NRS-493 Topic 7: Capstone Change Project Evaluation Plan

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NRS-493 Topic 7: Capstone Change Project Evaluation Plan

Students must develop skills related to systematic evaluation for intervention effectiveness. The content covered this week prepares students to evaluate the effectiveness of interventions and develop communication plans for the dissemination of information related to project outcomes. Synthesis of information from the process of evaluating outcomes (whether outcomes were met or not) generates new knowledge and adds to the body of knowledge for nursing practice Capstone Change Project Evaluation Plan.

Objectives:

  1. Determine how the capstone project change proposal could be disseminated to leadership.
  2. Create a plan for evaluating outcomes of the proposed nursing practice intervention used in the change proposal.
  3. Integrate reflective practice into the practicum reflective journal.

Assessments

 

Topic 7 DQ 1

Start Date

Jul 25, 2022, 12:00 AM

Due Date

Jul 27, 2022, 11:59 PM

Points
5
Status
Upcoming
Assessment Description 

Describe one internal and one external method for the dissemination of your evidence-based change proposal. For example, an internal method may be the hospital board, and an external method may be a professional nursing organization. Discuss why it is important to report your change proposal to both of these groups. How will your communication strategies change for each group? NRS-493 Topic 7: Capstone Change Project Evaluation Plan

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Topic 7 DQ 2

Start Date

Jul 25, 2022, 12:00 AM

Due Date

Jul 29, 2022, 11:59 PM

Points
5
Status
Upcoming
Assessment Description 

In order to evaluate an evidence-based practice project, it is important to be able to determine the effectiveness of your change. Discuss one way you will be able to evaluate whether your project made a difference in practice.

 

Capstone Change Project Evaluation Plan

Start Date

Jul 25, 2022, 12:00 AM

Due Date

Jul 31, 2022, 11:59 PM

Points
5
Status
Upcoming
Assessment Description 

The assignment will be used to develop a written implementation plan.

Step 1) Review your strategic plan to implement the change proposal, the objectives, the outcomes, and listed resources.

Step 2) Develop a process to evaluate the intervention if it were implemented.

Step 3) Write a 150-250 word summary of the evaluation plan that will be used to evaluate your intervention.
Address the following in your summary:

  • What data was collected?
  • What tool will be used to collect the data?
  • Who will be responsible for collecting data?
  • How will this data be communicated to the team?

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

 

 

Lopes Activity Tracker

Start Date

Jul 25, 2022, 12:00 AM

Due Date

Jul 31, 2022, 11:59 PM

Points
10
Status
Upcoming
Assessment Description 

Document your clinical practice hours using the Lopes Activity Tracker (LAT) in your student portal. Once you have opened the app, click on the link for your class to record your hours. Clinical practice hours should be documented and submitted within 48 hours of the clinical experience. After the hours have been submitted, the preceptor will verify the hours, which are then reviewed by the faculty. Students need to meet the required clinical hours in both leadership and community categories. As such, each category will have an hours maximum of 50 hours Capstone Change Project Evaluation Plan. Students will not be able to document in excess of 50 hours per category. The clinical requirements remain unchanged. NRS-493 Topic 7: Capstone Change Project Evaluation Plan

Download the electronic summary of your practicum experience from the Lopes Activity Tracker. Save the file and submit it though the assignment dropbox for faculty approval.

This report is to be submitted in every topic.

 

Professional Capstone and Practicum Reflective Journal- Topic 7

Start Date

Jul 25, 2022, 12:00 AM

Due Date

Jul 31, 2022, 11:59 PM

Points
10
Rubric

View Rubric

Status
Upcoming
Assessment Traits 

Requires Lopeswrite
Assessment Description 

Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week’s entry, students should reflect on the personal knowledge and skills gained.

Write a  reflection journal (250-300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.

Topic Focus: The Role of Technology in Improving Health Care Outcomes

While APA style is not required for the body of this assignment, solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance Capstone Change Project Evaluation Plan. NRS-493 Topic 7: Capstone Change Project Evaluation Plan

 

Topic 7 Participation

Start Date

Jul 25, 2022, 12:00 AM

Due Date

Jul 31, 2022, 11:59 PM

Points
15
Status
Upcoming
Assessment Description 

There is no description for this assessment.

