Well Exam Child Soap Note

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Well Exam Child Soap Note

 

 

 

 

 

 

Well Exam Child Soap Note

 

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Well Exam Child Soap Note

SUBJECTIVE

ID: S.J, Age: 8, Race: African American, Gender: Female, Date of Birth: January 15, 2014, Insurance: N/A

CC: “I came for my annual wellness visit.”

HPI: S.J is an eight-year-old female who presents to the clinic for her annualwellness examination alongside her mother. The patient comes in for a her annual checkup and currently has no worrying medical concerns. The patient answers questions accurately and looks healthy. She leaves with her father, mother, and 2 siblings. Her last wellness exam was done on January 5, 2021, and she turned out to be healthy.

PAST MEDICAL HISTORY: The patient was treated for pneumonia in May 2020 using amoxicillin. No surgery history.

CURRENT MEDICATIONS: None.

IMMUNIZATION: Patient has received all recommended immunizations for her age, including Tetanus diphtheria, Tdap, Hpv human papillomavirus, meningococcal, pneumonia, hepatitis B, hepatitis A, Polio, MMR measles, mumps, rubella, chickenpox vavicella, and flu vaccine.

PREGNANCY AND BIRTH HISTORY: Mother says she has never used illegal substances, smoked cigarettes, or consumed alcoholic beverages. She stated that the patient was delivered vaginally at full term, and patient was able to breastfeed without difficulty.

Developmental History: According to the patient’s mother, the patient met all developmental age-related milestones on time.

FAMILY HISTORY: The parents of the patient are both alive and together. The father is 41 years old and is allergic to pollen. The mother is 37 years old and suffers from hypertension, which she manages by a healthy lifestyle and Losartan 25mg PO. The patient has 4 years old twin brothers who are healthy and have no medical history. The patient’s paternal grandmother is 69 years old and suffers from arthritis. The grandmother has been on nonsteroidal anti-inflammatory drugs to manage the condition. The paternal grandfather is 74 years old and suffers from mild dementia. His memory is deteriorating, and he is having difficulties remembering past events. He has been in therapy to help him with his memory.

SOCIAL HISTORY: The patient lives with her father, mother, and younger brother. She studies at a school near her home. She is a performer and wants to be a surgeon when she grows up. She has a friend she schools with called Emma. Both enjoy dancing and are in a dancing class. She enjoys eating pancakes and juice.

DIET: The patient claims to consume red meat twice a week, enjoys cake and sugary drinks, and dislikes vegetables. However, she claims to eat an apple at least twice a week.

SLEEP/STRESS: She goes to bed between 8:00 and 9:00 p.m. and sleeps for at least nine hours.

SAFETY: When riding a bicycle or scooter, the patient take precautions such as wearing a helmet and knee protection. When she is in a vichicle, she also wears a belt.

SPIRITUAL AFFLIATIONS: Christian

 

REVIEW OF SYSTEMS

GENERAL: The patient disagrees with having a high fever, weight increase, night sweats, change in appetite, weight loss, low exercise tolerance, and fatigue.

HAIR, SKIN, AND NAILS: The patient denies rashes, no color changes, no sunburns, and nodes.

HEAD: The patient denies frequent headaches, visual changes, redness, no injury, or drainage.

NECK: The patient does not feel pain or stiffness in the neck—no noted masses or edema.

EYES: No scotomata, no tearing, no pain. The patient has normal vision. She has itchy eyes due to landscaping.

EARS: The patient denies bleeding, having any hearing difficulties, bleeding, tinnitus. No vertigo.

NOSE: Denies nasal drainage and congestion. Throat: Denies throat or neck pain, sore throat, edema, hoarseness, difficulty swallowing.

 

MOUTH & THROAT: The patient denies edema, sore throat, complications absorption, hoarseness, no dental complications, no use of dentures.

CARDIOVASCULAR:  The patient doesn’t suffer from peripheral edema, chest pain, or palpitations.

GASTROINTESTINAL: The patient disagrees with having abdominal pain. She disagrees with having nausea, disgorging, or cramps.

PULMONARY: Normal

ENDOCRINE: The patient has a normal appetite and denies extreme thirst or unconscious prejudice.

LYMPHATICS: The patient has no tender lymph nodes.

GENITOURINARY: The patient has negative dysuria. Denies difficulty starting/stopping a stream of urine or incontinence.

HAEMATOLOGICAL: denies bruising, blood clots, or history of blood transfusions.

MUSCULOSKELETAL: The patient refutes redness and edema to muscles.

INTEGUMENTARY: Denies rash, hives, dry skin, lesions.

NEUROLOGICAL: The patient has no memory loss or confusion problems.

PSYCHIATRIC: The patient denies extreme sadness, mood fluctuations, or sleeplessness.

ALLERGIC: smoke from cigarettes, pollen.

OBJECTIVE

VITAL SIGNS: Temp 97.8 F, RR 32, HR 85, B/P 100/70, SpO2 100%, BMI 25.63 kg/m², Wt 70 lb , Ht 4.2″.

PHYSICAL EXAMINATION

GENERAL APPEARANCE: Vigilant, well-groomed female. No acute pains were detected. She is presentable.

HEENT: Normocephalic. Atraumatic. Eyes: PERRLA. NAOMI. No nystagmus bilateral, Pupils are equal, round, and sensitive to light reconciliation. Ears: Bilateral outer ears are normal—free from drainage. Nose: Sputum is midline. No alterations. It is symmetrical, and vessels expound in the mutual snout with transparent drainage.

NECK: Flexible and balanced. No tracheal variation. No goiter noted—no inflamed lymph node.

ABDOMEN: The patient has a gentle and non-tender flat belly. There was no inguinal found. No ascites were discovered.

RESPIRATORY: Normal

CARDIOVASCULAR: Denies chest pains, palpitations, extremity swelling, or chest stiffness.

GENITOURINARY: No wing, suprapubic sympathy, or CVA devotion.

SKIN: Skin looks hydrated and glowing.

MUSCULOSKELETAL: No joint malformation was noticed. Her spine aroused straight calibration without any curving.

NEUROLOGIC: No cerebellar signs or symptoms, no neural shortfall.

PSYCHIATRIC: Factual to time. Content and appropriate.

ASSESSMENT

DIFFERENTIAL DX:

Wellness Exam: ICD-10 CM Z00.129. A healthy female who came for a well exam. According to the American Academy of Pediatrics, surveillance should be done at each clinic visit for formal developmental screening.

Other nonmedicinal substance allergy status: ICD-10-CM Z91.048. Patient is allergic to smoke from cigarettes, and pollen, evidenced by patient verbalizing that she experiences sneezing, watering, itchy and red eyes

Dietary surveillance and counseling ICD-10-CM Z71.3 Healthy growth and development of a child are aided by nutritious meals. Following the CACFP, a child should be provided nutritious foods in appropriate portion sizes. The meals include fruits, diary, bread, grains, vegetables and meat or meat substitutes. In addition, the child should be taught about good dietary habits. Juices and sugary drinks should be avoided at all costs. It is important to urge them to drink milk and water.

 

FINAL DIAGNOSIS: Wellness: ICD-10-CM Z00.129

PLAN

CBC for overall wellness check

Annaul well exam to follow up on immunizations, development, and safety issues.

EDUCATION: the patient was advised to continue maintaining a healthy lifestyle, take in a lot of water, fruits, vegetable, whole grains, fat-free and low diary products. A good vriety of protein-rich food, healthy oils derived from fish and vegetables and (Goolamally et al., 2019). She was also advised to take food rich in calcium to help maintain strong bones. Educate the patient on the importance of having an adult oversee them at all times when swimming to avoid a drowning accident. Educate the mother to seek emergency medical attention if the child experience severe shortness of breath or any other symptoms of an exacerbated allergic response.

Follow up in a month to discuss dietary modifications that will help the child maintain a healthy weight and avoid obesity.

REFERRALS: None at this time

 

 

 

Reference

Goolamally, N., Hamid, S. A., Ramli, A. Z., & Rahim, R. A. (2019). Application of rasch model in measuring the quality of health and wellness final exam questions.

 

Week 11: Journal

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Week 11: Journal

 

 

 

 

 

 

Week 11: Journal

 

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Week 11: Journal

During the time frame under consideration, I’ve grown as a practitioner. It hasn’t been a time of total career development for me. For starters, I need some guidance in detecting clinical indications and symptoms of mental illness and distinguishing between pathophysiological and psychopathological problems, among other things. In order to improve my mental state evaluation competence and self-confidence, it’s abundantly evident to me as well as my diagnostic and psychotherapy treatment planning abilities. In this sector, I believe that these talents will be learned and strengthened via regular practice and investment of time, all of which is required for education.

