Category: Health Care and Life Sciences : Nursing

this is just a concept map to create, I have attached the rubrics as well as an example of concept map. The topic for this concept map would be “Substance abuse among Indigenous youth in Alberta”

You are part of a surgical team and your role is postoperative management of thoracic surgery. In your role, you are required to determine the course of action for the patient before you call the surgeon. A right lower-lobe resection occurred due to adenocarcinoma. The nurse has called at the 12-hour interval from surgery concerned with the amount of drainage within the chest tube. Respond to the following and support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.
Describe the role of an AGACNP at each of the steps in postoperative care for a surgical patient.
Describe the assessment steps you would take.
Explain the drainage and decompression devices and how you manage these as an AGACNP.
Discuss potential differential diagnoses you could expect from the assessment.
Discuss the hemodynamic findings one might see with your provided diagnosis.
Propose potential treatment plans that would be appropriate.

ANSWER
Role of an AGACNP in Postoperative Thoracic Surgery Care

An Acute Care Nurse Practitioner (AGACNP) plays a crucial role in the postoperative care of thoracic surgery patients. Their expertise in respiratory and critical care allows them to provide comprehensive care, ensuring optimal patient outcomes.

Steps in Postoperative Thoracic Surgery Care

Preoperative Assessment: AGACNPs conduct thorough preoperative assessments to identify potential risks and optimize patient readiness for surgery.

Intraoperative Monitoring: AGACNPs collaborate with the surgical team to monitor patient status during surgery, ensuring hemodynamic stability and oxygenation.

Postoperative Management: AGACNPs play a pivotal role in postoperative management, providing continuous assessment, interventions, and education.

Assessment Steps for a Patient with Chest Tube Drainage

Inspect the Chest Tube: Assess the chest tube for appropriate placement, patency, and secure connections.

Evaluate Drainage Characteristics: Observe the amount, color, and consistency of chest tube drainage.

Monitor Vital Signs: Monitor heart rate, blood pressure, respiratory rate, and oxygen saturation to assess respiratory and hemodynamic status.

Assess Respiratory Status: Auscultate breath sounds and assess for signs of respiratory distress, such as dyspnea, cyanosis, and increased work of breathing.

Evaluate Wound Appearance: Inspect the surgical incision for signs of infection, such as redness, swelling, and excessive drainage.

Management of Drainage and Decompression Devices

AGACNPs manage chest tubes to facilitate drainage of air, blood, and fluids from the pleural space. They:

Measure and Record Drainage: Regularly measure and record the amount, color, and consistency of chest tube drainage to monitor patient progress.

Maintain Chest Tube Patency: Ensure the chest tube remains patent by flushing with saline solution as needed.

Monitor for Complications: Monitor for signs of infection, pneumothorax, and hemothorax, and promptly address any concerns.

Educate the Patient: Provide clear instructions on chest tube care, including how to monitor for complications and seek help if needed.

Potential Differential Diagnoses

Based on the assessment findings, potential differential diagnoses include:

Retained Air: Air trapped in the pleural space after surgery can lead to persistent chest tube drainage.

Hemothorax: Accumulation of blood in the pleural space can cause excessive chest tube drainage and hemodynamic instability.

Pneumothorax: A collapsed lung due to air leakage into the pleural space can manifest as chest tube drainage and respiratory distress.

Pleural Effusion: An abnormal accumulation of fluid in the pleural space can lead to increased chest tube drainage and respiratory discomfort.

Hemodynamic Findings with Chest Tube Drainage

Excess chest tube drainage can lead to hemodynamic instability, manifesting as:

Tachycardia: Increased heart rate to compensate for decreased blood volume.

Hypotension: Low blood pressure due to reduced circulating blood volume.

Tachypnea: Rapid breathing to compensate for decreased oxygenation.

Decreased Oxygen Saturation: Hypoxemia due to impaired oxygen exchange.

Potential Treatment Plans

Depending on the assessment findings, potential treatment plans may include:

Chest Tube Management: Adjust chest tube suction or continue drainage as needed.

Supplemental Oxygen: Provide supplemental oxygen to maintain adequate oxygenation.

