NURS 6521 Advanced Pharmacology Weekly Discussions & Assignments 

NURS 6521 Advanced Pharmacology Weekly Discussions & Assignments

NURS 6521 Advanced Pharmacology Weekly Discussions & Assignments

NURS 6521 Week 1 Assignment 1: CASE STUDIES

Directions: For each of the scenarios below, answer the questions using clinical practice guidelines. Explain the problem and explain how you would address the problem. If prescribing a new drug, write out a complete medication order just as you would if you were completing a prescription. Use at least 3 sources for each scenario and cite sources using APA format.

• A 52-year-old man PT was recently discharged from the hospital following treatment for atrial fibrillation. He was discharged on warfarin 5 mg po q day and amiodarone 200 mg tid. His INR is 8.8. What interaction has occurred with these 2 medications? What changes in his medications would you make?

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• LM is an 89-year-old female resident of a long-term care facility who has been experiencing multiple falls, some resulting in injuries such as bruising and skin tears. Over the last 6 months, her ambulation status has declined from independent to wheelchair level. She complains of pain in her legs when walking more than short distances across the nursing unit. Past medical history includes HTN, Alzheimer’s disease, and diabetes. Her current medications include amlodipine 10 mg daily, donepezil 10 mg QHS, furosemide 40 mg QAM, glyburide 5mg BID, ketorolac 10mg daily, metformin 500mg daily. Physical exam shows bilateral 2+ edema to lower extremities and vitals include blood pressure of 177/82. Labs show K+ 3.3, glucose 101, BUN 42, Cr 1.6 and eGFR 45 mL/min. What treatment plan would you implement for this patient? What medication(s) would you prescribe? How would you monitor the effectiveness of this plan?

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• Name two drugs that are highly affected by the first pass effect. As a prescriber, what actions would you take in prescribing these drugs to counter the first pass effect?

• A 65-year-old man DH with liver cirrhosis is admitted to the medical-surgical unit with nausea and vomiting. He also has a diagnosis of heart failure. You note that his serum albumin (protein) level is low. The physician has written admission orders, and you are trying to make the patient comfortable. He is to take nothing by mouth except for clear liquids. An intravenous infusion of dextrose 5% in water at 50 mL/hr has been ordered, and the nurses have had difficulty inserting his intravenous (IV) line.

1. One of the drugs ordered is known to reach a maximum level in the body of 200 mg/L and has a half-life of 2 hours. If this maximum level of 200 mg/L is reached at 4 pm, then what will the drug’s level in the body be at 10 pm

2. Describe how factors identified in the patient’s history would affect the following:

• Absorption

• Distribution

• Metabolism

• Excretion

3. This patient is also receiving digoxin (Lanoxin) for heart failure. This drug is known to have a low therapeutic index. Explain this concept.

ASSIGNMENT 1: CASE STUDIES

Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.

For this Assignment, you evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Review the case study posted in “Announcements” by your Instructor for this Assignment

Review the information provided and answer questions posed in the case study

When recommending a medication, write out a complete prescription for the medication

Whenever possible, use clinical practice guidelines in developing your answers when possible

Include at least three references to support your answer and cite them in APA format.

BY DAY 7 OF WEEK 1

Submit the Assignment.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK1Assgn1_LastName_Firstinitial

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6521_Week1_Assignment1_Rubric

NURS_6521_Week1_Assignment1_Rubric
Criteria Ratings Pts

This criterion is linked to a Learning OutcomeScenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15 to >11.0 pts

Excellent

Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11 to >7.0 pts

Good

Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7 to >3.0 pts

Fair

Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3 to >0 pts

Poor

Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15 pts

This criterion is linked to a Learning OutcomeScenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

3 pts

Complete

Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0 pts

Poor

The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts

This criterion is linked to a Learning OutcomeScenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable

4 pts

Excellent

References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3 pts

Good

References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2 pts

Fair

References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0 pts

Poor

No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4 pts

This criterion is linked to a Learning OutcomeScenario 1: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
3 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

2 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3 pts

This criterion is linked to a Learning OutcomeScenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15 to >11.0 pts

Excellent

Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11 to >7.0 pts

Good

Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7 to >3.0 pts

Fair

Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3 to >0 pts

Poor

Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15 pts

This criterion is linked to a Learning OutcomeScenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts

Complete

Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0 pts

Poor

The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3 pts

This criterion is linked to a Learning OutcomeScenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4 pts

Excellent

References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3 pts

Good

References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2 pts

Fair

References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0 pts

Poor

No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4 pts

This criterion is linked to a Learning OutcomeScenario 2: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
3 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

2 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts

This criterion is linked to a Learning OutcomeScenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15 to >11.0 pts

Excellent

Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11 to >7.0 pts

Good

Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7 to >3.0 pts

Fair

Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3 to >0 pts

Poor

Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15 pts

This criterion is linked to a Learning OutcomeScenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts

Complete

Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0 pts

Poor

The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3 pts

This criterion is linked to a Learning OutcomeScenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts

Excellent

References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3 pts

Good

References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2 pts

Fair

References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0 pts

Poor

No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4 pts

This criterion is linked to a Learning OutcomeScenario 3: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

2 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts

This criterion is linked to a Learning OutcomeScenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to >11.0 pts

Excellent

Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11 to >7.0 pts

Good

Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7 to >3.0 pts

Fair

Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3 to >0 pts

Poor

Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts

This criterion is linked to a Learning OutcomeScenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts

Complete

Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0 pts

Poor

The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts

This criterion is linked to a Learning OutcomeScenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4 pts

Excellent

References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3 pts

Good

References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2 pts

Fair

References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0 pts

Poor

No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4 pts

This criterion is linked to a Learning OutcomeScenario 4: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

2 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3 pts

Total Points: 100

NURS 6512 Week 1 Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 2, “The History and Interviewing Proce

This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.

Chapter 5, “Recording Information”

This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–29)

Adly, N. N., Abd-El-Gawad, W. M., & Abou-Hashem, R. M. (2019). Relationship between malnutrition and different fall risk assessment tools in a geriatric in-patient unit

Links to an external site.. Aging Clinical and Experimental Research, 32(7), 1279–1287. https://doi.org/10.1007/s40520-019-01309-0

Chow, R. B., Lee, A., Kane, B. G., Jacoby, J. L., Barraco, R. D., Dusza, S. W., Meyers, M. C., & Greenberg, M. R. (2019). Effectiveness of the “Timed Up and Go” (TUG) and the Chair test as screening tools for geriatric fall risk assessment in the ED

Links to an external site.. The American Journal of Emergency Medicine, 37(3), 457–460. https://doi.org/10.1016/j.ajem.2018.06.015

Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level

Links to an external site.. British Journal of Nursing, 30(4), 238–243. https://doi.org/10.12968/bjon.2021.30.4.238

Shadow Health Support and Orientation Resources

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

Shadow Health. (2021). Welcome to your introduction to Shadow Health

Links to an external site.. https://link.shadowhealth.com/Student-Orientation-Video

Shadow Health. (n.d.). Shadow Health help desk

Links to an external site.. Retrieved from https://support.shadowhealth.com/hc/en-us

Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students.

Download Walden University quick start guide: NURS 6512 NP students.

Document: Shadow Health Nursing Documentation Tutorial

Download Shadow Health Nursing Documentation Tutorial (Word document)

Required Media

Welcome and General Course Guidelines

Dr. Tara Harris reviews the overall guidelines and the expectations for the course. Consider how you will manage your time as you review your media and Learning Resources throughout the course to better prepare for your Discussions, Case Study Lab Assignments, Digital Clinical Experience (DCE) Assignments, and your Midterm and Final Exams (14m).

Module 1 Introduction

Dr. Tara Harris reviews the overall expectations for Module 1. Please pay special attention to the registration requirements for your use of Shadow Health for your Digital Clinical Experience (DCE) Assignments as well as the criteria for the DCE Assignments (3m).

Building a Comprehensive Health History – Week 1 (19m

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw- Hill Medical.

Chapter 2, “History Taking and the Medical Record” (pp. 14–27)

To prepare:

With the information presented in Chapter 2 of Ball et al. in mind, consider the following:

By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.

How would your communication and interview techniques for building a health history differ with each patient?

How might you target your questions for building a health history based on the patient’s social determinants of health?

What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?

Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

Select one of the risk assessment instruments presented in Chapter 2 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.

Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:

Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

Suggest additional health-related risks that might be considered.

Validate an idea with your own experience and additional research

NURS_6512_Week_1_Discussion_Rubric

NURS_6512_Week_1_Discussion_Rubric
Criteria Ratings Pts

This criterion is linked to a Learning Outcome Main Posting

50 to >44.0 pts

Excellent

“Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

44 to >39.0 pts

Good

“Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

39 to >34.0 pts

Fair

“Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.

34 to >0 pts

Poor

“Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.

50 pts

This criterion is linked to a Learning Outcome Main Post: Timeliness
10 to >0.0 pts

Excellent

Posts main post by Day 3.

0 pts

Fair

N/A

0 pts

Good

N/A

0 pts

Poor

Does not post main post by Day 3.
10 pts

This criterion is linked to a Learning Outcome First Response
18 to >16.0 pts

Excellent

“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.

16 to >14.0 pts

Good

 

“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.

14 to >12.0 pts

Fair

“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

12 to >0 pts

Poor

“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
18 pts

This criterion is linked to a Learning Outcome Second Response

17 to >15.0 pts

Excellent

“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.

15 to >13.0 pts

Good

“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.

13 to >11.0 pts

Fair

“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

11 to >0 pts

Poor

“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.