Ken Fowler iHuman Soap Note

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Ken Fowler iHuman Soap Note

Ken Fowler ihuman soap note

Patient Information

Name: Ken Fowler

Age: 70 years

Sex: Male

Subjective

CC (chief complaint): Nausea and vomiting

HPI: Ken Fowler is a 70-year-old male who presents at the ED for evaluation of elevated creatinine having being referred by his PCP (Primary Care Provider) Ken Fowler ihuman soap note.  Prior before his visit to the PCP, Fowler experienced nausea and vomiting lasting 24 hours, which begun after taking  a painkiller (naproxen) for lower back pain he experienced after hurting his  back while carrying a load. The vomitus was clear with only residual food properties; it aggravated with meals and was relieved with decreased oral intake. As a result, for the past three days, he has not taken anything orally. The nausea and vomiting are associated extreme fatigue, decreased urinary output, and decreased oral intake. Ken Fowler iHuman Soap Note

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Current medications: HCTZ, lisinopril, and metroprolol

Allergies: None

Vaccinations: Up to date

Pertinent PMHx: He is a hypertensive on HCTZ, lisinopril, and metroprolol. H is also on follow-up, he has a history of mild chronic renal disease creatinine 1.1 and microalbuminuria (400mg) Ken Fowler ihuman soap note

Social hx: He consumes a glass of wine with dinner either once or twice every week.

Questions:

  • What is your name?
  • Where are you?
  • What time is it?
  • What happened?
  • How can I help you today?
  • Have you had nausea and vomiting like this before?
  • What does your vomit look like?
  • Has there been any change in your nausea and/or vomiting over time?
  • Have you been vomiting anything that looks like blood or coffee grounds?
  • Do you have any pain or other symptoms associated with your nausea and/or vomiting?
  • Does anything make your nausea and/or vomiting better or worse?
  • How severe is your nausea and/or vomiting?
  • Have you lost weight?
  • Do you have any pain in your abdomen?
  • Do you have frothy urine?
  • Do you have any other symptoms or concerns we should discuss?
  • Can you tell me about any current or past medical problems you have had?
  • Are you taking any over-the-counter herbal medications?
  • Do you have any allergies? Ken Fowler iHuman Soap Note
  • Are you taking any prescription medications?
  • Do you drink alcohol? If so, what do you drink and how many drinks per day?

ROS

General: Ken fowler presents for evaluation independently. He reports nausea and vomiting but denies chills, fevers, night sweats, or sore throats.

Cardiovascular/Peripheral Vascular: the patient denies palpitations, lower limb/upper limb edema, facial edema, chest pains/pressure, SOB, cold/blue fingers

Respiratory: the patient denies cough, wheezing, SOB, DIB

Gastrointestinal: patient acknowledges nausea, vomiting, and decreased appetite. He however denies constipation, diarrhea, or change in stool color.

Genitourinary: patient denies any pain, burning, dribbling, difficulty starting or stopping, urgency, frequency, or incontinence with urination. He reports decreased urine output

Musculoskeletal: the patient denies back pain, muscle and joint pain/swelling, and joint stiffness

Psychiatric: the patient denies feeling sad, depressed, mood changes, lack of interest, and nervousness.

Neurologic: the patient denies tremors, numbness, tingling, weakness, fainting, or dizziness. Ken Fowler ihuman soap note

Endocrine: the patient denies increased sweating, increased thirst, he reports decreased appetite, but denies cold/heat intolerance.

Hematologic/lymphatic: the patient denies easy bleeding or bruising, bleeding from gums or nosebleeds.

Allergic/immunologic: the patient denies environmental, food, or drug allergies.

Physical Exam

General:  Patient is A&O x4, in no acute pain or respiratory distress

VS: BP- 108/62 HR-98 (apical), RR-17, O2 sat-99% LA

HEENT: Eyes: PERRLA, there is no conjunctival pallor. Ear: no discharge, sharp optic disks, bilateral red reflex, Nose/Mouth/Throat: mucous membranes are dry

Cardiovascular/Peripheral Vascular: normal S1, S2 heard, no gallops, rubs, or murmurs.  PMI slightly displaced downwards and laterally

Respiratory: the chest moves symmetrically, bilaterally clear lungs, and bronchial breath sounds auscultated no crackles, wheezes, or rhonchi.

Gastrointestinal: soft and non-distended, bowel sounds present in all four abdominal quadrants no palpated masses or lumps, there is mild periumbilical tenderness Musculoskeletal/Peripheral Vascular: no lower or upper extremity edema, 5/5 muscle strength across all groups.

