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Research Capstone Presentation Guidelines
Instructions: Follow the instructions below. Nine slides in total.
Follow the instructions for each slide. Time limit: Minimum 10
minutes – Maximum 20 mins.
Slide 1: Title page
· Give your presentation a unique name
· Include name, panther ID, class name/CCJ4700
· Introduce yourself
Slide 2: Present your research question
· Formally state what your research question is
· Identify your dependent variable
· Describe your dependent variable
Slide 3: Present why your research question is important or why
your dependent variable is important and needs to be studied
· Use the references you located in Assignment 9
Slide 4: What is your unit of analysis
· Explain what/who your unit of analysis is
· Describe the population you are studying
· Why are they important to study?
· What level of analysis is your unit on? Individual or
aggregate?
· Make sure you review prior lectures if you are confused – we
have been talking about this since the beginning of the semester
Slide 5: Use the title “Variable Conceptualization.”
· List four basic control variables
· See Assignment 6, page 1 for examples
· List two explanatory variables of theoretical interest (your
main independent variables)
· For students using an experimental design: If you did not get
approved for experimental design, ignore this:
· List four basic control variables
· See Assignment 6, page 1 for examples
· List one explanatory variable of theoretical interest (this is
your experimental stimuli)
· List one placebo (if appropriate) – If you do not administer a
placebo to your control group make a note of that in the
presentation
Slide 6: Use the title “Variable Operationalization.”
· Identify the level of measurement for each of the variables you
defined in slide 5
· Tell me whether each variable is nominal, multinomial,
ordinal, or interval
· Hint: If you are confused by their definitions, refer to earlier
lectures or the textbook
· Note: You do not need to have one of each type of variable. It
is acceptable to have four nominal variables. Just make sure you
operationalize each variable correctly.
Slide 7: How will you acquire data?
· Will you use:
· Survey research
· Interviews
· Experimental research
· Choose one and then support your decision
· If you choose:
· Survey research – Provide six sample questions based on the
variables you designed in slide 5. For example, if one of your
control variables is age, then one of your sample survey
questions will be: “What is your age (in years)?”
· Interviews (used with hard to reach populations) - Provide six
sample questions based on the variables you designed in slide 5.
For example, if one of your control variables is age, then one of
your sample survey questions will be: “What is your age (in
years)?”
· Experimental design – Create a figure and clearly explain
where your control group and experimental groups are in the
figure. Display and explain where the stimulus is administered
in the figure. Explain where the pre and post-tests are in the
figure.
Slide 8: What is your sampling method?
· Explain whether you will be using probability sampling or
non-probability sampling
· Explain which specific sampling method you will use to
recruit participants into your study
· Explain how the sampling method you chose works
· Refer to Assignment 8
Slide 9: Reference sheet (NO ORAL PRESENTATION
REQUIRED)
· Refer to Assignment 9
· You can re-use the articles you acquired for assignment 9.
Make sure your references are in APA format.
Running head: MILESTONE TWO 1
MILESTONE TWO 9
Milestone Two
Born in 1775, Jane Austen was a novelist from England whose
works were founded on the British landed gentry. She had six
major novels, including "Pride and Prejudice," "Persuasion,"
and "Emma," among others. Austen died when she was forty-
one years old after manifesting a myriad of diseases that went
undiagnosed. However, with advancements in medicine years
later, White (2009) asserts that Austen died after succumbing to
Addison's sickness, a failure of the adrenal organs. The
pathophysiology of Addison’s sickness changes the normal state
of the body by affecting the mineralocorticoid and
glucocorticoid functions.
Mineralocorticoids facilitate the excretion of potassium and the
reabsorption of sodium. Therefore, if mineralocorticoids are not
produced, there will be high potassium and sodium content in
the body resulting in high urinary salt and water loss.
Consequently, one will portray symptoms such as severe
hydration, decreased circulatory volume, and plasma
hypertonicity, among others (Bancos et al., 2015). On the other
hand, a deficiency in glucocorticoids adversely affects the
metabolism of protein, carbohydrate, and fats. Also, it leads to
insulin sensitivity and hypotension. Symptoms include
weakness, which is caused by compromise neuromuscular
function, and myocardial weakness, which is caused by
circulatory failure.
The clinical manifestations of Addison’s sickness start slowly
through things like fatigue, weight loss, and muscle weakness.
Other symptoms include vomiting, diarrhea, and low blood
pressure that can cause fainting episodes or dizziness.
Addison’s sickness is also characterized by skin discoloration
where one has dark hyperpigmentation in pressure points such
as elbows, knees, and lips. Individuals diagnosed with this
sickness may be irritable or depressed since they crave salt-
laden foods (Bancos et al., 2015). Considering that these
symptoms appear gradually, most cases of Addison’s sickness
tend to go untreated until the condition becomes severe.
History
There are two major explanations for variations in
pathophysiology. On the one hand, Addison's sickness can occur
in the early years of one's life in what is known as the
autoimmune polyendocrine syndrome type 1 (APS type 1). This
variation happens when the autoimmune suppressor gene in
chromosome 21q22.3 is mutated. Eighty percent of individuals
with APS type 1 go on to contract Addison’s sickness. On the
other hand, Addison’s sickness can occur in the later years of
one’s life in what is referred to as APS type 2. This is a more
genetically complex variation compared to the APS type 1. APS
type 2 is prevalent in the genotypes HLA- DR4/DQ8, and
DR3/DQ2 (Leelarathna, Powrie, & Carroll, 2009). Furthermore,
Addison’s sickness can develop in an individual who has a
mutated allele of a MICA gene that does not rely on the
polymorphism of the DQ or DR gene.
There are two physiological stressors that affect the course of
Addison’s sickness. First, there is the primary adrenal
insufficiency. This relates to the adrenal cortex being gradually
destroyed by the immune system of the body. Consequently, the
majority of individuals diagnosed with Addison's sickness are
caused by autoimmune disorders. The antibodies of an
individual's immune system slowly attack and destroy the
organs and tissues of the affected person. When the destruction
of the adrenal cortex reaches approximately ninety percent,
primary adrenal insufficiency occurs. Second, there is the
secondary adrenal insufficiency. In this case, the production of
cortisol by the adrenal glands drops significantly. Secondary
adrenal insufficiency is common when a person stops taking
glucocorticoid hormone medication after consuming it for a
long time. Also, one can experience secondary adrenal
insufficiency when benign ACTH producing tumors are
surgically removed.
It follows that the historical impact of patient care technology
in the context of Addison’s sickness has been immense.
Initially, little was known about Addison’s sickness, which is
why Jane Austen died before receiving a proper diagnosis.
Thomas Addison, the man credited with identifying the disease,
used a monograph to identify the problem with the adrenal
glands. This was an isolated incident since little was known
about adrenal glands at the time. Nevertheless, the use of the
monograph proved to be a technological breakthrough in patient
care.
Planning
Two Short-Term Goals
Goal 1 – Accurately diagnose the patient and determine whether
he/she has primary or secondary adrenal insufficiency and any
other notable aspects that can affect the intervention methods.
This goal is achieved within one day. The diagnosis can be
achieved through four tests. First, there are blood tests that
measure the levels of antibodies that propagate Addison’s
sickness. Also, they measure the patient’s ACTH, cortisol,
potassium, and sodium levels in the blood, all of which affect
the production of hormones in the adrenal cortex. Second, there
is the insulin-induced hypoglycemia test, which entails giving
the patient an injection of insulin then checking his/her cortisol
and blood sugar levels. This will denote if the patient’s
condition is due to pituitary disease. Third, there are the ACTH
simulation tests that signal the production of cortisol from the
adrenal gland. Finally, there are the imaging tests where adrenal
glands’’ sizes are checked using a CT scan of the abdomen.