17 pts

This criterion is linked to a Learning Outcome Participation
5 to >0.0 pts

Excellent

Meets requirements for participation by posting on three different days.

0 pts

Fair

N/A

0 pts

Good

N/A

0 pts

Poor

Does not meet requirements for participation by posting on three different days.

5 pts

Total Points: 100

NURS 6512 Week 2 Assignment 1: Case Study

Greetings Class,

The CASE STUDY for Assignment -1 in week 2 is listed below.

*PLEASE be sure to review the rubric for this assignment; it will be strictly followed for grading.

Please note: in addition to the content for the case study review, the rubric also includes assessment and grading for correct grammar, mechanics, and proper punctuation. APA is required. It is expected that the paper follows correct APA format for title page, headings, font, spacing,?margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.

Case:

This is a 46 y/o African American male who recently was seen in the Emergency Department for alcoholic withdrawal seizures and released. He was referred to clinic for follow up on his hypertension history. He ran out of the Norvasc prescription given by the Emergency Department. He is living in a homeless shelter now. He states he is not drinking anymore but needs to smoke cigarettes to calm down and function.

Please follow assignment 2 guidelines to complete this assignment by the due date: Sunday 3/10/24 by 11:59pm.

Thank you,

Dr. Terry

BUILDING A HEALTH HISTORY: COMMUNICATING EFFECTIVELY TO GATHER APPROPRIATE HEALTH-RELATED INFORMATION

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting.

There may also be significant cultural factors. In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged Black women to maintain a weight above what is considered healthy. Randall explained from her observations and her personal experience, as a Black woman, that many African American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate at the time; however, they emphasize an underlying reality in the healthcare field: Different populations, cultures, and groups have diverse beliefs and practices that impact their health. APRNs and other healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

As an advanced practice nurse, you must build a patient health history that takes into account all of the factors that make a patient unique and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with each patient, but it will also enable you to more effectively gather the information needed to assess a patient’s health risks.

For this first Assignment, you will take on the role of an APRN who is building a health history for a particular patient assigned by your Instructor. You will consider how social determinants of health and specific cultural considerations will influence your interview and communication techniques as you work in partnership with the patient to gather data for an accurate health history.

Note: You are expected to draw on the resources for both Week 1 and Week 2 when completing your Assignment.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resource links to access the resources.

WEEK 1 WEEKLY RESOURCES

WEEK 2 WEEKLY RESOURCES

Learning Resources

Lecturio Resources

Week 2 Video

Cultural Norms and Cultural Sensitivity (04:30)

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023).?Seidel’s guide to physical examination: An interprofessional approach?(10th ed.). Elsevier Mosby.

Chapter 1, “Cultural Competency”

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019).?Advanced health assessment and clinical diagnosis in primary care?(6th ed.). Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th edition by Dains, J. E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 2, “Evidenced-Based Clinical Practice Guidelines

Download Evidenced-Based Clinical Practice Guidelines”

i-Human?Patients. (2023).?i-Human Patients case player: Student manual

Download ?i-Human Patients case player: Student manual.?I-Human Patients by Kaplan.

Note: This link provides a PDF download for this manual.

Required Media

To access this resource, use the Access i-Human Patients link from the Start Here Module.

i-Human Patients. (2023).?Case studies: Marvin Webster, Jr.?[Video]. i-Human Patients by Kaplan.

Important Note: Once you have purchased your i-Human Patients access code from the bookstore, you should receive an email with your i-Human Patients login and password information. If you have not received this information, please contact the Course Instructor.

Supplemental Resources

Note: These readings are intended to serve as supplementary to the Lecturio content and required textbook readings provided in this course. Please refer/review these supplementary resources should you need help in reinforcing concepts and in preparation for completing this week’s Assessments.

National Prevention Information Network. (2021, September 10).?Cultural competence in health and human services

Links to an external site.. Centers for Disease Control and Prevention. https://npin.cdc.gov/pages/cultural-competence

This website discusses cultural competence as defined by the National Prevention Information Network at the Centers for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website.

U.S. Department of Human & Health Services Office of Minority Health. (n.d.).?A physician’s practical guide to culturally competent care

Links to an external site.. https://cccm.thinkculturalhealth.hhs.gov/

From the Office of Minority Health, this website offers CME and CEU credit and equips healthcare professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.

Coleman, D. E. (2019).?Evidence based nursing practice: The challenges of health care and cultural diversity

Links to an external site..?Journal of Hospital Librarianship, 19(4), 330–338. https://doi.org/10.1080/15323269.2019.1661734

Pirhofer, J., Bükki, J., Vaismoradi, M., Glarcher, M., & Paal, P. (2022). A qualitative exploration of cultural safely in nursing from the perspectives of advanced practice nurses: Meaning, barriers, and prospects

Links to an external site.. BMC Nursing, 21, 178. https://doi.org/10.1186/s12912-022-00960-9

Note: Although this resource page displays as an Assignment, it will not be counted towards your final grade. Your progress through the Lecturio resources will be reported as a percentage in the gradebook that will only be used as reference.

To prepare:

Reflect on your experience as an advanced practice nurse and on the information provided in the Week 1 Learning Resources on building a health history and the Week 2 Learning Resources on diversity issues in health assessments.

By Day 1 of this week, your Instructor will assign a case study for this Assignment.?Note: Please see the Course Announcements section of the classroom for your Case Study Assignment.

Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of your assigned patient.

Consider how you would build a health history for the patient. What questions would you ask? How might you target your questions based on the patient’s social determinants of health? How would you frame the questions to be sensitive to the patient’s background, lifestyle, and culture?

Identify any potential health-related risks, based on the patient’s age, gender, ethnicity, or environmental setting, which should be taken into consideration.

What risk assessment instruments would be appropriate to use with this patient?

What questions would you ask to assess the patient’s health risks?

Select?one?(1) risk assessment instrument discussed in the Learning Resources, or another tool with which you are familiar, related to your selected patient.

Develop five (5) targeted questions you would ask the patient to build their health history and to assess their health risks.

Think about the challenges associated with communicating with patients from a variety of specific populations. What communication techniques would be most appropriate to use with this patient? What strategies can you as an APRN employ to be sensitive to different cultural factors while gathering the pertinent information?

Assignment: Building a Health History With Cultural and Diversity Awareness

Include the following:

Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Be specific.

Explain the issues that you would need to be sensitive to when interacting with the patient, and why.

Describe the communication techniques you would use with this patient. Include strategies to demonstrate sensitivity with this patient. Be specific and explain why you would use these techniques.

Summarize the health history interview you would conduct with this patient. Provide at least five (5) targeted questions you would ask the patient to build their health history and to assess their health risks. Explain your reasoning for each question and how you frame each for this specific patient.

Identify the risk assessment instrument you selected, and then justify why it would be applicable to your assigned patient. Be specific.

By day 7 of Week 2

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK2Assgn1_LastName_FirstInitial

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6512_Week 2_Assignment 1_Rubric

NURS_6512_Week 2_Assignment 1_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Be specific.
15 to >12.0 pts

Excellent

The response clearly, accurately, and in detail explains the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the assigned patient.

12 to >9.0 pts

Good

The response accurately explains the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the assigned patient.

9 to >6.0 pts

Fair

The response vaguely and with some inaccuracy explains the socioeconomic, spiritual, lifestyle, and other cultural factors associated with the assigned patient.

6 to >0 pts

Poor

The response is inaccurate and/or missing explanations of the socioeconomic, spiritual, lifestyle, and other cultural factors associated with the assigned patient.

15 pts

This criterion is linked to a Learning Outcome Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
15 to >12.0 pts

Excellent

The response clearly, accurately, and in detail explains the issues to be sensitive to when interacting with the patient; explanations why are clear, accurate, and detailed.

12 to >9.0 pts

Good

The response accurately explains the issues to be sensitive to when interacting with the patient; explanations why are accurate.

9 to >6.0 pts

Fair

The response vaguely and with some inaccuracy explains the issues to be sensitive to when interacting with the patient; explanations why are vague and/or inaccurate.

6 to >0 pts

Poor

The response is inaccurate and/or missing explanations of the issues to be sensitive to when interacting with the patient; explanations why are inaccurate or missing.
15 pts

This criterion is linked to a Learning Outcome Describe the communication techniques you would use with this patient. Include strategies to demonstrate sensitivity with this patient. Be specific and explain why you would use these techniques.
15 to >12.0 pts

Excellent

The response clearly and accurately identifies and describes in detail communication techniques to use with the patient, including specific strategies to demonstrate sensitivity with this patient, and a detailed explanation of why to use these techniques.

12 to >9.0 pts

Good

The response accurately identifies and describes communication techniques to use with the patient, including specific strategies to demonstrate sensitivity with this patient, and an explanation of why to use these techniques.

9 to >6.0 pts

Fair

The response vaguely and with some inaccuracy identifies and describes communication techniques to use with the patient, including strategies to demonstrate sensitivity with this patient, and a vague explanation of why to use these techniques.

6 to >0 pts

Poor

The response identifies inaccurately and/or is missing descriptions of communication techniques to use with the patient, including inaccurate or missing strategies to demonstrate sensitivity with this patient, and an inadequate or missing explanation of why to use these techniques.

15 pts

This criterion is linked to a Learning Outcome Summarize the health history interview you would conduct with this patient. Provide at least five (5) targeted questions you would ask the patient to build their health history and to assess their health risks. Explain your reasoning for each question and how you frame each for this specific patient.
25 to >22.0 pts

Excellent

The response clearly, accurately, and in detail summarizes the health history interview to conduct with this patient, including at least five targeted questions to ask to build the health history and assess health risks, with detailed explanations for the wording of each question and why it is asked.