Neurologic:  A&O x4 to person, place, time, and situation, MMSE 30/30, deep tendon reflexes

Integumentary/Skin:  dry and warm skin, no pallor, jaundice, ulceration, or scaling, 3-4 seconds blanching time

Genitourinary: normal external genitalia, no urethral discharge, no tenderness, or masses

Test Ordered and Diagnostic Results

  • Renal Ultrasound
  • Ken Fowler ihuman soap note
  • Complete Blood Count
  • Eosinophils urine
  • Sodium (Na+), urine
  • Basic Metabolic Panel
  • Urinalysis
  • Pelvic Ultrasound

List the Differential Diagnosis You Identified In Ihuman

  1. Medication-Related (Side Effect)
  2. Uremia (intrarenal azotemia)
  3. Uremia (prerenal azotemia)
  4. Urinary Obstruction

List your primary dx with ICD code. Briefly explain/ discuss your primary dx and the rational

  • Acute Kidney Failure, Unspecified (N17.9) (Uremia-prerenal azotemia) – Ken Fowler presented with complaints of elevated creatinine, nausea, and vomiting following an intake of naproxen, an NSAID. The nausea and vomiting were associated with fatigue, reduced oral intake, and decreased appetite. The sequence of occurrence of these events indicates that the most likely diagnosis would primarily be acute kidney injury with the drug naproxen as the primary causative factor. Naproxen is highly nephrotoxic and is a pre-renal cause of kidney failure (Hoste et al., 2018). The physical exam findings of an elevated heart rate, dehydration, tenderness at the periumbilical region, and hypotension also support this diagnosis. Ken Fowler iHuman Soap Note

List the Differential Dx with ICD and A Brief Explanation the Rational

  1. Medication-Related Side Effect (ICD 10 995A) – Ken Fowler reports that prior to visiting his PCP, he experienced severe nausea, and vomiting that just preceded the intake of naproxen, an NSAID for Backpain. Naproxen acts by inhibiting COX enzymes to decrease prostaglandins synthesis, which can primarily result in renal ischemia, reduce glomeruli pressure, and increase the risk of acute kidney injury.
  2. Acute Nephritic Syndrome (ICD 10 N00.9) – Patients with ANS will demonstrate high levels of creatinine, oliguria, fatigue, vomiting, and nausea, pain at the periumbilical region, and anorexia (Bhalla et al., 2019). It however follows a recent systemic illness, which lacks in the case of Ken Fowler. On physical exam, the clinician is likely to find pedal and facial edema, and periorbital edema.
  3. Urinary Obstruction (ICD 10 9) – patients with urinary obstruction report symptoms such as; decreased urine output (oliguria), hesitancy, and abdominal pain. Ken Fowler ihuman soap note Its risk factors are: advanced age, a previous history of mild chronic renal disease, decreased urinary output, and underlying chronic diseases such as hypertension (Serlin, Heidelbaugh & Stoffel, 2018).

Assessment/Plan

  • Admit to: med-surge
  • Allergy: None
  • Diet: low-sodium
  • Activity: mild physical activity such as walking
  • Consult/ specialty services and rational: consult with a renal specialist
  • Nursing Orders:
    • IV Rehydration therapy with NS (normal saline) till the return of intravascular volume (Moore, Hsu & Liu, 2018).
  • Medication/intervention: dose, route, time
    • Hold the patient’s HCTZ and lisinopril
    • Discontinue the patient’s NSAIDs
  • LABS: none
  • Ancillary orders: insert Foleys catheter to monitor input-output
  • Supportive services: consult with a dietician on appropriate dietary forms for a patient with hypertension and mild chronic renal disease.
  • Patient education:
    • Next time do not self-medicate. Since you are taking drugs for high blood pressure, it is important to understand that drugs interact with each other. If you have to take any OTC drug, prescription drug, or herbal medication, you must first inform and obtain the consent of your PCP (Moore, Hsu & Liu, 2018).
    • Maintain a DASH diet and adhere to your hypertensive drug regimen for adequate blood pressure control as  guided
  • Follow up or disposition:
    • return immediately when you experience similar symptoms or  new onset of symptoms
    • follow up in 2 weeks post-discharge for evaluation of progress Ken Fowler ihuman soap note
  • Health maintenance and Preventive health: advice on the need to maintain upto date immunizations

 

References

Bhalla, K., Gupta, A., Nanda, S., & Mehra, S. (2019). Epidemiology and clinical outcomes of acute glomerulonephritis in a teaching hospital in North India. Journal of Family Medicine and Primary Care, 8(3), 934.

Hoste, E. A., Kellum, J. A., Selby, N. M., Zarbock, A., Palevsky, P. M., Bagshaw, S. M., & Chawla, L. S. (2018). Global epidemiology and outcomes of acute kidney injury. Nature Reviews Nephrology, 14(10), 607-625.

Moore, P. K., Hsu, R. K., & Liu, K. D. (2018). Management of acute kidney injury: core curriculum 2018. American Journal of Kidney Diseases, 72(1), 136-148.

