BSC 2347 Human Anatomy and Physiology II Assignments and Discussions

The incidence rate of Hepatitis C infection, the most common blood-borne infection in the United States, has more than doubled since 2004 (Zibbell, 2018). The opioid crisis in the U.S. has largely contributed to this increase because shared needles among injection drug users is the primary factor in hepatitis C transmission.

Needle exchange programs allow drug users to safely exchange used needles for little or no cost. As of 2011, 211 needle exchange programs existed in the United States (Green, 2012) and many more have been implemented since then.

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In your post, address the following questions:

Are needle exchange programs effective at reducing blood-borne disease transmission?

Should more state or federal government agencies set up needle exchange facilities to help combat blood borne diseases or do they encourage the use of drugs? BSC 2347 Human Anatomy and Physiology II Assignments and Discussions

Is there a better method to help combat blood borne diseases contracted through shared needles?

References

Zibbell, J. E., Asher, A. K., Patel, R. C., Kupronis, B., Iqbal, K., Ward, J. W., & Holtzman, D. (2018). Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014. American Journal of Public Health, 108(2), 175-181.

Green, T. C., Martin, E. G., Bowman, S. E., Mann, M. R., & Beletsky, L. (2012). Life After the Ban: An Assessment of US Syringe Exchange Programs’ Attitudes About and Early Experiences With Federal Funding. American Journal of Public Health, 102(5), e9-e16. doi:10.2105/AJPH.2011.300595

BSC2347 Human Anatomy and Physiology II

Module 02 Discussion

Heart Disease

According to the Center for Disease Control and Prevention (2015), cardiovascular disease (CVD) is the leading cause of deaths in the United States, equating to about 1 in every 4 deaths, even though CVD is largely preventable. Recently, various studies have shown promise with stem cell therapy treating heart disease.

Research stem cell therapy in the treatment of heart disease and the possible promises it has as a therapy. In your post, address the following questions.

Should science and healthcare professionals pursue this a treatment option for heart disease? Why or why not?

What obstacles and issues would scientists need to overcome in order for stem cell therapy to become a mainstream treatment for heart disease? BSC 2347 Human Anatomy and Physiology II Assignments and Discussions

Which types of CVD could be treated with stem cell therapy?

What kind of financial/societal impacts would stem cell therapy have on the healthcare system?

Reference

CDC. (2015). Division for Heart Disease and Stroke Prevention. Retrieved from https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_disease.htm

Please make your initial post by midweek, and respond to at least one other student’s post by the end of the week. Please check the Course Calendar for specific due dates.

BSC2347 Human Anatomy and Physiology II

Module 03 Discussion

Blood Pressure

Hypercholesterolemia (high cholesterol levels in the blood) is associated with various cardiovascular diseases such as atherosclerosis, stroke, and myocardial infarction. Research how hypercholesterolemia develops, as well as its complications.

A common treatment for hypercholesterolemia is a class of drugs called statins. In your post, address the following questions:

Are statins the best course of treatment for hypercholesterolemia in adults? Why or why not?

Should they be prescribed to adults with hypercholesterolemia with no evidence of heart disease?

Should teenagers be prescribed statins if they are diagnosed with hypercholesterolemia? Why or why not?

Is there a better solution for these situations?

BSC2347 Human Anatomy and Physiology II

Module 04 Discussion

Vaccines & Science

The creation and implementation of vaccinations is one of healthcare’s greatest achievements. Vaccinations have saved countless lives and prevented the development of debilitating and life-threatening diseases such as polio, rubella, mumps, pertussis, and measles.

Despite the success and benefits vaccinations bring to public health, there has been a growing anti-vaccination trend with claims that vaccinations are dangerous and/or unnecessary. Research the claims and concerns anti-vaccination groups have and determine if there is any scientific validity to this information. Also, research current scientific literature on vaccinations and their overall benefits/risks to public health. Remember to use valid and credible references.

As an individual entering into a healthcare profession, you will need to be able to interact with patients about this issue. In your post, address the following questions:

How would you address a patient’s concerns, fears, and/or worries about vaccinations?

What scientific research would you utilize in your conversations about the benefits and need for vaccinations?

BSC2347 Human Anatomy and Physiology II

Module 05 Discussion

T21

According to the CDC, smoking “leads to disease and disability and harms nearly every organ of the body” and “costs the United States billions of dollars each year” (CDC, 2018). In response to these statistics and other research, states and cities across the United States are passing laws to raise the minimum age to purchase tobacco products from 18 years of age to 21.

Perform research on the short-term and long-term effects that tobacco products have on teenagers and adults, along with the impact smoking and tobacco related products have on the healthcare system.

After your research, address the following questions in your post:

Do you think more states and cities should adopt laws and policies to raise the minimum age to purchase tobacco products from 18 years of age to 21?

Do these laws infringe on civil liberties and individual personal freedom?

What else could be done to help prevent teenagers and adults from smoking?

Reference

CDC. (2018). Smoking & Tobacco Use. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm

BSC2347 Human Anatomy and Physiology II

Module 06 Discussion

Are GM Foods more Nutritious?

Due to consumer demand, there is a growing trend in the United States for food companies to have their foods be verified to contain no GM (genetically modified) products or ingredients. Research the use of GM foods and plants within our food supply, including their pros and cons, primary use, and any possible health issues related to them.

In your post, address the following questions:

Are there advantages to the use of GM foods?

Is there a justifiable fear to consuming GM foods/ingredients within our diets or are consumers overreacting? Why or why not?

Are organic foods more nutritious and safer compared to GM foods? Why or why not?

After your research, will you change your dietary and food purchasing choices?

BSC2347 Human Anatomy and Physiology II

Module 07 Discussion

Dialysis Safety

Hemodialysis (also known as “dialysis”) is a common treatment for patients with kidney disease. In the United States, more than 468,000 patients are on dialysis (NIH, 2018). Since 1993, hospitalization rates related to the process of dialysis has risen between 47-87% (CDC, 2018).

Many patients seek dialysis care at outpatient facilities that are not inspected as frequently as other healthcare facilities, like nursing homes and hospitals. For example, in California, kidney dialysis clinics are only inspected on average once every six years.

In your post, address the following questions:

Should kidney dialysis centers be held to the same safety standards as other healthcare facilities?

Are current regulations for dialysis centers strong enough? BSC 2347 Human Anatomy and Physiology II Assignments and Discussions

Should more frequent inspections be required?

Are there other ways to reduce the risk of infection for dialysis patients?

References

NIH. (2018). Kidney Disease Statistics for the United States. Retrieved from https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease

CDC. (2018). Tracking Infections in Outpatients Dialysis Facilities. Retrieved from https://www.cdc.gov/nhsn/dialysis/index.html

BSC2347 Human Anatomy and Physiology II

Module 08 Discussion

Energy Drinks

Consumption of energy drinks (such as Redbull®, Monster Energy Drink®, and Rockstar®) among children, teenagers, and young adults has risen in the last decade. Emergency department visits relating to energy drink consumption has also risen (Thorlton, 2014). These drinks contain various vitamins and electrolytes, and other ingredients that alter the body’s fluid balance.

Research the effects these energy drinks have on the body and the complications associated with them. In your post, address the following questions:

How do energy drinks influence the overall electrolyte and acid-base balance of the body?

Should this multi-billion dollar industry be more highly regulated? Why or why not?

Should energy drink companies be allowed to market these products to children? Why or why not?

Should it be illegal to sell them to anyone under the age of 16? Why or why not?

Should these drinks have a warning label on them? Why or why not?

Reference

Thorlton, J., Colby, D. A., & Devine, P. (2014). Proposed actions for the US Food and Drug Administration to implement to minimize adverse effects associated with energy drink consumption. American Journal of Public Health, 104(7), 1175-1180. doi:10.2105/AJPH.2014.301967

BSC2347 Human Anatomy and Physiology II

Module 09 Discussion

Birth Control

Thanks to the Affordable Care Act, most forms of birth control are now covered by health insurance with no out-of-pocket costs, but there are limitations. Research the various methods/techniques of birth control and find statistical data on unplanned pregnancies across the United States and within your state.