I believe I’ve shown the ability to work ethically and legally within the bounds of my profession, to set and enforce professional limits, and to recognize and resolve ethical and legal difficulties. As significant as these milestones are, they are just a small part of the broader process of becoming the professional and practitioner that I aim to be. Aspiration and retaining my vision that this is a journey that does not take place quickly in the sense that without exerting any effort I will one day wake up becoming all that I want to be are of crucial significance to me. That’s not going to happen at all, period. Week 11: Journal

As a newbie, there are some areas where I need to focus my time and energy on learning the proper screening tools, making appropriate referrals, and documenting my findings. As a result, I’ve prioritized them as the areas in which I have the most room for improvement in my work life.

“difficult” patients in each of the three examples presented a problem since they resisted giving me with the knowledge, I required to accomplish my job. Once again, this is a skill that can be developed with time and practice, and I have faith that they will always tell me what I want to know if I know how to ask for it. No issue or flaw can be resolved unless it is recognized and accepted as such, I believe. To put it another way, I intend to put all of my resources, time and effort to improve these highlighted flaws and realizing that this is all part of the process of becoming the person I want to be in the future. To that end, I’m going to make a diagnosis and ask for input as soon as possible; I’m going to work hard to document every patient interaction accurately, again asking for input as soon as possible; and I’m going to learn more about medications, their mechanisms, and any possible contraindications so that I can better prescribe them.

Conclusions of a Systematic Review with Narrative Synthesis

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Conclusions of a Systematic Review with Narrative Synthesis

APPENDIX C

Appraisal Guide:

Conclusions of a Systematic Review  with Narrative Synthesis

Citation:

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____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Synopsis

What organization or persons produced the systematic review (SR)?

How many persons were involved in conducting the review?

What topic or question did the SR address?

How were potential research reports identified?

What determined if a study was included in the analysis?

How many studies were included in the review?

What research designs were used in the studies?

What were the consistent and important across-studies conclusions?

Credibility

Was the topic clearly defined?                                                   Yes   No   Not clear

Was the search for studies and other
evidence comprehensive and unbiased?                                     Yes   No   Not clear

Was the screening of citations for
inclusion based on explicit criteria?                                            Yes   No   Not clear

*Were the included studies assessed
for quality?                                                                                  Yes   No   Not clear

Were the design characteristics and
findings of the included studies displayed
or discussed in sufficient detail?                                                Yes   No   Not clear

*Was there a true integration (i.e., synthesis) of the findings—not
merely reporting of findings from
each study individually?                                                             Yes   No   Not clear

*Did the reviewers explore why differences
in findings might have occurred?                                               Yes   No   Not clear

Did the reviewers distinguish between
conclusions based on consistent findings
from several good studies and those
based on inferior evidence (number  or quality)?                       Yes   No   Not clear

Which conclusions were supported by
consistent findings from two or more
good or high-quality studies?                                                    List

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Are the conclusions
credible?                                                                             Yes All   Yes Some   No

Clinical Significance

*Across studies, is the size of the
treatment or the strength of the
association found or the
meaningfulness of qualitative findings
strong enough to make a difference
in patient outcomes or experiences  of care?                              Yes   No   Not clear

Are the conclusions relevant to the
care the nurse gives?                                                                   Yes   No   Not clear

Are the conclusions
clinically significant?                                            Yes All   Yes Some   No

Applicability

Does the SR address a problem,
situation, or decision we are addressing  in our setting?            Yes   No   Not clear

Are the patients in the studies or a
subgroup of patients in the studies
similar to those we see?                                                              Yes   No   Not clear

What changes, additions, training, or
purchases would be needed to implement
and sustain a clinical protocol based
on these conclusions?                                                                 Specify and list

____________________________________________________________________________

____________________________________________________________________________

Is what we will have to do to implement
the new protocol realistically achievable
by us (resources, capability, commitment)?                                Yes   No   Not clear

How will we know if our patients are
benefiting from our new protocol?                                            Specify

____________________________________________________________________________

____________________________________________________________________________

Are these conclusions
applicable to our setting?                                    Yes All   Yes Some   No

Should we proceed to design
a protocol incorporating
these conclusions?                                                      Yes All   Yes Some   No

* = Important criteria

Comments

____________________________________________________________________________

____________________________________________________________________________

Delegation – The Root of Practice

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Delegation – The Root of Practice

Delegation – The Root of Practice

Chapter 1a – Assignment

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SCENARIO

Nancy, a registered nurse, has recorded a telephone order from the attending physician to administer one unit of blood to Baby Robby, a pediatric patient. She delegates this order to a licensed professional nurse whose name is Kelly. Kelly has been with the hospital for several years and has just graduated LPN school. Kelly is known among the nurses as an assistant and unit secretary for many years and she is considered a very trustworthy nurse. Kelly also just finished an IV certification class but claims that she will document it on Monday since Human resources is not open, it being a weekend. Nancy sends Kelly to get the unit from the blood bank, hang the blood with saline and then administer it. After one hour it is time for the charge nurse to give report, she sends Kelly in to get the first set of vital signs and check on Robby. Since Nancy is also the charge nurse, she finds herself a little behind, so she has Kelly write a short note in the record and a set of vital signs. When Kelly checks on the patient she finds that Robby is lethargic and she immediately reports this to Nancy who then declares that she needs to write an incident report up and once she is finished giving report she does exactly that and then writes in the chart that an incident report has been filed with all the relevant facts listed. She then clocks out with the knowledge that she finished everything that needed to be done.

 

Instructions:

 

  1. Read through the scenario above carefully and list each mishap and violation of practice that you can detect. Explain whether it was:
  1. possibly something forgotten
  2. a violation of standard of practice
  3. a legal mishap
  4. an ethical violation
  5. a delegation problem
  6. or some other problem
  1. List each deviation from safe and legal practice.
  2. Explain what was done or not done.
  3. Your paper should be:
    • One (1) page
    • Typed according to APA style for margins, formatting, and spacing standards
    • Typed into a Microsoft Word document, save the file, and then upload the file
  4. Upload your file by clicking “Browse My Computer” for Attach File.

Family Nursing Module 1 assignment Overview

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Family Nursing Module 1 assignment Overview


Family Nursing Module 1 assignment
Overview

Discuss from your nursing experience an intervention you used with a family using each of the 4 types of approaches:

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  1. Family as Context
  • Focuses on the assessment and care of an individual patient in which the family is the context.
  • Traditional
  • Individual is in the foreground and the family is in the background
  • Family serves as context for the individual as a resource orstressor (so the family can be either anegative or positive context).
    An example of this would be in the care of children under 18.  Physician rounds are generally “family centered” and done with the focus on the patient, but with discussion with both the patient and the parents or caregivers.

** For the Approaches to Family Nursing Assignment, think of a time in your clinical practice or with your own particular family when one of the members of the family needed health care and other members of the family were involved in that person’s health care needs.  Explain who the family member in need of health care was, what was the condition of the family member, health problem, and health care needs.  What roles did each family member take in helping care for the individual family member?

  1. Family as Client
  • Assesses all family members
  • The nurse is interested in the way all the family members are individually affected by the health/hospitalization of one member of the family unit.
  • The family is in the foreground.
  • Focus is on every member of the family.

An example of could be when a beloved matriarch of the family gets a grave diagnosis, the nurse would ask the patient how her family was dealing with the diagnosis?  How are the members of your family adjusting to this news?  Will the care you will need be a problem for your family?

**For the Approaches to Family Nursing Assignment, think of a time in your clinical practice or with your own particular family when one family member suffered from a health care problem and as a result other members of the family developed health care needs.  Describe the health needs of all of the family members and the overall affects of the family members’ illness on the rest of the family.

  1. Family as System
  • The family as a whole is the patient.  The focus is on the individual and the family simultaneously.
  • Interactions between family members become the target for nursing interventions.
  • Emphasis is on the interactions between the family members.
  • Runs on the theory that when something happens to one part of the system, the other parts of the system are affected as well (if one member of the family becomes ill, then the other members of the family are affected as well).
    For example, when a child is diagnosed with cancer, the nurse may ask the father, what has changed between you and your wife since the diagnosis?  How has this devastating diagnosis affected this child’s siblings?

**For the Approaches to Family Nursing Assignment, describe how the family interacts with one another when one family member becomes ill.  Describe the types of interactions that occur such as one family member is in denial, one family member is crying and panicking, one family member becomes the caregiver, and so forth. Base your answer on your practice or your personal experience.