Goal 2 – Effectively deal with cases of patients experiencing an
Addisonian crisis. This goal is achieved within two to four
hours. It entails the patient receiving intravenous injections of
dextrose, saline, and hydrocortisone. The objective of the goal
is to ensure the patient’s potassium, blood sugar, and blood
pressure levels are normalized.
The accomplishment of these short-term goals should be
complete before patients can attain long-term goals. The main
objective of these goals is to measure and record the progress of
the patients with respect to the long-term goals. More so, the
achievement of these short-term goals offers the patients
suitable reinforcement that can encourage them to continue
working towards fighting the disease. These short-term goals
are effective in acute care conditions that require nurses to
emphasize on the immediate needs of the patients.
Two Long-Term Goals
Goal 1 – After six weeks of undergoing treatment, the
patient is expected to have acceptable levels of steroid
hormones to take over the roles played by cortisol and
aldosterone in the body. The patient’s body is expected to have
better metabolism, mood, tissue function, and response to
stress.
Goal 2 – After six weeks of treatment, the patient should
be well equipped to effectively live with Addison’s disease and
handle emergencies in case of an Addisonian crisis. The patient
is expected to have a medical bracelet or card that informs
emergency healthcare workers of his/her condition. Also, the
patient must have extra medication in case of emergencies.
These two long-term goals define the changes that the
patient undergoes over a long period. The goals defined work to
restore the normal functioning of the patients' problem areas. In
case the restoration of normal functioning is impossible, then
these goals will define the maximum functioning level, which is
attainable based on the resources and health condition of the
patient.
Intervention
An interdependent intervention will be used to handle a
case of a patient that has Addison's sickness. This form of
intervention entails collaboration between a nurse and other
healthcare workers, for instance, physicians, and dietitians. The
first part of the intervention will be observation. The nurse will
have to carefully observe the patient and note how he/she
responds to treatment and whether any complications develop.
The nurse must make a note of every issue, including high-risk
problems and probable nursing diagnoses. During this stage, the
nurse can take note of the common symptoms associated with
Addison's sickness, for instance, hyperpigmentation of the skin,
muscle weakness, low appetite, changes in mood, craving for
salt-laden food, headache, diarrhea, vomiting, and fainting
(Neto & de Carvalho, 2014). Also, the nurse will have to take
note of things like low blood pressure, severe abdominal or
back pains, low sodium levels, and high potassium levels.
Observation is crucial in this regard since the quick worsening
of symptoms might result in an Addisonian crisis or acute
adrenal failure. If such situations go unnoticed, the result might
be death.
The second part of the intervention is prevention. This entails
implementing the necessary care to ensure complications are
prevented, and risk factors are reduced. This part of the
intervention is crucial for collaborative challenges and high-risk
nursing diagnoses. Nevertheless, they can be utilized for
practical nursing diagnoses. One solution in this regard is the
use of salt additives in food (Michels & Michels, 2014). Since a
patient might be unable to retain sodium naturally, he/she might
require his/her food to have salt additives. This is especially
handy in periods of salt loss, for instance, high temperatures
and sweating.
The third part of the intervention is treatment. It normally
entails implementing the necessary care to treat a problem.
Often, actual nursing diagnoses require appropriate treatment.
There are three major treatments for Addison’s sickness. First,
there is the use of hydrocortisone. This refers to a form of
synthetic medication that takes the place of the cortisol lost in
the body. The doses given to the patient vary from 20 to 50
milligrams, depending on his/her metabolism and weight.
Patients with Cushing syndrome might need dosage adjustment.
Typically, hydrocortisone is given in two doses. There is the 2/3
dose in the morning, and 1/3 does in the afternoon. Second,
there is the use of fludrocortisone. This refers to a synthetic
mineralocorticoid, which is necessary for individuals that do not
have aldosterone. It is vital for the kidney's potassium excretion
and sodium retention. It is crucial to take note of fluid overload
and hypertension in the patient that might occur as a result of
excessive retention of sodium. Finally, there is the androgen
replacement therapy. This therapy is necessary for females who
require replacement therapy for the androgen that is produced
by the adrenal cortex (Michels & Michels, 2014). However, this
form of therapy is only carried out under special circumstances.
The final part of the intervention entails health promotion.
In situations where health problems are absent, the nurse will
ensure the patient can identify certain improvement areas, to
promote better wellness levels. Strategies that propagate the
promotion of health are needed to encourage approach
behaviors. This way, a patient can prevent the occurrence of
negative outcomes and promote the occurrence of positive
outcomes. These strategies actualize the health potential of the
patient. In this regard, the prevention of the Addisonian crisis is
vital. Nurses can aid patients in monitoring their levels of
hypotension, hypoglycemia, electrolyte and fluid balance, and
appropriate fluid volume.
Throughout the intervention process, technology can be utilized
for health promotion and patient safety. For starters, technology
facilitates communication between the different healthcare
workers that take care of the patient. This reduces any errors or
miscommunication that might be fatal for the patient. Also,
technology promotes patient-centered care. This is vital to
patient safety and satisfaction in the care received.
Evaluation
An evaluation of the plan of care is vital in noting the health
status of the patient and the results of the intervention. The
evaluation, in this case, will involve a comparison between the
patient's initial condition and their present condition. More so,
the evaluation will check the response of the patients to the
intervention strategies. It is expected that the evaluation process
will be ongoing and iterative involving the patient and the
healthcare workers to determine the extent of the achievement
of the medication and the effectiveness of the intervention plan.
The necessary data in this regard will cover the patients’ levels
of hypotension, hypoglycemia, electrolyte and fluid balance,
and appropriate fluid volume (Neto & de Carvalho, 2014).
Others include things like low blood pressure, severe abdominal
or back pains, low sodium levels, and high potassium levels.
Taking note of such data will enable the nurses and physicians
to determine how the patient is responding to the intervention
and whether additional strategies are required.
Following the successful intervention, for Addison's
sickness, a patient is expected to be no longer dehydrated and
have standard blood pressure. Also, it is expected that a patient
will be oriented, alert, and ready to cater to his/her needs while
at home. Catering to his needs will show that the patient
understands his/her dietary requirements and maintains his/her
medication doses. Overall, the evaluation is supposed to reveal
normal fluid balance and standard peripheral perfusion with
normalized blood pressure. Furthermore, symptoms such as
fatigue, diarrhea, vomiting, and abdominal pains are expected to
go away. If the evaluation does not yield such results, then the
healthcare professionals will have to reevaluate their approach
and come up with a new plan of intervention.
References
Bancos, I., Hahner, S., Tomlinson, J., & Arlt, W. (2015).
Diagnosis and management of adrenal insufficiency. The Lancet
Diabetes & Endocrinology, 3(3), 216-226.
Leelarathna, L., Powrie, J. K., & Carroll, P. V. (2009). Thomas
Addison's disease after 154 years: modern diagnostic
perspectives on an old condition. QJM: An International Journal
of Medicine, 102(8), 569-573.
Michels, A., & Michels, N. (2014). Addison disease early
detection and treatment principles. Am Fam Physician, 89(07).
Neto, R. A. B., & de Carvalho, J. F. (2014). Diagnosis and
classification of Addison's disease (autoimmune adrenalitis).
Autoimmunity Reviews, 13(4-5), 408-411.
White, K. G. (2009). Jane Austen and Addison's disease: an
unconvincing diagnosis. Medical Humanities, 35(2), 98.
Running head: MILESTONE ONE
1
MILESTONE ONE
4
Milestone One
Introduction of Individual
In 1816, the author of such beloved books as "Emma" and
"Pride and Prejudice" came down with a large group of puzzling
diseases including fatigue, back pain, skin discoloration,
"bilious attacks" and fever. Only one year later, she was dead at
41 years old. Much theory has been dedicated to Jane Austen's
infection in the years since, with the most widely recognized
diagnosis being that she had Addison's sickness, a malfunction
of the adrenal organs that wasn't known to medicine until quite
a while after her demise (White, 2009). Even though delayed in
its onset, the confusion is known to cause changes in skin color
during its late stages, which may clarify Austen's cases that her
complexion had turned "black and white and every wrong
color."