22 to >19.0 pts

Good

The response accurately summarizes the health history interview to conduct with this patient, including five targeted questions to ask to build the health history and assess health risks, with explanations for the wording of each question and why it is asked.

19 to >16.0 pts

Fair

The response vaguely summarizes the health history interview to conduct with this patient, including five questions to ask that are vague or lacking specificity to build the health history and assess health risks, with vague explanations for the wording of each question and why it is asked.

16 to >0 pts

Poor

The response inadequately summarizes the health history interview to conduct with this patient, including fewer than five questions that are inadequate for building the health history and assessing health risks, with inadequate or missing explanations for the wording of each question and why it is asked.

25 pts

This criterion is linked to a Learning Outcome Identify the risk assessment instrument you selected, and then justify why it would be applicable to your assigned patient. Be specific.

15 to >12.0 pts

Excellent

The response clearly and accurately identifies the selected risk assessment instrument, and provides detailed and specific justification for why it is applicable to the assigned patient.

12 to >9.0 pts

Good

The response accurately identifies the selected risk assessment instrument, and provides specific justification for why it is applicable to the assigned patient.

9 to >6.0 pts

Fair

The response vaguely identifies the selected risk assessment instrument, and provides vague justification for why it is applicable to the assigned patient.

6 to >0 pts

Poor

The response inadequately identifies the selected risk assessment instrument, and provides inadequate or missing justification for why it is applicable to the assigned patient.
15 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting: Paragraph Development and Organization — Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused and neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting: English Writing Standards — Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with understanding.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting: APA The paper follows correct APA format for title page, headings, font, spacing,?margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with understanding.
5 pts

Total Points: 100

NURS 6512 Week 3 Assignment 1: Case Study  Assessment of Nutrition in Children

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

For this Assignment, you will consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 3, “Examination Techniques and Equipment”

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.

Chapter 8, “Growth and Nutrition”

In this chapter, the authors explain examinations for growth, gestational age, and pubertal development. The authors also differentiate growth among the organ systems.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Student checklist: Health history guide

Download Student checklist: Health history guide. In Seidel’s guide to physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Centers for Disease Control and Prevention. (2021, April 9). Childhood overweight & obesity

Links to an external site.. http://www.cdc.gov/obesity/childhood/

This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 1, “Clinical Reasoning, Evidence-Based Practice, and Symptom Analysis”

This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

Nyante, S. J., Benefield, T. S., Kuzmiak, C. M., Earnhardt, K., Pritchard, M., & Henderson, L. M. (2021). Population‐level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures

Links to an external site.. Cancer, 127(12), 2111–2121. https://doi.org/10.1002/cncr.33460

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). History subjective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Week 1)

Chapter 5, “Pediatric Preventative Care Visits” (pp. 91 101)

Shadow Health Support and Orientation Resources

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

Shadow Health. (2021). Welcome to your introduction to Shadow Health

Links to an external site.. https://link.shadowhealth.com/Student-Orientation-Video

Shadow Health. (n.d.). Shadow Health help desk

Links to an external site.. Retrieved from https://support.shadowhealth.com/hc/en-us

Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students.

Download Walden University quick start guide: NURS 6512 NP students. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide

Document: Shadow Health Nursing Documentation Tutorial

Download Shadow Health Nursing Documentation Tutorial (Word document)

Required Media

Taking a Health History

How do nurses gather information and assess a patient’s health? Consider the importance of conducting an in-depth health assessment interview and the strategies you might use as you watch. (16m)

Assessment Tool, Diagnostics, Growth, Measurements, and Nutrition in Adults and Children – Week 3 (11m)

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.

Chapter 3, “The Screening Physical Examination”

Chapter 17, “Principles of Diagnostic Testing”

Chapter 18, “Common Laboratory Tests”

To Prepare

Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.

Based on the risks you might identify consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment

Assignment (3–4 pages, not including title and reference pages):

Assignment: Child Health Case:

Include the following:

An explanation of the health issues and risks that are relevant to the child you were assigned.

Describe additional information you would need in order to further assess his or her weight-related health.

Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.

Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

By Day 6 of Week 3

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK3Assgn1+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6512_Week_3_Assignment_1_Rubric

NURS_6512_Week_3_Assignment_1_Rubric
Criteria Ratings Pts

This criterion is linked to a Learning Outcome In 3–4 pages, address the following: An explanation of the health issues and risks that are relevant to the child you were assigned.

25 to >24.0 pts

Excellent

The response clearly, accurately, and in detail explains the relevant health issues and risks for the assigned child.

24 to >23.0 pts

Good

The response accurately explains the relevant health issues and risks for the assigned child.

23 to >17.0 pts

Fair

The response vaguely and with some inaccuracy explains the relevant health issues and risks for the assigned child.

17 to >0 pts

Poor

The response is inaccurate and/or missing explanations of the relevant health issues and risks for the assigned child.
25 pts

This criterion is linked to a Learning Outcome Describe additional information you would need in order to further assess his or her weight-related health.
25 to >24.0 pts

Excellent

The response clearly and accurately describes detailed additional information needed to further assess the child’s weight-related health.

24 to >23.0 pts

Good

The response accurately describes additional information needed to further assess the child’s weight-related health.

23 to >17.0 pts

Fair

The response vaguely and with some inaccuracy describes additional information needed to further assess the child’s weight-related health.

17 to >0 pts

Poor

The response is inaccurate and/or missing a description of additional information needed to further assess the child’s weight-related health.

25 pts

This criterion is linked to a Learning Outcome Identify and describe any risks, and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

20 to >17.0 pts

Excellent

The response clearly and accurately identifies and describes in detail any risks to the child’s health. The response clearly and accurately identifies and describes in detail further information needed to gain a full understanding of the child’s health, with a detailed explanation of how to gather that information in a way that is sensitive to the child.

17 to >14.0 pts

Good

The response accurately identifies and describes any risks to the child’s health. The response accurately identifies and describes further information needed to gain a full understanding of the child’s health, with a clear explanation of how to gather that information in a way that is sensitive to the child.

14 to >13.0 pts

Fair

The response vaguely and with some inaccuracy identifies and describes any risks to the child’s health. The response vaguely identifies and describes further information needed to gain a full understanding of the child’s health, with a vague explanation of how to gather that information in a way that is sensitive to the child.

13 to >0 pts

Poor

The response identifies inaccurately and/or is missing descriptions of any risks to the child’s health. The response identifies inaccurately and/or is missing descriptions of further information needed to gain a full understanding of the child’s health, with an inadequate or missing explanation of how to gather that information in a way that is sensitive to the child.

20 pts

This criterion is linked to a Learning Outcome Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
10 to >9.0 pts

Excellent

The response clearly and accurately lists three or more specific questions that would gather more information about the child. Specific questions are carefully worded to clearly demonstrate sensitivity to the parent(s) or caregiver(s) of the child.

9 to >8.0 pts

Good

The response lists three specific questions that would gather more information about the child. Specific questions are worded to demonstrate sensitivity to the parent(s) or caregiver(s) of the child.

8 to >7.0 pts

Fair

The response lists three questions with wording that is vague and lacking specificity for gathering more information about the child. Some wording of the questions lacks sensitivity to the parent(s) or caregiver(s) of the child.

7 to >0 pts

Poor

The response lists two or fewer confusing or inadequate questions, or is missing questions, for gathering more information about the child. Wording of questions provided lacks sensitivity to the parent(s) or caregiver(s) of the child.
10 pts

This criterion is linked to a Learning Outcome Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

5 to >4.0 pts

Excellent

The response clearly describes two or more detailed strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.

4 to >3.0 pts

Good

The response describes at least two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.

3 to >2.0 pts

Fair

The response vaguely describes two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.

2 to >0 pts

Poor

The response inadequately describes one strategy or is missing strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.

5 pts

Total Points: 100

NURS 6512 Week 4 Lab Assignment 1: Differential Diagnosis for Skin Conditions

Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.

In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 9, “Skin, Hair, and Nails”

This chapter reviews the basic anatomy and physiology of skin, hair, and nails. The chapter also describes guidelines for proper skin, hair, and nails assessments.

Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis.

Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center.

This section explains the procedural knowledge needed prior to performing various dermatological procedures.

Chapter 1, “Punch Biopsy

Download Chapter 1, “Punch Biopsy”

Chapter 2, “Skin Biopsy”

Download Chapter 2, “Skin Biopsy”

Chapter 10, “Nail Removal”

Download Chapter 10, “Nail Removal”

Chapter 15, “Skin Lesion Removals: Keloids, Moles, Corns, Calluses”

Download Chapter 15, “Skin Lesion Removals: Keloids, Moles, Corns, Calluses”

Chapter 16, “Skin Tag (Acrochordon) Removal”

Download Chapter 16, “Skin Tag (Acrochordon) Removal”

Chapter 22, “Suture Insertion”

Download Chapter 22, “Suture Insertion”

Chapter 24, “Suture Removal”

Download Chapter 24, “Suture Removal”

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 28, “Rashes and Skin Lesions”

Download Chapter 28, “Rashes and Skin Lesions”

This chapter explains the steps in an initial examination of someone with dermatological problems, including the type of information that needs to be gathered and assessed.