  1. Family as Component of Society
  • Looks at the family as a component of society.
  • The family as a whole interacts with other institutions to receive, exchange, or give communication or services.
  • This is a major aspect of Community Health nursing.
  • Examples of this may include suggesting a support group for a patient/family for their disease, or asking how “society” (those outside of their family) have reacted to their diagnosis.

**For the Approaches to Family Nursing Assignment, describe how one family used a variety of community resources to help them care for a family member who has become ill or who has been diagnosed with a health care problem.  What resources did the family use or seek? What were the results?  How effective were the healthcare resources for the family and the ill family member?  What problems were encountered when the family tried to obtain community resources? 

Objectives

  • Differentiate roles within a family
  • Discuss the role of the family healthcare nurse

Points: 40

Due Date: Sun, May 15 by 11:59 p.m. Eastern Standard Time (EST) of the US.

References

Minimum of three (3) total references: one (1) reference from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style

Unless otherwise specified, all the written assignment must follow APA 7th edition formatting, citations and references. Click here to download a Microsoft Word APA template. Review this annotated student sample paper guide which draws attention to relevant content and formatting in 7th edition APA style. Make sure you cross-reference the APA 7th edition book as well before submitting the assignment. Refer to the ‘LEARNER SUPPORT’ tab for more information regarding APA 7th edition with comparisons to 6th edition.

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

 

Overview

Discuss from your nursing experience an intervention you used with a family using each of the 4 types of approaches:

  1. Family as Context
  • Focuses on the assessment and care of an individual patient in which the family is the context.
  • Traditional
  • Individual is in the foreground and the family is in the background
  • Family serves as context for the individual as a resource orstressor (so the family can be either anegative or positive context).
    An example of this would be in the care of children under 18.  Physician rounds are generally “family centered” and done with the focus on the patient, but with discussion with both the patient and the parents or caregivers.

** For the Approaches to Family Nursing Assignment, think of a time in your clinical practice or with your own particular family when one of the members of the family needed health care and other members of the family were involved in that person’s health care needs.  Explain who the family member in need of health care was, what was the condition of the family member, health problem, and health care needs.  What roles did each family member take in helping care for the individual family member?

  1. Family as Client
  • Assesses all family members
  • The nurse is interested in the way all the family members are individually affected by the health/hospitalization of one member of the family unit.
  • The family is in the foreground.
  • Focus is on every member of the family.

An example of could be when a beloved matriarch of the family gets a grave diagnosis, the nurse would ask the patient how her family was dealing with the diagnosis?  How are the members of your family adjusting to this news?  Will the care you will need be a problem for your family?

**For the Approaches to Family Nursing Assignment, think of a time in your clinical practice or with your own particular family when one family member suffered from a health care problem and as a result other members of the family developed health care needs.  Describe the health needs of all of the family members and the overall affects of the family members’ illness on the rest of the family.

  1. Family as System
  • The family as a whole is the patient.  The focus is on the individual and the family simultaneously.
  • Interactions between family members become the target for nursing interventions.
  • Emphasis is on the interactions between the family members.
  • Runs on the theory that when something happens to one part of the system, the other parts of the system are affected as well (if one member of the family becomes ill, then the other members of the family are affected as well).
    For example, when a child is diagnosed with cancer, the nurse may ask the father, what has changed between you and your wife since the diagnosis?  How has this devastating diagnosis affected this child’s siblings?

**For the Approaches to Family Nursing Assignment, describe how the family interacts with one another when one family member becomes ill.  Describe the types of interactions that occur such as one family member is in denial, one family member is crying and panicking, one family member becomes the caregiver, and so forth. Base your answer on your practice or your personal experience.

  1. Family as Component of Society
  • Looks at the family as a component of society.
  • The family as a whole interacts with other institutions to receive, exchange, or give communication or services.
  • This is a major aspect of Community Health nursing.
  • Examples of this may include suggesting a support group for a patient/family for their disease, or asking how “society” (those outside of their family) have reacted to their diagnosis.

**For the Approaches to Family Nursing Assignment, describe how one family used a variety of community resources to help them care for a family member who has become ill or who has been diagnosed with a health care problem.  What resources did the family use or seek? What were the results?  How effective were the healthcare resources for the family and the ill family member?  What problems were encountered when the family tried to obtain community resources? 

Objectives

  • Differentiate roles within a family
  • Discuss the role of the family healthcare nurse

Points: 40

Due Date: Sun, May 15 by 11:59 p.m. Eastern Standard Time (EST) of the US.

References

Minimum of three (3) total references: one (1) reference from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style

Unless otherwise specified, all the written assignment must follow APA 7th edition formatting, citations and references. Click here to download a Microsoft Word APA template. Review this annotated student sample paper guide which draws attention to relevant content and formatting in 7th edition APA style. Make sure you cross-reference the APA 7th edition book as well before submitting the assignment. Refer to the ‘LEARNER SUPPORT’ tab for more information regarding APA 7th edition with comparisons to 6th edition.

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

 

PMHNP PRAC 6645 Clinical Skills Self-Assessment Form

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PMHNP PRAC 6645 Clinical Skills Self-Assessment Form

PMHNP PRAC 6645 Clinical Skills 

Self-Assessment Form

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Desired Clinical Skills for Students to Achieve Confident (Can complete independently) Mostly confident (Can complete with supervision) Beginning (Have performed with supervision or need supervision to feel confident) New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in: 
Recognizing clinical signs and symptoms of psychiatric illness across the lifespan   X    
Differentiating between pathophysiological and psychopathological conditions    X    
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)    X    
Performing and interpreting a mental status examination      X  
Performing and interpreting a psychosocial assessment and family psychiatric history      X  
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).   X    
Diagnostic reasoning skill in:
Developing and prioritizing a differential diagnoses list   X    
Formulating diagnoses according to DSM 5 based on assessment data    X    
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes   X    
Pharmacotherapeutic skills in:
Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management)      X  
Evaluating patient response and modify plan as necessary      X  
Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)   X    
Psychotherapeutic Treatment Planning:
Recognizes concepts of therapeutic modalities across the lifespan     X  
Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation)      X  
Applies age appropriate psychotherapeutic counseling techniques with individuals, families, and/or groups     X  
Develop an age appropriate individualized plan of care     X  
Provide psychoeducation to individuals, family, and/or groups     X  
Promote health and disease prevention techniques   X    
Self-Assessment skills:
Develop SMART goals for practicum experiences    X    
Evaluating outcomes of practicum goals and modify plan as necessary    X    
Documenting and reflecting on learning experiences   X    
Professional skills:
Maintains professional boundaries and therapeutic relationship with clients and staff X      
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings  X      
Identifies ethical and legal dilemmas with possible resolutions   X    
Demonstrates non-judgmental practice approach and empathy X      
Practices within scope of practice X      
Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation    X    
Implements the screening instrument efficiently and effectively with the clients   X    
Interprets results for screening instruments accurately   X    
Develops an appropriate plan of care based upon screening instruments response     X  
Identifies the need to refer to another specialty provider when applicable   X    
Accurately documents recommendations for psychiatric consultations when applicable   X    

 

Summary of strengths:

My foremost strength is professionalism. I definitely fathom my responsibility and I recognize how to uphold limitations with patients and colleagues. In my daily life I make it a practice not to judgment regardless of their situation. It is not hard to apply this habit in my professional practice.

 

 

 

 

 

 

 

 

Opportunities for growth:

My greatest opportunity for progress this quarter will be working with groups and families. This will be a new area in this semester. It will be remarkable how to traverse group and family dynamics while commerce with specific traits and interests.

 

 

 

 

 

 

 

 

 

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1.       Goal: I want to perform mental status exams on at various patients by the end of this practicum rotation.

a.       Objective: Comprehensive psychiatric evaluation skill

b.      Objective: Diagnostic Reasoning Skills

c.       Objective: Professional Skills

 

2.       Goal: I want to correctly identify clinical signs and symptoms to the corresponding mental illness for each patient that I see this quarter, as evidenced by acknowledging of practicum instructor.

a.       Objective: Comprehensive psychiatric evaluation

b.      Objective: Diagnostic Reasoning

c.       Objective: Shadow and participate in patient care

 

3.       Goal: Will complete 160 hours of clinical hours for this course as required.

a.       Objective: Arrive at the clinical site on time and well prepared.

b.      Objective: Enter patient information on Meditrek.

c.       Objective: Complete time log and patient information on a timely manner during practicum experience.