Identification of Pathophysiology
Mineralocorticoid deficiency
Sodium reabsorption and excretion of potassium from the body
are stimulated by mineralocorticoids, whereby if
mineralocorticoids are not produced, it leads to decreased
production of potassium and increased excretion of sodium,
primarily through sweat, urine, saliva and times in
gastrointestinal tract. A high serum concentration of potassium
and low sodium concentration may be detected as a result.
Symptoms such as but not limited may result where there is
high water loss and urinary salt: hypotension, decreased
circulatory volume, acidosis, plasma hypertonicity, severe
dehydration, and finally, circulatory collapse. Nevertheless,
when adrenocorticotropic hormone (ACTH) leads to adrenal
inadequacy due to its low production, the circulatory problems
are less severe, and the electrolyte levels are somewhat normal
or mildly deranged (Bancos et al., 2015).
Glucocorticoid deficiency
Insufficiency of Glucocorticoid production leads to hypotension
and severe insulin sensitivity as well as interferes with protein,
fat, and carbohydrate metabolism. From protein, carbohydrates
are formed when there is inadequate production of cortisol, and
also hypoglycemia and reduced liver glycogen result. As a
result of neuromuscular function, the person feels weak.
Circulatory failure may result due to myocardial weakness and
dehydration because there is reduced cardiac output.
Additionally, glucocorticoid deficiency leads to reduced
production of cortisol which affects ACTH production to a
decreased level and elevated the amount of blood beta-
lipotropin, which has melanocyte-stimulating activity and, when
combined with ACTH, causes the hyperpigmentation of skin and
mucous membranes characteristic of Addison disease (Bancos et
al., 2015). Therefore, hyperpigmentation is not caused by the
adrenal deficiency secondary to pituitary failure.
Clinical Manifestations
Addison’s disease manifestation starts gradually. Symptoms
such as weight loss, loss of appetite, muscle weakness, fatigue,
and chronic are examples of disease characteristics. In about
50% of reported cases, victims have diarrhea, vomiting, and
nausea (Bancos et al., 2015). The patient’s blood pressure falls
drastically when standing, causing dizziness or fainting. Skin
discoloration is part of Addison's disease with a spot of dark
tainting or hyperpigmentation covering naked body parts. In
most cases, these dark skin spots are visible in pressure points,
elbows, or scars such as mucous membranes, lips, toes,
knuckles, knees, and elbows. Patients can develop depression
and irritability as a result of Addison's disease. This is due to
increased craving of foods with salt leading to salt loss. In
children, hypoglycemia is more prevalent than in adults. There
are irregular menstrual cycles in women.
Since the manifestations progress gradually, they are typically
disregarded until an unpleasant event like an ailment or a
mishap makes them worse. This is called an Addisonian crisis
or intense adrenal deficiency. In many patients, side effects are
severe enough to look for treatment before an emergency
happens. Nonetheless, in around 25% of patients, manifestations
initially show up during an Addisonian crisis (Bancos et al.,
2015).
References
Bancos, I., Hahner, S., Tomlinson, J., & Arlt, W. (2015).
Diagnosis and management of adrenal insufficiency. The Lancet
Diabetes & endocrinology, 3(3), 216-226.
White, K. G. (2009). Jane Austen and Addison's disease: an
unconvincing diagnosis. Medical humanities, 35(2), 98.
NUR 315 Final Project Guidelines and Rubric
Overview
Pathophysiology is a topic that is studied by most healthcare
professional students—including nursing, medicine, and other
allied health professionals.
Increasingly, this study has been enriched and enhanced through
the use of various patient care technologies. Pathophysiology is
defined as the study of the
disturbance of normal mechanical, physical, and biochemical
functions, either caused by a disease or resulting from an
abnormal syndrome or condition that may
not qualify to be called a disease. Pathophysiology may also be
thought of as the study of the biological and physical
manifestations of disease as they correlate
with the underlying abnormalities and physiological
disturbances. It is critically important for nurses to understand
and be able to assess common health
challenges or diseases.
The final project for this course will require you to choose a
well-known individual from history or current popular
literature, with instructor approval, who has a
known physiological disease or illness of interest, and analyze
that person’s case. You will then develop a plan of care using
aspects of the nursing process for
your selected case.
This assessment addresses the following course outcomes:
x Differentiate between normal physiological processes and
pathological presentations of adult health states for promoting
health and preventing disease
x Assess the role of patient care technologies in managing and
promoting patient outcomes in individuals with chronic diseases
and acute illnesses
x Explain the pathological processes of adult diseases and
illnesses for guiding risk-reduction and prevention strategies
x Develop plans of care for adult diseases and illnesses that
utilize current evidence-based research
Prompt
You will choose a well-known individual from history or
current popular literature, with instructor approval, who has a
known physiological—as opposed to
psychiatric or psychological—disease or illness, and, using a
systematic approach, you will analyze that disease or illness.
You will also develop a plan of care for
that disease or illness.
In your analysis, you will describe the pathophysiology for your
selected disease or illness, propose historical explanations for
variations in findings (when
applicable), and demonstrate use of nursing conceptual models
to frame your discussion of adaptation and stressors collectively
for system analysis.
Your plan of care should utilize the PIE (planning, intervention,
and evaluation) format. The planning (P) section should include
at least two short-term and two
long-term goals that are most appropriate for your chosen case,
and each goal should have measurable criteria and have a
hypothetical target date or time. The
intervention (I) section should include interventions or nursing
actions that directly relate to the selected case’s goals and that
are specific in action and
frequency. The number of interventions should be appropriate
for helping to meet individual goals. Finally, the evaluation (E)
section of the plan of care should
include proposed measures for determining success of the plan
and an evaluation of the potential success of the plan, based on
those measures.
Specifically, the following critical elements must be addressed:
I. Introduce your selected case
a) Identify the individual you selected and his or her disease or
illness, and provide a brief explanation of why you selected this
case.
b) Describe how normal physiology is changed by the disease
state for your selected case.
c) Define the pathophysiology and clinical manifestations
associated with your selected case and how they may be
explained by altered physiology.
Be sure to support your claims with scholarly evidence.
d) Assess the extent to which clinical manifestations of your
selected case affect multiple body systems, using scholarly
evidence to support your
claims.
II. History of selected case
a) Describe historical variations (that is, examples of
individuals with the selected disease or illness) of your selected
case, using evidence from
literature.
b) Identify physiological stressors that may affect the course of
the disease or illness, and explain their impact.
c) Identify adaptive physiological mechanisms that may affect
the course of the disease for your selected case.
d) Assess the historical impact of patient care technologies on
patient outcomes for your selected case. Be sure to justify your
claims with scholarly
evidence.
III. Planning for care for your selected case
a) Write a goal statement that is patient-centered and contains at
least one measurable criterion or target date/time. In order to
address this
element comprehensively, you should be sure to provide at least
two short-term and two long-term goals for your selected case.
b) Analyze the critical nursing concerns associated with this
disease state, and prioritize them from a treatment standpoint.
c) Identify patient care technologies that are appropriate for
managing clinical manifestations of your selected case.
IV. Intervention
a) Outline appropriate nursing interventions for your selected
case. Be sure to substantiate your claims with scholarly
evidence.
b) Outline common classes of medications used to manage the
disease. Be sure to provide examples from scholarly evidence to
support your
claims.
c) Assess the extent to which current patient care technologies
improve health promotion for your selected case, using
scholarly evidence to
support your claims.
d) Assess the extent to which current patient care technologies
assist in decreasing medication errors and improving patient
safety with regard to
your selected case.