Serlin, D. C., Heidelbaugh, J. J., & Stoffel, J. T. (2018). Urinary retention in adults: evaluation and initial management. American family physician, 98(8), 496-503 Ken Fowler ihuman soap note. Ken Fowler iHuman Soap Note

Episodic, Comprehensive and Alternative SOAP Note Example

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Episodic, Comprehensive and Alternative SOAP Note Example

Episodic, Comprehensive and Alternative SOAP Note Example

Episodic Write-up: Episodic visits are mostly encounters which require about one time visit (sometimes with a short follow-up depending on the diagnosis/existing comorbidities), or occurs occasionally.  Episodic visit ROS and physical examination (PE) are targeted and focused on the body system(s) affected.  Examples are URI, bronchitis, seasonal allergic rhinitis, acute pharyngitis, acute gastroenteritis, pneumonia, contact dermatitis, etc.

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This write-up should be 2-4 pages single spaced and concentrate on the most pertinent information. Not all the systems or sections from a comprehensive write up will be represented. Only the sections and information that are important to this case need be included. This helps clarify your understanding of using only the best/most important tools and information to justify your critical thinking.

Comprehensive Write-up: Comprehensive visits often requires head to toe or extensive ROS and physical examination (PE). Visits which may necessitate a comprehensive ROS, physical exam, and write-up include annual physical, well woman exam(may not always include head to toe, but could be the only preventive care most women receive), well child exam, new or established patients with complex or chronic diseases or comorbidities, non-specific complaints, such as fatigue, generalized weakness or body ache, dizziness, etc.  Episodic, Comprehensive and Alternative SOAP Note Example. This episodic, comprehensive and alternative soap note example  should be 5-8 pages single spaced.

You must know how to delineate which visits are episodic versus comprehensive.  Conducting a comprehensive exam on a patient whose chief complaint and ROS support an episodic visit or write-up may paint a picture of a clueless provider; and can constitute a waste of time for you and the patient. Your patient may not trust your clinical reasoning/judgment (diagnosis/plan of care) if they perceive you are all over the place!  Insurance is not going to pay you more because you decided to complete a comprehensive note on an episodic visit or diagnosis!

Alternative Write-up: Some courses may have specialized write-ups based on a patient with certain demographics or with certain disease process episodic, comprehensive and alternative soap note example. These write ups will follow the same guidelines as comprehensive-write ups.

Case Write-up Outline

 

Following the format of: https://meded.ucsd.edu/clinicalmed/write.htm.

 

Subjective:

CC: This should be in quotes: “I’ve had a cough and sore throat for 2 days”

HPI: One of the most important parts of the assessment. Check the list of important questions to ask (OLD CARTS or PQRST). As you become more proficient in physical exam and lab testing, the HPI does not decrease in importance – your ability to use it in diagnostic reasoning just increases.

Past Medical History: Past or present illness. Be careful with “blindly” copying history from a prior clinical note.

Past Surgical History: Past surgeries and rough dates when possible. Should also include traumas and hospitalizations

Medications: List name, dose, frequency and indication (why are they taking it?) Do NOT omit the indication (reason) for a specific drug being taken. Do NOT omit PRN medications and how often the medications are taken. This is one way to check whether you’ve put all important information in your patient history.  If a patient is taking Metformin and there’s no related information on the history and/or diagnoses list, something is missing.

Allergies: Medications. Food allergies when applicable.

Social History: This includes several factors: alcohol use, cigarette use, sexual history, work history are a few examples. Include health promotion information such as exercise and immunizations. Immunization is important – we want to know the date of an adult patient’s last tetanus immunization. Be specific, don’t just say UTD. For children, list dates for all immunizations. Episodic, Comprehensive and Alternative SOAP Note Example

Family History: It is generally appropriate to go back at least two generations.

Obstetrical History: When appropriate, document number of pregnancies and other relevant information.

Review of Symptoms (ROS): For comprehensive visits: should be extensive and include every system. For episodic visits: Think about your likely differential diagnosis list and tailor your ROS to it. Always address growth and development in pediatric patients. In childbearing women, make sure to document date of last menstrual period (LMP) and methods of contraceptive use on every visit on any woman capable of becoming pregnant (having menses and has not had a tubal ligation/hysterectomy). Every visit – If you order such a medication without documenting the above information, we have to assume that the patient could be pregnant (as would any lawyer in a lawsuit).  For a young teen you can put “not sexually active” (but make sure you have asked).  episodic, comprehensive and alternative soap note example This is sometimes tricky with teens being seen for general health problems but so very important.  If in any doubt, ask the parent to step out for a moment so that you can talk to the teen alone.

