The ANA Scope and Standards of Practice describe how registered nurses use the nursing process as the foundation for decision-making and care delivery. These are the standards of care you will be held accountable to as an RN. They are the basis for evaluating the appropriateness and quality of your nursing care in the event you are involved in a malpractice lawsuit.

Base your response in this discussion post on the ANA Standards of Professional Practice. Nursing: Scope and Standards of Practice (Links to an external site.) (4th ed.)

• Choose one of the six (6) ANA Standards of Practice (starting on p. 53). Compare and contrast how the practice of an RN is different from your current role in healthcare for that standard. Provide specific examples to supports your explanation.
• Discuss an experience in your life (as a patient, family member or professional) where an RN demonstrated one of the competencies from the ANA Standard of Practice.

Base your initial post on your readings and research on this topic.

Your initial post is due by Thursday at 11:59 PM ET.  Your responses are due by Sunday at 11:59 PM ET.

This is a “post first” discussion forum. You must submit your initial post before you can view other students’ posts.

Response to Classmates

You are required to make a minimum of two responses. One to the initial post of at least one other student, and then one to another student post. In your responses to your peers’ posts you must provide constructive and insightful comments that go beyond that of agree or disagree.

Your discussion postings may be reviewed for plagiarism. Plagiarism is not acceptable. Evidence of plagiarism will result in a zero (0) grade for the discussion and may also result in academic discipline.

Submission

Your discussion postings must conform to the AD Nursing Discussion Posting Requirements  Download AD Nursing Discussion Posting Requirements; review the requirements prior to submitting your discussion posts.

Be sure to check your work and correct any spelling or grammatical errors before you post it. When you are ready to post, click on the “Reply” button for a new thread or “Reply” beneath an existing post to respond to the post. Then, copy/paste the text from your document into the message field and click “Post Reply.”

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric below prior to beginning your work to ensure your participation meets the criteria in place for this discussion. This discussion is worth 4% of your grade; all discussions combined are worth 32% of your final course grade.

list the six types of sensory receptors classified based on the type of stimulus they detect and describe the types of stimuli that each type can detect. Classify the three types of sensory receptors categorized based on their location; identify the origin of stimuli that activate them; and describe the nature of the stimuli that cause their excitation.

You are called to the delivery room at 2:00 a.m. for a laboring gravida 1 para 0 mother at 28 weeks gestation. The mother had good an-
prenatal care and had a normal integrated prenatal screening (IPS), normal 20-week ultrasound, and protective serology, including rubella immune, human immunodeficiency virus (HIV) negative, venereal disease research laboratory (VDRL) negative, and hepatitis negative. Group B Streptococcus (GBS) status is unknown as the woman had not yet had swabs done. Social history was negative for tobacco, alcohol, or recreational drug use during the pregnancy. She has gestational diabetes mellitus, which was reasonably controlled by diet and exercise
alone.

You arrive at the delivery room moments before the baby is born and prepare equipment for a potential resuscitation, which includes oxygen, a bag and mask, suction, towels to dry, and intubation equipment. At birth, the newborn cries spontaneously. She is placed on the warmer to be dried and stimulated; her heart rate is 120 beats per minute and her respiratory rate is 60 breaths per minute. The infant grunts intermittently. At 4 minutes of age, the newborn has both subcostal and intercostal retractions, nasal flaring, and continuous grunting. Her respiratory rate is now 82 breaths per minute and her heart rate is 190 beats per minute. Oxygen saturation by pulse oximetry is 84% with blow-by oxygen. You begin providing CPAP at 6 cm H2O by mask with a t-piece resuscitator. A systolic murmur gr 2/6 is auscultated loudest at the left upper sternal border (LUSB). The infant is transferred to the NICU where she continues to receive nasal CPAP at 6 cm H2O and a FiO2 of 0.45. The chest X-ray shows a diffuse ground-glass appearance with air bronchograms. An arterial umbilical catheter (UAC) is inserted. Arterial blood gas reveals the following: pH 7.23, CO2 60, PaO2 40, HCO3 27, BE +1, and lactate 4.8.
Blood work shows white blood cell count 20.3, neutrophils 12.3, no left shift, hemoglobin 16.5, platelets 260.

1. What is the first line of therapy for this premature infant considering her presentation?
2. What are the chemical components that make up surfactants?
3. How does surfactant work in the lung?