V. Evaluation
a) Identify the most appropriate measures for determining the
success of your plan of care. In other words, what data will you
need to collect to
determine if your plan worked? Be sure to substantiate your
claims with scholarly evidence.
b) In terms of the outcome measures you identified, evaluate the
potential success of your plan of care and proposed nursing
interventions for
your selected case. In other words, do you feel your proposed
plan of care and interventions for your selected case will result
in successful
outcomes? Be sure to justify your rationale with evidence-based
research.
Milestones
Milestone One: Selection of Case
In Module Two, you will identify and introduce your selected
case. This submission will be graded with the Milestone One
Rubric.
Milestone Two: Draft of Selected Case and Plan
In Module Five, you will submit a draft of your final project. Be
sure to incorporate instructor feedback in your final project.
This submission will be graded with
the Milestone Two Rubric.
Final Submission: Case Analysis and Plan of Care
In Module Seven, you will submit your final project. It should
be a complete, polished artifact containing all of the critical
elements of the final product. It should
reflect the incorporation of feedback gained throughout the
course. This submission will be graded with the Final Product
Rubric.
Final Product Rubric
Guidelines for Submission: Your case analysis and plan of care
paper should be between 6 and 10 pages, not including title
page and reference list. It should be
formatted with 12-point Times New Roman font and one-inch
margins; all citations should follow proper APA guidelines.
Critical Elements Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Introduce: Identify Meets “Proficient” criteria and
uses industry-specific language
to establish expertise
Identifies selected individual
and disease or illness and
provides reasoning behind
selection
Identifies selected individual
and disease or illness, but does
not provide reasoning behind
selection
Does not identify selected
individual and disease or illness
4
Introduce: Describe
Meets “Proficient” criteria, and
description is exceptionally
clear and well-informed
Accurately describes how
normal physiology is changed
by disease state for selected
case
Describes how normal
physiology is changed by
disease state for selected case,
but with gaps in accuracy
Does not describe how normal
physiology is changed by
disease state for selected case
7.7
Introduce: Define
Meets “Proficient” criteria, and
definition is exceptionally clear
and well-informed
Defines the pathophysiology
and clinical manifestations
associated with selected case
and how they may be explained
by altered physiology and
supports claims with scholarly
evidence
Defines the pathophysiology
and clinical manifestations
associated with selected case,
but not how they may be
explained by altered
physiology, or does not support
claims with scholarly evidence
Does not define the
pathophysiology and clinical
manifestations associated with
selected case
7.7
Introduce: Assess
Meets “Proficient” criteria, and
assessment is exceptionally
clear and well-informed
Assesses the extent to which
clinical manifestations of
selected case affect multiple
body systems and supports
claims with scholarly evidence
Assesses the extent to which
clinical manifestations of the
selected case affect multiple
body systems, but does not
support claims with scholarly
evidence
Does not assess the extent to
which clinical manifestations of
the selected case affect
multiple body systems
7.7
History: Variations
Meets “Proficient” criteria and
demonstrates keen insight into
historical variations of selected
case
Describes historical
explanations of variations in
the selected case using
evidence from literature
Describes historical
explanations of variations in
the selected case, but does not
use evidence from literature
Does not describe historical
explanations of variations in
the selected case
5.75
History: Stressors
Meets “Proficient” criteria and
draws nuanced connections
between concepts
Identifies physiological
stressors that may affect the
course of the disease or illness
and explains their impact
Identifies physiological
stressors that may affect the
course of the disease or illness,
but does not explain their
impact
Does not identify physiological
stressors that may affect the
course of the disease or illness
5.75
History:
Mechanisms
Meets “Proficient” criteria, and
identification is exceptionally
clear and well-informed
Clearly identifies adaptive
physiological mechanisms that
may affect the course of the
disease for selected case
Identifies adaptive
physiological mechanisms that
may affect the course of the
disease for selected case, but
with gaps in clarity or accuracy
Does not identify adaptive
physiological mechanisms that
may affect the course of the
disease for selected case
5.75
History: Impact
Meets “Proficient” criteria and
draws nuanced connections
between concepts
Comprehensively assesses the
historical impact of patient care
technologies on patient
outcomes for selected case and
justifies claims with scholarly
evidence
Assesses the historical impact
of patient care technologies on
patient outcomes for selected
case, but with gaps in detail or
accuracy, or does not justify
claims with scholarly evidence
Does not assess the historical
impact of patient care
technologies on patient
outcomes for selected case
5.75
Planning: Statement
Meets “Proficient” criteria, and
goal statement is creatively
written and supported by
scholarly evidence
Writes a comprehensive goal
statement that is patient-
centered and contains
measurable criteria or target
date/time
Writes a goal statement that is
not patient-centered or does
not contain measurable criteria
or target/date time, or goal
statement lacks detail
Does not write goal statement 4.6
Planning: Concerns
Meets “Proficient” criteria, and
analysis is exceptionally clear
and well-informed
Comprehensively analyzes
critical nursing concerns for this
disease state and appropriately
prioritizes them from a
treatment standpoint
Analyzes critical nursing
concerns for this disease state,
but with gaps in detail, or
prioritizes them inappropriately
from a treatment standpoint or
does not prioritize them
Does not analyze critical
nursing concerns for this
disease state
4.6
Planning:
Technologies
Meets “Proficient” criteria and
provides detailed examples of
how the technologies will
support management of the
clinical manifestations
Identifies patient care
technologies that are
appropriate for managing
clinical manifestations of
selected case
Identifies patient care
technologies, but they are not
appropriate for managing
clinical manifestations of
selected case
Does not identify patient care
technologies
5.75
Intervention:
Nursing
Meets “Proficient” criteria and
outlines multiple interventions
to help patients or family meet
goal, and interventions are
specific in action and frequency
Outlines appropriate nursing
interventions for selected case
and substantiates claims with
scholarly evidence
Outlines nursing interventions
that are not appropriate for
selected case or does not
substantiate claims with
scholarly evidence
Does not outline nursing
interventions for selected case
4.6
Intervention:
Medications
Meets “Proficient” criteria and
demonstrates keen insight into
the use of pharmaceutical
interventions
Outlines common classes of
medications used to manage
the selected case and supports
claims with specific examples
from scholarly evidence
Outlines common classes of
medications used to manage
the selected case, but does not
support claims with specific
examples from scholarly
evidence
Does not outline common
classes of medications used to
manage the selected case
5.75
Intervention: Assess
Meets “Proficient” criteria and
draws nuanced connections
between current patient care
technologies and health
promotions
Assesses the extent to which
current patient care
technologies improve health
promotion for selected case
and supports claims with
scholarly evidence
Assesses the extent to which
current patient care
technologies improve health
promotion for selected case,
but does not support claims
with scholarly evidence
Does not assess the extent to
which current patient care
technologies improve health
promotion for selected case
5.75
Intervention: Extent
Meets “Proficient” criteria and
demonstrates keen insight into
the use of patient care
technologies as a patient safety
intervention
Accurately assesses the extent
to which current patient care
technologies assist in
decreasing medication errors
and improving patient safety
for selected case
Assesses the extent to which
current patient care
technologies assist in
decreasing medication errors
or improving patient safety for
selected case, but with gaps in
accuracy or detail
Does not assess the extent to
which current patient care
technologies assist in
decreasing medication errors
and improving patient safety
5.75
Evaluation: Identify
Meets “Proficient” criteria and
draws nuanced connections
between concepts
Comprehensively identifies
appropriate measures for
determining success of plan of
care and substantiates claims
with scholarly evidence
Identifies measures that are
not appropriate for
