NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

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NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal

One critical element of any physical exam is the ability of the examiner to put the patient at ease. By putting the patient at ease, nurses are more likely to glean quality, meaningful information that will help the patient get the best care possible. When someone feels safe, listened to, and cared about, exams often go more smoothly. This is especially true when dealing with issues concerning breasts, genitals, prostates, and rectums, which are subjects that many patients find difficult to talk about. As a result, it is important to gain a firm understanding of how to gain vital information and perform the necessary assessment techniques in as non-invasive a manner as possible. NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

For this week, you explore how to assess problems with the breasts, genitalia, rectum, and prostate.

Learning Objectives

Students will:

  • Evaluate abnormal findings on the genitalia and rectum
  • Apply concepts, theories, and principles relating to health assessment techniques and diagnoses for the breasts, genitalia, prostate, and rectum

Learning Resources

Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th 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.

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·         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”

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. NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

·         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”

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”

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”

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)

Cucci, E., Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G. (2015). Sclerosing adenosis of the breast: Report of two cases and review of the literature. Polish Journal of Radiology, 80, 122–127. doi:10.12659/PJR.892706. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/

Sabbagh , C., Mauvis, F., Vecten, A., Ainseba, N., Cosse, C., Diouf, M., & Regimbeau, J. M. (2014). What is the best position for analyzing the lower and middle rectum and sphincter function in a digital rectal examination? A randomized, controlled study in men. Digestive and Liver Disease, 46(12), 1082–1085. doi:10.1016/j.dld.2014.08.045

Westhoff , C. L., Jones, H. E., & Guiahi, M. (2011). Do new guidelines and technology make the routine pelvic examination obsolete? Journal of Women’s Health, 20(1), 5–10.

This article describes the benefits of new technology and guidelines for pelvic exams. The authors also detail which guidelines and technology may become obsolete.

Centers for Disease Control and Prevention. (2019). Sexually transmitted diseases (STDs). Retrieved from http://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)

Optional Resource

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.

  • Chapter 8, “The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts” (Section 2, “The Breasts,” pp. 434–444)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” (pp. 541–562)In this chapter, the authors provide an overview of the female reproductive system. The authors also describe symptoms of disorders in the reproductive system. NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal
  • Chapter 12, “The Male Genitalia and Reproductive System” (pp. 563–584)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” (pp. 445–527)

 

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/

Assignment: Lab Assignment: 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.

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.

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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. NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

By Day 7 of Week 10

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 10 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:

Week 10 Assignment Sample Paper

 

NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

Special Examinations-Breast, Genital, Prostate, and Rectal

Additional Subjective Data

During the physical examination, the nurse should conduct a more detailed analysis of the symptoms to determine their size, shape, color, and pattern. The patient should be asked to give a more detailed description of her symptoms. The patient will be asked whether it is the first time she is experiencing the signs, or she has had them previously. If it is not the first time, she will be asked to describe when she last experienced them and the medication used to manage the previous episodes. The nurse should enquire whether the patent has noticed the bumps in any other body part other than the genitals, such as the skin (Ball, Dains, Flynn, Solomon & Stewart, 2014).

Sometimes bumps in the genitourinary tract are associated with other general conditions. Therefore, the physician should check for other conditions such as the presence of skin rash, recent weight loss, loss of body hair, a fever, sores on the anus, dysuria, fatigue, and muscle aches.

The patient will be asked whether any of her sex partners had had the symptoms, what she was doing when she noticed the bumps, and whether her house is infested with parasites such as lice or scabies. The nurse should also enquire whether the patient has experienced any itching or burning currently or before noticing the bumps.

It will also be essential to determine whether the bumps have looked the same all week or their appearance has changed and whether they are spreading, present 100% of the time, or do they come and go. The patient should report if she is aware of anything that aggravates the bumps or decreases the number of cracks and whether she has tried home remedies and what outcomes were achieved.

The patient should be asked about exposure to genital bump risk factors such as douching, use of scented and medicated genital soaps, lotion, and sanitary pads.

Under the past medical history, the patient should be asked about any recent surgeries or procedures requiring anesthesia, recently started medications and the drugs that were prescribed for her previous chlamydia infection. The physician should inquire whether the patient has any skin conditions, allergies, a full course of immunization, and the age of asthma diagnosis.

The medical history should also entail the patient’s gynecological history regarding menstrual onset, frequency, duration, volume, date of last menstrual period, contraception use, and HIV status. It helps eliminate hormonal imbalance, pregnancy, and HIV, which could be responsible for genital bumps. NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

On the sexual history, the patient’s preference for risky sexual practices such as unprotected sex, anal sex, and multiple sexual partners, should be documented t determine the exposure to STD risk factors. The client’s occupational history is very significant in determining exposure to STD risk factors (Westhoff, Jones & Guiahi, 2011).

Additional Objective Data

Documentation of the overall patient’s appearance regarding the level of cleanliness and grooming helps determine the level of body hygiene, which could be a factor in the development of genital bumps.

HEENT exam should also entail throat assessment to check for redness, drainage, edema, enlarged tonsils, cold sores, lesions, and nodal tenderness. It should also entail cervical evaluation to check for enlarged cervical nodes. A mouth examination to check for mouth sores is also essential. These assessments help in determining the presence of viral infection.

The Chest exam should also check for non-labored breathing, enlarged axillary nodes, discharge, and tenderness over the nipples, which could also be signs of viral infection.

In the genito-urinary exam, it would be essential to assess for cervix tenderness, vaginal bleeding, and foul-smelling vaginal discharge. A rectal exam to ascertain any lesions, hemorrhoids, masses, and trauma is also necessary.