Note: Download and use the Student Checklist and the Key Points when you conduct your assessment of the skin, hair, and nails in this Week’s Lab Assignment.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Weeks 1 and 3)

VisualDx. (2021). Clinical decision support

Links to an external site.: For professionals. Retrieved July 16, 2021, from http://www.skinsight.com/professionals

This interactive website allows you to explore skin conditions according to age, gender, and area of the body.

Bonifant, H., & Holloway, S. (2019). A review of the effects of ageing on skin integrity and wound healing

Links to an external site.. British Journal of Community Nursing, 24(Sup3), S28–S33. https://doi.org/10.12968/bjcn.2019.24.sup3.s28

Document: Skin Conditions

Download Skin Conditions (Word document)

This document contains images of different skin conditions. You will use this information in this week’s Discussion.

Document: Comprehensive SOAP Exemplar

Download Comprehensive SOAP Exemplar (Word document)

Document: Comprehensive SOAP Template

Download Comprehensive SOAP Template (Word document)

Shadow Health Support and Orientation Resources

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

Shadow Health. (2021). Welcome to your introduction to Shadow Health

Links to an external site.. https://link.shadowhealth.com/Student-Orientation-Video

Shadow Health. (n.d.). Shadow Health help desk

Links to an external site.. Retrieved from https://support.shadowhealth.com/hc/en-us

Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students.

Download Walden University quick start guide: NURS 6512 NP students. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide

Document: Shadow Health Nursing Documentation Tutorial

Download Shadow Health Nursing Documentation Tutorial (Word document)

Document: DCE (Shadow Health) Documentation Template for Health History

Download DCE (Shadow Health) Documentation Template for Health History (Word document)

Use this template to complete your Assignment 2 for this week.

Required Media

Module 3 Introduction

Dr. Tara Harris reviews the overall expectations for Module 3. Consider how you will manage your time as you review your media and Learning Resources for your Discussions, Case Study Lab Assignments, DCE Assignments, and your Midterm exam (12m).

Skin, Hair, and Nails – Week 4 (19m)

Suturing Tutorials

The following suturing tutorials provide instruction on the basic interrupted suture, as well as the vertical and horizontal mattress suturing techniques

Tulane Center for Advanced Medical Simulation & Team Training. (2010, July 8). Suturing technique

Links to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=c-LDmCVtL0o

Note: Approximate length of this media program is 5 minutes.

Mikheil. (2014, April 22). Basic suturing: Simple, interrupted, vertical mattress, horizontal mattress

Links to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=MFP90aQvEVM

Note: Approximate length of this media program is 9 minutes.

Incision and Drainage of an Abscess (a common procedure in primary care)

New England Journal of Medicine (NEJM). (2013, September 30). NEJM abscess incision and drainage

Links to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=MwgNdrA18fM&list=PL9UKTUFtRDcNq4–Vf2NYfUANEyObfeNm&index=8

Note: Approximate length of this media program is 10 minutes.

Dermablade Use for Shave Biopsies

Dermablade®. (2012, November 9). PersonnaBlades

Links to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=D8u1Y18L9DQ

Note: Approximate length of this media program is 5 minutes.

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.

Chapter 6, “The Skin and Nails”

In this chapter, the authors provide guidelines and procedures to aid in the diagnosis of skin and nail disorders. The chapter supplies descriptions and pictures of common skin and nail conditions.

Ethicon, Inc. (n.d.-a). Absorbable synthetic suture material. Retrieved from https://web.archive.org/web/20170215015223/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/absorbable_suture_chart.pdf

Download absorbable_suture_chart.pdf

Ethicon, Inc. (n.d.-b). Ethicon sutures. Retrieved from https://web.archive.org/web/20150921202525/http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/suture_chart_ethicon.pdf

Download suture_chart_ethicon.pdf

Ethicon, Inc. (n.d.-c). Wound closure manual

Links to an external site.Retrieved from http://www.uphs.upenn.edu/surgery/Education/facilities/measey/Wound_Closure_Manual.pdf

MEDSimplified

Links to an external site.. (2019, September 17). Simple interrupted sutures-Suturing techniques for beginners [Video]. YouTube. https://www.youtube.com/watch?v=nT0lOlb5pe8

Surgical Teaching

Links to an external site.. (2019, June 21). Basics of sutures part 1 | Learn the different sizes and shapes of suture needles? [Video]. YouTube. https://www.youtube.com/watch?v=Ec1Fb6eeOcA

VATA. (2017, June 30). Suture techniques course video

Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=Akyr4zlBS9E

To Prepare

Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.

Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?

Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.

Consider which of the conditions is most likely to be the correct diagnosis, and why.

Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.

Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.

Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.

The Lab Assignment

Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources.

By Day 7 of Week 4

Submit your Lab Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK4Assgn1+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6512_Week_4_Assignment_1_Rubric

NURS_6512_Week_4_Assignment_1_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Using the SOAP (Subjective, Objective, Assessment, and Plan) note format: · Create documentation, following SOAP format, of your assignment to choose one skin condition graphic (identify by number in your Chief Complaint). · Use clinical terminologies to explain the physical characteristics featured in the graphic.
35 to >29.0 pts

Excellent

The response clearly, accurately, and thoroughly follows the SOAP format to document one skin condition graphic and accurately identifies the graphic by number in the Chief Complaint. The response clearly and thoroughly explains all physical characteristics featured in the graphic using accurate terminologies.

29 to >23.0 pts

Good

The response accurately follows the SOAP format to document one skin condition graphic and accurately identifies the graphic by number in the Chief Complaint. The response explains most physical characteristics featured in the graphic using accurate terminologies.

23 to >17.0 pts

Fair

The response follows the SOAP format, with vagueness and some inaccuracy in documenting one skin condition graphic, and accurately identifies the graphic by number in the Chief Complaint. The response explains some physical characteristics featured in the graphic using mostly accurate terminologies.

17 to >0 pts

Poor

The response inaccurately follows the SOAP format or is missing documentation for one skin condition graphic and is missing or inaccurately identifies the graphic by number in the Chief Complaint. The response explains some or few physical characteristics featured in the graphic using terminologies with multiple inaccuracies.

35 pts

This criterion is linked to a Learning Outcome · Formulate a different diagnosis of three to five possible considerations for the skin graphic. · Determine which is most likely to be the correct diagnosis, and explain your reasoning using at least three different references from current evidence-based literature.

50 to >44.0 pts

Excellent

The response clearly, thoroughly, and accurately formulates a different diagnosis of five possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained clearly, accurately, and thoroughly using three or more different references from current evidence-based literature.

44 to >38.0 pts

Good

The response accurately formulates a different diagnosis of three to five possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained accurately using at least three different references from current evidence-based literature.

38 to >32.0 pts

Fair

The response vaguely or with some inaccuracy formulates a different diagnosis of three possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained vaguely and with some inaccuracy using three different references from current evidence-based literature.

32 to >0 pts

Poor

The response formulates inaccurately, incompletely, or is missing a different diagnosis of possible considerations for the skin graphic, with two or fewer possible considerations provided. The response vaguely, inaccurately, or incompletely determines the most likely correct diagnosis with reasoning that is missing or explained using two or fewer different references from current evidence-based literature.

50 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.
5 pts

Total Points: 100

NURS 6512 Week 4 Assignment 2: Digital Clinical Experience (DCE): Health History Assessment

In Week 3, you began your DCE: Health History Assessment. For this week, you will complete this Health History Assessment in your simulation tool, Shadow Health and finalize for submission.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCE

To Prepare

Review this week’s Learning Resources as well as the Taking a Health History media program in Week 3, and consider how you might incorporate these strategies. Download and review the Student Checklist: Health History Guide and the History Subjective Data Checklist, provided in this week’s Learning Resources, to guide you through the necessary components of the assessment.

Review the DCE (Shadow Health) Documentation Template for Health History found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.

Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.

Review the Shadow Health Student Orientation media program and the Useful Tips and Tricks document provided in the week’s Learning Resources to guide you through Shadow Health.

Review the Week 4 DCE Health History Assessment Rubric, provided in the Assignment submission area, for details on completing the Assignment.

Note: There are 2 parts to this assignment – the lab pass and the documentation. You must achieve a total score of 80% in order to pass this assignment. Carefully review the rubric and video presentation in order to fully understand the requirements of this assignment.

DCE Health History Assessment:

Complete the following in Shadow Health:

Orientation

DCE Orientation (15 minutes)

Conversation Concept Lab (50 minutes, Required)

Health History

Health History of Tina Jones (180 minutes)

Note: Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve a total of 80% or better (this includes your DCE and your Documentation Notes), but you must take all attempts by the Week 4 Day 7 deadline.

submission information

Complete your Health Assessment DCE assignments in Shadow Health via the Shadow Health link in Canvas.

Once you complete your assignment in Shadow Health, you will need to download your lab pass and upload it to the corresponding assignment in Canvas for your faculty review.

(Note: Please save your lab pass as “LastName_FirstName_AssignmentName”.) You can find instructions for downloading your lab pass here: https://link.shadowhealth.com/download-lab-pass

Links to an external site.

Complete your documentation using the documentation template in your resources and submit it into your Assignment submission link below.

To submit your completed assignment, save your Assignment as WK4Assgn2+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select both files and then Submit Assignment for review.

Note: You must pass this assignment with a minimum score of 80% in order to pass the class. Once submitted, there are not any opportunities to revise or repeat this assignment.

By submitting this assignment, you confirm that you have complied with Walden University’s Code of Conduct including the expectations for academic integrity while completing the Shadow Health Assessment.