determining success of plan of
care or identification lacks
detail, or does not substantiate
claims with scholarly evidence
Does not identify measures for
determining success of plan of
care
4.5
Evaluation: Evaluate
Meets “Proficient” criteria and
cites specific, relevant
examples to establish a robust
context for the evaluation
Evaluates plan of care and
proposed nursing interventions
for selected case in terms of
identified outcome measures
and justifies rationale with
scholarly evidence
Evaluates plan of care and
proposed nursing
interventions, but does not
address identified outcome
measures or does not justify
rationale with scholarly
evidence
Does not evaluate plan of care
and proposed nursing
interventions
4.6
Articulation of
Response
Submission is free of errors
related to citations, grammar,
spelling, syntax, and
organization and is presented
in a professional and easy-to-
read format
Submission has no major errors
related to citations, grammar,
spelling, syntax, or organization
Submission has major errors
related to citations, grammar,
spelling, syntax, or organization
that negatively impact
readability and articulation of
main ideas
Submission has critical errors
related to citations, grammar,
spelling, syntax, or organization
that prevent understanding of
ideas
4
Earned Total 100%
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Research Capstone Presentation GuidelinesInstructions Follow th.docx

  • 1. Research Capstone Presentation Guidelines Instructions: Follow the instructions below. Nine slides in total. Follow the instructions for each slide. Time limit: Minimum 10 minutes – Maximum 20 mins. Slide 1: Title page · Give your presentation a unique name · Include name, panther ID, class name/CCJ4700 · Introduce yourself Slide 2: Present your research question · Formally state what your research question is · Identify your dependent variable · Describe your dependent variable Slide 3: Present why your research question is important or why your dependent variable is important and needs to be studied · Use the references you located in Assignment 9 Slide 4: What is your unit of analysis · Explain what/who your unit of analysis is · Describe the population you are studying · Why are they important to study? · What level of analysis is your unit on? Individual or aggregate? · Make sure you review prior lectures if you are confused – we have been talking about this since the beginning of the semester Slide 5: Use the title “Variable Conceptualization.” · List four basic control variables · See Assignment 6, page 1 for examples · List two explanatory variables of theoretical interest (your main independent variables) · For students using an experimental design: If you did not get approved for experimental design, ignore this: · List four basic control variables · See Assignment 6, page 1 for examples · List one explanatory variable of theoretical interest (this is
  • 2. your experimental stimuli) · List one placebo (if appropriate) – If you do not administer a placebo to your control group make a note of that in the presentation Slide 6: Use the title “Variable Operationalization.” · Identify the level of measurement for each of the variables you defined in slide 5 · Tell me whether each variable is nominal, multinomial, ordinal, or interval · Hint: If you are confused by their definitions, refer to earlier lectures or the textbook · Note: You do not need to have one of each type of variable. It is acceptable to have four nominal variables. Just make sure you operationalize each variable correctly. Slide 7: How will you acquire data? · Will you use: · Survey research · Interviews · Experimental research · Choose one and then support your decision · If you choose: · Survey research – Provide six sample questions based on the variables you designed in slide 5. For example, if one of your control variables is age, then one of your sample survey questions will be: “What is your age (in years)?” · Interviews (used with hard to reach populations) - Provide six sample questions based on the variables you designed in slide 5. For example, if one of your control variables is age, then one of your sample survey questions will be: “What is your age (in years)?” · Experimental design – Create a figure and clearly explain where your control group and experimental groups are in the figure. Display and explain where the stimulus is administered in the figure. Explain where the pre and post-tests are in the figure. Slide 8: What is your sampling method?
  • 3. · Explain whether you will be using probability sampling or non-probability sampling · Explain which specific sampling method you will use to recruit participants into your study · Explain how the sampling method you chose works · Refer to Assignment 8 Slide 9: Reference sheet (NO ORAL PRESENTATION REQUIRED) · Refer to Assignment 9 · You can re-use the articles you acquired for assignment 9. Make sure your references are in APA format. Running head: MILESTONE TWO 1 MILESTONE TWO 9 Milestone Two Born in 1775, Jane Austen was a novelist from England whose works were founded on the British landed gentry. She had six major novels, including "Pride and Prejudice," "Persuasion," and "Emma," among others. Austen died when she was forty- one years old after manifesting a myriad of diseases that went undiagnosed. However, with advancements in medicine years later, White (2009) asserts that Austen died after succumbing to Addison's sickness, a failure of the adrenal organs. The pathophysiology of Addison’s sickness changes the normal state of the body by affecting the mineralocorticoid and glucocorticoid functions. Mineralocorticoids facilitate the excretion of potassium and the reabsorption of sodium. Therefore, if mineralocorticoids are not produced, there will be high potassium and sodium content in the body resulting in high urinary salt and water loss. Consequently, one will portray symptoms such as severe hydration, decreased circulatory volume, and plasma hypertonicity, among others (Bancos et al., 2015). On the other
  • 4. hand, a deficiency in glucocorticoids adversely affects the metabolism of protein, carbohydrate, and fats. Also, it leads to insulin sensitivity and hypotension. Symptoms include weakness, which is caused by compromise neuromuscular function, and myocardial weakness, which is caused by circulatory failure. The clinical manifestations of Addison’s sickness start slowly through things like fatigue, weight loss, and muscle weakness. Other symptoms include vomiting, diarrhea, and low blood pressure that can cause fainting episodes or dizziness. Addison’s sickness is also characterized by skin discoloration where one has dark hyperpigmentation in pressure points such as elbows, knees, and lips. Individuals diagnosed with this sickness may be irritable or depressed since they crave salt- laden foods (Bancos et al., 2015). Considering that these symptoms appear gradually, most cases of Addison’s sickness tend to go untreated until the condition becomes severe. History There are two major explanations for variations in pathophysiology. On the one hand, Addison's sickness can occur in the early years of one's life in what is known as the autoimmune polyendocrine syndrome type 1 (APS type 1). This variation happens when the autoimmune suppressor gene in chromosome 21q22.3 is mutated. Eighty percent of individuals with APS type 1 go on to contract Addison’s sickness. On the other hand, Addison’s sickness can occur in the later years of one’s life in what is referred to as APS type 2. This is a more genetically complex variation compared to the APS type 1. APS type 2 is prevalent in the genotypes HLA- DR4/DQ8, and DR3/DQ2 (Leelarathna, Powrie, & Carroll, 2009). Furthermore, Addison’s sickness can develop in an individual who has a mutated allele of a MICA gene that does not rely on the polymorphism of the DQ or DR gene. There are two physiological stressors that affect the course of Addison’s sickness. First, there is the primary adrenal insufficiency. This relates to the adrenal cortex being gradually
  • 5. destroyed by the immune system of the body. Consequently, the majority of individuals diagnosed with Addison's sickness are caused by autoimmune disorders. The antibodies of an individual's immune system slowly attack and destroy the organs and tissues of the affected person. When the destruction of the adrenal cortex reaches approximately ninety percent, primary adrenal insufficiency occurs. Second, there is the secondary adrenal insufficiency. In this case, the production of cortisol by the adrenal glands drops significantly. Secondary adrenal insufficiency is common when a person stops taking glucocorticoid hormone medication after consuming it for a long time. Also, one can experience secondary adrenal insufficiency when benign ACTH producing tumors are surgically removed. It follows that the historical impact of patient care technology in the context of Addison’s sickness has been immense. Initially, little was known about Addison’s sickness, which is why Jane Austen died before receiving a proper diagnosis. Thomas Addison, the man credited with identifying the disease, used a monograph to identify the problem with the adrenal glands. This was an isolated incident since little was known about adrenal glands at the time. Nevertheless, the use of the monograph proved to be a technological breakthrough in patient care. Planning Two Short-Term Goals Goal 1 – Accurately diagnose the patient and determine whether he/she has primary or secondary adrenal insufficiency and any other notable aspects that can affect the intervention methods. This goal is achieved within one day. The diagnosis can be achieved through four tests. First, there are blood tests that measure the levels of antibodies that propagate Addison’s sickness. Also, they measure the patient’s ACTH, cortisol, potassium, and sodium levels in the blood, all of which affect the production of hormones in the adrenal cortex. Second, there is the insulin-induced hypoglycemia test, which entails giving