Do Subjective and Objective Data support the Assessment?

The patient was diagnosed with Chancre, a highly infectious painless ulcer, which is a primary stage of syphilis. A chancre is a sexually transmitted infection that usually develops over the genital area. In females, chancres can also present over the vagina, anus, or the vulva and take between 3 weeks to 3 months to show after infection.

Subjective data support the diagnosis because the patient reportedly noticed a painless and rough lump over her genital area and reported no vaginal discharge. She also said to be sexually active, have more than one sex partner, which increases her risk of a sexually transmitted infection. Objective data also support the diagnosis. The objective data ascertain that the client had around, a small painless ulcer on the external labia. Additionally, the performed HSV specimen test is the primary diagnostic test for chancre. However, other HEET examinations were normal (Cucci, Santoro, Di Gesù, Cerce & Sallustio, 2015).

The Relevance of Diagnostics and Its Use to Make a Diagnosis

The diagnostics approach used in this case was an HSV specimen, which was sent to the lab for viral culture. The test is relevant in this case because it assesses for the presence of bacteria Haemophilus ducreyi, which is the chancre causative agent. Additional diagnostics are crucial to rule out the differential diagnosis since many STDs present with similar symptoms. A Polymerase Chain Reaction can also be done to test for herpes simplex antibodies to confirm the diagnosis of herpes simplex. A serology test should be done to rule out syphilis. To rule out Chlamydia and Gonorrhea, rapid Nucleic Acid Amplification tests should be the most recommended.

Would You Reject or Accept the Current Diagnosis?

I would accept the current diagnosis. This is because the patient presents with chancre clinical presentation, rough and painless bumps on the genitals. The patient also confirms exposure to chancre risk factors, such as a history of chlamydia, multiple sex partners. An HSV specimen culture is also positive for bacteria Haemophilus ducreyi, which is the chancre causative agent (Dains, Baumann & Scheibel, 2018).

Possible Differential Diagnoses

The primary diagnosis, in this case, is chancre. The patient presents with chancre clinical presentation, and an HSV specimen culture is positive for bacteria Haemophilus ducreyi, which is the chancre causative agent.

The most potential differential diagnoses, in this case, include syphilis, herpes simplex II and acute contact dermatitis. These conditions are STD’s and present with clinical presentations and risk factors similar to chancre. Syphilis can, however, be ruled out through a serological test that assesses the presence of Treponema pallidum bacteria, a syphilis causative agent.

Herpes Simplex II also presents with similar symptoms and risk factors as a chancre. However, in Herpes Simplex II, the genital bumps are very painful bumps and lesions with a burning sensation during urination. Diagnostic tests also show the presence of a viral infection. NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

Squamous cell carcinoma is another differential diagnosis with similar symptoms as a chancre. It is a form of skin cancer. However, laboratory tests show no presence of infection, and a skin biopsy reveals the presence of cancerous cells (Centers for Disease Control and Prevention, 2019).

 

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2014). Seidel’s Guide to Physical Examination-E-Book. Elsevier Health Sciences.

Centers for Disease Control and Prevention. (2019). Sexually transmitted diseases (STDs)

Cucci, E., Santoro, A., Di Gesù, C., Di Cerce, R., & Sallustio, G. (2015). Sclerosing adenosis of the breast: report of two cases and review of the literature. Polish journal of radiology, 80, 122.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2018). Advanced Health Assessment & Clinical Diagnosis in Primary Care E-Book. Elsevier Health Sciences.

Westhoff, C. L., Jones, H. E., & Guiahi, M. (2011). Do new guidelines and technology make the routine pelvic examination obsolete?. Journal of Women’s Health, 20(1), 5-10.

 

Week 10 Assignment

What’s Coming Up in Module 4?

Next week, you will consider how evidence-based practice guidelines and ethical considerations factor into health assessments. You specifically explore evidence-based practice guidelines and ethical considerations for specific scenarios.

Week 11 Final Exam

Next week, you take your Final Exam, which will cover the topics and resources from Weeks 7, 8, 9, and 10 for this course. Please take the time to review and plan your time accordingly so that you may be better prepared for your exam. NURS 6512 Week 10 Assignment – Special Examinations—Breast, Genital, Prostate, and Rectal

 

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

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

Week 9: Assessment of Cognition and the Neurologic System
A 63-year-old woman comes to your office because she’s been forgetting things…a young mother comes in concerned because her baby fails to make eye contact and is unresponsive to touch…a teenager comes in and a parent complains that the teen obsessively washes his hands.

An array of neurological conditions could be causing the above symptoms. When assessing the neurologic system, it is vital to formulate an accurate diagnosis as early as possible to prevent continued damage and deterioration of a patient’s quality of life.

This week, you will explore methods for assessing the cognition and the neurologic system.

Learning Objectives
Students will:

Evaluate abnormal neurological symptoms
Apply concepts, theories, and principles relating to health assessment techniques and diagnoses for cognition and the neurologic system
Assess health conditions based on a head-to-toe physical examination
Learning Resources
Required Readings

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. NURS 6512 Week 9 Assignment: Case Study Assignment: Assessing Neurological Symptoms

· 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”
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”
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”
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”
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”
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.

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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)
Note: Download the Physical Examination Objective Data Checklist to use as you complete the Comprehensive (Head-to-Toe) Physical Assessment assignment. NURS 6512 Week 9 Assignment: Case Study Assignment: Assessing Neurological Symptoms

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical examination objective 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.