Objective

Vital signs (BMI should be included on every visit)

Physical examination

Laboratory data, diagnostic tests, imaging: These should be what is available at the time the visit. Do not include testing that was ordered during the visit but not results were not available.

TIP:

Make sure to proper distinguish between subjective and objective data. Subjective data, as the name suggests, is the information you gather by interviewing the patient, family, or significant other. This will include data from chief complaint, Social/family history, and Review of system (ROS). Objective data will include those information or data you elicited through physical examination, vital signs and/or diagnostic test results. Note that statement such as “Denies chest pain, sob, dysuria, vaginal bleeding, diarrhea, etc.” should be in the subjective section (ROS) of your note, and not in PE section.  Do not write “Alert and oriented; no tenderness; no erythema; breath sounds clear; no spine curvature” under ROS or subjective section. These are objective findings. You elicited these data through your physical examination of the patient.

Assessment

List both your differential diagnoses and your presumptive diagnosis. Remember that these should be supported by findings in your history and physical exam episodic, comprehensive and alternative soap note example. For a comprehensive exam, you should document at least three ICD code diagnoses.

Plan

Include medications ordered, labs tests, teaching, referrals, and when the patient needs to follow-up. All write-up plans should include documentation of patient education, especially if medication is prescribed and anticipatory guidance. Health maintenance such as screening for breast or colon cancer, should be addressed.

Coding Resource:

All write ups should include the billing codes.  We do not expect you to memorize these codes. You can get them from the billing form that the physician or NPs uses in the office. You can put the billing codes at the end of the write-up.  You should include both the E&M code (level of service) and the ICD-9 diagnosis codes. Your E&M code should be consistent with your patient visit. Episodic, Comprehensive and Alternative SOAP Note Example

MSN Case Write Up Assignment

The purpose of the Case Write- Up Assignment is for your instructor to “see” what you are doing in clinical and “see” how you are making clinical decisions. For these write-ups, you will select a patient seen in your current clinical rotation. You will “write-up” the visit, omitting any identifying patient factors. Ensure your write-ups demonstrate comprehensive advanced practice thinking and not just the new skills of ordering and prescribing.

Make sure to start “fresh”. Do not copy and paste from any examples, templates, other students work or even your own work. Put all your old case write-ups away and give your brain a chance to formulate the note so that it really becomes a part of what you know. THAT will make you a competent NP.

Be honest in your write up. If you realize that you have forgotten to assess something or forgot a certain part of the teaching, just put a note at the bottom of the write-up saying what should have been done. Your clinical faculty do not expect perfect write-ups, but do expect that you use every patient encounter and subsequent write-up as a time to learn and to evaluate and improve your own practice.

 

If your preceptor orders something that is not appropriate or fails to order something that you believe should have been part of the plan, write a note at the end of the write-up to let your instructor know that you are aware and what you would have done. You are not responsible for what your preceptor orders, but you are responsible for knowing the appropriate plan of care and you are responsible for knowing if a plan of care is inappropriate. You and your faculty are the only ones that see the write-up, so no feelings will be hurt. We all get set in our ways and tend to order the same thing over and over. If your readings and research indicate that another plan is more appropriate, write it as an addendum or in parentheses in the plan.

You are learning to practice evidence-based practice. Support at least one item in the assessment AND plan with research. This can be your textbook and/or other class readings. The best way to support your research is using a research article. Make sure that the article is current (5 years or less old). The article can be used to support the use of the medication (or other therapy) for the presumptive diagnosis. When using an article, please attach the article along with the write-up into the appropriate assignment category. Failure to cite your plan will result in a point penalty reduction (see rubric for additional information)

Note that you CANNOT redo write-ups. A grade cannot be improved by redoing a write up. Faculty will not read and comment on rough draft of write-ups

All case write ups are to be submitted to SafeAssign and the appropriate assignment category by the due date. Failure to submit to SafeAssign will incur a penalty of 5 points per day including weekends (maximum deduction of 25 pt.). Late submissions to the appropriate assignment category will incur a 5pt/day penalty (no maximum) including weekends unless an extension has been requested and approved before the due date episodic, comprehensive and alternative soap note example.

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MSN Case Write-Up Rubric

 

Criteria Exceeds Expectations Meets Expectations Below Expectations No Effort
Chief Complaint 

(CC)

 3 Points 

Includes CC that includes the reason for visit, is appropriate for the type of write-up AND is in the patient/

family’s own words.

