharge of meds under the supervision of another nurse. A notable skill I practiced involved setting up a patient’s PCA pump, where I learned the importance of having a second nurse present for cosigning and verifying dosages. These experiences reinforced my understanding of clinical processes and safety measures.

NR 325 Week 2 Clinical Reflection

The highlight of my week was the relationship I developed with one of my patients. Building strong patient relationships was one of my initial concerns, and I was relieved to find myself growing more comfortable and confident in this area. Although I felt somewhat uncertain and overwhelmed during my first week, this week allowed me to move beyond my initial hesitation and actively support the team. I completed essential tasks such as taking vital signs and performing a head-to-toe assessment on my patient, which helped me feel more assured in my clinical abilities. Clinical practice has allowed me to appreciate the real-world application of nursing, where tasks feel different compared to theoretical or online practice. Skills such as head-to-toe assessments seemed challenging in theory but flowed naturally when executed in a clinical setting. As I continue in my clinical journey, I am excited to develop further and explore more of what nursing has to offer.

NR 325 Week 2 Clinical Reflection

Clinical Reflection Summary

References

NR 325 Week 2 Clinical Reflection

American Psychological Association. (2020). Publication Manual of the American Psychological Association (7th ed.). Washington, DC: American Psychological Association.

NR 325 Week 1 Endocrine Disorders – Worksheet

Name

Chamberlain University

NR-325 Adult Health II

Prof. Name

Date

NR 325 Endocrine Disorders Worksheet

Student Name:
Date:
Assignment Week/Day: Week 1

This worksheet summarizes major concepts and key points related to endocrine disorders, drawing on prior course materials in pathophysiology. Each disorder’s characteristics, including etiology, pathophysiology, clinical manifestations, diagnostic tests, nursing interventions, and possible complications, are reviewed.

Diabetes Mellitus Type I

Diabetes Mellitus Type I, commonly referred to as juvenile-onset or insulin-dependent diabetes, accounts for 5-10% of all diabetes cases. This autoimmune disorder predominantly affects individuals younger than 40 years, though it may present at any age. The condition develops when the immune system mistakenly attacks insulin-producing cells in the pancreas, leading to a lack of insulin production. Symptoms include hyperglycemia with rapid onset, ketoacidosis, unexplained weight loss, and the “three Ps”—polydipsia, polyuria, and polyphagia. Fatigue and weakness are also common. Diagnostic tests involve checking hemoglobin A1C levels, with a value of 6.5% or higher indicating diabetes, along with fasting plasma glucose tests. Management includes insulin therapy, nutritional counseling, and exercise to control blood glucose levels, prevent acute complications, and promote well-being. Patients must be educated on managing blood sugar levels to avoid life-threatening complications such as metabolic acidosis.

Diabetes Mellitus Type II

Type II Diabetes, or adult-onset diabetes, represents 90-95% of diabetes cases. Risk factors include age, family history, obesity, and insulin resistance, where the body does not effectively use insulin. Clinical symptoms may develop gradually and include hyperglycemia, fatigue, polyuria, polydipsia, recurrent infections, and delayed wound healing. Routine laboratory tests, especially A1C levels of 6.5% or higher, confirm the diagnosis. Lifestyle modifications, including diet, exercise, and weight management, are critical. Pharmacological interventions may include insulin or oral hypoglycemic agents. Without proper management, complications such as wound healing delays and vision problems may occur.

Other Endocrine Disorders

This section covers various disorders of the endocrine system, including pituitary, thyroid, and adrenal gland disorders. For instance, acromegaly results from excessive growth hormone, leading to significant bone growth and potential complications if untreated. Hypopituitarism, marked by the pituitary gland’s failure to produce essential hormones, affects growth, blood pressure, and reproductive functions, with treatments tailored to specific hormone deficiencies. Disorders of the posterior pituitary, such as Syndrome of Inappropriate Antidiuretic Hormone (SIADH), involve excess ADH secretion, causing fluid retention and hyponatremia, whereas diabetes insipidus involves insufficient ADH, leading to excessive urination and potential dehydration risks. Hyperthyroidism and hypothyroidism involve imbalances in thyroid hormone levels, affecting metabolism and systemic functions, with treatments including medications, lifestyle adjustments, and in severe cases, surgery.

NR 325 Week 1 Endocrine Disorders – Worksheet

Table Structure

References

American Diabetes Association. (2023). Standards of medical care in diabetes—2023 abridged for primary care providers. Diabetes Care, 46(Supplement_1), S18-S26.