Note: Download and review the Student Checklists and Key Points to use during your practice neurological examination.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Neurologic system: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (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.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Neurologic system: Key points. In Seidel’s guide to physical examination: An interprofessional approach (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.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Mental status: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (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.

Bearden , S. T., & Nay, L. B. (2011). Utility of EEG in differential diagnosis of adults with unexplained acute alteration of mental status. American Journal of Electroneurodiagnostic Technology, 51(2), 92–104.

This article reviews the use of electrocenographs (EEG) to assist in differential diagnoses. The authors provide differential diagnostic scenarios in which the EEG was useful.

Athilingam, P ., Visovsky, C., & Elliott, A. F. (2015). Cognitive screening in persons with chronic diseases in primary care: Challenges and recommendations for practice. American Journal of Alzheimer’s Disease & Other Dementias, 30(6), 547–558. doi:10.1177/1533317515577127

Sinclair , A. J., Gadsby, R., Hillson, R., Forbes, A., & Bayer, A. J. (2013). Brief report: Use of the Mini-Cog as a screening tool for cognitive impairment in diabetes in primary care. Diabetes Research and Clinical Practice, 100(1), e23–e25. doi:10.1016/j.diabres.2013.01.001

Roalf, D. R., Moberg, P. J., Xei, S. X., Wolk, D. A., Moelter, S. T., & Arnold, S. E. (2013). Comparative accuracies of two common screening instruments for classification of Alzheimer’s disease, mild cognitive impairment, and healthy aging. Alzheimer’s & Dementia, 9(5), 529–537. doi:10.1016/j.jalz.2012.10.001. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036230/

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

Frey, C. [Chris Frey]. (2015, September 4). Student orientation [Video file]. Retrieved from https://www.youtube.com/watch?v=Rfd_8pTJBkY

Shadow Health. (n.d.). Shadow Health help desk. Retrieved from https://support.shadowhealth.com/hc/en-us

Document: Shadow Health. (2014). Useful tips and tricks (Version 2) (PDF)

Document: Student Acknowledgement Form (Word document)

Note: You will sign and date this form each time you complete your DCE Assignment in Shadow Health to acknowledge your commitment to Walden University’s Code of Conduct.

Document: 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.

Optional Resources
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical. NURS 6512 Week 9 Assignment: Case Study Assignment: Assessing Neurological Symptoms

· Chapter 14, “The Neurologic Examination” (pp. 683–765)
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” (pp. 766–786)
In this chapter, the authors provide a list of common psychiatric syndromes. The authors also explain the mental, psychiatric, and social evaluation process.

Mahlknecht, P., Hotter, A., Hussl, A., Esterhammer, R., Schockey, M., & Seppi, K. (2010). Significance of MRI in diagnosis and differential diagnosis of Parkinson’s disease. Neurodegenerative Diseases, 7(5), 300–318.

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/

Assignment 1: Case Study Assignment: 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.

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.

 

 

Week 9 Assignment Sample Paper

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

Episodic/Focused SOAP Note Template

 

Patient Information:

Initials: GM Age: 33 y.o Sex: Female Race: African American

SUBJECTIVE DATA:

Chief complaint: She states, I have a drooping on the right side of my face

HPI: G.M is a 33-year-old African American woman who presents in the clinic complaining of a right-sided facial drooping. She states that she noted it after waking up in the morning. She further says that her right eye has been watering continuously, and she cannot stop drooling out of her mouths side right. She has no pain.

Current Medications: Multivitamin every day, Tylenol 325mg-2 PO every 4 hours as required, Ibuprofen 200mg-2 PO as required, Valtrex 500mg – PO 3 x every day

Allergies: NKDA

Past Medical History: Asthma when she was a child and genital herpes some years back.

Past Surgical History: Cholecystectomy in the year 2000 and extraction of wisdom teeth while young
Social History: She takes alcohol rarely; denies making illicit drug use or smoking.

 

Family History: She has one brother with hypertension and a daughter who is 13years old healthy and living at home

Immunizations History: Her vaccinations are up to date. She had a flu vaccine lastly on February and had tetanus shot the previous two years when she had injured her arm on a metal piece.

REVIEW OF SYSTEMS
General: Pleasant 33-year-old woman posing in a chair talking reasonably fast. She appears very worried and is anxious; she has had a stroke. She is a good historian.

HEENT: No variations in hearing or vision; she had an eye test previous two years. GL stated no glaucoma, floaters, diplopia, photophobia, or extreme tearing history. She never before had any current infections of the ear, release, or tinnitus from her ears. Intact smell sense. GL has had no epistaxis episodes. She has no nasal polyp’s history or current sinus infection. Her previous dental examination was three years. She denied lesions, ulceration, bleeding gums, gingivitis, and she has no dental applications. No trouble swallowing or eating. NURS 6512 Week 9 Assignment: Case Study Assignment: Assessing Neurological Symptoms

 

Throat: No sneezing, loss of hearing, congestion, sore throat, or runny nose.

Skin: No itching or rash.

Cardiovascular: No chest distress, palpitations murmurs, no history of arrhythmias, paroxysmal nocturnal dyspnea, orthopnea, claudication, or edema history.

Respiratory: Denied hemoptysis and has no trouble breathing at rest.

Gastrointestinal: No nausea. No abdomen ache, no variations in the bowel pattern.

Genitourinary: No variation in her urinary form, incontinence, or dysuria. GL is heterosexual. She has consistent menses. Human Papilloma Virus is positive and is not sexually active presently.