 2 Points 

Includes CC that includes the reason for visit, is appropriate for the type of write-up but is not in the patient/family’s own words

 

 1 Point 

CC is not appropriate for the type of write-up AND is not in the patient/family’s own words

 

 0 Points 

 Not included
History of Present Illness 

(HPI)

 10 points 

Provides a comprehensive HPI that includes all the pertinent information and excludes irrelevant information.

HPI is focused and detailed.

Does not include any objective data

 7 points 

Provides a HPI that includes pertinent information but misses 1 -2 key components and/or includes information that is irrelevant to the patient visit. HPI is somewhat focused. Does not include objective data. Episodic, Comprehensive and Alternative SOAP Note Example

 4 points 

Provides a superficial HPI that misses 3 or more key components and/or does not include all pertinent information, includes irrelevant information OR includes objective data

 0 Points 

Not included
Medications 3 Points 

Documents a comprehensive

Medication list that includes drug name (brand and generic), dosage, route, frequency and indication. Allergies are documented and includes reaction. Includes NDKA, if applicable.

 2 Points 

Documentation includes medication list but omits 1-2 details. Allergies are documented but does not include reaction.

 1 Point 

Documentation includes medications but omits 3 or more details. Allergies are not documented

 0 Points 

Not included
Pertinent History 10 Points 

Provides comprehensive past medical history, surgical, family, social, and obstetrical history (when applicable). History is consistent with other documentation. Includes immunization information

 

 7 Points 

Provides a history but history is superficial AND/OR omits 1 -2 necessary details

 

 4 Points 

Provides a history but history of superficial and omits 3 or more details

 

 0 Points 

Not included
Review of Systems 10 Points 

Complete ROS that addresses each physical system for a comprehensive visit and includes only necessary (but at least 4 systems) for an episodic visit.

ROS is completed with a clear narrative.

Do not write within normal limit or other variations. If documented abnormalities, states what is considered ‘normal’

 7 Points 

Incomplete ROS that misses 3 or less components for a comprehensive visit OR includes inappropriate systems for an episodic visit

 

 4 Points 

Incomplete ROS that misses 4 or more components for a comprehensive visit AND/OR includes objective data

episodic, comprehensive and alternative soap note example

 

 0 Points 

 No ROS attempted
Objective Data 20 Points 

Documents vital signs with documented BMI

Documents physical examination:

Each system addressed completely for comprehensive exam. Includes only necessary (but at least 4 systems) for an episodic visit. Include pertinent positive and pertinent negative findings.

Documents labs, diagnostic tests that are available for that visit.

 14 Points 

 Documents vital signs but is missing BMI

Documents an incomplete physical examination:

missing 3 or less components for a comprehensive visit and/or missing up to 3 pertinent positives/negatives OR

includes unnecessary systems for an episodic visit and/or assesses less than 3 systems

Documents labs, diagnostic tests that should be a part of the plan

 

 8 Points 

Does not document vital signs

Documents an incomplete physical examination:

missing 4 or more of the components for a comprehensive visit and/ or missing 4 or more pertinent positives/negatives

OR

Includes unnecessary systems for an episodic visit and/or assesses less than 2 systems

Fails to document labs, diagnostic tests

 

 

 0 Points 

Not included
Assessment 14 Points 

Provides 3 or more differential diagnoses and a presumptive diagnosis for an episodic visit.

Provides at least 3 diagnoses for a comprehensive visit

ICD-9 codes included with each diagnosis

 9 Points 

Provides a presumptive diagnosis but only includes 1-2 differential diagnoses

 

Does not include ICD-9 codes

 

 4 Points 

No differential diagnoses OR no presumptive diagnosis

 

 0 Points 

No differential diagnosis AND no presumptive diagnosis
Plan 20 Points 

Provides a plan that includes appropriate labs/tests ordered that are pending

Includes medications ordered and/or refilled and details about dosing and instructions, and patient teaching are included.

Plan includes both pharmacological and non-pharmacological interventions

Plan includes referrals and follow up details

Orders are appropriate for patient visit. Rationales and citations for sources of interventions

Coding and Billing included

 

 14 Points 

Missing 3 or more components and/or does not include dosing and instructions for medications and/or does not include Coding and Billing

 

 8 Points 

Missing 4 or more of the required components OR Plan is not supported by evidence and citations for sources of intervention are missing AND

Does not include Coding and Billing

 

 0 Points 

Not included or inappropriate to patient visit
Formatting/APA 10 Points 

No errors in  grammar and spelling .

No errors in APA format

Write-up is in proper format and adheres to the appropriate page limits.