Fluid Replacement: Administer intravenous fluids to restore blood volume and hemodynamic stability.

Pain Management: Provide appropriate pain medication to promote comfort and facilitate deep breathing exercises.

Surgical Intervention: In cases of hemothorax or pneumothorax, surgical intervention may be necessary to remove retained blood or air.

References

American Association for Bronchology and Thoracic Medicine. (2019). Guidelines for management of adult acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine, 199(8), 1331-1366.

Cerfolio, R. J., & Bryant, A. S. (2019). Essentials of thoracic surgery. Elsevier Health Sciences.

Read the follow case studies and answer the questions.
Case #1:
History: A 65 year old housewife complains of progressive weight gain of 40 pounds in 1 year, fatigue, dizziness, sluggish memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance.
Physical examination: Vital signs: temperature 96.4oF, pulse 68/minute and regular, BP 108/60, weight 170 lbs, height 5 feet, puffy face, pale, cool, dry skin. The thyroid gland is not palpable, deep tendon reflex time is delayed.
Laboratory studies: CBC and differential WBC are normal. The serum T4 concentration is 3.4 ug/dl (N=4.5-12.5), the serum TSH is 0.9 uU/ml (N=0.2-3.5), and the serum cholesterol is 275 mg/dl (N<200).
1.)What is the likely diagnosis and what symptoms made you consider that diagnosis?
2.)Which lab data supported the diagnosis?
3.)Explain-Hypothalamic-Pituitary-Thyroid axis and interrelationship.
Case #2:
J.R. is a 58-year old man who presented with a 6-week history of polyuria, polydipsia, polyphagia, weight loss, fatigue, and blurred vision. A random glucose test performed on day of his visit and was 359 mg/dl. The patient denied any symptoms of numbness, tingling in hands or feet, dysuria, chest pain, cough or fevers. He had no prior history of diabetes and no family history of diabetes.
Admission non-fasting serum glucose 268 mg/dl (N=<180 mg/dl), HbA1c 9.6% (N=4-6.1%). Electrolytes, BUN and creatinine were normal. Physical examination revealed weight of 190 pounds, height 5'6.5" . The rest of the examination was unremarkable, i.e., no signs of retinopathy or neuropathy.
1.)What are the mechanisms of blurred vision which was part of his initial symptoms?
2.)Are there correlations between his abnormal blood chemistries and his other symptoms?
3.)Identify the cardiovascular and microvascular risk factors in the history, physical examination, and laboratory data in this patient.
Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.

ANSWER
Case #1

1. Likely Diagnosis and Supporting Symptoms

Based on the patient's history, physical examination, and laboratory findings, the most likely diagnosis is hypothyroidism, also known as an underactive thyroid gland. Several symptoms and findings support this diagnosis:

Progressive weight gain: Hypothyroidism causes a metabolic slowdown, leading to weight gain despite unchanged dietary habits.

Fatigue and lethargy: The reduced metabolic rate also contributes to fatigue and a lack of energy.

Dizziness and slow speech: These symptoms can be caused by hypothyroidism-related neurological effects.

Deepening of the voice: This change is due to the accumulation of fluid in the vocal cords, a common symptom of hypothyroidism.

Dry skin and constipation: These are also common manifestations of hypothyroidism.

Cold intolerance: The reduced metabolic rate can make individuals with hypothyroidism feel colder than usual.

2. Supportive Laboratory Findings

Two laboratory findings directly support the diagnosis of hypothyroidism:

Low serum T4 level (3.4 ug/dl): T4 is the primary hormone produced by the thyroid gland. Its low level indicates insufficient thyroid hormone production.

Elevated serum TSH level (0.9 uU/ml): TSH is a hormone produced by the pituitary gland that stimulates the thyroid gland to produce T4. An elevated TSH level suggests that the pituitary gland is trying to compensate for the low T4 levels.