Neurological: No episodes of syncopal or dizziness, headaches, and paresthesia. No variation in the original patterns; no abnormal movements or twitches; no gait disorder history or difficulties with coordination. No seizure or falls history.

Musculoskeletal: No myalgia or arthralgia, gout or restraint in her motion range by the report, no arthritis. No history of fractures or trauma.

Hematologic: No anemia, bleeding, or bruising.

Lymphatic: No itching or staining, rashes. G.I use lotion to avert dry skin. No skin cancer history or removal of the lesion. She has no blood loss conditions, clotting problems, or transfusions history.

Psychiatric: No depression or anxiety history. No delusions sleep disruption or a history of mental condition. Denied homicidal or suicidal history

Endocrine: No signs of endocrine or hormone therapies

Allergies: She has no recognized immune shortages. Had an HIV test lastly the previous two years

OBJECTIVE DATA
Physical Exam:

Vital signs: B/P: 120/80, RR 18, T 98.8 orally; Wt. 115, Ht: 5’2 and BMI 21

General: Nothing Abnormal Detected, appears to be contented

HEENT: EOMI, PERRLA, clear oronasopharynx; extreme tearing right eye; faces right side drooping as well as mild nasolabial fold destruction

Neck: No JVD or legally and bruit

Chest: CTA AP&L

Heart: RRR with no murmurs, gallop or rub; pulsations, two bilat pedal, and two radial

Abdomen: benign, no organomegaly; no suprapubic sensitivity; no reverberation

Genital/Rectal: Peripheral genitalia complete no cervical wave sensitivity, no adnexal crowds.

Musculoskeletal: Asymmetric muscle growth. All joints are ordinary.

Neuro: CN II – XII grossly complete, Deep Tendon Reflex perfect for paresis on the faces right side and for trouble making facial languages.

Skin/Lymph Nodes: No clubbing, edema, or cyanosis; no tangible nodes

History essential to obtain from the patient
If the patient has any pain, burning, loss of feeling anywhere in her body if she is having problems with her vision. History of her recent illness, history of stroke in her family, her past medical history, surgeries, and medications would be necessary as well. NURS 6512 Week 9 Assignment: Case Study Assignment: Assessing Neurological Symptoms

Additional Physical Examinations:
Performing an original Cincinnati Stroke Scale and Glasgow Coma Scale to evaluate mentation and stroke possibility, thoroughly inspect her face, head, and neck, neurovascular valuation in all the 4 extremities, swallow assessment, and cost of her facial cranial nerve function through raising her eyebrows, squeezing her eyes shut, puff out her cheeks, smile and purse her lips and blow out. This will indicate more of Bell’s palsy.

Additional Diagnostic Testing
In an outpatient situation, I would reach out for 911 for transport to an emergency unit for further assessment, and insist on a head CT to rule out a severe stroke. I would then consider extra electrophysiological testing on a cranial facial nerve in case an acute stroke was ruled out to find if the facial nerve is the culprit.

ASSESSMENT:

Priority Diagnosis: Facial Nerve Paralysis (Bell’s Palsy)-Classically presents as one-sided upper and lower facial paralysis with reduced eyelid cessation to the affected side and trouble tearing, sensory variations to the affected side occasionally noted, and flattened forehead with incapability of creating creases whenever raising eyebrows on affected side (Eviston, Croxson, Kennedy, Hadlock & Krishnan 2015).
Differential Diagnoses
Stroke: Frequently present with the facial drooping, but affects one side of body Writing, (Mozaffarian, Benjamin, Go, Arnett, Blaha & Fullerton 2016). If a patient can raise their eyebrows usually and correspondingly, but the inferior part of their face remains paralyzed, the health care provider will need to rule out stroke
Tetanus: Cephalic tetanus, although uncommon, generally occurs after an ear infection or trauma, and presents with cranial nerve palsy, which might be localized
Mastoiditis: This is a bacterial infection of the temporal bone and presents with otalgia, otorrhea, tenderness, swelling like symptoms, and facial palsy is an intertemporal problem (Mather, Yates, Powell & Zammit-Maempel 2019).
Lyme disease: A disease triggered by a bacteria that ticks may carry. Lyme disease causes Bell’s palsy since advanced signs of Lyme illness can affect the nervous system.
Guillain-Barre Syndrome: Generally begins as weakness and paresthesias weakness and gradually ascending, the symptoms include facial droop, dysphagia, diplopia, dysarthria, and pupillary disorders (Willison, Jacobs & van Doorn 2016).

References
Eviston, T. J., Croxson, G. R., Kennedy, P. G., Hadlock, T., & Krishnan, A. V. (2015). Bell’s palsy: etiology, clinical features, and multidisciplinary care. J Neurol Neurosurg Psychiatry, 86(12), 1356-1361.

Mather, M. W., Yates, P. D., Powell, J., & Zammit-Maempel, I. (2019). Radiology of acute mastoiditis and its complications: a pictorial review and interpretation checklist. The Journal of Laryngology & Otology, 1-6.

Willison, H. J., Jacobs, B. C., & van Doorn, P. A. (2016). Guillain-barre syndrome. The Lancet, 388(10045), 717-727.

Writing, G. M., Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., … & Fullerton, H. J. (2016). Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation, 133(4), e38.

 

 

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.

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By Day 6 of Week 9

Submit your Assignment.

Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK9Assgn1+last name+first initial.(extension)” as the name.
Click the Week 9 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 9 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. NURS 6512 Week 9 Assignment: Case Study Assignment: Assessing Neurological Symptoms
Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 9 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 9 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 6 of Week 9

 

To participate in this Assignment:

Week 9 Assignment 1
Assignment 2: Lab Assignment: Practice Assessment: Neurological Examination
Short of opening a patient’s cranium or requesting a brain scan, what can an advanced practice nurse do to determine the cause of neurological symptoms? A multitude of techniques can be used to generate a neurological diagnosis.

