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Clinical Evidence-based Skill Paper – Topic chosen: Overworked Nurses and Effect on Nursing Skills and
Patient Care
A 2-3 page paper relating to an evidence-based Clinical skill that is relevant totoday’s practice of nursing.
Considertheuseofevidence-basedpracticein the care of a patient in clinical, where a current skill is applied.
“Each nurse must develop their own clinical practice by finding and evaluating all the evidence for all
nursing interventions they carry out” (Holland & Rees, 2010, p. 34). Book: Nursing Evidence- Based
Practice Skills, Authors: Karen Holland & Colin Rees.

  1. Make sure you cover the following:
    a. Write two paragraphs about the significance of the skill
    b. How is the skill being performed at your clinical site versus what the article states
    c. Link one clinical guideline that is relevant to your selected skill.
    d. What would be patient teaching aspects of the skill?

Sample Solution

Microglia are scavenger cells they resemble tissue macrophages and remove debris resulting from injury, infection, and disease (eg, multiple sclerosis, AIDS-related dementia, Parkinson disease, and Alzheimer disease). Microglia arise from macrophages outside the nervous system and are physiologically and embryologically unrelated to other neural cell types. Glial cells continue to undergo cell division even in adults and their ability to proliferate is particularly noticeable after brain injury (eg, stroke). There are three types of macroglia: 1 Oligodendrocytes, 2 Schwann Cells, and 3 Astrocytes. Oligodendrocytes and Schwann cells form myelin around axons in the CNS and PNS , respectively. Astrocytes are of two subtypes. Fibrous astrocytes, which contain intermediate filaments, found primarily in white matter. Protoplasmic astrocytes are found in gray matter having granular cytoplasm. Both types of astrocytes send processes to blood vessels, where they induce capillaries forming the tight junctions making up the blood–brain barrier. They send processes enveloping synapses and surface of nerve cells. Protoplasmic astrocytes have a membrane potential varying with the external K+ concentration but they do not generate propagated potentials. They produce substances that are tropic to neurons, and they help maintain the appropriate concentration of ions and neurotransmitters by taking up K+ and the neurotransmitters glutamate and γ-aminobutyrate (GABA). The axons of many neurons are myelinated, that is, they acquire myelin sheath, a complex of protein & lipid wrapped around axon. In the peripheral nervous system, when a Schwann cell wraps its membrane around an axon up to 100 times myelin is formed. The myelin is then compacted when the extracellular portions of a membrane protein called protein zero (P0) lock to the extracellular portions of P0 in the apposing membrane. The axon is covered by myelin sheath except at the ending and at the nodes of Ranvier, periodic 1-m constrictions that are about 1 mm apart (Barrett et al., 2012). In the myelinated neurons, the junction between the 2 Schwann cells is known as the node of Ranvier, where the axon remains uninsulated. The intermodal distance is the distance between the 2 nodes of Ranvier and depends upon the spacing of Schwann cells at the time of myelination. As there is no proliferation of Schwann cells later on, intermodal distance increases during the growth of nerve. Thus the fibers myelinated early have longer intermodal distance, larger diameter and wid>

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