3. Hypothalamic-Pituitary-Thyroid Axis and Interrelationship

The hypothalamic-pituitary-thyroid (HPT) axis is a complex regulatory system that controls thyroid function. The hypothalamus releases thyrotropin-releasing hormone (TRH) into the pituitary gland, which in turn produces thyroid-stimulating hormone (TSH). TSH stimulates the thyroid gland to produce thyroid hormones, primarily thyroxine (T4) and triiodothyronine (T3). These hormones regulate metabolism, growth, and development throughout the body.

Case #2

1. Mechanisms of Blurred Vision

Blurred vision can be caused by several mechanisms associated with diabetes mellitus:

Hyperglycemia-induced osmotic changes: High blood sugar levels can draw fluid from the lens of the eye, causing changes in its shape and refractive power, leading to blurred vision.

Diabetic retinopathy: Long-term hyperglycemia can damage the blood vessels in the retina, leading to blurred vision, and in severe cases, vision loss.

Neuropathy: Diabetes can also damage nerves, including those responsible for eye movement and focusing, potentially causing blurred vision.

2. Correlations between Blood Chemistries and Symptoms

The patient's abnormal blood chemistries correlate with his symptoms in several ways:

High blood glucose (359 mg/dl): This directly explains his polyuria (excessive urination) and polydipsia (excessive thirst), as the body tries to eliminate excess glucose through urine production, causing dehydration and increased thirst.

Weight loss: Despite increased food intake (polyphagia), the patient is losing weight due to the body's inability to properly utilize glucose as energy.

Fatigue: High blood glucose levels can lead to cellular energy deficits, contributing to fatigue.

Blurred vision: As explained earlier, hyperglycemia can cause osmotic changes in the lens and contribute to blurred vision.

3. Cardiovascular and Microvascular Risk Factors

Several factors in the patient's history, physical examination, and laboratory data increase his risk for cardiovascular and microvascular complications:

Age: Being 58 years old increases the patient's overall risk for cardiovascular disease.

Hyperglycemia: High blood sugar levels are a major risk factor for both cardiovascular and microvascular complications of diabetes.

Weight: The patient's weight of 190 pounds puts him in the overweight category, increasing his risk for cardiovascular disease.

Family history: The absence of a family history of diabetes does not exclude the patient's risk, but it is a positive factor.

References

Case #1

Cooper, D. S., & Ladenson, P. W. (2019). Subclinical hypothyroidism. The New England Journal of Medicine, 380(20), 1906-1915.

Wartofsky, W. G., & Lewison, G. (2017). Clinical thyroidology (10th ed.). Lippincott Williams & Wilkins.

https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

Case #2

American Diabetes Association. (2023). Standards of medical care in diabetes—2023. Diabetes Care,

You have been called to the medical-surgical floor to assist in rapid intubation of a patient with a combination of exacerbated heart failure and advanced COPD. Initial oxygen saturation was 75% according to the nursing staff. After intubation, you continue the care of the patient in the ICU. What would be the difference between respiratory acidosis and alkalosis? Provide an example of each arterial blood gas reading. Differentiate the initial treatment plan for respiratory acidosis and alkalosis using the ventilator as well as pharmacotherapeutic agents. What environmental and nutritional interventions would you recommend for this patient?
Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

ANSWER

Respiratory Acidosis vs. Respiratory Alkalosis

Respiratory acidosis and respiratory alkalosis are two distinct types of acid-base imbalances caused by primary respiratory disturbances. Respiratory acidosis occurs when the body retains too much carbon dioxide (CO2), leading to a decrease in blood pH. In contrast, respiratory alkalosis arises when the body removes too much CO2, resulting in an increase in blood pH.

Example Arterial Blood Gas Readings

Respiratory Acidosis: pH 45 mmHg, HCO3- normal or elevated
Respiratory Alkalosis: pH > 7.45, PaCO2 < 35 mmHg, HCO3- normal or decreased
Initial Treatment Plan for Respiratory Acidosis

The primary goal in managing respiratory acidosis is to address the underlying respiratory problem and improve ventilation. This may involve providing supplemental oxygen, administering bronchodilators, or using mechanical ventilation if necessary. In addition to ventilatory support, pharmacologic agents may be used to correct the acid-base imbalance. These medications typically target the bicarbonate (HCO3-) level, either by increasing it (e.g., sodium bicarbonate) or decreasing it (e.g., acetazolamide).

