Health and Individuals Capstone Final Assignment

Health and Individuals Capstone Final Assignment pg. 1

CAPSTONE FINAL ASSIGNMENT The purpose of this assignment is to help students assimilate theoretical concepts into a conceptual structure. The student will be required to critically analyze data, identify relationships and make connections within a patient’s overall health picture. The capstone assignment is in the form of a concept map assignment that specifically addresses course outcome #5: “Students will synthesize the conceptual link between nursing theory and application using critical analysis”. The CLPNA competencies addressed within this assignment include: A: Nursing knowledge, D: Communication and interpersonal skills, and E: Nursing practice. This assignment requires students to visually represent and integrate ideas and to link concepts together. Students will work to create a concept map drawing for a specific patient scenario along with a 1500-2000 academic focused word document and a 750-1000 word personal reflection. The document will use research in the form of peer reviewed evidence-based practice to explain the links between the concepts. APA (5th edition) format is required with a title page and a reference page. A minimum of two, current scholarly (peer reviewed) medical journal articles (current and published within the past 7 years) are required to be built into the assignment. PART 1- Concept Map Drawing: Due Mar 1, 2019 Submit through Canvas and give a hardcopy to your instructor A one page concept map showing the connections between the patient and all his/her diseases, conditions, disorders, and personal situations. Paper size is to be 8.5 x11 and only white computer-type paper will be accepted. No construction paper, graph or lined paper, or poster board! The map may be hand drawn or be a computer generated diagram. Include colour and shapes to separate connections. Only include connections- NOT nursing interventions. All connections must have a supporting current definition and reference source included on the diagram. Sources may be taken from your academic articles, a nursing textbook, nursing dictionary, care plan book etc. Sources may be included directly on your map or on a WN 19 PNG 1148 Health and Individuals Capstone Final Assignment pg. 2 separate reference page. Ensure good esthetical use of the page by having the concept map centered on the page with clean, professional lines either computer drawn or neatly hand drawn (use a ruler if necessary) between connections. All handwritten components MUST be legible. PART 2- Academic Paper and Reference Page: Due week of April 8 Submit through Canvas and give a hard copy to your instructor **Academic articles you plan to use for this part are due in hardcopy to your instructor NO LATER than Mar 15, 2019 1500-2000 words typed, double spaced and using the Lethbridge College APA guidelines format (5th edition). The academic paper will use a minimum of two (three for full marks) current scholarly, peer reviewed academic articles to support at least two connections within the concept map and scenario. The academic articles must be current within the past 7 years. Do not write this assignment as an opinion paper but as a scholarly discussion. Include headings for each section as well as an introduction and conclusion. When Part 2 is complete submit through the assignment section of your Canvas course (this will automatically go to “Turnitin” the college’s antiplagiarism software). Your similarity % must be less than 25% to be accepted and graded. If your percent is not in the accepted range you will be contacted by your instructor. *Marks will be deducted if the word count is not within the instructed guidelines* PART 3: Personal Reflection: Due week of April 8, 2019 Attach to the hardcopy of your academic paper only – DO NOT SUBMIT TO CANVAS *Marks will be deducted if the word count is not within the instructed guidelines* 750-1000 word reflection on the students learning specific to the process and connections that were made. Written in first person language. Ensure you answer the following three questions within your reflection. 1. Did anything surprise you about the connections between the course material and the links in the scenarios? WN 19 PNG 1148 Health and Individuals Capstone Final Assignment pg. 3 2. Did you make any big picture connections that surprised you or caused you to question what you thought you knew? 3. How does this process of linking nursing theory and potentially nursing practice with the case studies help you see a “bigger picture”? Hint: Do not use questions as a heading followed by your answer to the question as the question will not be included in the word count for this Part 3 Students will choose one of the four following scenarios to map and research: 1. Patient: Rita (80 years) Admission diagnosis: Ovarian cancer, Palliative pain control and unintentional opioid overdose Patient History includes the following:  Patient lives in an assisted living facility and was recently transferred to acute care due to an unintentional opioid overdosage.  Patient had been experiencing severe abdominal pain the past 3-4 months and was prescribed opioid analgesics.  Patient saw a specialist and was diagnosed 3 weeks ago with an inoperable ovarian malignancy.  She presented upon transfer to the ER with slurred speech, itchiness, paleness, slow, shallow respirations and a slow, erratic pulse.  Chest x-ray shows multiple tumors in the lungs. Oxygen saturation levels are 87% on room air and patient displays shortness of breath on exertion.  Lab work shows significantly elevated levels of HCG and Estrogen.  She reports feeling depressed about being palliative and has a fear of dying a painful, drawn out death.  She is accompanied by her daughter and son in law as well as an adult granddaughter.  She has been asked to contemplate the different levels of care.  A week prior to her admission she was exploring and considering the new provincial option of medical assistance with dying. 2. Patient: Sonya (75 years) WN 19 PNG 1148 Health and Individuals Capstone Final Assignment pg. 4 Admission diagnosis: Stage 2 Coccyx Pressure Injury Patient History includes:  Patient has suffered from Crohns disease for 30 years. It has become severe in the past 10 years.  