 

 

 

 

 

 

Signature:

Date: 3/1/22

Course/Section: NURS 6645 PRAC

Locating Sources: Library Activity

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Locating Sources: Library Activity

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Locating Sources

One of the most important aspects of your research is your ability to locate sources related to your topic.  Search the LIRN library and locate (3) publications related to a topic you are interested in researching. Type directly on this form, save it and submit it on c………………. by assignment deadline. The example provides should be used as a guide to complete this assignment. You will complete #1, #2, and #3 based on the publications you find in the College’s LIRN library.

 

Number Article Information: Be sure entries are presented in alphabetical order.
EXAMPLE What is the title of the article:  Education and Technology

What year was it published:  2014

List the author(s) by last name, first name:  Bean, John and Smith, Susan

What is the journal title:  Higher Education Today

What key words did you use to find the article:  education, technology, classes, distance education

What database did you use to find the article: Education

Summarize the publication: The article discussed the importance of integrating technology into the classroom setting……… (this section should be at least a paragraph long)
1.        What is the title of the article:

What year was it published:

List the author(s) by last name, first name:

What is the journal title:          

What key words did you use to find the article:

What database did you use to find the article:

 

Summarize the publication:

 
2.        What is the title of the article:

What year was it published:

List the author(s):

What is the journal title: 

What key words did you use to find the article:

What data base did you use to find the article:

Summarize the publication:
3.       

 

 What is the title of the article:

What year was it published:

List the author(s):

What is the journal title: 

What key words did you use to find the article:

What database did you use to find the article:

Summarize the publication:

 

PRAC 6665 Clinical Skills/ Self-Assessment

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PRAC 6665 Clinical Skills/ Self-Assessment

PRAC 6665 Clinical Skills/ Self-Assessment

 

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PRAC 6665/6675 Clinical Skills 

Self-Assessment Form

Performing a self-assessment of an individual’s clinical skills makes them able to increase their clinical performance during practical experience (Macfarlane, 2019). A self-assessment will be significant in the identification of strengths and areas for improvement. Therefore, conducting this self-assessment and setting goals and objectives will provide a guide to my practicum experience.

Desired Clinical Skills for Students to Achieve Confident (Can complete independently) Mostly confident (Can complete with supervision) Beginning (Have performed with supervision or needs supervision to feel confident) New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in: 
Recognizing clinical signs and symptoms of psychiatric illness across the lifespan ü      
Differentiating between pathophysiological and psychopathological conditions  ü      
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)  ü      
Performing and interpreting a mental status examination  ü      
Performing and interpreting a psychosocial assessment and family psychiatric history  ü      
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational). ü      
Diagnostic reasoning skill in:
Developing and prioritizing a differential diagnoses list ü      
Formulating diagnoses according to DSM 5 based on assessment data  ü      
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes ü      
Pharmacotherapeutic skills in:
Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management)    ü    
Evaluating patient response and modify plan as necessary  ü      
Documenting (e.g., adverse reaction, the patient response, changes to the plan of care) ü      
Psychotherapeutic Treatment Planning:
Recognizes concepts of therapeutic modalities across the lifespan   ü    
Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation)    ü    
Applies age appropriate psychotherapeutic counseling techniques with individuals and/or any caregivers ü      
Develop an age appropriate individualized plan of care ü      
Provide psychoeducation to individuals and/or any caregivers ü      
Promote health and disease prevention techniques ü      
Self-assessment skill:
Develop SMART goals for practicum experiences  ü      
Evaluating outcomes of practicum goals and modify plan as necessary  ü      
Documenting and reflecting on learning experiences ü      
Professional skills:
Maintains professional boundaries and therapeutic relationship with clients and staff ü      
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings    ü    
Identifies ethical and legal dilemmas with possible resolutions ü      
Demonstrates non-judgmental practice approach and empathy ü      
Practices within scope of practice ü      
Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation  ü      
Implements the screening instrument efficiently and effectively with the clients   ü    
Interprets results for screening instruments accurately ü      
Develops an appropriate plan of care based upon screening instruments response ü      
Identifies the need to refer to another specialty provider when applicable ü      
Accurately documents recommendations for psychiatric consultations when applicable ü      

 

Summary of strengths:

Communication. I have excellent written and verbal communication skills, which act as a core strength in any healthcare environment. Communication skills will enhance my ability to share information with other groups in the healthcare environment, such as doctors, nurses, and patients. The skills will also be significant while explaining to patients issues related to their diagnoses, test results, and the development of their treatment plans.

Attention to Detail. I am very attentive to details, and this gives me another significant strength that I can leverage in the practicum. Nurses interact with a large number of patients and other interprofessional teams on a daily basis. Therefore, being attentive to details will enable me to assess the accuracy and validity of each piece of information or activity in the healthcare environment. By so doing, I will be effective in inspiring positive quality in patient care.

Empathy. This is one of my core strengths, and it enables me to understand patients and their families and relate to them. It also helps me connect with these groups and help them cope with their problems. Using empathy, I can effectively comprehend and share the feelings of the patient and their loved ones and work towards making sure that they obtain optimal health outcomes (Buljac-Samardžić & van Woerkom, 2018).

Flexibility. Flexibility is a significant strength for every nurse or healthcare professional (Xie et al., 2020). There are usually rapid changes to the health care environment, and nurses need to be flexible to adapt quickly. Therefore, I will leverage this strength to effectively and efficiently manage changes in the healthcare environment.

 

Opportunities for growth:

Learning New Skills. The practical environment will help me to grow my skills by undertaking several assigned responsibilities. I plan to make sure that I do not limit myself to the routines and procedures in my area alone, but also interact with other interprofessional teams with the aim of enhancing my knowledge and skills.

Performing Research. While undertaking my responsibilities, I can also carry out research to improve my knowledge of my practice in these areas. I will be able to retrieve evidence-based information that I can utilize in my quest to achieve my clinical and professional goals and objectives (Wei et al., 2019). Conducting research is an opportunity to advance my knowledge and skills in various areas using the best available scientific literature.

Collaboration. I will also be presented with an opportunity to collaborate with other interprofessional teams while working in a healthcare environment. As Foster et al. (2018) explain, nursing is not an isolated practice. Therefore, I will collaborate with others to enhance my knowledge and skills while responding to patients’ needs. I will also seek advice and guidance from more experienced professionals to help advance my own practice.

 

 

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1.      Goal: To improve my skills in the selection and implementation of screening instruments and interpreting results.

a.       Objective: To accurately interpret results for the screening instruments.

b.      Objective: To properly implement screening instruments while providing care to patients.

c.       Objective: To properly document psychotherapy recommendations using data from the interpreted results.

 

2.      Goal: To improve my psychotherapeutic treatment planning skills.

a.       Objective: To independently and collaboratively create appropriate plans of care for clients.

b.      Objective: To successfully identify therapeutic modalities concepts.

c.       Objective: To successfully identify and utilize proposed evidence-based clinical practice guidelines in psychotherapeutic treatment planning.

 

3.      Goal: To improve my professional skills.

a.       Objective: To identify ethical and legal dilemmas and provide possible solutions.

b.      Objective: To successfully collaborate with other interprofessional teams in the healthcare environment.

c.       Objective: To successfully maintain professional boundaries with other professionals and with patients.

Conclusion

The self-assessment above, combined with the goals and objectives set, will act as effective guides during my practicum experience. Achieving these goals and objectives will significantly improve my clinical skills and performance. All the goals and objectives developed above are based on the areas that I plan to improve. In the end, the experience will positively impact my educational and clinical progress.

Signature:

Date:

Course/Section:

 

 

 

 

 

 

 

 

 

 

 

References

Buljac-Samardžić, M., & van Woerkom, M. (2018). Improving quality and safety of care in nursing homes by team support for strengths use: A survey study. Plos one, 13(7), e0200065.

Foster, K., Cuzzillo, C., & Furness, T. (2018). Strengthening mental health nurses’ resilience through a workplace resilience programme: A qualitative inquiry. Journal of psychiatric and mental health nursing, 25(5-6), 338-348.

Macfarlane, J. (2019). Exploring how awareness of character strengths can benefit mental health nurses. British Journal of Mental Health Nursing, 8(3), 145-152.

Wei, H., Roberts, P., Strickler, J., & Corbett, R. W. (2019). Nurse leaders’ strategies to foster nurse resilience. Journal of nursing management, 27(4), 681-687.

Xie, J., Liu, M., Zhong, Z., Zhang, Q., Zhou, J., Wang, L., … & Cheng, A. S. (2020). Relationships among character strengths, self-efficacy, social support, depression, and psychological well-being of hospital nurses. Asian Nursing Research, 14(3), 150-157.