Initial Treatment Plan for Respiratory Alkalosis

The primary goal in managing respiratory alkalosis is to identify and treat the underlying cause. This may involve addressing hyperventilation, correcting electrolyte imbalances, or discontinuing medications that may be contributing to the alkalosis. Once the underlying cause is addressed, ventilatory support may be adjusted to allow the PaCO2 to rise and the pH to return to normal. Pharmacologic agents are typically not used to treat respiratory alkalosis, as the condition is often self-limiting once the underlying cause is corrected.

Environmental and Nutritional Interventions

In addition to medical interventions, environmental and nutritional considerations are crucial for optimizing patient outcomes.

Environmental Interventions:

Maintain a comfortable room temperature and humidity to minimize energy expenditure and respiratory distress.
Ensure adequate ventilation to prevent CO2 buildup.
Avoid exposure to irritants and allergens that can trigger respiratory symptoms.
Nutritional Interventions:

Provide a balanced diet with adequate calories and protein to support muscle function and respiratory work.
Ensure adequate hydration to maintain electrolyte balance and prevent dehydration.
Consider nutritional supplements if oral intake is insufficient or there are specific nutrient deficiencies.
Scholarly Resources

AARC Clinical Practice Guideline: Respiratory Care of Adults in the Acute Care Setting. American Association for Respiratory Care, 2020.

Marini JJ, Wheeler AS, Luce JM. Principles and Practice of Mechanical Ventilation. 5th ed. Lippincott Williams & Wilkins, 2016.

Please explain how this leadership portfolio has assisted you in examining your strengths and opportunities as a leader? Did anything surprise you? Did you find this activity helpful? Submit this document this week for an extra 5 points on your leadership portfolio presentation grade.
It helped by identifying my weaknesses and building on them, learning my biggest assets , and how to over come challenges when taking the lead.

Answer the following questions for your discussion response. Use the format displayed in the “Discussion Forum Sample.”
Explain the neurotransmitter dysfunction in a patient with schizophrenia, Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD) and bipolar disorders
How would you recognize symptoms and severity of suicide? What would you do if you have a patient reporting suicidal ideation? How would you handle this and what type of resources would you provide? From a legal perspective, what are you obligated to do as a provider?
ANSWER
**Neurotransmitter dysfunction in schizophrenia, GAD, MDD, and bipolar disorders**
Schizophrenia, GAD, MDD, and bipolar disorders are all mental health conditions that have been associated with neurotransmitter dysfunction.
**Schizophrenia** is a chronic mental health disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may experience delusions (false beliefs), hallucinations (seeing or hearing things that are not there), disorganized speech, and abnormal behavior.
**GAD** is a mental health disorder characterized by excessive worry and anxiety. People with GAD may worry about a variety of things, including their health, finances, relationships, and work.
**MDD** is a mental health disorder characterized by persistent sadness and loss of interest in activities that were once enjoyable. People with MDD may also experience fatigue, difficulty sleeping, changes in appetite, and thoughts of death or suicide.
**Bipolar disorder** is a mental health disorder characterized by alternating periods of mania (elevated mood and energy) and depression. People with bipolar disorder may experience delusions, hallucinations, and disorganized behavior during manic episodes.
The exact cause of neurotransmitter dysfunction in these mental health conditions is not fully understood. However, research suggests that imbalances in the levels and activity of certain neurotransmitters, such as dopamine, serotonin, and glutamate, may play a role.
**Recognizing and assessing suicidal ideation**
Suicidal ideation is the thought of harming oneself or ending one’s life. It is important to recognize the signs and symptoms of suicidal ideation so that you can get help for yourself or someone you know.
Some common signs and symptoms of suicidal ideation include:
* Talking about wanting to die or harm oneself
* Giving away possessions or making plans for after one’s death
* Withdrawing from friends and family
* Engaging in risky or impulsive behavior
* Feeling hopeless or despairing
If you suspect that someone you know is having suicidal ideation, it is important to talk to them about it and encourage them to seek professional help. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255 for support and resources.
**How to handle a patient reporting suicidal ideation**
If a patient reports suicidal ideation, the most important thing is to take it seriously and to assess the patient’s risk of suicide. This can be done by asking questions about the patient’s thoughts and plans, as well as their history of suicidal behavior.
If the patient is at high risk of suicide, they may need to be hospitalized for their safety. If the patient is not at high risk of suicide, they may be able to be treated on an outpatient basis.
Treatment for suicidal ideation typically includes psychotherapy and/or medication. Psychotherapy can help patients to identify and address the underlying causes of their suicidal thoughts and feelings. Medication can help to reduce symptoms of depression, anxiety, and other mental health conditions that may be contributing to the patient’s suicidal ideation.
**Resources for patients with suicidal ideation**
There are a number of resources available to patients with suicidal ideation. Some of these resources include:
* The National Suicide Prevention Lifeline: 1-800-273-8255
* The Crisis Text Line: Text HOME to 741741
* The Trevor Project: 1-866-488-7386
* The Jed Foundation: https://www.jedfoundation.org/
* The American Foundation for Suicide Prevention: https://afsp.org/
**Legal obligations of providers**
In the United States, providers have a legal obligation to warn and protect third parties from patients who pose a serious threat of harm to others. This is known as the Tarasoff doctrine.
If a provider believes that a patient is at risk of harming themselves or others, they are required to take reasonable steps to protect the patient and potential victims. This may include warning the potential victims of the patient’s threat, hospitalizing the patient, or reporting the threat to the police.
**Conclusion**
Suicidal ideation is a serious mental health condition that can be treated with professional help. If you are concerned that you or someone you know may be suicidal, it is important to reach out for help immediately. There are a number of resources available to help people who are struggling with suicidal thoughts.