In preparation for the Comprehensive (Head-to-Toe) Physical Assessment due this week, it is recommended that you practice performing a neurological examination.

Note: This is a practice physical assessment.

To Prepare
Arrange an appropriate time and setting with a volunteer “patient” to perform a neurological examination.
Download and review the Neurological Checklist provided in this week’s Learning Resources as well as review Seidel’s Guide to Physical Examination online media.
The Lab Assignment
Complete the following in Shadow Health:

Neurological (Practice)
Assignment 3: Digital Clinical Experience: Comprehensive (Head-to-Toe) Physical Assessment
Throughout this course, you were encouraged to practice conducting various physical assessments on multiple areas of the body, ranging from the head to the toes. Each of these assessments, however, was conducted independently of one another. For this DCE Assignment, you connect the knowledge and skills you gained from each individual assessment to perform a comprehensive head-to-toe physical examination in your Digital Clinical Experience.

To Prepare
Review this week’s Learning Resources, and download and review the Physical Examination Objective Data Checklist as well as the Student Checklists and Key Points documents related to neurologic system and mental status.
Review the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation with the Shadow Health platform. Review the examples also provided. NURS 6512 Week 9 Assignment: Case Study Assignment: Assessing Neurological Symptoms
Review the DCE (Shadow Health) Documentation Template for Comprehensive (Head-to-Toe) Physical Assessment 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 Week 9 DCE Comprehensive Physical Assessment Rubric provided in the Assignment submission area for details on completing the Assessment in Shadow Health.
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 Comprehensive Physical Assessment:
Complete the following in Shadow Health:

Episodic/Focused Note for Comprehensive Physical Assessment 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 9 Day 7 deadline.

Submission and Grading Information

By Day 7 of Week 9

Complete your Comprehensive (Head-to-Toe) Physical Assessment DCE Assignment in Shadow Health via the Shadow Health link in Blackboard.
Once you complete your Assignment in Shadow Health, you will need to download your lab pass and upload it to the corresponding Assignment in Blackboard 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
Once you submit your Documentation Notes to Shadow Health, make sure to copy and paste the same Documentation Notes into your Assignment submission link below.
Download, sign, date, and submit your Student Acknowledgement Form found in the Learning Resources for this week.
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.
Grading Criteria

To access your rubric:

Week 9 Assignment 3 DCE Rubric

Submit Your Assignment by Day 7 of Week 9

 

To submit your Lab Pass:

Week 9 Lab Pass

To sumit this required part of the Assignment:

Week 9 Documentation Notes for Assignment 3

To Submit your Student Acknowledgement Form:

Submit your Week 9 Assignment 3 DCE Student Acknowledgement Form

What’s Coming Up in Week 10?
Next week, you will examine how to assess problems with the breasts, genitalia, rectum, and prostate while making the patient feel safe, listened to, and cared about using a non-invasive approach. Once again, you will use a SOAP note format to complete your Lab Assignment for this week.

Week 10 Required Media
Next week, you will need to view several videos and animations in the Seidel’s Guide to Physical Examination as well as other media, as required, prior to completing your Discussion. There are several videos of various lengths. Please plan ahead to ensure you have time to view these media programs to complete your Lab Assignment on time. NURS 6512 Week 9 Assignment: Case Study Assignment: Assessing Neurological Symptoms

NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns

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NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns

Module 4: Ethics in Assessments
What’s Happening in This Module?
Module 4: Ethics in Assessments is a 1-week module, Week 11 of the course and the last module in which you examine evidence-based practice guidelines and ethical considerations factor into health assessments.

What do I have to do? When do I have to do it?
Review your Learning Resources Days 1–7, Week 11
Lab Assignment: Ethical Concerns Submit by Day 6 of Week 11.
Final Exam Complete and Submit By Day 7 of Week 11.

Go to the Module’s Content

Week 11

Week 11: The Ethics Behind Assessment
Consider the following scenarios:

You are a nurse at a large county hospital. One of your patients is leaning toward selecting a certain radical treatment for cancer, to which the family is in opposition. The family is concerned about making the correct decision and asks for your advice.
The state of Oregon has passed a “Death with Dignity” act that allows for euthanasia in certain situations. One of your patients suffering from terminal cancer is thinking of moving there to take advantage of this law and asks your opinion. NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns
Throughout this course, you have explored a wide range of health assessments and abnormal examination findings. Although you have predominantly focused on the procedural aspects of health assessment, this week, you will focus on ethical considerations that should be taken into account when advising patients or their families.

This week, you will consider how evidence-based practice guidelines and ethical considerations factor into health assessments. You will also evaluate health assessment concepts related to sports physicals and well-child and well-woman examinations.

Learning Objectives
Students will:

Apply evidence-based practice guidelines to make an informed healthcare decision
Apply ethical considerations to a health assessment response
Apply concepts, theories, and principles relating to sports physicals and well-child and well-woman examinations
Identify concepts, theories, and principles related to advanced health assessment
Learning Resources
Required Readings
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

· Chapter 24, “Sports Participation Evaluation”
In this chapter, the authors describe the process of a sports participation evaluation. The chapter also states the most common conditions encountered in a sports participation evaluation.

· Chapter 25, “Putting It All Together”
In this chapter, the authors tie together the concepts introduced in previous chapters. In particular, the chapter has a strong emphasis on the patient-caregiver relationship.