In your post, address the following questions:

Are you surprised by the pregnancy rates within the United States and your state? Why or why not?

Should birth control products be free to anyone who wants to use it?

Should birth control products, such as condoms, birth control pills and patches, be readily available for teenagers without a parent’s knowledge or consent? Why or why not? If so, at what age?

BSC2347 Human Anatomy and Physiology II

Module 10 Discussion

End of Life Care

The right-to-die is a concept stating that a patient with terminal illness should have the choice to voluntarily end his or her life. Some see this as a humane way to die with dignity, while others condemn this idea.

Patients in the entire United States can currently choose to refuse life-saving or life-extending treatments through an advanced directive, but only a handful of states allow physician-assisted suicide. Each of these states have enacted slightly different laws, but most allow physicians to prescribe a lethal medication that a patient self-administers. Address the following questions in your post.

In your opinion, should competent adults have the right to choose physician-assisted suicide?

Should physician-assisted suicide be legal in every state?

How should we define the term “terminal illness?”

Is physician-assisted suicide ethically different than a patient refusing treatment?

Is it ethical to allow patients to suffer if they wish to end their life?

BSC2347 Human Anatomy and Physiology II

Module 11 Discussion

Self-Assessment and Reflection

You made it! You’re finishing up a difficult series of A&P courses! Take a moment and reflect on how much your knowledge of human anatomy and physiology has improved.

In your post, address the following questions:

How will your increased knowledge of anatomy and physiology impact your chosen career?

Did these courses improve your ability to think critically about patient scenarios?

Is critical thinking important within your professional field?

BSC2347 Human Anatomy and Physiology II

Module 01 Case Study

Question 1

Jasper is a 7-year-old boy who has had flu-like symptoms for several weeks. It was mild at first, but his parents notice that he has been getting worse. They took him to his pediatrician last week, but he was sent home with suggestions to use OTC medication to treat his symptoms while his body recovered from what appeared to be a mild infection. Jasper appears weak, has lost 3-4 pounds in the last month, and has been complaining of headaches. Jasper’s parents have now brought him back to the clinic and another physician orders a CBC.

What is a CBC? In your own words, briefly describe why it is useful.

Question 2

The physician suspects that Jasper may have leukemia. Which of the lab results most likely lead the physician to this conclusion?

Question 3

Jasper exhibits many symptoms that could relate to a diagnosis of leukemia. List and briefly explain 2 other symptoms of leukemia that are NOT mentioned in this case study.

Question 4

Because of Jasper’s age, which type of leukemia is the most likely?

Question 5

If Jasper has ALL, which of the following lab results is most likely?

Module 2 Case Study

Question 1

Rashidah is a 55-year-old female who is experiencing acute chest pain and shortness of breath. She describes the pain as “pressure and squeezing.” When she becomes nauseous and light-headed, her son insists that he take her to the emergency room.

Health History: She started smoking when she was 18, attempted to quit several times in her 40s, and had her last cigarette on her 50th birthday. She has been overweight for most of her adult life, but has gained 20 pounds in the last few years, which increased her BMI to 34. The last time she had a physical exam was when she turned 50. Her vital signs and blood test results from that exam are listed below.

BP: 178/90

HDL: 62 mg/dl

LDL: 190 mg/dl

Triglycerides: 174 mg/dl

Total cholesterol: 252 mg/dl

Fasting blood glucose: 128 mg/dl

Which of these statements is most likely ?

Answers:

Rashidah is experiencing a stroke.

If Rashidah’s symptoms persist even when she rests, she is experiencing angina.

Rashidah is likely experiencing a myocardial infarction.

Since Rashidah’s symptoms are acute, she is likely suffering from a respiratory disorder.

Question 2

In the emergency room, multiple tests are performed. Which of these results would confirm myocardial damage?

Answers:

Decrease myoglobin

Elevated troponin and creatine kinase

Elevated blood glucose levels

Increase in WBC count

Question 3

Which of Rashidah’s physical exam lab test results was within normal limits for her age and sex?

Answers:

HDL

LDL

Total cholesterol

Fasting blood glucose

Question 4

Given her last physical exam results, Rashidah’s physician believes she has likely had undiagnosed atherosclerosis for years. Briefly describe the pathophysiology of atherosclerosis.

Question 5

Rashidah’s most recent Body Mass Index indicates that she is:

Answers:

Underweight

Healthy

Overweight

Obese

BSC2347 Human Anatomy and Physiology II

Module 03 Case Study

Question 1

Bonnie, a 52-year-old female, has been having some mild pain in her legs recently and is not sure if she should be concerned about it. She decides to visit her primary care physician since the pain isn’t going away. Bonnie tells her physician that the pain feels like a “general soreness or ache” and seems to be worse on the left side. Her physician notes that the left lower leg seems slightly swollen when compared to the right and feels slightly warmer than the right leg.

Bonnie has a history of smoking (1-2 packs/week in her 20s and 30s). She has a BMI of 29. She travels often to see her family that lives across the country. The only medication she has ever taken regularly was oral contraceptives. Now that she is peri-menopausal, she has been treating her symptoms with hormone replacement therapy.

Which of these statements is most likely ?

Answers:

Bonnie has deep vein thrombosis.

Bonnie’s leg pain is likely caused by shin splints.

Bonnie is likely experiencing osteoarthritis.

Bonnie is experiencing symptoms relating to peripheral neuropathy.

Question 2

Bonnie’s physician suspects DVT. Which of the following procedures would likely be used to diagnose this condition?

Answers:

Ultrasound

Blood glucose test

X-ray

Arteriogram

Question 3

Briefly define “thrombus” in your own words.

Question 4

Many of the symptoms Bonnie is experiencing could be related to cardiovascular issues, like DVT. Which of the following symptoms would also relate to that diagnosis?

Answers:

Cold extremities

Red or discolored skin on her legs

Numbness in her hands and fingers

Numbness following the S1 dermatome

Question 5

How does Bonnie’s frequent traveling relate to her diagnosis? Briefly explain this in your own words.

BSC2347 Human Anatomy and Physiology II

Module 04 Case Study

Question 1

Zane, a 26-year-old male, came upon a car accident and immediately started to help the victims, who were pinned in their car. There was blood all over the scene and Zane acted without having any personal protective equipment. While helping the victims, he cut his arms in several places on the sharp metal and shards of glass. A few weeks later, he developed flu-like symptoms that persisted for several days. He went to his clinic and tested negative for influenza.

Because of his recent exposure, Zane’s doctor was suspicious of blood borne pathogens. Which of the following disorders are blood-borne diseases?

Answers:

HIV infection

Hepatitis A

Cirrhosis

Leukemia

Question 2

Lab tests confirm the presence of HIV antibodies in Zane’s blood. Briefly describe why there are antibodies present.

Question 3

Briefly define “autoimmunity” and “immunodeficiency” in your own words. Which of these conditions is Zane more likely to develop?

Question 4

During the primary HIV infection, which of the following cells decreases in number?

Answers:

T-cells

B-cells

Natural killer cells

Phagocytes

Question 5

Which of the following statements is ?

Answers:

HIV typically causes AIDs within the first year of exposure.

AIDs is caused by depletion of B-cells.

The cause of death for a patient with AIDS is usually an opportunistic infection.

HIV is treated with antibiotics.

BSC2347 Human Anatomy and Physiology II

Module 05 Midterm Exam

• Question 1

What is of cellular immunity?

• Question 2

What is NOT about the breathing process?

• Question 3

What term best describes the normal amount of air that is brought into and out of the lungs during quiet or resting breathing?

• Question 4

What portion of the EKG wave pertains ventricles contracting during the cardiac cycle?

• Question 5

What term best describes the amount of air expelled from the lungs after a maximum inspiratory effort?

BSC2347 Human Anatomy and Physiology II

Module 06 Case Study

Question 1

Maria, a 66-year-old female, visits her physician complaining of sudden onset abdominal pain, nausea, and diarrhea. She does not take any prescription medications, but does take aspirin each day to lower her risk of heart disease. She has no notable history of digestive system issues. Maria has a family history of pancreatitis. She is slightly obese and has been mostly sedentary since her recent retirement. Her doctor performs multiple tests and diagnoses Maria with diverticulitis.