  • 6. the patient an injection of insulin then checking his/her cortisol and blood sugar levels. This will denote if the patient’s condition is due to pituitary disease. Third, there are the ACTH simulation tests that signal the production of cortisol from the adrenal gland. Finally, there are the imaging tests where adrenal glands’’ sizes are checked using a CT scan of the abdomen. Goal 2 – Effectively deal with cases of patients experiencing an Addisonian crisis. This goal is achieved within two to four hours. It entails the patient receiving intravenous injections of dextrose, saline, and hydrocortisone. The objective of the goal is to ensure the patient’s potassium, blood sugar, and blood pressure levels are normalized. The accomplishment of these short-term goals should be complete before patients can attain long-term goals. The main objective of these goals is to measure and record the progress of the patients with respect to the long-term goals. More so, the achievement of these short-term goals offers the patients suitable reinforcement that can encourage them to continue working towards fighting the disease. These short-term goals are effective in acute care conditions that require nurses to emphasize on the immediate needs of the patients. Two Long-Term Goals Goal 1 – After six weeks of undergoing treatment, the patient is expected to have acceptable levels of steroid hormones to take over the roles played by cortisol and aldosterone in the body. The patient’s body is expected to have better metabolism, mood, tissue function, and response to stress. Goal 2 – After six weeks of treatment, the patient should be well equipped to effectively live with Addison’s disease and handle emergencies in case of an Addisonian crisis. The patient is expected to have a medical bracelet or card that informs emergency healthcare workers of his/her condition. Also, the patient must have extra medication in case of emergencies. These two long-term goals define the changes that the patient undergoes over a long period. The goals defined work to
  • 7. restore the normal functioning of the patients' problem areas. In case the restoration of normal functioning is impossible, then these goals will define the maximum functioning level, which is attainable based on the resources and health condition of the patient. Intervention An interdependent intervention will be used to handle a case of a patient that has Addison's sickness. This form of intervention entails collaboration between a nurse and other healthcare workers, for instance, physicians, and dietitians. The first part of the intervention will be observation. The nurse will have to carefully observe the patient and note how he/she responds to treatment and whether any complications develop. The nurse must make a note of every issue, including high-risk problems and probable nursing diagnoses. During this stage, the nurse can take note of the common symptoms associated with Addison's sickness, for instance, hyperpigmentation of the skin, muscle weakness, low appetite, changes in mood, craving for salt-laden food, headache, diarrhea, vomiting, and fainting (Neto & de Carvalho, 2014). Also, the nurse will have to take note of things like low blood pressure, severe abdominal or back pains, low sodium levels, and high potassium levels. Observation is crucial in this regard since the quick worsening of symptoms might result in an Addisonian crisis or acute adrenal failure. If such situations go unnoticed, the result might be death. The second part of the intervention is prevention. This entails implementing the necessary care to ensure complications are prevented, and risk factors are reduced. This part of the intervention is crucial for collaborative challenges and high-risk nursing diagnoses. Nevertheless, they can be utilized for practical nursing diagnoses. One solution in this regard is the use of salt additives in food (Michels & Michels, 2014). Since a patient might be unable to retain sodium naturally, he/she might require his/her food to have salt additives. This is especially handy in periods of salt loss, for instance, high temperatures
  • 8. and sweating. The third part of the intervention is treatment. It normally entails implementing the necessary care to treat a problem. Often, actual nursing diagnoses require appropriate treatment. There are three major treatments for Addison’s sickness. First, there is the use of hydrocortisone. This refers to a form of synthetic medication that takes the place of the cortisol lost in the body. The doses given to the patient vary from 20 to 50 milligrams, depending on his/her metabolism and weight. Patients with Cushing syndrome might need dosage adjustment. Typically, hydrocortisone is given in two doses. There is the 2/3 dose in the morning, and 1/3 does in the afternoon. Second, there is the use of fludrocortisone. This refers to a synthetic mineralocorticoid, which is necessary for individuals that do not have aldosterone. It is vital for the kidney's potassium excretion and sodium retention. It is crucial to take note of fluid overload and hypertension in the patient that might occur as a result of excessive retention of sodium. Finally, there is the androgen replacement therapy. This therapy is necessary for females who require replacement therapy for the androgen that is produced by the adrenal cortex (Michels & Michels, 2014). However, this form of therapy is only carried out under special circumstances. The final part of the intervention entails health promotion. In situations where health problems are absent, the nurse will ensure the patient can identify certain improvement areas, to promote better wellness levels. Strategies that propagate the promotion of health are needed to encourage approach behaviors. This way, a patient can prevent the occurrence of negative outcomes and promote the occurrence of positive outcomes. These strategies actualize the health potential of the patient. In this regard, the prevention of the Addisonian crisis is vital. Nurses can aid patients in monitoring their levels of hypotension, hypoglycemia, electrolyte and fluid balance, and appropriate fluid volume. Throughout the intervention process, technology can be utilized for health promotion and patient safety. For starters, technology
  • 9. facilitates communication between the different healthcare workers that take care of the patient. This reduces any errors or miscommunication that might be fatal for the patient. Also, technology promotes patient-centered care. This is vital to patient safety and satisfaction in the care received. Evaluation An evaluation of the plan of care is vital in noting the health status of the patient and the results of the intervention. The evaluation, in this case, will involve a comparison between the patient's initial condition and their present condition. More so, the evaluation will check the response of the patients to the intervention strategies. It is expected that the evaluation process will be ongoing and iterative involving the patient and the healthcare workers to determine the extent of the achievement of the medication and the effectiveness of the intervention plan. The necessary data in this regard will cover the patients’ levels of hypotension, hypoglycemia, electrolyte and fluid balance, and appropriate fluid volume (Neto & de Carvalho, 2014). Others include things like low blood pressure, severe abdominal or back pains, low sodium levels, and high potassium levels. Taking note of such data will enable the nurses and physicians to determine how the patient is responding to the intervention and whether additional strategies are required. Following the successful intervention, for Addison's sickness, a patient is expected to be no longer dehydrated and have standard blood pressure. Also, it is expected that a patient will be oriented, alert, and ready to cater to his/her needs while at home. Catering to his needs will show that the patient understands his/her dietary requirements and maintains his/her medication doses. Overall, the evaluation is supposed to reveal normal fluid balance and standard peripheral perfusion with normalized blood pressure. Furthermore, symptoms such as fatigue, diarrhea, vomiting, and abdominal pains are expected to go away. If the evaluation does not yield such results, then the healthcare professionals will have to reevaluate their approach and come up with a new plan of intervention.