Tingle, J. & Cribb, A. (2014). Nursing law and ethics (4th ed.). Chichester, UK: Wiley Blackwell.

Furman , C. D., Earnshaw, L. A., Farrer, L. A. (2014). A case of inappropriate apolipoprotein E testing in Alzheimer’s disease due to lack of an informed consent discussion. American Journal of Alzheimer’s Disease & Other Dementias, 29(7), 590–595. doi:10.1177/1533317514525829.

Navarro-Illana, P., Aznar, J., & Díez-Domingo, J. (2014). Ethical considerations of universal vaccination against human papilloma virus. BMC Medical Ethics, 15(29). doi:10.1186/1472-6939-15-29. Retrieved from http://www.biomedcentral.com/1472-6939/15/29

Maron , B. J., Friedman, R. A., & Caplan, A. (2015). Ethics of preparticipation cardiovascular screening for athletes. Nature Reviews Cardiology, 12(6), 375–378. doi:10.1038/nrcardio.2015.21

May, K. H., Marshall, D. L., Burns, T. G., Popoli, D. M. & Polikandriotis, J. A. (2014). Pediatric sports specific return to play guidelines following concussion. The International Journal of Sports Physical Therapy, 9(2), 242–255. PMCID: PMC4004129. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004129/

American Academy of Pediatrics. (2008). Recommendations for preventative pediatric health care (periodicity schedule). Retrieved from https://www.harmonyhpi.com/WCAssets/illinois/assets/IL_MedicaidProviderManual_PEM_AdultPHGsForProviders.pdf

This resource provides recommendations for preventative pediatric healthcare from infancy through adolescence. The periodicity schedule covers a variety of areas, from health history to measurements, developmental/behavioral screenings, physical exams, procedural screenings, and oral health. NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns

Rourke, L., Leduc, D., & Rourke, J. (2017). Rourke Baby Record. Retrieved from http://rourkebabyrecord.ca/

This website provides information on the Rourke Baby Record (RBR). The RBR supplies guidelines on growth and nutrition, developmental surveillance, physical exam parameters, and immunizations for well-baby and child care.

Document: Final Exam Review (Word document)

 

Required Media

Module 4 Introduction
Dr. Tara Harris reviews the overall expectations for Module 4. Consider how you will manage your time as you review your media and Learning Resources for your Case Study Lab Assignment and your Final exam (3m).

Sports Participation Evaluation – Week 11 (12m)

Assignment 1: 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?

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

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 and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name. NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns
Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 11 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 11 Assignment draft and review the originality report.

Submit Your Assignment by Day 6 of Week 11

To participate in this Assignment:

Week 11 Assignment

Week 11 Assignment Sample Paper

 

NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns

 

Lab Assignment: Ethical Concerns

Health Assessment Information
For the 49 -year -old patient with advanced cancer admitted with a cardiac arrest; an adequate health assessment would be required to make an adequate diagnosis. A comprehensive health assessment would provide details related to the patient’s physical status through measurement of vital signs, observation, and the patient’s self-reported symptoms. The comprehensive health assessment of the 49- year- the old patient would entail a medical history of the patient, a general survey, and a complete physical examination (Ingram, 2017). The general survey would be the first stage in the patient examination. This would include recording the patient’s age, height, weight, posture, build, gait, and hygiene. The general survey of the patient would provide baseline data and help build rapport with patients to establish a trusting relationship with the patient and ease anxiety. The general survey would then be followed by comprehensive health assessments, which would utilize different techniques, including inspection, auscultation, palpation, and percussion. Inspection is one of the most employed methods of assessment. Through inspections, different indications of health problems would be identified on the 49-year-old patient. An inspection would include inspecting skin color and lesions, rashes, as well as abnormal odors and sounds (Zambas, Smythe, & Koziol-Mclain, 2016). Another technique that would be utilized in health assessment is auscultations. This would include listening to the abdomen’s sounds by placing the bell of a stethoscope or diaphragm on the bare skin of patients. Before a comprehensive health assessment is adopted, the patient’s health history would be taken. This would include the patient’s medical compliance, past health records, presents the state of health, family history, psychosocial status, and family history. The health history would provide in-depth information on the symptoms of the 49 years old patient. Medical experiences, childhood illnesses, and the risk of developing certain diseases (Ingram, 2017). The health history collection would then be followed by a detailed physical examination of the patients, which would include a review of the patient’s body systems. A head-to-toe examination of the patients would include assessment of the patient, neurological functions, skin, eyes, nose, and throat. The respiratory functions of the patients would also be reviewed, and their cardiac, pulmonary system. This would be the central determinant of a cardiac arrest diagnosis. The patient’s muscle joints, abdomen reproductive systems, shoulders, limbs, ankles, hips, and feet would also be examined, with the patient’s reproductive system and nutrition being considered. The patient’s respiratory function results and cardiac and pulmonary system results would help determine the diagnosis of a cardiac arrest (Zambas et al., 2016). NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns

Response to the Scenario as an APRN
As an advanced practice nurse, there are several evidence based emergency practices that I would need to perform to help the 49-year-old with a cardiac arrest. This would include rapid resuscitation to guarantee the survival of the patient as an advanced practice nurse the use of an automated external defibrillator (AED) would therefore be necessary to help detect life-threatening arrhythmias in the patient’s chest and deliver a shock to restore a normal heart rhythm if such incidents were detected (Zègre-Hemsey, 2020). High-quality cardiopulmonary resuscitations (CPR) would also be adopted to help save the life of the 49-year-old patient. The use of AED on the patient would be followed by CPR as a way of treating cardiac arrest on the patients. The ethical considerations that would be utilized to make the decisions to administer AED and CPR to the 49-year-old patient suspected to have a cardiac arrest would be beneficence and non-maleficence. The adopted procedures would avoid the harm of death occurring on the patients while they would actively be positive actions meant to benefit the patients and save their life.