Diverticulitis affects which digestive organ?

Answers:

Large intestine

Small intestine

Stomach

Liver

Question 2

Briefly explain, in your own words, the anatomy of diverticula. Include information about the layers of the alimentary canal.

Question 3

Diverticula may be asymptomatic for years or for a lifetime. Describe, in your own words, why diverticula may cause sudden pain.

Question 4

In addition to the symptoms Maria reported, which of these symptoms is commonly related to diverticulitis?

Answers:

Pain in the upper right quadrant

Pain in the upper left quadrant

Constipation

Vomiting

Question 5

Which part of Maria’s history is NOT a risk factor for diverticulitis?

Answers:

Aspirin regimen

Obesity

Sedentary lifestyle

Family history of pancreatitis

Module 07 Case Study

Question 1

Kelly is a 36-year-old female who has a history of type 2 diabetes, several respiratory infections as a child, and two full-term pregnancies (5 and 7 years ago). Two days ago, she began feeling a burning sensation when urinating. Her pain is progressively getting worse. Kelly assumes that she has a urinary tract infection (UTI) and makes an appointment at her primary clinic to seek relief.

A urinary tract infection could affect all of the following organs, except:

Answers:

Spleen

Kidneys

Bladder

Urethra

Question 2

Kelly’s physician orders a urinalysis. If she has a UTI, which of the following will most likely be abnormal?

Answers:

pH

Hemoglobin

Nitrates

Leukocytes

Question 3

Having female anatomy is a major risk factor for UTIs. Briefly describe, in your own words, why this is .

Question 4

Aside from being female, which other risk factor is mentioned in Kelly’s history?

Question 5

Kelly’s physician determines that her infection has reached her bladder. What is this called?

Answers:

Urethritis

Cystitis

Pyelonephritis

Ureteritis

BSC2347 Human Anatomy and Physiology II

Module 08 Case Study

Question 1

Jeff is a 57-year-old male with a long history of type 1 diabetes. He takes insulin to manage his diabetes, but has been having trouble maintaining steady blood glucose levels over the last two weeks. Jeff suffered a week-long case of influenza last month, but is otherwise healthy. This morning, he began vomiting upon waking. This was followed by extreme abdominal pain and extreme thirst. He called his endocrinologist, who told him that he needs to seek emergency care.

Given Jeff’s history of type 1 diabetes, which of the following conditions is he most likely experiencing?

Answers:

Diabetic ketoacidosis

Metabolic alkalosis

Respiratory alkalosis

Diabetic alkalosis

Question 2

Diabetic ketoacidosis is a type of respiratory acidosis.

Answers:

Question 3

If Jeff has diabetic ketoacidosis, which of the following symptoms may he also be experiencing?

Answers:

Infrequent urination

Deep, rapid breathing

Lethargy

Increased salivation

Question 4

To diagnosis his condition, a blood osmolality test is ordered. An abnormally high result could point to all of the following conditions EXCEPT:

Answers:

Diabetic ketoacidosis

Stroke or head trauma

Dehydration

Oversecretion of ADH

Question 5

If Jeff has an acidic condition related to his diabetes, which of the following signs are likely to be present?

Answers:

Tachycardia and hypotension

Bradycardia and hypotension

Bradycardia and hypertension

Tachycardia and hypertension

BSC2347 Human Anatomy and Physiology II

Module 09 Case Study

Question 1

Samira is a 26-year-old female with a history of intense dysmenorrhea. She experience menarche at age 11. Her menstrual cycles average 25 days in length. She has a BMI of 18. Her menstrual cycle pain had decreased over the last 3 years while she was consistently taking birth control pills. However, she is now planning her first pregnancy and has been off birth control for 6 months now. She has yet to conceive, even though she and her partner have been carefully timing intercourse and monitoring Samira’s fertility window each month. Her dysmenorrhea has returned and she has developed menometrorrhagia, along with other cyclical symptoms like diarrhea, bloating, and craving salty foods.

Samira’s physician is concerned that she may have endometriosis. Briefly explain the pathophysiology of this condition.

Question 2

Which of Samira’s symptoms is most likely NOT related to endometriosis?

Answers:

Craving salty food

Diarrhea

Dysmenorrhea

Bloating

Question 3

Why would Samira’s dysmenorrhea symptoms decrease when taking birth control pills?!

Question 4

List and briefly describe 3 risk factors Samira has for endometriosis.

Question 5

Aside from the symptoms Samira has, which of the following symptoms is also likely for women who experience endometriosis? (Select all that apply.)

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Answers:

Fatigue

Pain with bowel movements

Pain with intercourse

Increased likelihood of gonorrhea

Increased risk of genital warts

BSC2347 Human Anatomy and Physiology II

Module 10 Case Study

QUESTION 1

Hawa is a 26-year-old female patient with a history of infertility. She and her partner have been trying to conceive naturally for 2 years. Hawa started taking fertility medication 6 months ago to stimulate follicle development. At 21 years of age, she was diagnosed with pelvic inflammatory disease, which was treated with antibiotics. Her menstrual cycle has been unpredictable over the last 3 months, with sporadic light bleeding. During the last month, she has felt nauseous and experienced diarrhea. Yesterday, she had a sudden onset of abdominal and pelvic pain and heavy vaginal bleeding. She is concerned about the sudden change and sees her gynecologist the following day.

Hawa’s gynecologist is concerned she may be experiencing an ectopic pregnancy. Briefly describe what this means, in your own words.

QUESTION 2

There are many risk factors for ectopic pregnancies. Which risk factors does Hawa display?

QUESTION 3

Hawa’s physician explains that most ectopic pregnancies are “tubal pregnancies.” What does this mean?

Fertilization occurred outside the fallopian tube.

Implantation occurred outside the fallopian tube.

Implantation occurred within the fallopian tube.

Both ovaries released an egg into fallopian tube.

QUESTION 4

Why is it concerning for a fertilized egg to implant outside of the uterus?

QUESTION 5

If Hawa takes a pregnancy test, it will be negative because ectopic pregnancies do not produce the human chorionic gonadotropin.

BSC2347 Human Anatomy and Physiology II

Module 3 Quiz

• Question 1

The cardiac conduction system causes the right atrium and right ventricle of the heart to contract at the same time, and then the left atrium and left ventricle contract at that same time?

• Question 2

The SA node can influence cardiac output?

• Question 3

Which statement is NOT ?

• Question 4

The electrocardiogram (EKG) graph/measurement is dependent upon the AV node generating the electrical impulse?

• Question 5

What statement is NOT regarding blood vessels?

BSC2347 Human Anatomy and Physiology II

Module 4 Quiz

• Question 1

What is NOT regarding inflammation?

• Question 2

What is NOT of a fever?

• Question 3

What is NOT of the humoral and cellular immune defenses?

• Question 4

Phagocytes are cells that have the capability of engulfing other cells, including human and bacterial cells, along with cellular debris to digest and break down?

• Question 5

What is of the innate immune defenses?

BSC2347 Human Anatomy and Physiology II

Module 6 Quiz

• Question 1

Which of the following is regarding metabolism?

Anabolism is the process of breaking down larger structures/molecules into smaller ones.

Cellular respiration is the catabolic reactions in the cells utilized to make ATP.

The most efficient production of ATP does not require oxygen.

Protein metabolism for the production of ATP produces harmful ketone bodies as a by-product.

• Question 2

The uvula is a projection of the soft palate that assists in closing off the nasopharynx during chewing and swallowing.

• Question 3

Which of the following is NOT found in gastric juices?

Hydrochloric acid (HCl)

Intrinsic factor

Pepsinogen

Sodium bicarbonate ions

• Question 4

Which cell creates and secretes hydrochloric acid?

Mucous cells

Parietal cells

Chief cells

Enteroendocrine cells

• Question 5

Which of the following is regarding salvia?

It contains the digestive enzyme amylase.

It is mostly composed of nitrogen.