Rubric

NURS_6512_Week_4_DCE_Assignment_2_Rubric

NURS_6512_Week_4_DCE_Assignment_2_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Student DCE score(DCE percentages will be calculated automatically by Shadow Health after the assignment is completed.)Note: DCE Score – Do not round up on the DCE score.
60 to >55.0 pts

Excellent

DCE score>93

55 to >50.0 pts

Good

DCE Score 86-92

50 to >45.0 pts

Fair

DCE Score 80-85

45 to >0 pts

Poor

DCE Score <79… No DCE completed.

60 pts

This criterion is linked to a Learning Outcome Subjective Documentation in Provider Note Template: Subjective narrative documentation in Provider Note Template is detailed and organized and includes: Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS)ROS: covers all body systems that may help you formulate a list of differential diagnoses. You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe.

40 to >35.0 pts

Excellent

Documentation is detailed and organized with all pertinent information noted in professional language….Documentation includes all pertinent documentation to include Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS).

35 to >30.0 pts

Good

Documentation with sufficient details, some organization and some pertinent information noted in professional language….Documentation provides some of the Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS).

30 to >25.0 pts

Fair

Documentation with inadequate details and/or organization; and inadequate pertinent information noted in professional language….Limited or/minimum documentation provided to analyze students critical thinking abilities for the Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS).

25 to >0 pts

Poor

Documentation lacks any details and/or organization; and does not provide pertinent information noted in professional language….No information is provided for the Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS)….or…No documentation provided.
40 pts

Total Points: 100

ORDER A CUSTOMIZED, PLAGIARISM-FREE NURS 6521 Advanced Pharmacology Weekly Discussions & Assignments  HERE

NURS 6512 Week 5 Assignment 1: Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat

Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment.

In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 11, “Head and Neck”

This chapter reviews the anatomy and physiology of the head and neck. The authors also describe the procedures for conducting a physical examination of the head and neck.

Chapter 12, “Eyes”

In this chapter, the authors describe the anatomy and function of the eyes. In addition, the authors explain the steps involved in conducting a physical examination of the eyes.

Chapter 13, “Ears, Nose, and Throat”

The authors of this chapter detail the proper procedures for conducting a physical exam of the ears, nose, and throat. The chapter also provides pictures and descriptions of common abnormalities in the ears, nose, and throat

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 15, “Earache”

Download Chapter 15, “Earache”

This chapter covers the main questions that need to be asked about the patient’s condition prior to the physical examination as well as how these questions lead to a focused physical examination.

Chapter 21, “Hoarseness”

Download Chapter 21, “Hoarseness”

This chapter focuses on the most common causes of hoarseness. It provides strategies for evaluating the patient, both through questions and through physical exams.

Chapter 25, “Nasal Symptoms and Sinus Congestion”

Download Chapter 25, “Nasal Symptoms and Sinus Congestion”

In this chapter, the authors highlight the key questions to ask about the patients symptoms, the key parts of the physical examination, and potential laboratory work that might be needed to provide an accurate diagnosis of nasal and sinus conditions.

Chapter 30, “Red Eye”

Download Chapter 30, “Red Eye”

The focus of this chapter is on how to determine the cause of red eyes in a patient, including key symptoms to consider and possible diagnoses.

Chapter 32, “Sore Throat”

Download Chapter 32, “Sore Throat”

A sore throat is one most common concerns patients describe. This chapter includes questions to ask when taking the patient’s history, things to look for while conducting the physical exam, and possible causes for the sore throat.

Chapter 38, “Vision Loss”

Download Chapter 38, “Vision Loss”

This chapter highlights the causes of vision loss and how the causes of the condition can be diagnosed.

Note: Download the six documents (Student Checklists and Key Points) below, and use them as you practice conducting assessments of the head, neck, eyes, ears, nose, and throat.

Document: Episodic/Focused SOAP Note Exemplar

Download Episodic/Focused SOAP Note Exemplar (Word document)

Document: Episodic/Focused SOAP Note Template

Download Episodic/Focused SOAP Note Template (Word document)

Document: Midterm Exam Review

Download Midterm Exam Review (Word document)

Shadow Health Support and Orientation Resources

Shadow Health. (2021). Welcome to your introduction to Shadow Health

Links to an external site.. https://link.shadowhealth.com/Student-Orientation-Video

Shadow Health. (n.d.). Shadow Health help desk

Links to an external site.. Retrieved from https://support.shadowhealth.com/hc/en-us

Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students.

Download Walden University quick start guide: NURS 6512 NP students. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide

Document: DCE (Shadow Health) Documentation Template
Download DCE (Shadow Health) Documentation Template for Focused Exam: Cough (Word document)

Use this template to complete your Assignment 2 for this week.

Required Media

Assessment of the Head, Neck, Eyes, Ears, Nose, and Throat – Week 5 (29m)

Online media for Seidel’s Guide to Physical Examination

It is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 10, 11, and 12 that relate to the assessment of the head, neck, eyes, ears, nose, and throat. Refer to the Week 4 Learning Resources area for access instructions on https://evolve.elsevier.com/.

Geeky Medics. (2020, June 5).Fundoscopy (Ophthalmoscopy)

Links to an external site. – OSCE guide [Video]. YouTube. https://www.youtube.com/watch?v=SVuP5Td23AQ&feature=youtu.be

Health4TheWorld Academy Videos Channel. (2020, February 15).Paranasal sinus imaging

Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=8TQBtdbEY-I

University of Iowa Ophthalmology. (2016, December 19).Fluorescein staining of the cornea

Links to an external site.. Retrieved from https://vimeo.com/198695974

Credit Line: University of Iowa Ophthalmology. (n.d.). Fluorescein staining of the cornea [Video file]. Retrieved from ​https://vimeo.com/198695974. The author(s) and publishers acknowledge the University of Iowa and EyeRounds.org for permission to reproduce this copyrighted material.

Note: Approximate length of this media program is 25 seconds.

Optional Resources

Hayashi, T., Kitamura, K., Hashimoto, S., Hotomi, M., Kojima, H., Kudo, F., Maruyama, Y., Sawada, S., Taiji, H., Takahashi, G., Takahashi, H., Uno, Y., & Yano, H. (2020). Clinical practice guidelines for the diagnosis and management of acute otitis media in children—2018 update

Links to an external site.. Auris Nasus Larynx, 47(4), 493–526. https://doi.org/10.1016/j.anl.2020.05.019

Mustafa, Z., & Ghaffari, M. (2020). Diagnostic methods, clinical guidelines, and antibiotic treatment for Group A streptococcal pharyngitis: A narrative reviewLinks to an external site.. Frontiers in Cellular and Infection Microbiology, 10. https://doi.org/10.3389/fcimb.2020.563627

Patel, G. B., Kern, R. C., Bernstein, J. A., Hae-Sim, P., & Peters, A. T. (2020). Current and future treatments of rhinitis and sinusitis

Links to an external site.. The Journal of Allergy and Clinical Immunology: In Practice, 8(5), 1522–1531. https://doi.org/10.1016/j.jaip.2020.01.031

Links to an external site.

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.

Chapter 7, “The Head and Neck”

This chapter describes head and neck examinations that can be made with general clinical resources. Also, the authors detail syndromes of common head and neck conditions.

To Prepare

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.

With regard to the case study you were assigned:

Review this week’s Learning Resources and consider the insights they provide.

Consider what history would be necessary to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

By Day 6 of Week 5

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK5Assgn1+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6512_Week_5_Assignment_1_Rubric

NURS_6512_Week_5_Assignment_1_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Using the Episodic/Focused SOAP Template: · Create documentation or an episodic/focused note in SOAP format about the patient in the case study to which you were assigned. · Provide evidence from the literature to support diagnostic tests that would be appropriate for your case.
50 to >44.0 pts

Excellent

The response clearly, accurately, and thoroughly follows the SOAP format to document the patient in the assigned case study. The response thoroughly and accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.

44 to >38.0 pts

Good

The response accurately follows the SOAP format to document the patient in the assigned case study. The response accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.

38 to >32.0 pts

Fair

The response follows the SOAP format to document the patient in the assigned case study, with some vagueness and inaccuracy. The response provides evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study, with some vagueness or inaccuracy in the evidence selected.

32 to >0 pts

Poor

The response incompletely and inaccurately follows the SOAP format to document the patient in the assigned case study. The response provides incomplete, inaccurate, and/or missing evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.
50 pts

This criterion is linked to a Learning Outcome · List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

35 to >29.0 pts

Excellent

The response lists five distinctly different and detailed possible conditions for a differential diagnosis of the patient in the assigned case study, and provides a thorough, accurate, and detailed justification for each of the five conditions selected.

29 to >23.0 pts

Good

The response lists four or five different possible conditions for a differential diagnosis of the patient in the assigned case study and provides an accurate justification for each of the five conditions selected.

23 to >17.0 pts

Fair

The response lists three to five possible conditions for a differential diagnosis of the patient in the assigned case study, with some vagueness and/or inaccuracy in the conditions and/or justification for each.

17 to >0 pts

Poor

The response lists two or fewer, or is missing, possible conditions for a differential diagnosis of the patient in the assigned case study, with inaccurate or missing justification for each condition selected.

35 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.

5 pts

Total Points: 100

NURS 6512 Week 6 Lab Assignment 1: Assessing the Abdomen

A male went to the emergency room for severe midepigastric abdominal pain. He was diagnosed with AAA ; however, as a precaution, the doctor ordered a CTA scan.

Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen.