 7 Points 

Up to 3 spelling or grammar errors OR 3 APA errors

Write-up is in proper format and adheres to the appropriate page limits

 

 4 Points 

Up to 3 errors in spelling and/ or grammar AND/OR APA errors AND

Write-up is not in proper format OR does not adhere to the appropriate page limits

episodic, comprehensive and alternative soap note example

 0 Points 

4 or more errors in spelling and/or grammar

AND/OR 4 or more APA errors

Lucas Callahan Bipolar Disorder Subjective Data Collection

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Lucas Callahan Bipolar Disorder Subjective Data Collection

Subjective Data Collection: 69 of 69 (100.0%)

Hover To Reveal…

Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions.

  • Found:

     Indicates an item that you found.

  • Available:

     Indicates an item that is available to be found.

Category

Scored Items

Experts selected these topics as essential components of a strong, thorough interview with this patient.

Patient Data

Not Scored

A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

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Chief Complaint


  • Finding:

    Asked about chief complaint


  • Finding:

    Reports being brought in by police

    (Found)

    Pro Tip: A patient’s chief complaint establishes any illnesses or concerns they are presenting. Asking about their chief complaint will allow the patient to voice any concerns or symptoms the patient may have in their own words. Lucas Callahan Bipolar Disorder Subjective Data Collection

    Example Question:

    What brings you to the emergency room?

History of Present Illness


  • Finding:

    Followed up on incident


  • Finding:

    Reports looking into cars for government agents chasing him

    (Found)

    Pro Tip: Asking a patient the details about their current health issues allows you to fully comprehend them. Details of their illness will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

    Example Question:

    What were you doing when the police found you?

  • Finding:

    Reports having been in a grocery store parking lot

    (Found)

    Pro Tip: Asking a patient the details about their current health issues allows you to fully comprehend them. Details of their illness will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

    Example Question:

    Where were you when the police found you?

  • Finding:

    Reports knowing the police stopped him for running around and looking in cars

    (Found)

    Pro Tip: Asking a patient the details about their current health issues allows you to fully comprehend them. Details of their illness will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Lucas Callahan Bipolar Disorder Subjective Data Collection

    Example Question:

    Do you know what caused the police to bring you in?

  • Finding:

    Denies having hurt himself or others

    (Available)

    Pro Tip: Asking a patient the details about their current health issues allows you to fully comprehend them. Details of their illness will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

    Example Question:

    Were you hurting anyone?

  • Finding:

    Denies having done anything illegal

    (Available)

    Pro Tip: Asking a patient the details about their current health issues allows you to fully comprehend them. Details of their illness will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

    Example Question:

    Were you doing anything illegal?

  • Finding:

    Followed up on government agents


  • Finding:

    Reports government is trying to imprison him for being enlightened

    (Found)

    Pro Tip: Asking a patient the details about their current health issues allows you to fully comprehend them. Details of their illness will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

    Example Question:

    What is the reason that government agents are following you?

  • Finding:

    Reports government sees his enlightenment as a threat to their secrets

    (Found)

    Pro Tip: Asking a patient the details about their current health issues allows you to fully comprehend them. Details of their illness will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

    Example Question:

    What is the reason that government agents are following you?

  • Finding:

    Asked about anxiety or paranoia


  • Finding:

    Reports last depressive period ended a couple months ago

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

    Example Question:

    When did your last period of depression end?

  • Finding:

    Reports last depressive period was a long one

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Lucas Callahan Bipolar Disorder Subjective Data Collection

    Example Question:

    How long was your last period of depression?

  • Finding:

    Asked about details of depression diagnosis


  • Finding:

    Reports being diagnosed by psychiatrist

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

    Example Question:

    Who diagnosed you with depression?

  • Finding:

    Reports diagnosed 3 years ago

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

    Example Question:

    When were you diagnosed with depression?

  • Finding:

    Asked about reason for seeing psychiatrist


  • Finding:

    Reports being made to see the psychiatrist following a suicide attempt

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

    Example Question:

    What did you see the psychiatrist for?

  • Finding:

    Asked about how depression was treated


  • Finding:

    Reports psychiatrist prescribed antidepressants

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

    Example Question:

    Did the psychiatrist prescribe anything for your depression?

  • Finding:

    Asked about hospitalizations


  • Finding:

    Reports being hospitalized after suicide attempt

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

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    Example Question:

    Were you hospitalized after your suicide attempt?

  • Finding:

    Reports being hospitalized 3 years ago

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

    Example Question:

    When were you hospitalized?

  • Finding:

    Asked about allergies


  • Finding:

    Denies allergies

    (Found)

    Pro Tip: Inquiring into the patient’s relevant history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

    Example Question:

    Do you have any allergies?