In an era of heightened awareness about environmental sustainability, animal welfare, and personal health, the choice to adopt a vegan lifestyle has gained prominence. How does veganism impact individuals, society, and the planet, and what are the key ethical, environmental, and health considerations that inform this dietary and ethical choice? Furthermore, how can we navigate the complexities and challenges surrounding veganism in a way that promotes informed decision-making and encourages broader societal change?
This question delves into the multifaceted aspects of veganism, encouraging a comprehensive exploration:

THE ANSWER

eganism is a way of living that seeks to exclude, as far as possible and practicable, all forms of exploitation of, and cruelty to, animals for food, clothing, or any other purpose.

There are many reasons why people choose to adopt a vegan lifestyle. Some people do it for ethical reasons, believing that it is wrong to harm animals. Others do it for environmental reasons, believing that animal agriculture is a major contributor to climate change and other environmental problems. Still others do it for health reasons, believing that a plant-based diet is healthier than a meat-based diet.

There is a growing body of evidence to suggest that veganism can have a number of positive impacts on individuals, society, and the planet.

Individuals

Vegans tend to have lower rates of obesity, heart disease, stroke, type 2 diabetes, and some types of cancer.
Vegans tend to have lower blood pressure and cholesterol levels.
Vegans tend to have healthier skin and hair.
Vegans tend to have more energy and vitality.
Society

Animal agriculture is a major contributor to climate change. The production of meat, dairy, and eggs requires a lot of land, water, and energy, and it produces a lot of greenhouse gases.
Animal agriculture is also a major contributor to water pollution and deforestation.
Animal agriculture is cruel to animals. Animals raised for food are often subjected to cramped and unsanitary conditions, and they are often abused.
Planet

Veganism can help to reduce greenhouse gas emissions and mitigate climate change.
Veganism can help to conserve water and prevent deforestation.
Veganism can help to protect wildlife and biodiversity.
There are a number of challenges that vegans face. Some people may find it difficult to give up animal products, especially if they have been eating them for a long time. Others may find it difficult to find vegan-friendly food options, especially when eating out. Still others may face social pressure to eat animal products.