Patient is markedly underweight as a result of her Crohns (also causing generalized weakness).  Patient lives at home with her retired spouse (who is 12 years older than she), they both receive “Meals on Wheels” three times a week. (These meals cannot be customized to an individual’s health condition).  Patient suffers from arthritis and as a result has a decreased activity level and uses a walker.  Initial lab work shows hyperproteinemia and low albumin. Other labs Na, K+, Cl, and HCO3 are out of balance, BUN and creatinine are increased. Hematocrit is also elevated and Hemoglobin is decreased.  Hypotension and orthostatic hypotension are evident.  Patient suffers from urinary incontinence and wears a pad at night, but often has to change her pants during the day. (The incontinent pads are expensive so she chooses only to wear them at night as finances are limited).  Patient has a history of depression and does not currently take medication (she has had medication in the past but subsequently declined the medication because she experienced adverse sideeffects 3. Patient: Charlene (59 years) Admission Diagnosis: Chronic pain (left leg and foot) Patient History:  Type 2 Diabetes Mellitus for the past 19 years  Obesity ( she is 50 pounds overweight)  Patient has a history of diabetic neuropathy and has had 3 toes on her left foot amputated over the years.  Patient expresses an inability to cope with the pain now present in her right leg and foot and insisted that the physician admit her to the hospital and treat her pain.  Patient uses a cane for mobility assistance.  She has just recently noticed a very small ulcer beginning on her right foot. WN 19 PNG 1148 Health and Individuals Capstone Final Assignment pg. 5  Patient suffers from poor circulation to the left and right lower limb.  For diabetes blood sugar control the patient had been instructed by her physician to have insulin twice daily. Each dose to be long acting and one to be a short acting insulin. The patient cannot bear to take more than one injection per day, so has agreed upon on a compromised alternative which is a pre-mixed insulin (such as 70/30: 70% NPH, 30% Regular). This does not keep her blood sugars below 7.0 mmol/L  Patient states she tries to stick to a diabetic diet but states occasionally she “Lets herself go”.  Lab work shows elevated Total Cholesterol and elevated Triglycerides. Hgb A1C levels are 9.5mmol/L  Patient has a history of narcotic dependency and “doubledoctoring” (deliberately seeing more than one doctor to obtain a larger amount of medications than would normally be prescribed by a single doctor). 4. Patient: Pierre (36 years) Admission Diagnosis: Sepsis Patient History includes:  Patient has a regular paying job.  Has a history of being a cocaine/stimulant addiction on and off for 10 years but states that he has been clean for 5 months now and attends ‘Narcotics Anonymous’ regularly.  He has never been an intravenous drug user  Patient recently had a root canal and placement of a tooth crown. He recently got a new tattoo.  Patient was admitted with symptoms of high fever and chills, joint and muscle pain and fatigue. Patient was also diagnosed with endocarditis after admission to hospital. While in hospital patient was on high-dose IV antibiotics for the first 5 days. He is still in hospital and is now taking an antibiotic orally.  Patient has a severe allergy to penicillin and peanuts.  Initial lab work when admitted showed extremely elevated white cell count, elevated platelets and decreased hemoglobin.  He has chronically inflamed tonsils (which are currently inflamed). WN 19 PNG 1148 Health and Individuals Capstone Final Assignment pg. 6  Patient recently lost both of his parents in a motor vehicle crash and is expressing deep feelings of sadness and grief but denies depression and still has a good appetite.  Patient has suffered from insomnia and anxiety since he was a child.  States he was bullied as a child and has low self-esteem issues.  Patient has a girlfriend who is supportive to him but struggles herself with alcoholism and goes to Alcoholics Anonymous. She has been “clean” for 3 months. 7 Updated January 2018 Academic Paper Guidelines for PN Program Lethbridge College Please refer to the “rubric” to guide you as you write the paper keeping the following in mind PRIOR to submitting your paper: The following criteria MUST be met prior to the paper being submitted and/or graded: o APA format followed – must include in-text citations, typed document, title page and reference page o Must include an introduction and conclusion o Section headings (note: these are different than a running head) o Academic references utilized within the paper (See #1 & #2 & #4) o Turnitin percentage of 25% or less (see #3) If the above criteria are not met, a) You will be notified via email. b) Your paper will not be graded until the criteria listed above are met. c) A grade deduction between 10 and 20% will be applied and d) Following a 24hr period after email notification late submission deductions will be applied until a paper meeting the criteria is received. 1. Strict adherence to Academic Honesty is required, ensuring accurate APA referencing. Please refer to the Student Rights and Code of Conduct Policy. 2. Papers must include at least the minimum number of valid academic references that your instructor indicates. 3. Papers will automatically be submitted to when the assignment is submitted in your Canvas course. Only your instructor will see the similarity score/report generated by Turnitin. Please see your course outline Academic Honesty section regarding 4. A valid reference is any academic source as per instructor guidelines. Use caution when using websites which may or may not be considered to be valid unless you are obtaining a quality journal article from an on-line data base. Please visit the library or the Learning Café if you are unsure what an academic source is or require assistance with APA formatting. For help with academic writing and APA formatting, please see the APA Student Guide or Purdue website: OWL Purdue Online Writing Lab

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