References
Ingram, S. (2017). Taking a comprehensive health Assessment: learning through practice and

reflection. British Journal of Nursing, 26(18), 1033–1037. doi:10.12968/bjon.2017.26.18.1033.

Zambas, S. I., Smythe, E. A., & Koziol-Mclain, J. (2016). The consequences of using advanced

physical assessment skills in medical and surgical nursing: A hermeneutic pragmatic study. International journal of qualitative studies on health and well-being, 11, 32090. https://doi.org/10.3402/qhw.v11.32090.

Zègre-Hemsey, J.K., (2020).Optimizing Patient Outcomes in Emergency Cardiac Care through

Advances in Technology: Nurse Scientists in Action. DOI:https://doi.org/10.1016/j.jen.2020.01.007. Vol.46, Iss 2, P136-138. NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns

Assignment 2: Lab Assignment: Practice Assessment: Mental Health Examination
The Lab Assignment
Complete the following in Shadow Health:

Mental Health (Practice)
Exam: Week 11 Final Exam
This exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will be on topics covered in weeks 7, 8, 9, 10, and 11. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit. NURS 6512 Week 11 Assignment: Lab Assignment: Ethical Concerns

Assignment: Position Paper on Health Policy

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Assignment: Position Paper on Health PolicyNow that you have analyzed many different aspects of health care policy, you are better able to form a comprehensive evidence-based opinion on its effectiveness. The policy you chose to focus on, like all policy, as you now well know, is a conglomeration of many different facets. Each of those facets is integral to the policy’s success, efficiency, and value.As a nursing professional and advocate for change, having an all-inclusive understanding of health care policy is extremely important. Nurses have a tremendous amount of untapped power to make positive changes. Your knowledge of policy is just a first step. With this new process of breaking down and analyzing each of the pieces of health care policy, you have added another tool to your toolkit.To complete this Assignment, consider all of your findings from the Discussion in Week 1 and the Assignments in Weeks 2 and 3. Analyze your research on the policy, including costs, quality, and/or safety issues.Address the following:Introduce the topic by drawing from your previous work. Introduce the policy by providing an overview of the suggested or implemented policy: background of the topic, including main elements of the policy, costs, and quality/safety. Assert your main thesis statement.Offer an evidence-based, informed opinion in support of the suggested or implemented policy. Describe at least two major contributions that this policy makes to health care, nursing, or health outcomes. Provide support with at least three sources of evidence.Discuss at least one opposing opinion to the suggested or implemented policy. Provide evidence and/or data to support the counterargument.Present a final position on the policy. Support the final defensible argument with current literature.Conclusion:A. Restate your argument.B. Provide a plan of action, but do not introduce new information. In total, your paper will be 4–5 pages in length, not including the title page or reference page.

Module 01 Written Assignment – Cancer Symptoms and their Management

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1. Cancer treatment is very aggressive in nature. The treatment can lead to symptoms that range from uncomfortable to life-threatening. Complete the Cancer Symptoms Management Table. Do not forget to include complementary alternative therapy that may help in symptom management.End-of-Life Care Concept Map2.  Mr. Rivera is a 72-year-old patient with end stage COPD who is in the care of Hospice. He has a history of smoking, hypertension, obesity, and type 2 Diabetes. He is on Oxygen 2L per nasal cannula around the clock. His wife and 2 adult children help with his care. Develop a concept map for Mr. Rivera. Consider the patients Ethnic background (he and his family are from Mexico) and family dynamics. Please use the concept map form provided.

WK 10 Discuss (03)

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You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choice.To Prepare:Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization.By Day 3 of Week 10Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

Nursing theory

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Borderline Case: Ethics of Patient CareFor this discussion, you will be applying defining attributes to an actual patient case. Please listen to the NPR podcast, “If You Have Dementia, Can You Hasten Death As You Wished?” Additionally, review Wilkinson’s defining attributes (found in the Wilkinson (1997) reading in the Learning Materials section). See attachments.https://www.npr.org/sections/health-shots/2015/02/10/382725729/if-you-have-dementia-can-you-hasten-death-as-you-wishedPlease respond to the following prompts:1. Review Wilkinson’s (1997) defining attributes and describe how the NPR podcast, “If You Have Dementia, Can you Hasten Death As You Wished?” case story meets the definition of a borderline case.2. Describe the ethical issues the case raises.3. If it were changed to meet criteria for a model case, what ethical issues would come to the forefront?Your post should contain two to three (2–3) paragraphs with three to four (3–4) sentences per paragraph. The post should integrate a minimum of three readings and/or other evidence-based research articles no more than three years old and use APA formatting for citations and references.TURNITIN ASSIGNMENT