  • 10. References Bancos, I., Hahner, S., Tomlinson, J., & Arlt, W. (2015). Diagnosis and management of adrenal insufficiency. The Lancet Diabetes & Endocrinology, 3(3), 216-226. Leelarathna, L., Powrie, J. K., & Carroll, P. V. (2009). Thomas Addison's disease after 154 years: modern diagnostic perspectives on an old condition. QJM: An International Journal of Medicine, 102(8), 569-573. Michels, A., & Michels, N. (2014). Addison disease early detection and treatment principles. Am Fam Physician, 89(07). Neto, R. A. B., & de Carvalho, J. F. (2014). Diagnosis and classification of Addison's disease (autoimmune adrenalitis). Autoimmunity Reviews, 13(4-5), 408-411. White, K. G. (2009). Jane Austen and Addison's disease: an unconvincing diagnosis. Medical Humanities, 35(2), 98. Running head: MILESTONE ONE 1 MILESTONE ONE 4 Milestone One Introduction of Individual In 1816, the author of such beloved books as "Emma" and "Pride and Prejudice" came down with a large group of puzzling diseases including fatigue, back pain, skin discoloration, "bilious attacks" and fever. Only one year later, she was dead at 41 years old. Much theory has been dedicated to Jane Austen's infection in the years since, with the most widely recognized diagnosis being that she had Addison's sickness, a malfunction of the adrenal organs that wasn't known to medicine until quite a while after her demise (White, 2009). Even though delayed in its onset, the confusion is known to cause changes in skin color during its late stages, which may clarify Austen's cases that her
  • 11. complexion had turned "black and white and every wrong color." Identification of Pathophysiology Mineralocorticoid deficiency Sodium reabsorption and excretion of potassium from the body are stimulated by mineralocorticoids, whereby if mineralocorticoids are not produced, it leads to decreased production of potassium and increased excretion of sodium, primarily through sweat, urine, saliva and times in gastrointestinal tract. A high serum concentration of potassium and low sodium concentration may be detected as a result. Symptoms such as but not limited may result where there is high water loss and urinary salt: hypotension, decreased circulatory volume, acidosis, plasma hypertonicity, severe dehydration, and finally, circulatory collapse. Nevertheless, when adrenocorticotropic hormone (ACTH) leads to adrenal inadequacy due to its low production, the circulatory problems are less severe, and the electrolyte levels are somewhat normal or mildly deranged (Bancos et al., 2015). Glucocorticoid deficiency Insufficiency of Glucocorticoid production leads to hypotension and severe insulin sensitivity as well as interferes with protein, fat, and carbohydrate metabolism. From protein, carbohydrates are formed when there is inadequate production of cortisol, and also hypoglycemia and reduced liver glycogen result. As a result of neuromuscular function, the person feels weak. Circulatory failure may result due to myocardial weakness and dehydration because there is reduced cardiac output. Additionally, glucocorticoid deficiency leads to reduced production of cortisol which affects ACTH production to a decreased level and elevated the amount of blood beta- lipotropin, which has melanocyte-stimulating activity and, when combined with ACTH, causes the hyperpigmentation of skin and mucous membranes characteristic of Addison disease (Bancos et al., 2015). Therefore, hyperpigmentation is not caused by the adrenal deficiency secondary to pituitary failure.
  • 12. Clinical Manifestations Addison’s disease manifestation starts gradually. Symptoms such as weight loss, loss of appetite, muscle weakness, fatigue, and chronic are examples of disease characteristics. In about 50% of reported cases, victims have diarrhea, vomiting, and nausea (Bancos et al., 2015). The patient’s blood pressure falls drastically when standing, causing dizziness or fainting. Skin discoloration is part of Addison's disease with a spot of dark tainting or hyperpigmentation covering naked body parts. In most cases, these dark skin spots are visible in pressure points, elbows, or scars such as mucous membranes, lips, toes, knuckles, knees, and elbows. Patients can develop depression and irritability as a result of Addison's disease. This is due to increased craving of foods with salt leading to salt loss. In children, hypoglycemia is more prevalent than in adults. There are irregular menstrual cycles in women. Since the manifestations progress gradually, they are typically disregarded until an unpleasant event like an ailment or a mishap makes them worse. This is called an Addisonian crisis or intense adrenal deficiency. In many patients, side effects are severe enough to look for treatment before an emergency happens. Nonetheless, in around 25% of patients, manifestations initially show up during an Addisonian crisis (Bancos et al., 2015).
  • 13. References Bancos, I., Hahner, S., Tomlinson, J., & Arlt, W. (2015). Diagnosis and management of adrenal insufficiency. The Lancet Diabetes & endocrinology, 3(3), 216-226. White, K. G. (2009). Jane Austen and Addison's disease: an unconvincing diagnosis. Medical humanities, 35(2), 98. NUR 315 Final Project Guidelines and Rubric Overview Pathophysiology is a topic that is studied by most healthcare professional students—including nursing, medicine, and other allied health professionals. Increasingly, this study has been enriched and enhanced through the use of various patient care technologies. Pathophysiology is defined as the study of the disturbance of normal mechanical, physical, and biochemical functions, either caused by a disease or resulting from an abnormal syndrome or condition that may not qualify to be called a disease. Pathophysiology may also be thought of as the study of the biological and physical
  • 14. manifestations of disease as they correlate with the underlying abnormalities and physiological disturbances. It is critically important for nurses to understand and be able to assess common health challenges or diseases. The final project for this course will require you to choose a well-known individual from history or current popular literature, with instructor approval, who has a known physiological disease or illness of interest, and analyze that person’s case. You will then develop a plan of care using aspects of the nursing process for your selected case. This assessment addresses the following course outcomes: x Differentiate between normal physiological processes and pathological presentations of adult health states for promoting health and preventing disease x Assess the role of patient care technologies in managing and promoting patient outcomes in individuals with chronic diseases and acute illnesses x Explain the pathological processes of adult diseases and illnesses for guiding risk-reduction and prevention strategies x Develop plans of care for adult diseases and illnesses that utilize current evidence-based research Prompt You will choose a well-known individual from history or current popular literature, with instructor approval, who has a known physiological—as opposed to psychiatric or psychological—disease or illness, and, using a systematic approach, you will analyze that disease or illness. You will also develop a plan of care for
  • 15. that disease or illness. In your analysis, you will describe the pathophysiology for your selected disease or illness, propose historical explanations for variations in findings (when applicable), and demonstrate use of nursing conceptual models to frame your discussion of adaptation and stressors collectively for system analysis. Your plan of care should utilize the PIE (planning, intervention, and evaluation) format. The planning (P) section should include at least two short-term and two long-term goals that are most appropriate for your chosen case, and each goal should have measurable criteria and have a hypothetical target date or time. The intervention (I) section should include interventions or nursing actions that directly relate to the selected case’s goals and that are specific in action and frequency. The number of interventions should be appropriate for helping to meet individual goals. Finally, the evaluation (E) section of the plan of care should include proposed measures for determining success of the plan and an evaluation of the potential success of the plan, based on those measures. Specifically, the following critical elements must be addressed: I. Introduce your selected case a) Identify the individual you selected and his or her disease or illness, and provide a brief explanation of why you selected this case.
  • 16. b) Describe how normal physiology is changed by the disease state for your selected case. c) Define the pathophysiology and clinical manifestations associated with your selected case and how they may be explained by altered physiology. Be sure to support your claims with scholarly evidence. d) Assess the extent to which clinical manifestations of your selected case affect multiple body systems, using scholarly evidence to support your claims. II. History of selected case a) Describe historical variations (that is, examples of individuals with the selected disease or illness) of your selected case, using evidence from literature. b) Identify physiological stressors that may affect the course of the disease or illness, and explain their impact. c) Identify adaptive physiological mechanisms that may affect the course of the disease for your selected case. d) Assess the historical impact of patient care technologies on patient outcomes for your selected case. Be sure to justify your claims with scholarly evidence. III. Planning for care for your selected case a) Write a goal statement that is patient-centered and contains at least one measurable criterion or target date/time. In order to address this
  • 17. element comprehensively, you should be sure to provide at least two short-term and two long-term goals for your selected case. b) Analyze the critical nursing concerns associated with this disease state, and prioritize them from a treatment standpoint. c) Identify patient care technologies that are appropriate for managing clinical manifestations of your selected case. IV. Intervention a) Outline appropriate nursing interventions for your selected case. Be sure to substantiate your claims with scholarly evidence. b) Outline common classes of medications used to manage the disease. Be sure to provide examples from scholarly evidence to support your claims. c) Assess the extent to which current patient care technologies improve health promotion for your selected case, using scholarly evidence to support your claims. d) Assess the extent to which current patient care technologies assist in decreasing medication errors and improving patient safety with regard to your selected case. V. Evaluation
  • 18. a) Identify the most appropriate measures for determining the success of your plan of care. In other words, what data will you need to collect to determine if your plan worked? Be sure to substantiate your claims with scholarly evidence. b) In terms of the outcome measures you identified, evaluate the potential success of your plan of care and proposed nursing interventions for your selected case. In other words, do you feel your proposed plan of care and interventions for your selected case will result in successful outcomes? Be sure to justify your rationale with evidence-based research. Milestones Milestone One: Selection of Case In Module Two, you will identify and introduce your selected case. This submission will be graded with the Milestone One Rubric. Milestone Two: Draft of Selected Case and Plan In Module Five, you will submit a draft of your final project. Be sure to incorporate instructor feedback in your final project. This submission will be graded with the Milestone Two Rubric. Final Submission: Case Analysis and Plan of Care In Module Seven, you will submit your final project. It should be a complete, polished artifact containing all of the critical elements of the final product. It should reflect the incorporation of feedback gained throughout the course. This submission will be graded with the Final Product Rubric.