 

South University Remediation Mastery Assignment

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South University Remediation Mastery Assignment

 

 

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South University Remediation Mastery Assignment

 

Identify 5 subject areas from The Role of the Advanced Practice Nurse that you have identified as a weakness in your learning.
1.the seven core competencies of APN 2. the four core roles of APN 3. the Hamrics model of advanced practice 4. impact of the role of APN on the quality of care and patients outcome 5. role of incongruity
Review the identified subject areas using your texts, evidence-based articles, and national practice guidelines. Provide an analysis of your readings which demonstrates an understanding of the areas you have identified as a weakness.
1.      Evidence based practice is one of the desired practices for APN. Their practice depends on 7 core competences ;

·         direct clinical practice,

·         expert coaching and advice, (COOKE et al., 2008)

·         consultation,

·         research skills,

·         clinical and professional leadership,

·         collaboration, and

·         ethical decision making(Thomas & Kleinpell, 2012)

 2. Unlike registered nurses APRNs are have had a graduate level of degree(Vega, 2021). They can assume four core roles;

·         certified nurse-midwife (CNM),

·         certified registered nurse anesthetist (CRNA), clinical nurse specialist (CNS), and(RegisteredNursing, 2021)

·         nurse practitioner (NP)

 3. Hamrics defined an integrative model that defines the different roles of APRN. This helps creates an understanding on the diverse functions of APRNs in health care. 4. With the rise in the prevalence of chronic illness and multimorbidity, there is need for acuity in care. APN workforce is greatly associated with quality care. The APN roles should be implemented at emergency and critical care areas for quality patient outcomes (Woo et al., 2017). Proper utilization of workforce reduces the high demand of health care services(Htay & Whitehead, 2021). 5. Role of incongruity describes intrarole conflict between skills and abilities and the role of APN (Hamric et al., 2013). Due to shortage of health care professionals, it is common for APNs to be given roles that they have not specialized in (Brykczynski, n.d.).
Provide a reference list (in proper APA format) of your resources used in the mastery process. Provide at least 2 references for each subject area.
Reference List

 

COOKE, L., GEMMILL, R., & GRANT, M. (2008). Advanced Practice Nurses Core Competencies. Clinical Nurse Specialist, 22(5), 218-225. https://doi.org/10.1097/01.nur.0000325366.15927.2d

 

Thomas, A., & Kleinpell, R. (2012). Nursing practice core competencies. Cdn.ymaws.com. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/npcorecomp

 Reference List

 

Vega, J. (2021). How Advanced Practice Nurses Are Part of the Medical Care Team. Verywell Health. Retrieved 1 May 2022, from https://www.verywellhealth.com/what-is-an-advanced-practice-nurse-3146085.

 

RegisteredNursing. (2021). Avanced Practice Registered Nurse (APRN). Registerednursing.org. https://www.registerednursing.org/aprn/#:~:text=According%20to%20the%20APRN%

 Reference List

 

COOKE, L., GEMMILL, R., & GRANT, M. (2008). Advanced Practice Nurses Core Competencies. Clinical Nurse Specialist, 22(5), 218-225. https://doi.org/10.1097/01.nur.0000325366.15927.2d

 

 

Hamric, A., O’Grady, E., Hanson, C., & Tracy, M. (2013). Advanced Practice Nursing. Google Books. https://books.google.co.ke/books?id=aafPeFGT6uoC&pg=PA90&lpg=PA90&dq=role+of+incongruity+in+APN&source=bl&ots=b5_p429HrD&sig=ACfU3U26D2zxZYK-Ng1d4rVPWA-2gmvTlw&hl=en&sa=X&ved=2ahUKEwj38IXB3b33AhUCSuUKHS1OBAEQ6AF6BAgCEAM#v=

 Reference List

 

Woo, B., Lee, J., & Tam, W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources For Health, 15(1). https://doi.org/10.1186/s12960-017-0237-9

 

Htay, M., & Whitehead, D. (2021). The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review. International Journal Of Nursing Studies Advances, 3, 100034. https://doi.org/10.1016/j.ijnsa.2021.100034

 Reference List

 

Brykczynski, K. Role Development of the Advanced Practice Nurse. Nurse Key. Retrieved 1 May 2022, from https://nursekey.com/role-development-of-the-advanced-practice-nurse/.

Hamric, A., O’Grady, E., Hanson, C., & Tracy, M. (2013). Advanced Practice Nursing. Google Books. https://books.google.co.ke/books?id=aafPeFGT6uoC&pg=PA90&lpg=PA90&dq=role+of+incongruity+in+APN&source=bl&ots=b5_p429HrD&sig=ACfU3U26D2zxZYK-Ng1d4rVPWA-2gmvTlw&hl=en&sa=X&ved=2ahUKEwj38IXB3b33AhUCSuUKHS1OBAEQ6AF6BAgCEAM#v=
Provide your progress to each weak area in The Role of the Advanced Practice Nurse by Day 6 and submit to the drop box.
         

 

         
 

2. Identify 5 subject areas from Nursing Theory that you have identified as a weakness in your learning.
1. Leininger’s Culture Care Theory 2. Hamrics intergrative model 3. Self-Care Deficit Nursing Theory. 4. expert practice domains 5. durnphy and winland brown circle of caring model
Review the identified subject areas using your texts, evidence-based articles, and national practice guidelines. Provide an analysis of your readings which demonstrates an understanding of the areas you have identified as a weakness.
1. According to Leininger’s Culture Care Theory there three main modes that guide them in providing appropriate and beneficial care (McFarland & Wehbe-Alamah, 2019). These modes are judgments, actions and decisions. this theory guides nurses in providing culturally congruent nursing care(Albougami, 2016). 2. the model defines the characteristics and responsibilities APRN. The three most important components are collaboration, evidenced based practice and leadership. Hamrics model highlights 7 core competencies. 3. This theory was developed by an American theorist Dorothea orem. According to this theory it is the role of a nurse to assist the patients to perform self-care activities (Khademian et al., 2020). 4. accountability and responsibility

Clinical expertise (Ericsson, 2009)

Inter-professional collaboration

Implementation of research into practice

Proper handling of medical information (Bathish, 2014)

 

 5. This is one of the first approaches to a synthesized practice. As new challenges continue emerging in health care there is need for nursing’s voice for effective management (Palardy & March, 2011). This model highlights the significance of nursing’s position in every therapeutic relationship.
Provide a reference list (in proper APA format) of your resources used in the mastery process. Provide at least 2 references for each subject area.
Reference List

 

McFarland, M., & Wehbe-Alamah, H. (2019). Leininger’s Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future. Journal Of Transcultural Nursing, 30(6), 540-557. https://doi.org/10.1177/1043659619867134

 

Albougami, A. (2016). Comparison of Four Cultural Competence Models in Transcultural Nursing: A Discussion Paper. International Archives Of Nursing And Health Care, 2(4). https://doi.org/10.23937/2469-5823/1510053

 Reference List

Hamric, A.,Hanson, C., Tracy, M., & O’Grady, E. (2014). Advanced Practice Nursing: An Integrative Approach. (5thed.). St. Louis: Sanders

COOKE, L., GEMMILL, R., & GRANT, M. (2008). Advanced Practice Nurses Core Competencies. Clinical Nurse Specialist, 22(5), 218-225. https://doi.org/10.1097/01.nur.0000325366.15927.2d

 

 Reference List

5 Nursing Theories for Nurse Educators. Norwich University Online. (2022). https://online.norwich.edu/academic-programs/resources/5-nursing-theories-for-nurse-educators.

 

Your Bibliography: Khademian, Z., Ara, F., & Gholamzadeh, S. (2020). The Effect of Self Care Education Based on Orem’s Nursing Theory on Quality of Life and Self-Efficacy in Patients with Hypertension: A Quasi-Experimental Study. Int J Community Based Nurs Midwifery., 8(2), 140–149. Retrieved 1 May 2022, from.

 Reference List

Ericsson, K. (2009). Deliberate Practice and the Acquisition and Maintenance of Expert Performance in Medicine and Related Domains. Academic Medicine, 79(Supplement), S70-S81. https://doi.org/10.1097/00001888-200410001-00022

Bathish, M. (2014). Deliberate Practice in Nursing. Deepblue.lib.umich.edu. https://deepblue.lib.umich.edu/bitstream/handle/2027.42/108734/mbathish_1.pdf;s

 

 Reference List

Dunphy, L.M. and Winland-Brown, J.E. (1998) The Circle of Caring: A Transformative Model of Advanced Practice Nursing. Clinical Excellence for Nurse Practitioners, 2, 241-247.