nursing multidimensional care2

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Module 05 Written Assignment – Acid-Base ImbalanceCompetencyDescribe strategies for safe, effective multidimensional nursing care for clients with acid-base imbalances.ScenarioTony is a 56-year-old, Hispanic male that presented to the Emergency Room with complaints of shortness of breath, which he has been experiencing for the past two days. He states “I haven’t felt good for about a week, but couldn’t afford to miss work.” He complains of a cough, fever, and feeling exhausted. Past medical history includes asthma, chronic obstructive pulmonary disease and diabetes. Upon physical examination, you notice that Tony is struggling to breathe, his respiratory rate is 36 breaths per minute and labored, heart rate 115 beats per minute, blood pressure 90/40 mm Hg, and his pulse oximetry is 84% on room air. You notify the MD. He orders oxygen at 4 L via NC and an arterial blood gas.Tony’s ABG results:pH 7.28PaCO2 – 55 mm HgPaO2 – 70 mm HgHCO3 – 30 mEq/LInstructionsIn a 1-2 page Word document:Determine Tony’s acid-base imbalanceDescribe possible causes of the imbalanceIdentify the signs and symptoms that Tony is exhibiting as a result of the acid-base imbalanceList the multidimensional care strategies that are appropriate for the care of TonyResourcesFor assistance with citations, refer to the APA Guide.For assistance with research, refer to the Nursing Research Guide.

Write a 2-3 page paper that examines the moral and ethical considerations of organ conscription policies and theories.

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Scarcity of Medical ResourcesFor this assessment, you will continue your survey of ethical principles in health care. Especially in our contemporary world, where needs for health care outstrip available resources, we regularly face decisions about who should get which resources.There is a serious shortage of donor organs. Need vastly outstrips supply, due not only to medical advances related to organ transplantation, but also because not enough people consent to be cadaveric donors (an organ donor who has already died). Munson (2014) points out that in the United States, approximately 10,000 patients die each year because an organ donor was not available, which is three times the number of people killed in the terrorist attacks on 9/11.But what is an efficient and morally sound solution to this problem? The policy of presumed consent, where enacted, has scarcely increased supply, and other alternatives, such as allowing donors to sell their organs, raise strong moral objections. In light of this, some have advocated for a policy of conscription of cadaveric organs (Spital & Erin, 2002). This involves removing organs from the recently deceased without first obtaining consent of the donor or his or her family. Proponents of this policy argue that conscription would not only vastly increase the number of available organs, and hence save many lives, but that it is also more efficient and less costly than policies requiring prior consent. Finally, because with a conscription policy allpeople would share the burden of providing organs after death and allwould stand to benefit should the need arise, the policy is fair and just.Demonstration of ProficiencyBy successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:Competency 1: Articulate ethical issues in health care.Articulate the moral concerns surrounding a policy of organ conscription.Articulate questions about the fairness and justness of organ conscription policy.Explain the relevance and significance of the concept of consent as it pertains to organ donation.Evaluate alternative policies for increasing available donor organs.Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.Exhibit proficiency in clear and effective academic writing skills.ReferencesMunson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth.Spital, A., & Erin, C. (2002). Conscription of cadaveric organs for transplantation: Let’s at least talk about it. American Journal of Kidney Disease, 39(3), 611–615.InstructionsDo you consider the policy of organ conscription to be morally sound?Write a paper that answers this question, defending that answer with cogent moral reasoning and supporting your view with ethical theories or moral principles you take to be most relevant to the issue. In addition to reviewing the suggested resources, you are encouraged to locate additional resources in the Capella library, your public library, or authoritative online sites to provide additional support for your viewpoint. Be sure to weave and cite the resources throughout your work.In your paper, address the following:On what grounds could one argue that consent is not ethically required for conscription of cadaveric organs? And on what grounds could one argue that consent is required?Is the policy truly just and fair, as supporters claim? Explain.Do you consider one of the alternative policies for increasing available donor organs that Munson discusses to be preferable to conscription? Explain why or why not.

Case Study Advanced Pharmacology

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PurposeProblem-based learning is a methodology designed to help students develop the reasoning process used in clinical practice through problem-solving actual patient problems in the same manner as they occur in practice. The purpose of this activity is to develop students’ clinical reasoning skills using a case-based learning exercise. Through participation in an online discussion forum, students identify learning issues in a self-directed manner which facilitates learning for the entire group. Activity Learning Outcomes Through this discussion, the student will demonstrate the ability to:Synthesize clinical knowledge, didactic learning and research findings to provide appropriate pharmacological care to primary care patients. (CO 1, 2, 3, 4 & 5)Case Study & Discussion QuestionsClaudia (G2P2) is a 36-year-old mother who recently delivered a child 9 months ago. She has been using condoms for birth control for the last 7 months. Today she is requesting a more convenient method of birth control. She is not sure of her current pregnancy plans, however, she does not wish to discuss sterilization or an IUD. She has no religious contraindications for treatment.PMH: positive for mild hypertension with first pregnancy, seasonal allergies.Surgeries: Left inguinal hernia and tonsillectomy.Family history: Mother-HTN; Father-Colon CA (both deceased)Social History: Denies tobacco use, wine one to two glasses a week, denies recreational drugs, exercises twice a week.Drug allergies-Sulfa causes a rash.Current medications-MVI with Fe, Calcium chews, Allegra 10mg daily prn for allergies.Vitals: Height 67 inches, weight 157 pounds, BP 110/75, P 70, R 16. PAP collected today, breast exam WNL, urine pregnancy negative.A physical exam is normal.What are your treatment goals for Claudia today?What are two possible medications (in different classes) that you can recommend for Claudia? Please provide a detailed rationale and mechanism of actions for each medication. Make sure that all recommendations are cited with guidelines or scholarly, peer-reviewed articles and always include medication, strength, dosage form, route, frequency, and duration when making recommendations.Pick one of the medications from your response above and list five (5) patient-centered teaching points to communicate to the patient.What would your contraceptive choice be if Claudia smoked 10-15 cigarettes per day? Explain your answer.