  • 19. Final Product Rubric Guidelines for Submission: Your case analysis and plan of care paper should be between 6 and 10 pages, not including title page and reference list. It should be formatted with 12-point Times New Roman font and one-inch margins; all citations should follow proper APA guidelines. Critical Elements Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Introduce: Identify Meets “Proficient” criteria and uses industry-specific language to establish expertise Identifies selected individual and disease or illness and provides reasoning behind selection Identifies selected individual and disease or illness, but does not provide reasoning behind selection Does not identify selected individual and disease or illness
  • 20. 4 Introduce: Describe Meets “Proficient” criteria, and description is exceptionally clear and well-informed Accurately describes how normal physiology is changed by disease state for selected case Describes how normal physiology is changed by disease state for selected case, but with gaps in accuracy Does not describe how normal physiology is changed by disease state for selected case 7.7 Introduce: Define Meets “Proficient” criteria, and definition is exceptionally clear and well-informed Defines the pathophysiology and clinical manifestations associated with selected case and how they may be explained
  • 21. by altered physiology and supports claims with scholarly evidence Defines the pathophysiology and clinical manifestations associated with selected case, but not how they may be explained by altered physiology, or does not support claims with scholarly evidence Does not define the pathophysiology and clinical manifestations associated with selected case 7.7 Introduce: Assess Meets “Proficient” criteria, and assessment is exceptionally clear and well-informed Assesses the extent to which clinical manifestations of selected case affect multiple body systems and supports claims with scholarly evidence Assesses the extent to which clinical manifestations of the selected case affect multiple body systems, but does not
  • 22. support claims with scholarly evidence Does not assess the extent to which clinical manifestations of the selected case affect multiple body systems 7.7 History: Variations Meets “Proficient” criteria and demonstrates keen insight into historical variations of selected case Describes historical explanations of variations in the selected case using evidence from literature Describes historical explanations of variations in the selected case, but does not use evidence from literature Does not describe historical explanations of variations in the selected case 5.75 History: Stressors
  • 23. Meets “Proficient” criteria and draws nuanced connections between concepts Identifies physiological stressors that may affect the course of the disease or illness and explains their impact Identifies physiological stressors that may affect the course of the disease or illness, but does not explain their impact Does not identify physiological stressors that may affect the course of the disease or illness 5.75 History: Mechanisms Meets “Proficient” criteria, and identification is exceptionally clear and well-informed Clearly identifies adaptive physiological mechanisms that may affect the course of the
  • 24. disease for selected case Identifies adaptive physiological mechanisms that may affect the course of the disease for selected case, but with gaps in clarity or accuracy Does not identify adaptive physiological mechanisms that may affect the course of the disease for selected case 5.75 History: Impact Meets “Proficient” criteria and draws nuanced connections between concepts Comprehensively assesses the historical impact of patient care technologies on patient outcomes for selected case and justifies claims with scholarly evidence Assesses the historical impact of patient care technologies on patient outcomes for selected case, but with gaps in detail or accuracy, or does not justify claims with scholarly evidence
  • 25. Does not assess the historical impact of patient care technologies on patient outcomes for selected case 5.75 Planning: Statement Meets “Proficient” criteria, and goal statement is creatively written and supported by scholarly evidence Writes a comprehensive goal statement that is patient- centered and contains measurable criteria or target date/time Writes a goal statement that is not patient-centered or does not contain measurable criteria or target/date time, or goal statement lacks detail Does not write goal statement 4.6 Planning: Concerns Meets “Proficient” criteria, and analysis is exceptionally clear and well-informed
  • 26. Comprehensively analyzes critical nursing concerns for this disease state and appropriately prioritizes them from a treatment standpoint Analyzes critical nursing concerns for this disease state, but with gaps in detail, or prioritizes them inappropriately from a treatment standpoint or does not prioritize them Does not analyze critical nursing concerns for this disease state 4.6 Planning: Technologies Meets “Proficient” criteria and provides detailed examples of how the technologies will support management of the clinical manifestations Identifies patient care technologies that are appropriate for managing clinical manifestations of selected case Identifies patient care
  • 27. technologies, but they are not appropriate for managing clinical manifestations of selected case Does not identify patient care technologies 5.75 Intervention: Nursing Meets “Proficient” criteria and outlines multiple interventions to help patients or family meet goal, and interventions are specific in action and frequency Outlines appropriate nursing interventions for selected case and substantiates claims with scholarly evidence Outlines nursing interventions that are not appropriate for selected case or does not substantiate claims with scholarly evidence Does not outline nursing interventions for selected case 4.6
  • 28. Intervention: Medications Meets “Proficient” criteria and demonstrates keen insight into the use of pharmaceutical interventions Outlines common classes of medications used to manage the selected case and supports claims with specific examples from scholarly evidence Outlines common classes of medications used to manage the selected case, but does not support claims with specific examples from scholarly evidence Does not outline common classes of medications used to manage the selected case 5.75 Intervention: Assess Meets “Proficient” criteria and draws nuanced connections
  • 29. between current patient care technologies and health promotions Assesses the extent to which current patient care technologies improve health promotion for selected case and supports claims with scholarly evidence Assesses the extent to which current patient care technologies improve health promotion for selected case, but does not support claims with scholarly evidence Does not assess the extent to which current patient care technologies improve health promotion for selected case 5.75 Intervention: Extent Meets “Proficient” criteria and demonstrates keen insight into the use of patient care technologies as a patient safety intervention Accurately assesses the extent to which current patient care
  • 30. technologies assist in decreasing medication errors and improving patient safety for selected case Assesses the extent to which current patient care technologies assist in decreasing medication errors or improving patient safety for selected case, but with gaps in accuracy or detail Does not assess the extent to which current patient care technologies assist in decreasing medication errors and improving patient safety 5.75 Evaluation: Identify Meets “Proficient” criteria and draws nuanced connections between concepts Comprehensively identifies appropriate measures for determining success of plan of care and substantiates claims with scholarly evidence Identifies measures that are not appropriate for
  • 31. determining success of plan of care or identification lacks detail, or does not substantiate claims with scholarly evidence Does not identify measures for determining success of plan of care 4.5 Evaluation: Evaluate Meets “Proficient” criteria and cites specific, relevant examples to establish a robust context for the evaluation Evaluates plan of care and proposed nursing interventions for selected case in terms of identified outcome measures and justifies rationale with scholarly evidence Evaluates plan of care and proposed nursing interventions, but does not address identified outcome measures or does not justify rationale with scholarly evidence Does not evaluate plan of care and proposed nursing
  • 32. interventions 4.6 Articulation of Response Submission is free of errors related to citations, grammar, spelling, syntax, and organization and is presented in a professional and easy-to- read format Submission has no major errors related to citations, grammar, spelling, syntax, or organization Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas 4 Earned Total 100%