 

Palardy, L., & March, A. (2011). The Circle of Caring Model. Nursing Science Quarterly, 24(2), 120-125. https://doi.org/10.1177/0894318411399463
 

 

Provide your progress to each weak area in Nursing Theory by Day 6 and submit to the drop box.
         
Identify 5 subject areas from Advanced Pathophysiology that you have identified as a weakness in your learning.
1.gastric ulcers 2.asthma 3. depression 4. stroke prevention 5. HIV opportunistic infections
Review the identified subject areas using your texts, evidence-based articles, and national practice guidelines. Provide an analysis of your readings which demonstrates an understanding of the areas you have identified as a weakness.
1. Gastric ulcers are sores that develop in the inner lining of the stomach. This disorder affects more than two thirds of united states and is caused by different factors (Woolf & Rose, 2021). Their treatment and management depends on the cause of the sores (NHS, n.d.). 2. Asthma is one of the chronic lower respiratory infections (WHO, 2021). It is caused by different allergens and is characterized by chronic inflammation that impairs breathing (American Thoracic Society, 2020). 3. Depression is a common mental disorder affecting all ages especially the adolescents. It is characterized with extreme sadness, disturbed sleep, feeling guilty, lack of appetite and tiredness (WHO, 2017). If it is not managed the victim can commit suicide. 4. Stroke results from the severe vascular disorders. That is why prevention of vascular risk factors remains an extremely important in management and prevention of stroke (Kleindorfer et al., 2021). This include life style modification and adherence to medications (Sabih et al., 2022). 5. If Hiv is not well managed it progresses and becomes AIDs. AIDs is diagnosed when the CD4 count of a patient is below 200(CDC, 2021). Patients can live longer with HIV however opportunistic diseases hastens their death.
Provide a reference list (in proper APA format) of your resources used in the mastery process. Provide at least 2 references for each subject area.
Reference List

 

Woolf, A., & Rose, R. (2021). Gastric Ulcer. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK537128/.

NHS. Stomach ulcer. nhs.uk. https://www.nhs.uk/conditions/stomach-ulcer/#:~:text=Stomach%20ulcers%2C%20also%20known%20as,which%20are%20called

 Reference List

 

American Thoracic Society. (2020). What Is Asthma?. Thoracic.org. https://www.thoracic.org/patients/patient-resources/resources/asthma.pdf.

WHO. (2021). Asthma. Who.int. https://www.who.int/news-room/fact-sheets/detail/asthma.

 

 Reference List

 

WHO. (2017). Depression and Other Common Mental Disorders. Apps.who.int. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf.

NIH. (2020). Depression. Nimh.nih.gov. https://www.nimh.nih.gov/sites/default/files/documents/health/publications/depression/21-mh-8079-depression_0.pdf.

 

 Reference List

 

Kleindorfer, D., Towfighi, A., Chaturvedi, S., Cockroft, K., Gutierrez, J., & Lombardi-Hill, D. et al. (2021). 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke, 52(7). https://doi.org/10.1161/str.0000000000000375

 

Sabih, A., Tadi, P., & Kumar, A. (2022). Stroke Prevention. Statpearls.com. Retrieved 1 May 2022, from https://www.statpearls.com/articlelibrary/viewarticle/29556.

 Reference List

 

CDC. (2021). AIDS and opportunistic infections. cdc.gov. https://www.cdc.gov/hiv/basics/livingwithhiv/opportunisticinfections.html

Wingfield, T., & Wilkins, E. (2010). Opportunistic infections in HIV disease. British Journal Of Nursing, 19(10), 621-627. https://doi.org/10.12968/bjon.2010.19.10.93543

 

 

         
Provide your progress to each weak area in Advanced Pathophysiology by Day 6 and submit to the drop box.
         
Identify 5 subject areas from Health Policy and Health Promotion that you have identified as a weakness in your learning.
1. principles of health promotion 2.importance of health policies 3. health promotion approaches 4. strategies of health promotion 5. health insurance plan in united states
Review the identified subject areas using your texts, evidence-based articles, and national practice guidelines. Provide an analysis of your readings which demonstrates an understanding of the areas you have identified as a weakness.
1.      health promotion is dependent on five core principles;

·         participation and involvement in health (Grabowski et al., 2017)

·         health equity

·         competent action

·         having a positive perspective on health

·         setting goals/perspectives

 2. Health policies guide health-professionals on how daily operations are conducted. They act as the general plan for achieving desired outcomes. They communicate with employees on their roles and responsibilities (Leahy, 2021).  There are different policies in health. 3. Antonovsky’s describes 5 approaches to health promotion(Janssen et al., 2012);

·         Medical

·         behavioral change

·         educational

·         client-centred, and

·         societal change(Kumar & Preetha, 2012)

 4. Health promotion not only improves patient outcomes but it also increase their control of health (WHO, 2021). The goal of these strategies is to improve health and prevent illness. These strategies include creating a supportive environment, strengthen community action, reorient health services and develop personal skills (Kumar & Preetha, 2012). 5. United states still records the highest health disparity despite the many strategies to get rid of the huge gap (IOM, n.d.). Even though most people have insurances they do not equally benefit while those without health insurance have a challenge accessing quality care. Some of the benefits of health insurance are; ensuring broad access to care, serve as a financial security and ensuring there are quality clinicians in the hospitals (Dey & Bach, 2019).
Provide a reference list (in proper APA format) of your resources used in the mastery process. Provide at least 2 references for each subject area.
Reference List Reference List Reference List Reference List Reference List

 

 

Grabowski, D., Aagaard-Hansen, J., Willaing, I., & Jensen, B. (2017). Principled Promotion of Health: Implementing Five Guiding Health Promotion Principles for Research-Based Prevention and Management of Diabetes. Societies, 7(2), 10. https://doi.org/10.3390/soc7020010

Kumar, S., & Preetha, G. (2012). Health promotion: An effective tool for global health. Indian Journal Of Community Medicine, 37(1), 5. https://doi.org/10.4103/0970-0218.94009

 

  

National Research Council (US) Committee on Health Impact Assessment. (2011). Why We Need Health-Informed Policies and Decision-Making. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK83538/.

 

Leahy, T. (2021). The Importance Of Healthcare Policy And Procedures. PolicyMedical. https://www.policymedical.com/importance-healthcare-policy-and-procedures/.

  

Janssen, B., Van Regenmortel, T., & Abma, T. (2012). Balancing Risk Prevention and Health Promotion: Towards a Harmonizing Approach in Care for Older People in the Community. Health Care Analysis, 22(1), 82-102. https://doi.org/10.1007/s10728-011-0200-1

 

Kumar, S., & Preetha, G. (2012). Health promotion: An effective tool for global health. Indian Journal Of Community Medicine, 37(1), 5. https://doi.org/10.4103/0970-0218.94009

  

Kumar, S., & Preetha, G. (2012). Health promotion: An effective tool for global health. Indian Journal Of Community Medicine, 37(1), 5. https://doi.org/10.4103/0970-0218.94009

 

WHO. (2021). Health promotion. Who.int. https://www.who.int/health-topics/health-promotion#tab=tab_1.

 

  

Dey, P., & Bach, P. (2019). The 6 Functions of Health Insurance. JAMA, 321(13), 1242. https://doi.org/10.1001/jama.2019.2320

 

IOM, I. Effects of Health Insurance on Health. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK220636/.
Provide your progress to each weak area in Health Policy and Health Promotion by Day 6 and submit to the drop box.
         

 

Nursing homework help

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Nursing homework help

MDC3 -3

MAKE SURE TO ANSWER ALL THE FOLLOW CAREFULLY AND CORRECTLY  WITH CAREFUL UNDERSTANDING

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  1. Which of the following assessment findings are consistent with aortic regurgitation?

Atrial fibrillation

Systolic click

Pitting edema

Blowing decrescendo diastolic murmur

  1. The nurse receives an order to infuse heparin 1000 units/hr IV. The IV bag contains 25.000 units heparin in 500ml. D5W. Calculate the IV rate in ml/hr___ ( record as a whole number)
  2. The nurse is assessing a client with severe anemia. Which clinical manifestation does the nurse expect to see in this clients?

Dyspnea with activity

Hypertension

Bradycardia

Warm flushed skin

  1. A nurse is caring for a 19 year old male recently diagnosed with leukemia. Which of the following nursing interventions is appropriate for the client?

Strict hand hygiene to prevent infection

Fluid restriction

Low residual diet

Therapeutic phlebotomy

  1. The nurse assesses a client and documents the following findings edema 2+ bilateral ankles brown pigmentation of lower extremity skin aching pain of lower extremities when standing that resolves with elevation and 2+pedal pulses. What condition does the client likely have?