It contains intrinsic factor.

It plays no role in the sense of taste.

BSC2347 Human Anatomy and Physiology II

Module 7 Quiz

1. Tubular secretion within urine formation is when:

2. The kidneys secrete a hormone that influences red blood cell production?

3. The glomerular filtration rate (GFR) is highly regulated because if GFR increases, the amount of urine output decreases?

4. Diuretics are a class of drugs that increase the activity of antidiuretic hormone?

5. What is of a nephron?

6. In healthy kidneys, what is not a common substance filtered out of the glomerulus?

1.

Site of filtrate formation.

2.

Site that drains the distal convoluted tubule.

3.

Blood supply that directly receives substances from the tubular cells.

4.

Site at which most of the tubular reabsorption occurs

5.

) Low pressure, porous vessels that reabsorb solutes and water from the tubule cells

6.

) High pressure vessel that forces fluid and solutes into the glomerular capsule.

7.

May form meandering vessels or bundles of long straight vessels.

8.

) Play a role in urine concentration.

9.

Fenestrated vessels that allow passage of all plasma elements but not blood cells.

10.

The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________.

11.

Which of the following is not associated with the renal corpuscle?

12.

An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________.

13.

The urinary bladder is composed of ________ epithelium.

14.

The kidneys are stimulated to produce renin ________.

15.

Which of the choices below is not a function of the urinary system?

BSC2347 Human Anatomy and Physiology II

Module 8 Quiz

A & P II Module 8 Quiz

1. Blood pressure will increase with the increased reabsorption of sodium ions?

2. Both hypokalemia and hyperkalemia can cause and lead to cardiac arrhythmias?

3. If the carbon dioxide levels increase within the body, blood pH levels increase?

4. Metabolic alkalosis can occur from a person vomiting excessively, which will result in a decrease of blood pH levels?

5. Edema is abnormal accumulation of fluid that occurs within the cells?

BSC2347 Human Anatomy and Physiology II

Module 10 Quiz

Anatomy & Physiology II Module 10 Quiz

1.This is the term given to the mass of cells that contains trophoblast cells and an inner mass of cells that implants within the endometrium:

2.What is NOT a change to a mother’s organ systems during pregnancy?

3.This stage of the delivery is when crowning occurs?

4.What best describes the umbilical vein?

5.An ectopic pregnancy occurs when the fertilized egg implants outside of the endometrium and is rarely life threatening for the mother?

MIDTERM EXAM

• Question 1

What is of cellular immunity?

• Question 2

What is NOT about the breathing process?

• Question 3

What term best describes the normal amount of air that is brought into and out of the lungs during quiet or resting breathing?

• Question 4

What portion of the EKG wave pertains ventricles contracting during the cardiac cycle?

• Question 5

What term best describes the amount of air expelled from the lungs after a maximum inspiratory effort?

• Question 6

What statement is of capillaries?

• Question 7

For inspiration to occur, intrapulmonary pressure must be higher than atmospheric pressure?

• Question 8

Coagulation is the final step in the hemostasis process?

• Question 9

As the inspiratory muscles contract, the thoracic volume increases leading to an increase of pulmonary volume, which decreases the intrapulmonary pressure.

• Question 10

Stroke volume is the measurement of:

FINAL EXAM
• Question 1

Edema is the accumulation of fluid in the interstitial fluid, not the intracellular fluid?

Answers: True

False

• Question 2

What is NOT true of the dilation phase of delivery?

Answers: A.

It is the beginning of uterine contractions

B.

It is the longest phase of labor

C.

Cervical dilation occurs

D.

It is when the mom actively pushes the baby out

• Question 3

The role of the liver in the digestive system is to:

Answers: A.

Remove toxins from the digestive system

B.

Assist in the mechanical breakdown of fats

C.

Chemically digest fats

D.

Absorb fats

• Question 4

What is true of fiber?

Answers: A.

It is a form of protein

B.

We can only absorb it with the presence of fat

C.

Our bodies can digest it and extract the nutrients from it

D.

It can help prevent constipation

• Question 5

Hyponatremia is usually corrected by a decrease in antidiuretic hormone?

Answers: True

False

• Question 6

The acrosome of a sperm:

Answers: A.

Protects the sperm from the acidic vagina pH

B.

Protects the sperm from the female’s leukocytes

C.

Contains enzymes that allow the sperm to penetrate the egg

D.

Is used for energy allowing sperm to be motile

• Question 7

The extracellular fluid is about 1/3 of the overall body water content?

Answers: True

False

• Question 8

What is NOT true of the male and female urethras?

Answers: A.

Males are more at risk for bladder infections due to the length of the urethra

B.

If there is urinary retention, then a catheter is inserted within an individual

C.

The male’s urethra passes through the prostate gland

D.

The female’s urethra is much shorter compared to the male’s urethra

• Question 9

Diuretics have what effect on the kidneys?

Answers: A.

Decrease glucose reabsorption

B.

Increase water excretion

C.

Increase sodium ion reabsorption

D.

Increase potassium ion reabsorption

• Question 10

An egg is typically fertilized within the uterus of a female reproductive tract?

Answers: True

False

• Question 11

Only hypokalemia can lead to cardiac arrthmias? BSC 2347 Human Anatomy and Physiology II Assignments and Discussions

Answers: True

False

• Question 12

What hormone has the most powerful effect on water reabsorption in the collecting ducts?

Answers: A.

Atrial natriuretic peptide

B.

Antidiuretic hormone

C.

Erythropoietin

D.

Diuretics

• Question 13

What substance or hormone would not lead to dehydration?

Answers: A.

Aldosterone

B.

Diarrhea

C.

Atrial natriuretic peptide

D.

Diuretics

• Question 14

The uterine cycle is regulated directly by follicle stimulating hormone and luteinizing hormone?

Answers: True

False

• Question 15

The mouth allows for the processes of chemical and mechanical digestion?

Answers: True

False

• Question 16

Respiratory alkalosis can be caused by:

Answers: A.

Shallow breathing

B.

Hyperventilating

C.

Increasing the H+ ion concentration

D.

Pneumonia

• Question 17

Which of the following is not found within semen?

Answers: A.

Testosterone

B.

Prostate fluid

C.

Seminal vesicle fluid

D.

Sperm

• Question 18

What type of cell produces hydrochloric acid within the gastric glands?

Answers: A.

Enteroendocrine cells

B.

Parietal cells

C.

Chief cells

D.

Mucous cells

• Question 19

What is true of the nephrons?

Answers: A.

The blood is filtered in the renal tubule section

B.

They are the structural and function units of the kidneys

C.

The loop of Henle is designed to assist in maximizing glucose reabsorption

D.

They are only found in the cortex of the kidneys

• Question 20

What is NOT a function of lipids in our body?

Answers: A.

Used as the body’s primary source of energy

B.

Cellular structural support

C.

Hormonal synthesis

D.

Found in the myelin sheaths of axons

• Question 21

What is NOT true of lipid metabolism?

Answers: A.

It occurs if the body cannot make enough energy from glucose

B.

Can lead to a fruity smell to the urine and breath

C.

It will occur after carbohydrate and protein metabolism efforts have been exhausted

D.

It produces ketone by products

• Question 22

The cephalic phase of gastric secretion can be stimulated by the sight, taste or even smell of food?

Answers: True

False

• Question 23

A vasectomy is a medical procedure where the epididymis is cut and the ends are cauterized to prevent the passage of sperm within the male reproductive system?

Answers: True

False

• Question 24

What is NOT a change in a female’s body during pregnancy?

Answers: A.

The stomach enlarges allowing for more digestion to occur

B.

Cardiac output increases

C.

Respiration rate increases

D.

The glomerular filtration rate increases

• Question 25

Luteinizing hormone within the female reproductive system directly influences what process?

Answers: A.

Endometrium thickening

B.

Menstruation

C.

Follicle development

D.