In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 18, “Abdomen”

In this chapter, the authors summarize the anatomy and physiology of the abdomen. The authors also explain how to conduct an assessment of the abdomen.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.Chapter 3, “Abdominal Pain

Download Chapter 3, “Abdominal Pain”

This chapter outlines how to collect a focused history on abdominal pain. This is followed by what to look for in a physical examination in order to make an accurate diagnosis.

Chapter 10, “Constipation”

Download Chapter 10, “Constipation”

The focus of this chapter is on identifying the causes of constipation through taking a focused history, conducting physical examinations, and performing laboratory tests.

Chapter 12, “Diarrhea”

Download Chapter 12, “Diarrhea”

In this chapter, the authors focus on diagnosing the cause of diarrhea. The chapter includes questions to ask patients about the condition, things to look for in a physical exam, and suggested laboratory or diagnostic studies to perform.

Chapter 29, “Rectal Pain, Itching, and Bleeding”

Download Chapter 29, “Rectal Pain, Itching, and Bleeding”

This chapter focuses on how to diagnose rectal bleeding and pain. It includes a table containing possible diagnoses, the accompanying physical signs, and suggested diagnostic studies.

Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis.

Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center.

These sections below explain the procedural knowledge needed to perform gastrointestinal procedures.

Chapter 115, “X-Ray Interpretation of Abdomen”

Download “X-Ray Interpretation of Abdomen” (pp. 514–520)

Note: Download this Student Checklist and Abdomen Key Points to use during your practice abdominal examination.

Document: Midterm Exam Review

Download Midterm Exam Review (Word document)

Required Media

Assessment of the Abdomen and Gastrointestinal System – Week 6 (14m)

Online media for Seidel’s Guide to Physical Examination

It is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapter 17 that relate to the assessment of the abdomen and gastrointestinal system. Refer to Week 4 for access instructions on https://evolve.elsevier.com/

Links to an external site.

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.

Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid”

This chapter explores the health assessment processes for the abdomen, perineum, anus, and rectosigmoid. This chapter also examines the symptoms of many conditions in these areas.

Chapter 10, “The Urinary System”

In this chapter, the authors provide an overview of the physiology of the urinary system. The chapter also lists symptoms and conditions of the urinary system.

Chabok, A., Thorisson, A., Nikberg, M., Schultz, J. K., & Sallinen, V. (2021). Changing paradigms in the management of acute uncomplicated diverticulitis

Links to an external site.. Scandinavian Journal of Surgery, 110(2), 180–186. https://doi.org/10.1177/14574969211011032

Hussein, A., Arena, A., Yu, C., Cirilli, A., & Kurkowski, E. (2021). Abdominal pain in the elderly patient: Point-of-care ultrasound diagnosis of small bowel obstruction

Links to an external site.. Clinical Practice and Cases in Emergency Medicine, 5(1), 127–128. https://doi.org/10.5811/cpcem.2020.11.50029

To Prepare

Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.

With regard to the Episodic note case study provided:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Assignment

Analyze the subjective portion of the note. List additional information that should be included in the documentation.

Analyze the objective portion of the note. List additional information that should be included in the documentation.

Is the assessment supported by the subjective and objective information? Why or why not?

What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?

Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

By Day 7 of Week 6

Submit your Lab Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK6Assgn1+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6512_Week_6_Assignment_1_Rubric

NURS_6512_Week_6_Assignment_1_Rubric
Criteria Ratings Pts

This criterion is linked to a Learning Outcome With regard to the SOAP note case study provided, address the following:Analyze the subjective portion of the note. List additional information that should be included in the documentation.
12 to >9.0 pts

Excellent

The response clearly, accurately, and thoroughly analyzes the subjective portion of the SOAP note and lists detailed additional information to be included in the documentation.

9 to >6.0 pts

Good

The response accurately analyzes the subjective portion of the SOAP note and lists additional information to be included in the documentation.

6 to >3.0 pts

Fair

The response vaguely and/or with some inaccuracy analyzes the subjective portion of the SOAP note and vaguely and/or with some inaccuracy lists additional information to be included in the documentation.

3 to >0 pts

Poor

The response inaccurately analyzes or is missing analysis of the subjective portion of the SOAP note, with inaccurate and/or missing additional information included in the documentation.
12 pts

This criterion is linked to a Learning Outcome Analyze the objective portion of the note. List additional information that should be included in the documentation.
12 to >9.0 pts

Excellent

The response clearly, accurately, and thoroughly analyzes the objective portion of the SOAP note and lists detailed additional information to be included in the documentation.

9 to >6.0 pts

Good

The response accurately analyzes the objective portion of the SOAP note and lists additional information to be included in the documentation.

6 to >3.0 pts

Fair

The response vaguely and/or with some inaccuracy analyzes the objective portion of the SOAP note and vaguely and/or inaccurately lists additional information to be included in the documentation.

3 to >0 pts
Poor

The response inaccurately analyzes or is missing analysis of the objective portion of the SOAP note, with inaccurate and/or missing additional information included in the documentation.

12 pts

This criterion is linked to a Learning Outcome Is the assessment supported by the subjective and objective information? Why or why not?

16 to >13.0 pts

Excellent

The response clearly and accurately identifies whether or not the assessment is supported by the subjective and/or objective information, with a thorough and detailed explanation.

13 to >10.0 pts

Good

The response accurately identifies whether or not the assessment is supported by the subjective and/or objective information, with an explanation.

10 to >7.0 pts

Fair

The response vaguely and/or inaccurately identifies whether or not the assessment is supported by the subjective and/or objective information, with a vague explanation.

7 to >0 pts

Poor

The response inaccurately identifies whether or not the assessment is supported by the subjective and/or objective information, with an inaccurate or missing explanation.

16 pts

This criterion is linked to a Learning Outcome What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?

20 to >17.0 pts

Excellent

The response thoroughly and accurately describes appropriate diagnostic tests for the case and explains clearly, thoroughly, and accurately how the test results would be used to make a diagnosis.

17 to >14.0 pts

Good

The response accurately describes appropriate diagnostic tests for the case and explains clearly and accurately how the test results would be used to make a diagnosis.

14 to >11.0 pts

Fair

The response vaguely and/or with some inaccuracy describes appropriate diagnostic tests for the case and vaguely and/or with some inaccuracy explains how the test results would be used to make a diagnosis.

11 to >0 pts

Poor

The response inaccurately describes appropriate diagnostic tests for the case, with an inaccurate or missing explanation of how the test results would be used to make a diagnosis.

20 pts

This criterion is linked to a Learning Outcome · Would you reject or accept the current diagnosis? Why or why not?· Identify three possible conditions that may be considered as a differenial diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.
25 to >22.0 pts

Excellent

The response states clearly whether to accept or reject the current diagnosis, with a thorough, accurate, and detailed explanation of sound reasoning. The response clearly, thoroughly, and accurately identifies three conditions as a differential diagnosis, with reasoning that is explained clearly, accurately, and thoroughly using at least three different references from current evidence-based literature.

22 to >19.0 pts

Good

The response states whether to accept or reject the current diagnosis, with an accurate explanation of sound reasoning. The response accurately identifies three conditions as a differential diagnosis, with reasoning that is explained accurately using three different references from current evidence-based literature.

19 to >16.0 pts

Fair

The response states whether to accept or reject the current diagnosis, with a vague explanation of the reasoning. The response identifies two or three conditions as a differential diagnosis, with reasoning that is explained vaguely and/or inaccurately using three references from current evidence-based literature.

16 to >0 pts

Poor

The response inaccurately or is missing a statement of whether to accept or reject the current diagnosis, with an explanation that is inaccurate and/or missing. The response identifies two or fewer conditions as a differential diagnosis, with reasoning that is missing or explained inaccurately using three or fewer references from current evidence-based literature.

25 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.

5 pts

Total Points: 100

NURS 6512 Week 8 Discussion: Assessing Musculoskeletal Pain

The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 6, “Vital Signs and Pain Assessment” (Previously read in Week 6)

Chapter 22, “Musculoskeletal System”

This chapter describes the process of assessing the musculoskeletal system. In addition, the authors explore the anatomy and physiology of the musculoskeletal system.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 22, “Lower Extremity Limb Pain”

Download Chapter 22, “Lower Extremity Limb Pain”

This chapter outlines how to take a focused history and perform a physical exam to determine the cause of limb pain. It includes a discussion of the most common tests used to assess musculoskeletal disorders.

Chapter 24, “Low Back Pain (Acute)”

Download Chapter 24, “Low Back Pain (Acute)”The focus of this chapter is the identification of the causes of lower back pain. It includes suggested physical exams and potential diagnoses.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Chapter 2, “The Comprehensive History and Physical Exam” (“Muscle Strength Grading”) (Previously read in Weeks 1, 2, 3, 4, and 5)

Chapter 3, “SOAP Notes”

This section explains the procedural knowledge needed to perform musculoskeletal procedures.

Document: Episodic/Focused SOAP Note Exemplar (Word document)

Download Episodic/Focused SOAP Note Exemplar (Word document)

Document: Episodic/Focused SOAP Note Template (Word document)
Download Episodic/Focused SOAP Note Template (Word document)

Required Media

Musculoskeletal System – Week 8 (12m)

Online media for Seidel’s Guide to Physical Examination

In addition to this week’s resources, it is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapter 21 that relate to the assessment of the musculoskeletal system. Refer to the Week 4 Learning Resources area for access instructions on https://evolve.elsevier.com/

Links to an external site.

Marquis, P. (2019, April 4). Orthopedic knee evaluation with Paul Marquis PT [Video].

Links to an external site. YouTube. https://www.youtube.com/watch?v=YVx4BepjjiY&feature=youtu.be

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.