Deep vein thrombosis

Venous insufficiency

Peripheral arterial disease

Raynaud disease

  1. The nurse is caring for a 65 year old female who presented to the emergency department with shortness of breath and chest discomfort. The client has not been feeling well for the past few days and complains of a productive cough of blood tinged sputum. Laboratory an elevated brain natriuretic peptide (BNP) and chest x-ray reveals pulmonary congestion , Based on the assessment findings which of the following diagnosis are consistent with these findings?

Heart failure(left- sided)

Pulmonary embolism

Heart failure(right-sided)

Lung cancer

  1. A nurse is performing discharge teaching for a client who was recently diagnosed with heart failure. Which of the following should be included in the client and family teaching? (SATA)

Medication teaching

Low sodium diet

Fluid restriction

Weekly weight

Symptoms to report to the provider

  1. A 65 year old female presented to the emergency room with complaints of progressively worsening fatigue shortness of breath, and palpitations. Upon assessment heart rate is  150 beats per minute and irregular, and there is positive jugular vein distention heart tones reveal a high pitched holosystolic murmur. Which of the following disorders are consistent with these findings?

Mitral regurgitation

Mitral stenosis

Aortic regurgitation

Mitral valve prolapse

  1. Which of the following assessment findings is consistent with mitral valve prolapse?

Systolic click

Urinary frequency

Atrial fibrillation

Claudication

  1. The nurse is caring for four clients on a post surgical unit . The nurse understands that monitoring the client for which post operative complication takes priority?

Constipation

Nausea

Urinary retention

Pneumonia

  1. A nurse is caring for a client who was recently diagnosed with hemophilia. Which of the following laboratory tests is consistent with that diagnosis?

Decreased bleeding time

Prolonged activated partial thromboplastin time

Prolonged prothrombin time

Decreased platelet count

  1. A 78 year old female presented to the emergency department with shortness of breath. Her daughter is at the bedside and shares that the client has a history of heart failure. You place the client on the cardiac monitor and find that the client is in atrial fibrillation at rate of 180 beats per minute. Which of the following are your concerns regarding this rhythm?(SATA)

Potential for embolic event

Hypotension due to elevated heart rate

Worsening heart failure

Dizziness and light headedness

Cerebral edema

  1. Which of the following is the most common assessment finding related to autoimmune thrombocytopenic purpura?

Bruising

Fatigue

Confusion

Fever

  1. A client is receiving treatment for the diagnosis of hemophilia A. Which of the following is most appropriate to include in the assessment of the client?

Appetite

Urine output

Joint pain and bruising

Respiratory rate

  1. A nurse is caring for a client who recently underwent a heart transplant. Which of the following post operative nursing interventions is the priority?

Assess for signs and symptoms of rejection

Advanced diet as tolerated

Auscultated bowel sounds

Maintain strict bedrest

  1. A nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education?

Decrease fluid intake to no more than 1 liter per day

Wear support hose while awake

Diet  high in vitamin K intake

Resume normal activity

  1. The nurse knows that hemolytic reaction to blood transfusion occur most often within the —-first minutes of the infusion?

100

15

45

60

  1. The family of a neutropenic client reports that the client confused and is not acting right, What action by the nurse is the priority?

Ask the client about pain

Assess the client for infection

Delegate taking a set of vital signs

Look at todays laboratory results

  1. During hourly rounding the nurse enters a room where the client is unresponsive without a pulse. What is the nurses priority action?

Call the family

Begin ventilation at 1 breath every 6-8 seconds

Start chest compressions at a rate of 100-120 compression per minutes

Wait for the emergency response team for direction

  1. Which of the following assessment findings is a priority during a blood transfusion?

Chest pain

Headache

Joint pain

Fatigue

  1. A nurse is caring for a client with a history of an abdominal aortic aneurism. Which of the following assessment findings request immediate intervention?

Decreased urine output

Back pain

Nausea and vomiting

Absent peripheral pulses

  1. A nurse is caring for a client who has heart failure and a prescription for digoxin 125mcg PO daily . Available is digoxin PO 0.25mg/tablet. How many tablets should the nurse administer per dose? (round nearest tenth)
  2. A client admitted for sickle cell crisis is distraught after learning her child also has the disease. What response by the nurse is best?

Both you and the father are equally responsible for passing it on

I can see you are upset . I can stay here with you a while if you like

Its not your fault there is no way to know who will have this disease

There are many good treatments for sickle call disease these days

  1. A female client is being treated for a deep vein thrombus she developed post operatively about one week ago and was treated with unfractionated heparin, Today she presents to the clinic with petechiae on bilateral hands and feet. Laboratory results show a platelet count of 42, 000/mm3(42* 109/L). The nurse is concerned about a drug reaction and anticipates the client has which of the following?

Heparin induced thrombocytopenia(HIT)

Hemophilia A (classic hemophilia)

Thrombotic thrombocytopenic purpura(TTP)

Sickle call crisis

  1. The nurse educates the client on which of the following tests as the best tool for diagnosing heart failure?

Echocardiography

Pulmonary artery catheter

Radionuclide studies

Mitigated angiographic (MUGA) scan

  1. Which of the following nursing interventions would be appropriate for a client with sickle cell disease? (SATA)

Administer IV morphine

Keep the client strictly NPO

Remove restrictive clothing

Prepare the client for surgery

Provide a cool environment

  1. A nurse is caring for a client who was received in the emergency department with a heart rate of 220 beats per minute. The clients  cardiac monitor displays supraventricular tachycardia(SVT) . Which of the following interventions should the nurse anticipate?

Apply compression stockings

Check blood glucose

Draw labs

Vagal maneuver

  1. A nurse is caring for a client diagnosed with peripheral artery disease. Which of the following is a common assessment finding?

3+ pedal pulses

1+ pedal pulses

4+pedal pulses

Bounding pulses in all 4 extremities

  1. A nurse is planning a client for a client who is iron deficient. Which of the following foods high in iron should the nurse include in the plan?

Oranges

Cashews

Red meat

Yogurt

  1. A client states that their legs have pain with walking that decreases with rest. The nurse observes absence of hair on the clients lower extremities and the client has a thready weakened posterior tibial pulse. What would be the best position to have the clients legs?

Elevated on pillows

Crossed at the knee

Slightly bent with a pillow under the knees

Dependent position

  1. A client diagnosed with stable angina is complaining of substernal chest pain, rating the pain 5 out of 10 what would be the priority action by the nurse?

Administer nitroglycerin 1 table sublingual immediately

Administer 81 mg of aspirin immediately

Administer the clients prescribed beta blocker

Administer morphine

  1. A male client is presenting with radiating chest pain. Which of the following would the nurse recognize as indicators that an acute myocardial infarction may be occurring?(SATA)

Positive troponin markers

ST elevation on EKG on two contiguous leads

History of atherosclerosis

Pain radiating in jaw back shoulder or abdomen

Pain relieved with rest

  1. Which of the following is a common early assessment finding consistent with a diagnosis of hereditary hemochromatosis?

Flank pain

Fever

Hypoglycemia

Liver dysfunction

  1. Which of the following is a treatment option for a client with sickle cell disease?

Pain management with NSAIDs only

Arthrocentesis

NPO diet

IV fluid bolus

  1. Which of the following medications are appropriate for the treatment of heart failure?(SATA)

Antibitics

Diuretics

Digoxin

Bronchodilators

Angiotensin- converting enzyme(ACE) inhibitors

  1. Which of the following is a possible treatment plan for a client diagnosed with leukemia?

Therapeutic phlebotomy

Stem cell transplant

Splenectomy

Dialysis

  1. You are caring for a client who presented to the emergency department with pulmonary edema. The clients is hypotensive with a pulse oximeter reading of 85% on room air. Which of the following is a nursing priority?

Administer diuretics

Administer IV fluids

Administer oxygen

Obtain a chest X-ray

  1. The nurse is arriving at the beginning of her shift and taken report on four clients on a medical surgical unit. Which client should the nurse see first?

A client with pyelonephritis with nausea and vomiting

A client post total abdominal hysterectomy with 9/10 abdominal pain

A client with chronic obstructive pulmonary disease with an oxygen saturation of 89% on room air.

A client post prostatectomy with bright red blood and clots in his catheter

  1. Which of the following interventions should be included in the nutrition care plan of the client with atherosclerosis?