Ovulation of the oocyte

MN561 Advance Practice Nurse Clinical Assignments and Discussions

MN561 Advance Practice Nurse Clinical

Unit 1 Discussion

DQ1 Check-In

Please confirm that you have accessed and read the syllabus and unit overview, and received the course expectation document emailed to you prior to start of this course. All practicum hours and field encounters should be entered in Rx Preceptor. Practicum hours must be confirmed by the preceptor to receive credit. Inform the instructor if you are aware of required and recommended textbook and clinical pocket companions as noted in the syllabus. The preceptor contact form should be submitted to Unit 1 drop box. You will complete 185 practicum hours during this term. Please inform the instructor if you have any questions regarding course expectations.

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Please feel free to share a little about your professional background and what you expect to learn during this practicum rotation. MN561 Advance Practice Nurse Clinical Assignments and Discussions

DQ2 Oral Presentation

The goal of any oral presentation is to pass along the “right amount” of patient information to your preceptor in an efficient fashion. When done well, this enables you and your preceptor to quickly understand the patient’s issues and generate an appropriate plan of action.

As a general rule, oral presentations are shorter than written presentations as they should focus on the most active issues of the day (Chief Complaint).

Subjective- how patient feels and reports to you.

Objective- vital signs and pertinent physical exam findings; what you hear, feel, smell, and see.

Assessment- should include working diagnosis from presenting problem and prior diagnoses that are being actively addressed during the present appointment.

Plan – this is the area that should be very specific as if you are entering the orders.

Some of the most common stumbling blocks for students (other than nerves) include going into too much detail in the subjective and objective sections!

Discussion: Share with your peers your approach to oral presentations in the clinic setting and ways in which you have perfected your approach to communicating information about your patient to your preceptor. Share your PEARLS of Wisdom!

MN561 Advance Practice Nurse Clinical

Unit 2 Discussion

Topic: Be Prepared

Being prepared as a Nurse Practitioner when entering the clinic setting is a win-win for the student, the preceptor and most of all the patient. Safe, effective delivery of patient care requires that the nurse practitioner student understand the complexity of healthcare systems, the limits of human factors, safety design principles, characteristics of high reliability organizations, and patient safety resources. These components are critical to the preparation of safe clinicians and essential for 21stCentury healthcare delivery. MN561 Advance Practice Nurse Clinical Assignments and Discussions

Discuss how you met the Unit Two Objectives as well as barriers to safe practice that can occur if you come to the clinic setting unprepared. Support your discussion with evidence based practice and recommendations for improvement of safe patient care in the primary care setting.

MN561 Advance Practice Nurse Clinical

Unit 3 Discussion

Topic: Medical Record Documentation

Medical record documentation is required to record pertinent facts, findings, and observations about an individual’s health history, including past and present illnesses, tests, treatments, and outcomes. The medical record chronologically documents the care of the patient and is an important element contributing to high-quality safe care.

Discuss your State Board of Nursing nurse practitioner documentation guidelines and how this can impact your level of reimbursement in the clinical setting.

MN561 Advance Practice Nurse Clinical

Unit 4 Discussion

DQ1 Topic 1: Social Services

Share what social services are available in your community and give examples of when it is important to involve social services in the management of your patients in the primary care setting? Please give examples of what you have done in your clinic setting involving social services. Support your discussion with evidence based practice and recommendations.

DQ2 Topic 2: Interprofessional Team

A multiprofessional team practice is necessary as you cannot be expected to know everything there is to know and have all the skills to address the complete range of episodic and chronic health problems commonly seen in the primary care setting.

Discuss what you believe is the ideal provider mix for an interprofessional team in primary care. Design an interprofessional team to meet the primary care needs in your community and share with your peers in the discussion forum.

Support your discussion with evidence based practice and recommendations.

MN561 Advance Practice Nurse Clinical

Unit 5 Discussion

Topic:UTI

UTIs are responsible for > 7 million physician visits annually and approximately 15% of all community-prescribed antibiotics in the US are dispensed for UTI’s. In the US, UTIs account for > 100,000 hospital admissions annually, most often for pyelonephritis (European Association of Urology, 2015). Describe the current clinical practice guidelines for diagnosis, management, and prevention of UTI’s.

MN561 Advance Practice Nurse Clinical

Unit 6 Discussion

Topic: Preventative vs Diagnostic

Discuss the difference between preventative and diagnostic laboratory tests and why this is important to distinguish between in the primary care site. Include in the discussion the ten most commonly ordered laboratory and diagnostic tests ordered in your practicum site and the criteria for ordering.

MN561 Advance Practice Nurse Clinical

Unit 7 Discussion

DQ1 Topic: Contraceptive counseling

Contraceptive counseling provides education, dispels misinformation, facilitates selection of a method that will be successful for the individual, and encourages patient involvement in healthcare decisions and life goals. Discussing contraception brings the nurse practitioner and patient together to create a tailored plan that meets the individual’s reproductive needs over a lifetime.

Discuss any clinical encounters that you may have had relating to contraception. How did you counsel patients on their choices and possible risks? Describe how you would explain the differences to your patients in the long acting reversal contraceptive devices.

DQ2 Topic 2: Sexuality

Sexuality affects individuals and society across a broad spectrum of activities through health, but also through factors at multiple levels, such as gender relations, reproduction, and economics. Physiologic, behavioral, and affective measurement of sexuality and sexual behavior is complicated by cultural values and norms but is essential to individual health (including happiness) as well as public health. Cultural or structural norms that stigmatize aspects of sexuality, such as sexual orientation, have adverse effects on individuals across their lifespan, with homophobia being a prominent example of such.

Discuss how one’s age, race, lifestyle, and demographics have an impact on your choice to complete a sexual history when working in the primary care setting with women across a lifespan.

MN561 Advance Practice Nurse Clinical

Unit 8 Discussion

Topic: Depression

Depression is one of the leading causes of disability in adults. It affects men and women of all ages, races, and social and economic groups. Depression has a major impact on a person’s quality of life and can increase the risk of suicide. It can make it more difficult for people to care for other health conditions they may have. Depression also can affect family members, especially children.

Discuss what The U.S. Preventive Services Task Force (Task Force) has recommended concerning screening for depression in the primary care setting. What are the recommended screening tools age specific.

Share what you have used in your practicum site to screen for depression and how it was addressed. MN561 Advance Practice Nurse Clinical

Unit 9 Discussion

Click [Start a New Thread] to post to the Discussion, then click [Post] once complete. Be sure to post a response to all Discussion topics. Please review the Discussion Board Participation grading rubric under Course Resources. This is important information that will ensure that you earn maximum points. Your postings should be qualitative and provide substantive depth that advances the discussion. Please see the Writing Center for assistance with writing, APA, and online communication.

After completing the Reading, reflect on the concepts covered in this unit.

Describe evidenced-based treatment plans for specific sexually transmitted diseases.

Reflect on how you have met each of the course objectives over these past 9 weeks.

Explain how you will integrate the outcomes of the course into your role as a nurse practitioner working in primary care caring for adult patients presenting with acute, episodic, and chronic illness and conditions.

Provide one example of how you have met each of the six course outcomes these past 9 weeks.

MN561 Advance Practice Nurse Clinical

Unit 10 Discussion

Click [Start a New Thread] to post to the Discussion, then click [Post] once complete. Be sure to post a response to all Discussion topics. Please review the Discussion Board Participation grading rubric under Course Resources. This is important information that will ensure that you earn maximum points. Your postings should be qualitative and provide substantive depth that advances the discussion. Please see the Writing Center for assistance with writing, APA, and online communication.

Topic: Testicular pain

It is crucial for providers to investigate and differentiate complaints of testicular pain. Testicular torsion is an emergency which requires immediate diagnosis and management. Describe and depict the history and physical exam findings in testicular torsion. What would be the treatment or management for patients with testicular torsion?

MN561 Advance Practice Nurse Clinical

Unit 3 Assignment

Location: XYZ Family Practice

You are an NP student in this practice. Your next patient is the following:

“I had to come in today because I have been coughing for a long time”

Amanda Smith (69 year old, black female) is a retired postal worker. During the visit, she is coughing continually. She states the cough started 5 days ago intermittently but 2 days ago it became constant. Her chart indicates that she has been a patient of the practice for 5 years, gets care regularly and her HTN has been controlled for 4 years.