Chapter 13, “The Spine, Pelvis, and Extremities”

In this chapter, the authors explain the physiology of the spine, pelvis, and extremities. The chapter also describes how to examine the spine, pelvis, and extremities.

Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., Ferreira, P. H., Fritz, J. M., Koes, B. W., Peul, W., Turner, J. A., Maher, C. G., Buchbinder, R., Hartvigsen, J., Cherkin, D., Foster, N. E., Maher, C. G., Underwood, M., van Tulder, M., . . . Woolf, A. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions.

Links to an external site. The Lancet, 391(10137), 2368–2383. https://doi.org/10.1016/s0140-6736(18)30489-6

Hicks, C., Levinger, P., Menant, J. C., Lord, S. R., Sachdev, P. S., Brodaty, H., & Sturnieks, D. L. (2020). Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people.

Links to an external site. BMC Geriatrics, 20(1), 94. https://doi.org/10.1186/s12877-020-1487-2

To prepare:

By Day 1 of this week, you will be assigned to one of the following specific case studies for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

Review the following case studies:

Case 1: Back Pain

A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?

Case 2: Ankle Pain

A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?

Case 3: Knee Pain

A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform?

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: When you submit your initial post, please include a header as the first line indicating your assigned case study. For example, “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.

By Day 3 of Week 8

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

Read a selection of your colleagues’ responses.

By Day 6 of Week 8

Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

NURS 6512 Week 9 Assignment 1: Case Study Assessing Neurological Symptoms

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 7, “Mental Status”

This chapter revolves around the mental status evaluation of an individual’s overall cognitive state. The chapter includes a list of mental abnormalities and their symptoms.

Chapter 23, “Neurologic System”

The authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 4, “Affective Changes”

Download Chapter 4, “Affective Changes”

This chapter outlines how to identify the potential cause of affective changes in a patient. The authors provide a suggested approach to the evaluation of this type of change, and they include specific tools that can be used as part of the diagnosis.

Chapter 9, “Confusion in Older Adults”

Download Chapter 9, “Confusion in Older Adults”

This chapter focuses on causes of confusion in older adults, with an emphasis on dementia. The authors include suggested questions for taking a focused history as well as what to look for in a physical examination.

Chapter 13, “Dizziness”

Download Chapter 13, “Dizziness”

Dizziness can be a symptom of many underlying conditions. This chapter outlines the questions to ask a patient in taking a focused history and different tests to use in a physical examination.

Chapter 19, “Headache”

Download Chapter 19, “Headache”

The focus of this chapter is the identification of the causes of headaches. The first step is to ensure that the headache is not a life-threatening condition. The authors give suggestions for taking a thorough history and performing a physical exam.

Chapter 31, “Sleep Problems”

Download Chapter 31, “Sleep Problems”

In this chapter, the authors highlight the main causes of sleep problems. They also provide possible questions to use in taking the patient’s history, things to look for when performing a physical exam, and possible laboratory and diagnostic studies that might be useful in making the diagnosis.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Chapter 2, “The Comprehensive History and Physical Exam” (“Cranial Nerves and Their Function” and “Grading Reflexes”) (Previously read in Weeks 1, 2, 3, and 5)

O’Caoimh, R., & Molloy, D. W. (2019). Comparing the diagnostic accuracy of two cognitive screening instruments in different dementia subtypes and clinical depression.

Links to an external site. Diagnostics, 9(3), 93. https://doi.org/10.3390/diagnostics9030093

Shadow Health Support and Orientation Resources

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

Shadow Health. (2021). Welcome to your introduction to Shadow Health.

Links to an external site. https://link.shadowhealth.com/Student-Orientation-Video

Shadow Health. (n.d.). Shadow Health help desk.

Links to an external site.Retrieved from https://support.shadowhealth.com/hc/en-us

Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students.

Download Walden University quick start guide: NURS 6512 NP students. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide

Document: DCE (Shadow Health) Documentation Template for Comprehensive (Head-to-Toe) Physical Assessment (Word document)

Download DCE (Shadow Health) Documentation Template for Comprehensive (Head-to-Toe) Physical Assessment (Word document)

Use this template to complete your Assignment 3 for this week.

Required Media

Neurologic System – Week 9 (16m)

Online media for Seidel’s Guide to Physical Examination

It is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 7 and 23 that relate to the assessment of cognition and the neurologic system. Refer to the Week 4 Learning Resources area for access instructions on https://evolve.elsevier.com/

Links to an external site.

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.

Chapter 14, “The Neurologic Examination”

This chapter provides an overview of the nervous system. The authors also explain the basics of neurological exams.

Chapter 15, “Mental Status, Psychiatric, and Social Evaluations”

In this chapter, the authors provide a list of common psychiatric syndromes. The authors also explain the mental, psychiatric, and social evaluation process.

Kim, H., Lee, S., Ku, B. D., Ham, S. G., & Park, W. (2019). Associated factors for cognitive impairment in the rural highly elderly.

Links to an external site. Brain and Behavior, 9(5), e01203. https://doi.org/10.1002/brb3.1203

Lee, K., Puga, F., Pickering, C. E., Masoud, S. S., & White, C. L. (2019). Transitioning into the caregiver role following a diagnosis of Alzheimer’s disease or related dementia: A scoping review.

Links to an external site. International Journal of Nursing Studies, 96, 119–131. https://doi.org/10.1016/j.ijnurstu.2019.02.007

To Prepare

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

By Day 6 of Week 9

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK9Assgn1+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6512_Week_9_Assignment1_Rubric

NURS_6512_Week_9_Assignment1_Rubric
Criteria Ratings Pts

This criterion is linked to a Learning Outcome Using the Episodic/Focused SOAP Template: · Create documentation or an episodic/focused note in SOAP format about the patient in the case study to which you were assigned. · Provide evidence from the literature to support diagnostic tests that would be appropriate for your case.
50 to >44.0 pts

Excellent

The response clearly, accurately, and thoroughly follows the SOAP format to document the patient in the assigned case study. The response thoroughly and accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.

44 to >38.0 pts

Good

The response accurately follows the SOAP format to document the patient in the assigned case study. The response accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.

38 to >32.0 pts

Fair

The response follows the SOAP format to document the patient in the assigned case study, with some vagueness and inaccuracy. The response provides evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study, with some vagueness or inaccuracy in the evidence selected.

32 to >0 pts

Poor

The response incompletely and inaccurately follows the SOAP format to document the patient in the assigned case study. The response provides incomplete, inaccurate, and/or missing evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.
50 pts

This criterion is linked to a Learning Outcome · List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

35 to >29.0 pts

Excellent

The response lists five distinctly different and detailed possible conditions for a differential diagnosis of the patient in the assigned case study and provides a thorough, accurate, and detailed justification for each of the five conditions selected.

29 to >23.0 pts

Good

The response lists four to five different possible conditions for a differential diagnosis of the patient in the assigned case study and provides an accurate justification for each of the five conditions selected.

23 to >17.0 pts

Fair

The response lists three to four possible conditions for a differential diagnosis of the patient in the assigned case study, with some vagueness and/or some inaccuracy in the conditions and/or justification for each.

17 to >0 pts

Poor

The response lists three or fewer, or is missing, possible conditions for a differential diagnosis of the patient in the assigned case study, with inaccurate or missing justification for each condition selected.
35 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.

5 pts

Total Points: 100

NURS 6512 Week 10 Lab Assignment 1: Assessing the Genitalia and Rectum

Patients are frequently uncomfortable discussing with healthcare professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.

In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 17, “Breasts and Axillae”

This chapter focuses on examining the breasts and axillae. The authors describe the examination procedures and the anatomy and physiology of breasts.

Chapter 19, “Female Genitalia”

In this chapter, the authors explain how to conduct an examination of female genitalia. The chapter also describes the form and function of female genitalia.

Chapter 20, “Male Genitalia”

The authors explain the biology of the penis, testicles, epididymides, scrotum, prostate gland, and seminal vesicles. Additionally, the chapter explains how to perform an exam of these areas.

Chapter 21, “Anus, Rectum, and Prostate”

This chapter focuses on performing an exam of the anus, rectum, and prostate. The authors also explain the anatomy and physiology of the anus, rectum, and prostate.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 5, “Amenorrhea”

Download Chapter 5, “Amenorrhea”

Amenorrhea, or the absence of menstruation, is the focus of this chapter. The authors include key questions to ask patients when taking histories and explain what to look for in the physical exam.

Chapter 6, “Breast Lumps and Nipple Discharge”

Download Chapter 6, “Breast Lumps and Nipple Discharge”

This chapter focuses on the important topic of breast lumps and nipple discharge. Because breast cancer is the most common type of cancer in women, it is important to get an accurate diagnosis. Information in the chapter includes key questions to ask and what to look for in the physical exam.

Chapter 7, “Breast Pain”

Download Chapter 7, “Breast Pain”

Determining the cause of breast pain can be difficult. This chapter examines how to determine the likely cause of the pain through diagnostic tests, physical examination, and careful analysis of a patient’s health history.

Chapter 27, “Penile Discharge”

Download Chapter 27, “Penile Discharge”

The focus of this chapter is on how to diagnose the causes of penile discharge. The authors include specific questions to ask when gathering a patient’s history to narrow down the likely diagnosis. They also give advice on performing a focused physical exam.