Increase saturated fats

Increase daily intake of vegetables fruits and whole grains

Limit sodium intake to 6 g per day

Increase full fat dairy products

  1. Which of the following is a treatment option for a client with infective endocarditis?

Antimicrobials

Antihypertensives

Diet modification

Bedrest

  1. A nurse is caring for a client recently diagnosed with pericarditis which of the following is a common assessment finding with this disorders?

ST segment depression

Pericardial friction rub

Elevated troponin

Heart failure

  1. A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client should the nurse see first?

Client with a blood pressure of 180/98mm Hg

Client who reports shortness of breath

Client who reports calf tenderness and swelling

Client with a swollen and painful left great toe

  1. A nurse sets an infusion pump to infuse 1 L of D5NS at the rate of 100 ml/hr.

How many hours will it take to complete the infusion? __ hours (record whole number)

  1. Which of the following is the priority nursing intervention for a client experiencing a transfusion reaction?

Stop transfusion immediately

Notify the provider

Flush the IV Line

Check vital signs

  1. The nurse knows which of the following is the most common problem for a client with valvular heart disease?

Decreased cardiac output

Difficulty coping

Bradycardia

Altered body image

  1. A nurse is caring for a 65 year old male who recently underwent an aortic valve replacement. Which of the following is a post operative nursing care priority?

Temperature monitoring

Advance diet as tolerated

Assess for bleeding

Dressing change

  1. A nurse is caring for a client recently diagnosed with hypertension. Which of the following should be included in the discharge teaching?

Only check your blood pressure at a clinic or pharmacy

Diet changes are not recommended

Decrease physical activity to avoid spikes in blood pressure

Adhere to prescribed  medications

  1. The nurse is discharging home a client at risk for venous thromboembolism on enoxaparin sodium. What instruction is a priority for the nurse to provide to this client?

Notify your health care provider if your stools appear  dark or tarry

Massage the injection site after the heparin is injected

You must have your PT/INR checked every 2 weeks

You must have you’re a PTT checked every 72 hours

  1. A nurse is caring for a client who presented to the emergency department with complaints of fatigue. Palpitations and chest pain . Upon assessment the provider notes an S3 and S4 gallop. Weak peripheral pulses and tachycardia. The provider orders a chest x-ray and echocardiogram. Which reveals left ventricular dilation. Which of the following disorders is consistent with these findings?

Dilated cardiomyopathy

Restrictive cardiomyopathy

Pericarditis

Cardiac tamponade

  1. A nurse is providing discharge teaching to a client who recently underwent a mechanical valve replacement which of the following statement by the client indicates the clients correct understanding of the discharge teaching regarding warfarin anticoagulant therapy?

I do not need to take my prescribed medication for the rest of my life

Additional monitoring is not required while on the anticoagulant

I can lead a normal life while on anticoagulants no restrictions are required

I may need to modify my diet while on this medication

  1. Which of the following procedures are performed for a client with a pericardial effusion?

Coronary artery bypass graft

Thoracotomy

Pericardiocentesis

Thoracentesis

  1. Which of the following is the treatment of choice for end stage heart failure?

Heart transplant

Coronary artery bypass grafting

Percutaneous angiogram

Medications

  1. A nurse are caring for a client diagnosed with atherosclerosis. Which of the following is considered a risk factor for the development of the disorder?

High HDL-C/ Low LDL- C

Vegan diet

Low HDL C/High LDL-C

Diet high in vitamin K

  1. Which of the following medications are utilized to treat peripheral artery disease(PAD)?

Antiplatelet drugs

Antibiotics

Nitroglycerin

Diuretics

  1. Which of the following client is most at risk for developing endocarditis?

A client who recently underwent a valve replacement

A client with Marfans syndrome

A client recently diagnosed with mitral stenosis

A client who recently had a valve replacement and had dental work recently performed

  1. A nurse is caring for a client who was recently diagnosed with left ventricular heart failure what is an early sign the client is most likely to report?

Abdominal distention

Weight gain

Swollen legs

Nocturnal coughing

  1. A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia PH 7;51 PaCO2 28mm Hg PaO2 70 mmHg and HCO2 24 mEq/L. What do these values indicates?

Metabolic acidosis

Respiratory alkalosis

Respiratory acidosis

Metabolic alkalosis

  1. You are providing care to a client with pericarditis. If left untreated which of the following is the client at risk of developing?

Cardiac tamponade

Pneumonia

Pulmonary embolism

Deep vein thrombosis

  1. A nurse is caring for a client recently diagnosed with leukemia. Which of the following signs and symptoms are consistent with this diagnosis?(SATA)

Bleeding gums

Bone pain

Weight gain

Increased urination

Fatigue

  1. A 65 year old male client is brought via EMS to the emergency department with chest pain , He  rates the pain as a 10 on a scale from 0-10 the pain is located mid-sternum and  radiates to his left arm, His heart rate is 126 bpm and  blood pressure is 96/60 mm Hg A 12 lead  electrocardiogram is performed and reveals ST segment elevation. Which of the  following interventions does the nurse anticipate performing immediately?(SATA)

Administer oxygen

Administer nitroglycerin

Administer a beta blocker

Administer morphine

Administer a statin

  1. The client is admitted for heart failure and has edema neck vein distension and ascites. What is the most accurate way to monitor fluid gain or loss in this client?

Check for pitting edema in the dependent body parts

Auscultate the lungs for crackles or wheezing

Assess skin turgor and the condition of mucus membranes

Weigh the client daily at the same time with the same scale

  1. When educating a female client on the signs and symptoms of myocardial infarction the nurse recognizes that which of the following should be included in the teaching?

Pain usually resolves with rest and relaxation

Women often present with a typical sign and symptoms

Substernal chest pain is the most common symptom in women

Women experience intermittent claudication

  1. The nurse questions which order for a client with thrombocytopenia?

Avoid IM injections

Administer enemas

Apply ice to areas of trauma

Test all urine and stool for the presence of occult blood

  1. The nurse is caring for a 55 year old male who presented to his primary physicians office for his yearly check up. Upon the physical assessment the provider noted enlarged lymph nodes in the groin and neck region. The provider questioned joe regarding the possible causes of the findings. Which of the following diagnosis are consistent with this finding?

Lymphoma

Sickle cell anemia

Leukemia

Polycythemia vera

  1. A nurse cares for a client who has a nasogastric tube attached to low suction because of a suspected bowel obstruction. Which of the following arterial blood gas results might be expected in this client?

pH 7.52 PCO2 54 mmHg

pH 7.42 PCO2 40 mmHg

pH &.25 PCO2 25 mm Hg

pH 7.38 PCO2 36 mm Hg

  1. Which of the following is a pharmacologic treatment option for a client with dilated cardiomyopathy? (SATA)

Diuretics

Sodium tablets

Digoxin

Phentermine

Anticholinergic

  1. The nurse is reviewing laboratory values for a client which of the following lab values should the nurse address immediately?

Creatinine 6.2mg/dl

Phosphorus 5.1mg/dl

Potassium 5.9mmo/L

Sodium 147 mEq/L

  1. The nurse is caring for a client with mitral regurgitation which of the following would you anticipate the client to develop if left untreated?

Myocardial ischemia

Left sided heart failure

Right sided heart failure

Renal failure

  1. A nurse is caring for four clients with leukemia after hand off report which client should the nurse see first?

Client who had two bloody diarrhea stools this morning

Client who has been premedicated for nausea prior to chemotherapy

Client with a respiratory rate change from 15 to 20 breaths /min

Client with an unchanged lesion to the lower right lateral malleolus

  1. The nurse is arriving at the beginning of her shift and has taken report on four clients on a medical surgical unit. Which client should the nurse see first?

A client with hypertension with blood pressure of 172/92mm Hg

A client with a history of asthma complaining of increased dyspnea

A client ready for discharge education after treatment of an acute kidney injury

A client with pain that is two days post operative from a prostatectomy

  1. A hospitalized client has a platelet count of 58, 00/mm3 (58*109/L) what action by the nurse is best?

Encourage high protein foods

Institute neutropenic precautions

Limit visitors to healthy adults

Apply ice to bruises or sites of injury

  1. Which of the following clients would not be a candidate for thrombolytic therapy?

Client with a blood pressure of 100. 60 mm Hg

Client with a pulse of 102 beats/minute

Client with a history of hemorrhage stroke one month ago

Client age 65

  1. Which of the following would predispose a client to mitral stenosis?

Obesity

Rheumatic fever

Diabetes

IV drug use

  1. Missing
  2. Which of the following is a priority nursing intervention for a client in atrial fibrillation with a rate of 180 beats per minute?

Apply compression stockings

Administer anticoagulants

Administer medication to slow that rate

Monitor urine output