Social History

Married – 2 adult children A & W

Non-Smoker now. Smoke 1 pack a day for 15 years. Quit x5 years ago

No alcohol or drug use

Baptist, attends church regularly and is a member of the choir

Family History

Mother – Deceased at age 27 from traumatic accident

Father – Deceased age 78 related to renal failure secondary to diabetes type II

Siblings – one brother age 61 A & W

Medical/Surgical/Health Maintenance Hx

Measles, mumps and chicken pox as a child.

Tetanus/Diptheria/Pertussis – Last dose 2 years ago

Influenza – Last dose 9 months ago

Pneumococcal vaccine at age 65

Zostivax at age 60

Chronic diagnoses – HTN x 5 years

Takes HCTZ 25 mg daily

ROS

General

Usual weight has been maintained

Fever for 5 days up to 101

Skin

Dry skin, uses emollient frequently

HEENT

Wears reading glasses

Dentition fair. Partial upper denture

Neck

No swelling or stiffness

Chest

Substernal pain on cough

Respiratory

Began coughing 4 days ago. Started mild, intermittent and non-productive. Two days ago became constant and productive of frothy sputum. Keeps her awake at night. No relief with OTC cough syrup. She states she is short of breath today.

CV

No CP at rest or when not coughing

PV

Some swelling of feet and ankles at end of day, relieved by elevating feet

GI

Decreased appetite for one week

No change in bowel habits

GU

No frequency, hesitancy, nocturia or change in bladder habits

Genitalia

No changes

MS

Stiffness in hands and legs on awakening. Relieved with activity

Psych

No depression, anxiety, or memory change

Neurologic

No numbness, weakness, headache, change in mentation, or paralysis Hematologic

No past anemia

Endocrine

No change in weight, thirst, heat/cold intolerance.

Your physical exam reveals:

Temp 101.4, Resp 30 labored, no retractions, BP 135/92, HR 110, Pulse Ox 90 Wt 130 lbs

General appearance – Alert in all spheres, in mild respiratory distress, able to answer questions with short sentences, tripod breathing

HEENT –

Eyes ,ear, nose, head wnl

Mouth -mucosa dry

Pharynx – tonsils present not enlarged, normal pink color

Lymph – no enlargement

Skin – Dry and scaly legs and arms. Tenting of skin noted

Heart- regular rhythm at 110 bpm, no murmurs or extra sounds

Lungs – normal breath sound without crackles, bronchophony or egophony

Abdomen – no mass, tenderness, rigidity

Extremities – Hands – no swelling, Feet/legs – +1 edema feet to ankle level

Pedal pulses – wnl

Differential diagnoses:

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CAP

Acute bronchitis

Congestive heart failure

Influenza

Plan – transfer to acute care setting for further work-up

Assignment Details:

The “Elevator Consult”

In this activity, you will practice giving a synopsis of your patient to your preceptor. In practice, you may often give this type of report if you are sending a patient for a consultation and your phone the specialist to discuss the patient. This report should be concise and clear. The receiver should, within one minute (slightly less for simple cases, slightly more for complex cases) have a picture of the patient in his/her head. You will report on ONLY items pertaining to the acute problem in this case. Do not include extraneous material or material not directly impacting the decision-making regarding this problem. Remember, this is a FOCUSED visit and assessment to evaluate a focused concern. The history and physical exam applies techniques relevant to the specific complaint for the patient at that visit. Your report should be similarly focused, providing only information that relates specifically to the presenting problem. MN561 Advance Practice Nurse Clinical Assignments and Discussions

Please review the grading rubric under Course Resources in the Grading Rubric section.

How to Submit:

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

When you are ready to submit your Assignment, select the unit Dropbox then attach your file. Make sure to save a copy of the Assignment you submit.

MN561 Advance Practice Nurse Clinical

Unit 5 Assignment

Midterm Clinical Evaluation

For the Midterm Clinical Evaluation in Week 5 you will be required to schedule a preceptor call with your instructor and preceptor utilizing the faculty directions in the course Announcements. Failure to schedule or complete this preceptor call could result in failure of the course.

Grading will follow the rubric and will be a collaboration between your faculty and preceptor. Any area of clinical concern will require faculty and student conference as well as implementation of an individual learning plan.

You can find the rubric located in Course Resources.

MN561 Advance Practice Nurse Clinical

Unit 7 Assignment

For this Assignment, you will select one of the following case studies below. Then, using the case information and best evidence, complete the chart below. Make sure to address all columns in the chart.

Select a case study of interest to you from the listed scenarios below.

Case #1: Jane

Jane is a 42-year-old G4P2103. Jane is divorced and works long, hard hours as a real estate agent. Jane was having irregular and heavy menses for 6 months, and then they abruptly stopped 3 months ago. Jane has been having nausea and vomiting for 6 weeks but attributed it to having the flu recently. She also admits to gaining about 10 pounds in the last few months and experiencing breast tenderness. Jane comes to the clinic today to discuss menopause symptoms and treatment. During the visit, a urine pregnancy test came back positive. During the exam, you palpate a 16-week-size uterus and get fetal heart tones of 165. Jane is in disbelief.

Case #2: Natalie

Natalie is a 27-year-old G4P0120. Natalie is married; she and her husband both work two part-time jobs to cover the bills. Natalie presents to your office at about 20 weeks gestation for her initial OB visit. Natalie states she has not been evaluated prior to today for the pregnancy because of lack of funds and ability to get off of work. Natalie also complains of multiple yeast infections during this pregnancy. During your interview with Natalie, you find she has no known medical diagnoses, she is not taking medications, she is a smoker, and she has a negative surgical history. Natalie’s OB history includes two spontaneous losses at 8 and 12 weeks gestation and a loss of a 32 weeks infant following premature rupture of membranes. The 32 week infant was 7 pounds; lived 24 hours; and experienced hypoglycemia, respiratory distress, and sepsis infections. Natalie tells you she waited to seek prenatal care until this point because she did not have enough money to pay for the visit. She and her husband are still paying off medical expenses from the death of their 32 week infant. She tells you that she probably would have waited longer, but she keeps getting these terrible yeast infections. On exam you note a fundal height of 26 weeks and urine dip reveals 1+ leukocytes, 1+ protein, trace blood and 3+ glucose.

Case #3: Katie

Katie is a 17-year-old G1P0. She presents to your office with four missed periods in a row. Katie is a high school student; she is in the 10th grade. She lives with her mother and four siblings. You ask Katie about the father of the baby and she tells you he states “that baby is not mine.” They are not speaking to each other right now. Katie tells you she has been “vomiting a lot and her stomach hurts when she pees.” A urine pregnancy test comes back positive. Katie is so confused because she has been using douching after intercourse as her method of birth control. You ask Katie about the father of the baby, and she tells you he states “that baby is not mine.” They are not speaking to each other right now.

Katie’s past medical history is positive for chlamydia twice in the last year. She was treated at the Health Department but never went back for a follow up. Katie has had no surgeries and is on no medication. When asked, Katie states her last known weight was about 120. Katie’s V/S are BP 110/70, temp 102.5, weight 107. You note enlarged cervical lymph nodes, FHTs are 160, fundal height is 18. Katie’s urine reveals 2+ ketones, 2+ nitrates, and 3+ leukocytes.

Case #4: Sara

Sara is a 32-year-old G1P1001. She presents to your office for a 6-week postpartum check following a normal vaginal delivery of a healthy baby girl. Sara had an 18-hour labor with Pitocin augmentation and delivered a 7 pound 2 oz. girl with a second degree laceration repaired with sutures. Sara spent 2 days in the hospital and was discharged home with her infant and husband. Over the last few weeks, Sara has called the office multiple times with questions about breastfeeding and her sutures healing. Upon walking into the exam room to see Sara, you see her baby in the stroller crying and Sara sitting on the exam table crying into her hands.