Chapter 36, “Vaginal Bleeding”

Download Chapter 36, “Vaginal Bleeding”

In this chapter, the causes of vaginal bleeding are explored. The authors focus on symptoms outside the regular menstrual cycle. The authors discuss key questions to ask the patient as well as specific physical examination procedures and laboratory studies that may be useful in reaching a diagnosis.

Chapter 37, “Vaginal Discharge and Itching”

Download Chapter 37, “Vaginal Discharge and Itching”

This chapter examines the process of identifying causes of vaginal discharge and itching. The authors include questions on the characteristics of the discharge, the possibility of the issues being the result of a sexually transmitted infection, and how often the discharge occurs. A chart highlights potential diagnoses based on patient history, physical findings, and diagnostic studies.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Chapter 3, “SOAP Notes” (Previously read in Week 8)

Centers for Disease Control and Prevention. (2021, April 13). Sexually transmitted disease surveillance, 2019

Links to an external site..

Links to an external site. https://www.cdc.gov/std/#

This section of the CDC website provides a range of information on sexually transmitted diseases (STDs). The website includes reports on STDs, related projects and initiatives, treatment information, and program tools.

Document: Final Exam Review (Word document)

Download Final Exam Review (Word document)

Required Media

Special Examinations – Breast, Genital, Prostate, and Rectal – Week 10 (14m)

Online media for Seidel’s Guide to Physical Examination

It is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 16 and 18–20 that relate to special examinations, including breast, genital, prostate, and rectal. Refer to the Week 4 Learning Resources area for access instructions on https://evolve.elsevier.com/

Links to an external site.

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2020). DeGowin’s diagnostic examination (11th ed.). New York, NY: McGraw Hill Medical.

Chapter 8, “The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts” (Section 2, “The Breasts,” pp. 380-390)

Section 2 of this chapter focuses on the anatomy and physiology of breasts. The section provides descriptions of breast examinations and common breast conditions.

Chapter 11, “The Female Genitalia and Reproductive System”

In this chapter, the authors provide an overview of the female reproductive system. The authors also describe symptoms of disorders in the reproductive system.

Chapter 12, “The Male Genitalia and Reproductive System”

The authors of this chapter detail the anatomy of the male reproductive system. Additionally, the authors describe how to conduct an exam of the male reproductive system.

Review of Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid”

Mealey, K., Braverman, P. K., & Koenigs, L. M. (2019). Why a pelvic exam is needed to diagnose cervicitis and pelvic inflammatory disease.

Links to an external site. Annals of Emergency Medicine, 73(4), 424–425. https://doi.org/10.1016/j.annemergmed.2018.11.028

Sanchez, C., Israel, R., Hughes, C., & Gorman, N. (2019). Well-woman examinations: Beyond cervical cancer screening.

Links to an external site. The Journal for Nurse Practitioners, 15(2), 189–194.e2. https://doi.org/10.1016/j.nurpra.2018.09.005

To Prepare

Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.

Based on the Episodic note case study:

Review this week’s Learning Resources, and consider the insights they provide about the case study. Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab Assignment.

Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided.

Consider what history would be necessary to collect from the patient in the case study.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Lab Assignment

Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.

Analyze the subjective portion of the note. List additional information that should be included in the documentation.

Analyze the objective portion of the note. List additional information that should be included in the documentation.

Is the assessment supported by the subjective and objective information? Why or why not?

Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?

Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

By Day 7 of Week 10

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK10Assgn1+last name+first initial

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6512_Week_10_Assignment1_Rubric

NURS_6512_Week_10_Assignment1_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome With regard to the SOAP note case study provided and using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature:· Analyze the subjective portion of the note. List additional information that should be included in the documentation.
12 to >9.0 pts

Excellent

The response clearly, accurately, and thoroughly analyzes the subjective portion of the SOAP note and lists detailed additional information to be included in the documentation.

9 to >6.0 pts

Good

The response accurately analyzes the subjective portion of the SOAP note and lists additional information to be included in the documentation.

6 to >3.0 pts

Fair

The response vaguely analyzes the subjective portion of the SOAP note and vaguely and/or inaccurately lists additional information to be included in the documentation.

3 to >0 pts

Poor

The response inaccurately analyzes the subjective portion of the SOAP note, with inaccurate and/or missing additional information included in the documentation.

12 pts

This criterion is linked to a Learning Outcome · Analyze the objective portion of the note. List additional information that should be included in the documentation.

12 to >9.0 pts

Excellent

The response clearly, accurately, and thoroughly analyzes the objective portion of the SOAP note and lists detailed additional information to be included in the documentation.

9 to >6.0 pts

Good

The response accurately analyzes the objective portion of the SOAP note and lists additional information to be included in the documentation.

6 to >3.0 pts

Fair

The response vaguely analyzes the objective portion of the SOAP note and vaguely and/or inaccurately lists additional information to be included in the documentation.

3 to >0 pts

Poor

The response inaccurately analyzes the objective portion of the SOAP note, with inaccurate and/or missing additional information included in the documentation.
12 pts

This criterion is linked to a Learning Outcome · Is the assessment supported by the subjective and objective information? Why or why not?
16 to >13.0 pts

Excellent

The response clearly and accurately identifies whether or not the assessment is supported by the subjective and/or objective information, with a thorough and detailed explanation.

13 to >10.0 pts

Good

The response accurately identifies whether or not the assessment is supported by the subjective and/or objective information, with a clear explanation.

10 to >7.0 pts

Fair

The response vaguely identifies whether or not the assessment is supported by the subjective and/or objective information, with a vague explanation.

7 to >0 pts

Poor

The response inaccurately identifies whether or not the assessment is supported by the subjective and/or objective information, with an inaccurate or missing explanation.
16 pts

This criterion is linked to a Learning Outcome · What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
20 to >17.0 pts

Excellent

The response thoroughly and accurately describes appropriate diagnostic tests for the case and explains clearly, thoroughly, and accurately how the test results would be used to make a diagnosis.

17 to >14.0 pts

Good

The response accurately describes appropriate diagnostic tests for the case and explains how the test results would be used to make a diagnosis.

14 to >11.0 pts

Fair

The response vaguely and/or with some inaccuracy describes appropriate diagnostic tests for the case and vaguely and/or with some inaccuracy explains how the test results would be used to make a diagnosis.

11 to >0 pts

Poor

The response inaccurately describes appropriate diagnostic tests for the case, with an inaccurate or missing explanation of how the test results would be used to make a diagnosis.

20 pts

This criterion is linked to a Learning Outcome · Would you reject or accept the current diagnosis? Why or why not?· Identify three possible conditions that may be considered as a differenial diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.
25 to >22.0 pts

Excellent

The response states clearly whether to accept or reject the current diagnosis, with a thorough, accurate, and detailed explanation of sound reasoning. The response clearly, thoroughly, and accurately identifies three conditions as a differential diagnosis, with reasoning that is explained clearly, accurately, and thoroughly using three or more different references from current evidence-based literature.

22 to >19.0 pts

Good

The response states whether to accept or reject the current diagnosis, with an accurate explanation of sound reasoning. The response accurately identifies three conditions as a differential diagnosis, with reasoning that is explained using three different references from current evidence-based literature.

19 to >16.0 pts

Fair

The response states whether to accept or reject the current diagnosis, with a vague explanation of the reasoning. The response identifies two to three conditions as a differential diagnosis, with reasoning that is explained vaguely and/or inaccurately using three or fewer references from current evidence-based literature.

16 to >0 pts

Poor

The response inaccurately states or is missing a statement of whether to accept or reject the current diagnosis, with an explanation that is inaccurate and/or missing. The response identifies three or fewer conditions as a differential diagnosis, with reasoning that is missing or explained inaccurately using two or fewer references from current evidence-based literature.

25 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.
5 pts

Total Points: 100

NURS 6512 Week 11 Lab Assignment: Ethical Concerns

As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?

In this Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare

Review the scenarios provided by your instructor for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your scenarios.

Based on the scenarios provided:

Select one scenario, and reflect on the material presented throughout this course.

What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

The Lab Assignment

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

By Day 6 of Week 11

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK11Assgn+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6512_Week_11_Assignment_Rubric

NURS_6512_Week_11_Assignment_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Write a detailed 1-page narrative (not a formal paper) addressing the following:· Explain the health assessment information required for a diagnosis of your selected patient (include the scenario number).
35 to >29.0 pts

Excellent

The response clearly, accurately, and thoroughly explains detailed health assessment information required to diagnose the selected patient, with correct scenario number included.

29 to >23.0 pts

Good

The response accurately explains health assessment information required to diagnose the selected patient, with correct scenario number included.

23 to >17.0 pts

Fair

The response vaguely explains health assessment information required to diagnose the selected patient, with scenario number, correct or inaccurate, included.

17 to >0 pts

Poor

The response lacks and/or inaccurately explains assessment information required to diagnose the selected patient, with scenario number inaccurate or missing.

35 pts

This criterion is linked to a Learning Outcome · Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

50 to >44.0 pts

Excellent

The response clearly, accurately, and thoroughly explains detailed evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with clear, accurate, and thorough justification using three or more different references from current evidence-based literature.

44 to >38.0 pts

Good

The response accurately explains evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with accurate justification using at least three different references from current evidence-based literature.

38 to >32.0 pts

Fair

The response vaguely explains evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with vague and/or inaccurate justification using two to three different references from current evidence-based literature.

32 to >0 pts

Poor

The response inaccurately explains or lacks evidence-based practice guidelines and ethical considerations applied by an advanced practice nurse in responding to the scenario, with inaccurate or missing justification using two or fewer references from current evidence-based literature.

50 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.
5 pts

Total Points: 100

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