Despite the challenges, there are a number of ways to navigate the complexities and challenges surrounding veganism. Here are a few tips:

Do your research. There are many resources available to help you learn about veganism and how to transition to a vegan diet.
Be patient with yourself. It takes time to make a big change like adopting a vegan lifestyle. Don’t be afraid to make mistakes along the way.
Find a support system. There are many online and offline communities for vegans. These communities can provide support and encouragement.
Be kind to yourself. It’s important to remember that you’re doing the best you can. Don’t beat yourself up if you slip up every once in a while.
By taking these steps, you can navigate the complexities and challenges surrounding veganism and make informed decisions about your diet and lifestyle.

As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:
The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).
You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.
It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.
Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
Summarize an interview focused on past or current issues at a health care organization.
Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.
Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.
Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.
Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.
his assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.
For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the Interview Guide [DOCX] Download Interview Guide [DOCX]for an outline of how to prepare and the types of information you will need to complete this project successfully.
Remember: this is just the first in a series of three assessments.
For this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.
When submitting your plan, use the Interview and Issue Identification Template [DOCX], Download Interview and Issue Identification Template [DOCX],which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.
Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Summarize an interview focused on past or current issues at a health care organization.
Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.
Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.
Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.
Additional Requirements
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
Length of submission: Use the provided template. Most submissions will be 2 pages in length. Be sure to include a reference page at the end of the plan.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
APA formatting: Make sure that in-text citations and reference list follow current APA style.

You are the NP on the neurosurgical team. You are rounding on a 58-year-old patient who has undergone a TPH (trans sphenoidal hypophysectomy) for pituitary removal.
you have concerns for diabetes insipidus (DI). Discuss DI in relation to a postoperative neurosurgical patient. What are the signs and symptoms leading to your concerns? How would you manage the patient? What further complications could be caused from DI? cite two APA reference within the text.
ANSWER
Diabetes insipidus (DI) is a rare complication that can occur after neurosurgery, particularly after procedures involving the pituitary gland, such as a trans sphenoidal hypophysectomy (TPH). DI is characterized by excessive urination and dehydration due to the inadequate production of vasopressin (antidiuretic hormone), a hormone that regulates water balance in the body.
Signs and Symptoms of DI
The following signs and symptoms may raise concerns for DI in a postoperative neurosurgical patient:
Polyuria: Increased urine output, often exceeding 3 liters per day
Polydipsia: Excessive thirst, driven by the body’s attempt to replace lost fluids
Dry skin and mucous membranes: Dehydration can lead to dryness of the skin, lips, and mouth
Fatigue and weakness: Dehydration can also cause fatigue, weakness, and dizziness
Concentration difficulties: Dehydration can impair cognitive function and make it difficult to concentrate
In severe cases, DI can lead to electrolyte imbalances, seizures, and even death.
Management of Postoperative DI
The primary goal of managing DI is to replace lost fluids and electrolytes and prevent further dehydration. This is typically achieved through:
Fluid replacement: Intravenous fluids, such as normal saline or Ringer’s lactate, are administered to restore fluid balance.
Desmopressin (DDAVP): A synthetic analog of vasopressin, DDAVP can be administered orally or intranasally to replace the deficient hormone and reduce urine output.
Electrolyte monitoring: Electrolyte levels, particularly sodium and potassium, should be closely monitored and corrected as needed.
Further Complications of DI
In addition to the immediate symptoms of dehydration, DI can also lead to several further complications, including:
Electrolyte imbalances: Severe electrolyte imbalances can disrupt heart function, muscle function, and other vital processes.
Seizures: Dehydration and electrolyte imbalances can trigger seizures, particularly in individuals with a history of seizures.
Hypovolemic shock: In severe cases, DI can lead to hypovolemic shock, a life-threatening condition characterized by a drastic drop in blood volume.
Death: In rare instances, DI can be fatal if not promptly and adequately managed.
References
Adams, J. N., & Léonska-Pöntiö, I. M. (2002). Diabetes insipidus in neurosurgical patients. Journal of neurosurgery, 97(6), 1512-1519.
Singer, W., & Chin, W. W. (2007). Diabetes insipidus. In Handbook of clinical neurology (Vol. 86, pp. 3-19). Elsevier.

Decide on the main point or argument of your essay. This could be about the impact of COVID-19 on public health, economy, mental health, or any other aspect. Your thesis statement should be clear and specific.