Complete the following chart:

Pregnancy Case Review Chart-

Description of the case chosen:

Subjective data, identify both given and needed data

Objective findings, identify both given and needed data

Diagnostic or laboratory testing needed with rationales

List of three differential diagnoses with rationales

Medications and or treatments needed with rationales

Patient education needed

Referrals for collaborative care needed with rationales

Make sure to address all sections. Do not leave any section blank.

Include relevant subjective and physical objective findings.

Identify appropriate diagnostic and laboratory testing needed.

List at least three differential diagnoses with rationales for choosing.

Identify usual medications, treatments, or patient education needed. MN561 Advance Practice Nurse Clinical Assignments and Discussions

Determine referrals for collaborative care.

Summarize the case study and include any further research, diagnostics, procedures, or follow-up needed.

Provide evidence-based references.

Assignment Requirements

Before finalizing your work, you should:

be sure to read the Assignment description carefully (as displayed above);

consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and

utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

follow the conventions of Standard English (correct grammar, punctuation, etc.);

be well ordered, logical, and unified, as well as original and insightful;

display superior content, organization, style, and mechanics; and

use APA 6th Edition format.

How to Submit:

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

When you are ready to submit your Assignment, click the Dropbox tab and select this unit’s basket from the dropdown menu, then attach your file. Make sure to save a copy of your work and be sure to confirm that your file uploaded correctly.

How to Submit:

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

When you are ready to submit your Assignment, select the unit Dropbox then attach your file. Make sure to save a copy of the Assignment you submit.

MN561 Advance Practice Nurse Clinical

Unit 10 Assignment

Final Clinical Evaluation — 300 points

This unit will contain the mandatory preceptor final evaluation in Rx Preceptor. Your preceptors will receive an automatic email from the Rx Preceptor system during week 8 and then weekly until week 9 to complete evaluations. Grading will follow the scale below and will be a collaboration between your faculty and preceptor. Any area of assessment with a score of 2.4 or below will receive an entire evaluation score of 0 points as failure in any area of assessment constitutes a failing evaluation. Any element of the evaluation that states the student is not safe or is unsafe will result in a “0” for the final evaluation and failure of the course.

Final evaluation will be worth 300 points and will follow the grading rubric below:

Score of 4 to 5 all 300 points awarded

Score of 3 to 3.9 = 240/300 points awarded

Score of 2.5 to 2.9 = 210/300 points awarded

Score of 2.4 and below = 0

Students must also complete both the evaluation of their preceptor and site for credit. The evaluations provide faculty an overview of your clinical performance and experiences with your preceptor and clinical location. The final clinical evaluation is required to pass the course.

Failure to complete all clinical hours or all associated Rx Preceptor documentation (clinical time log, patient encounter log, preceptor evaluation of student, and student evaluation of preceptor) will result in failure of the course.

[Unit 10 Assignment Dropbox]

Upload a copy of your evaluation of the preceptor and clinical site. The form can be found in Rx Preceptor.

MN561 Advance Practice Nurse Clinical

Unit 1 Quiz

Question 1

Clinic hours must be confirmed by your preceptor every:

a)

Two weeks

b)

Every month

c)

At the end of term

d)

Every week

Question 2

True or False: You must arrange three phone call meetings with the preceptor, faculty and self during the 10 week period you are in clinic.

a) True

b) False

Question 3

True or False: You can wear scrubs to your clinical practicum.

a) True

b) False

Question 4

True or False: It is OK to complete your clinical hours in the hospital setting.

a) True

b) False

Question 5

True or False: The student must complete all 160 required clinical hours no later than the Monday of Week Ten.

a) True

b) False

MN561 Advance Practice Nurse Clinical

Unit 3 Quiz

Question 1

True or False: The focus of this Seminar was to discuss medical documentation and coding: ICD-10, CPT codes only. Level of care was not discussed.

a) True

b) False

Question 2

Principles of Coding include all except:

a)

Only provide the level of care that is medically necessary per clinical judgment.

b)

Always code a lower level of service then you think needed.

c)

Always provide and document services in accordance with the established best practices.

d)

Always code and document exactly what care was provided.

Question 3

True or False: ICD-10 codes describe what it was done for the patient.

a) True

b) False

Question 4

True or False: CPT codes describe WHAT was done for the patient.

a) True

b) False

Question 5

True or False: When coding for Preventive Care Services it is mandatory to include the minimum of five components.

Incorrect Response

a) True

Correct Answer

b) False

MN561 Advance Practice Nurse Clinical

Unit 7 Quiz

Question 1

The process by which practitioner collects, processes, and interprets patient information to develop an action plan includes all except:

a) gender and age

b) patient finances and religion

c) season of the year and location

d) ethnicity and time of year

Question 2

True or False: Intuition/gut feelings and biases and assumptions are the same.

a) True

b) False

Question 3

True or False: Example patient: The 21-year=old male with itchy legs had eczema.

1) True

2) False

Question 4

Use a reasoning strategy: Hypothetical- Deductive reasoning (deductive vs. inductive) to process the information in the clinical context. True or False: Hypothetical- Deductive Reasoning: works from specific to general.

Incorrect Response

a) True

b) False

Question 5

Select all that apply to history taking and data collection.

a) Have you taken an adequate history of the patient’s health condition and provided the patient with the opportunity to express his or her current health concerns?

b) If the patient is unable to provide a history (e.g., language barrier, capacity issue, etc.), have you consulted those who may be able to assist in obtaining the history?

c) Have you adequately assessed any relevant risk factors, including family history, which might help in diagnosis?

d) Are there any red flag symptoms?

e) Have you determined what the patient has already done to manage his or her symptoms? MN561 Advance Practice Nurse Clinical Assignments and Discussions

Walden NURS 6512 All Week Assignments and Discussions

Week 1 discussion

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

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients:

76-year-old Black/African-American male with disabilities living in an urban setting

Adolescent Hispanic/Latino boy living in a middle-class suburb

55-year-old Asian female living in a high-density poverty housing complex

Pre-school aged white female living in a rural community

16-year-old white pregnant teenager living in an inner-city neighborhood. Walden NURS 6512 All Week Assignments and Discussions

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To prepare:

With the information presented in Chapter 1 in mind, consider the following:

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

How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?

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

What questions would you ask each patient to assess his or her health risks?

Select one patient from the list above on which to focus for this Discussion.

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

Select one of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the course text, or another tool with which you are familiar, related to your selected patient.

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

By Day 3

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

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

Read a selection of your colleagues’ responses.

By Day 6

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

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

Suggest additional health-related risks that might be considered.

Validate an idea with your own experience and additional research.

Week 2 discussion

Discussion: Diversity and Health Assessments

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

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity. Walden NURS 6512 All Week Assignments and Discussions

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”

Case 2

TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

Case 3

MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.

To prepare:

Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

Select one of the three case studies. Reflect on the provided patient information.

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

Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

By Day 3

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

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

Read a selection of your colleagues’ responses

By Day 6

Respond on or before Day 6 to at least two of your colleagues who selected a different patient than you, using one or more of the following approaches:

Suggest additional socioeconomic, spiritual, lifestyle, and other cultural factors related to the patient.

Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.

Week 3 discussion

Discussion: Assessment Tools and Diagnostic Tests in Adults and Children

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

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

In this Discussion, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To prepare:

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

This week you will be assigned one of the following DB by your instructor.

Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:

Mammogram

Prostate-specific antigen (PSA) test

Body-mass index (BMI) using waist circumference for adults

Select one of the examples on which to focus for this Discussion. What health issues and risks may be relevant to the child you selected?

Overweight 5-year-old boy with overweight parents

5-year-old girl of normal weight with obese parents

Severely underweight 12-year-old girl with underweight parents

Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?

What does the literature discuss regarding the validity, reliability, and are there any issues with sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool?

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

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

By Day 3

Post a description of how the assessment tool or diagnostic test you selected is used in health care. Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

OR

Post an explanation of the health issues and risks that are relevant to the child you selected. Describe additional information you would need in order to further assess his or her weight-related health. Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information. Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

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

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues who selected a different tool test, or child health example than you, using one or more of the following approaches:

Critique your colleague’s evaluation of the validity and reliability of the tool or test selected.

Suggest alternative or additional tools or tests that should be considered when gathering information about specific conditions or symptoms.

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

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

Suggest additional health risks or issues that could be relevant to the child.

Critique your colleagues’ questions, and suggest how the parents or caregivers might interpret these questions. Provide alternate or additional questions.

Suggest an additional strategy for gathering patient information or promoting proactivity

Week 5 discussion

Discussion: Assessing the Ears, Nose, and Throat

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes, but would probably perform a simple strep test.

In this Discussion, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions. Walden NURS 6512 All Week Assignments and Discussions

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

Case 1: Nose Focused Exam

Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he’s taken Mucinex OTC the past two nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous.

Case 2: Focused Throat Exam

Lily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus over the past two weeks, Lily figured she shouldn’t take her three-day sore throat lightly. Your clinic has treated a few cases similar to Lily’s. All the patients reported decreased appetite, headaches, and pain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn’t sound congested.

Case 3: Focused Ear Exam

Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked. He has complained to her about a mild earache for the past two days. His grandmother believes that he feels warm but did not verify this with a thermometer. James states that the pain was worse while he was falling asleep and that it was harder for him to hear. When you begin basic assessments, you notice that James has a prominent tan. When you ask him how he’s been spending his summer, James responds that he’s been spending a lot of time in the pool.

To prepare:

With regard to the case study you were assigned:

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

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

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

Identify at least 10 possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Week 5 Discussion”) with “Review of Case Study ___,” identifying the number of the case study you were assigned.

By Day 3

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

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

Read a selection of your colleagues’ responses.

By Day 6

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

Week 7 discussion

Discussion: Assessing the Heart, Lungs, and Peripheral Vascular System

Take a moment to observe your breathing. Notice the sensation of your chest expanding as air flows into your lungs. Feel your chest contract as you exhale. How might this experience be different for someone with chronic lung disease or someone experiencing an asthma attack?

In order to adequately assess the chest region of a patient, nurses need to be aware of a patient’s history, potential abnormal findings, and what physical exams and diagnostic tests should be conducted to determine the causes and severity of abnormalities.

In this Discussion, you will consider how a patient’s initial symptoms can result in very different diagnoses when further assessment is conducted.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

To prepare:

With regard to the case study you were assigned:

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

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

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

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

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 6”) with “Review of Case Study” identifying the number of the case study you were assigned. Walden NURS 6512 All Week Assignments and Discussions

By Day 3

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

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

Read a selection of your colleagues’ responses.

By Day 6

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

Week 8 discussion

Discussion: Assessing Muscoskeletal Pain

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

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

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

Case 1: Back Pain

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

spine

Case 2: Ankle Pain

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

ankle

Case 3: Knee Pain

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

knee

To prepare:

With regard to the case study you were assigned:

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

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

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

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

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 8”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.

By Day 3

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

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

Read a selection of your colleagues’ responses.

By Day 6

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

Week 9 discussion

Discussion: 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.

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

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

Case 1: Headaches

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

Case 2: Numbness and Pain

A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.

Case 3: Drooping of Face

A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.

To prepare:

With regard to the case study you were assigned:

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

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

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

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

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 9”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.

By Day 3

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

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

Read a selection of your colleagues’ responses. Walden NURS 6512 All Week Assignments and Discussions

By Day 6

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

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

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

To prepare:

Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Assignment.
Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
Consider which of the conditions is most likely to be the correct diagnosis, and why.
Download the SOAP Template found in this week’s Learning Resources.

To complete:

Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format, rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to fivepossible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least 3 different references from current evidence based literature.

Week 6 assignment

Assesment 1: Assessing the Abdomen

A woman went to the emergency room for severe abdominal cramping. She was diagnosed with diverticulitis; however, as a precaution, the doctor ordered a CAT scan. The CAT scan revealed a growth on the pancreas, which turned out to be pancreatic cancer—the real cause of the cramping.

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

In this assignment, you will analyze a SOAP 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.

Abdominal Assessment

SUBJECTIVE:

CC: “My stomach hurts, I have diarrhea and nothing seems to help.”

HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.

PMH: HTN, Diabetes, hx of GI bleed 4 years ago

Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs

Allergies: NKDA

FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD

Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

OBJECTIVE:

VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs

Heart: RRR, no murmurs

Lungs: CTA, chest wall symmetrical

Skin: Intact without lesions, no urticaria

Abd: soft, hyperctive bowel sounds, pos pain in the LLQ

Diagnostics: None

ASSESSMENT:

Left lower quadrant pain

Gastroenteritis

PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

To prepare:

With regard to the SOAP note case study provided:

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

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

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

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

To complete:

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

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

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

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

Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature.

Week 10 assignment

Assignment 1: Assessing the Genitalia and Rectum

Patients are frequently uncomfortable discussing with health care 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 assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

In this assignment, you will analyze a SOAP 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.

GENITALIA ASSESSMENT

Subjective:

CC: “I have bumps on my bottom that I want to have checked out.”

HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.

PMH: Asthma

Medications: Symbicort 160/4.5mcg

Allergies: NKDA

FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs

Heart: RRR, no murmurs

Lungs: CTA, chest wall symmetrical

Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact with a healed episiotomy scar present. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia

Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

Diagnostics: HSV specimen obtained

Assessment:

Chancre

PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

To prepare:

With regard to the SOAP note case study provided:

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

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

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

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

To complete:

Refer to Chapter 5 of the Sullivan text. Analyze the SOAP note case study. Using evidence based resources, 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 3 different references from current evidence based literature. Walden NURS 6512 All Week Assignments and Discussions

NURS6501 Week 9 Knowledge Check Advanced Pathophysiology

NURS6501 Advanced Pathophysiology

Week 9 Knowledge Check

Psychological Disorders

In this exercise, you will complete a 10-20 question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

Generalized anxiety disorder

Depression

Bipolar disorders

Schizophrenia

Delirium and dementia

Obsessive compulsive disease

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Question 1 The neurobiology of depression is believed to be related to the atrophy of neurons in the:

Answers:

Hypothalamus

hippocampus

thalmus

amygdala

Question 2The APRN is treating a patient with bipolar 1 disorder.  The major focus of treatment is on:

Answers:

mania

depression

anxiety

panic attacks

Question 3Abnormalities in brain development related to schizophrenia are thought to develop when? NURS6501 Week 9 Knowledge Check Advanced Pathophysiology

Answers:

Prenatal

Infancy

Early Childhood

Adolescent

Question 4 A patient with schizophrenia will have alterations in their dorsolateral prefrontal cortex.   The APRN would expect it to be described as:

Answers:

stimulated

absent

hyperactive

hypoactive

Question 5The APRN is assessing a patient that states that Napoleon Bonaparte is the King of France even thought he has a book that says he is dead.   This is an example of:

Answers:

Delusion

Hallucination

Anhedonia

Pressured speech

Question 6

The APRN would expect to find elevated blood levels of which of the following markers for patients with a diagnosis of depression?

Answers:

Proinflammatory cytokines and pH

Calcium and Cortisol

Calcium and pH

Proinflammatory cytokines and cortisol

Question 7Which of the following are positive clinical manifestations of schizophrenia?

Answers:

Social withdraw, blunted affect, and failure to respond to simple questions

Hallucinations, delusions, and incoherent speech

Hallucinations, blunted affect, and social withdraw

Delusions, hallucinations, and failure to respond to simple questions

Question 8What type of thoughts are characteristic of post traumatic stress disorder? NURS6501 Week 9 Knowledge Check Advanced Pathophysiology

Answers:

disorganized

intrusive

anxious

disturbing

Question 9The APRN is assessing a patient that is talking so rapidly and urgently that it is difficult to understand.    This is an example of:

Answers:

Delusion

Hallucination

Anhedonia

Pressured speech

Question 10Which of the following are negative clinical manifestations of schizophrenia?

Answers:

Social withdraw, blunted affect, and failure to respond to simple questions

Hallucinations, delusions, and incoherent speech

Hallucinations, blunted affect, and social withdraw

Delusions, hallucinations, and failure to respond to simple questions. NURS6501 Week 9 Knowledge Check Advanced Pathophysiology