Home Medications


  • Finding:

    Asked about effectiveness of medication


  • Finding:

    Reports antidepressants were not effective

    (Found)

    Pro Tip: A patient’s home medications can provide insight into the patient’s current treatment and its efficacy. Inquiring into medication history, dosage, and frequency will help you understand the patient’s background and how it may affect their current situation.

    Example Question:

    Were the antidepressants effective?

  • Finding:

    Reports antidepressants caused side effects

    (Found)

    Pro Tip: A patient’s home medications can provide insight into the patient’s current treatment and its efficacy. Inquiring into medication history, dosage, and frequency will help you understand the patient’s background and how it may affect their current situation.

    Example Question:

    Did the antidepressants cause any side effects?

  • Finding:

    Reports stopping the antidepressant regimen

    (Found)

    Pro Tip: A patient’s home medications can provide insight into the patient’s current treatment and its efficacy. Inquiring into medication history, dosage, and frequency will help you understand the patient’s background and how it may affect their current situation.

    Example Question:

    Did you continue taking the antidepressants?

  • Finding:

    Reports not consulting a healthcare provider before stopping regimen

    (Available)

    Pro Tip: A patient’s home medications can provide insight into the patient’s current treatment and its efficacy. Inquiring into medication history, dosage, and frequency will help you understand the patient’s background and how it may affect their current situation.

    Example Question:

    Did you consult your healthcare provider before stopping the antidepressants?

  • Finding:

    Followed up on medication side effects


  • Finding:

    Reports not wanting to discuss side effects

    (Found)

    Pro Tip: A patient’s home medications can provide insight into the patient’s current treatment and its efficacy. Inquiring into medication history, dosage, and frequency will help you understand the patient’s background and how it may affect their current situation.

    Example Question:

    What kind of side effects did the antidepressants cause?

  • Finding:

    Followed up on details of the medication prescription


  • Finding:

    Denies remembering details of the medication prescription

    (Found)

    Pro Tip: A patient’s home medications can provide insight into the patient’s current treatment and its efficacy. Inquiring into medication history, dosage, and frequency will help you understand the patient’s background and how it may affect their current situation.

    Example Question:

    What was the name of the antidepressant?

  • Finding:

    Asked about home medications beside antidepressants


  • Finding:

    Denies home medications beside antidepressants

    (Found)

    Pro Tip: A patient’s home medications can provide insight into the patient’s current treatment and its efficacy. Inquiring into medication history, dosage, and frequency will help you understand the patient’s background and how it may affect their current situation.

    Example Question:

    Do you take any other medications?

Ask Suicide Screening Questions


  • Finding:

    Followed up on suicide attempt


  • Finding:

    Reports attempt occurred 3 years ago

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety. Lucas Callahan Bipolar Disorder Subjective Data Collection

    Example Question:

    When was your suicide attempt?

  • Finding:

    Reports not wanting to discuss the suicide attempt

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    How did you attempt suicide?

  • Finding:

    Asked about other suicide attempts


  • Finding:

    Denies other suicide attempts

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Have you had other suicide attempts?

  • Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Do you ever think others would be better off without you?

  • Finding:

    Reports not wanting to discuss this belief

    (Available)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Do you ever think others would be better off without you?

  • Finding:

    Asked about thoughts of suicide


  • Finding:

    Denies current thoughts of suicide

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Are you having suicidal thoughts right now?

  • Finding:

    Reports previous thoughts of suicide during depressive episodes

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Have you ever had suicidal thoughts?

  • Finding:

    Reports that thoughts of suicide are permanently behind him

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Do you ever have suicidal thoughts?

  • Finding:

    Asked about current plans for suicide


  • Finding:

    Denies recent plan to attempt suicide

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Have you recently planned to commit suicide?

  • Finding:

    Reports last suicidal plans were before suicidal attempt 3 years ago

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Have you ever planned to commit suicide?

  • Finding:

    Asked about self-harming without intending to die


  • Finding:

    Reports only self-injury was the suicide attempt

    (Found)

    Pro Tip: Determining a patient’s risk for suicide is imperative for suicide prevention, intervention, and education. Using the Ask Suicide-Screening Questions (ASQ) will help you uncover the most relevant pieces of information around suicide ideation and action, both past and present, that are necessary for protecting the patient’s safety.

    Example Question:

    Have you ever self-harmed?

  • Finding:

    Asked about homicidal urges


  • Finding:

    Denies homicidal urges

    (Found)

    Pro Tip: Asking a patient if they are experiencing homicidal urges may be uncomfortable, but it is important for determining a patient’s mental health, issues with rage or violence, and the safety levels of the patient and the people in their lives.

    Example Question:

    Do you ever feel homicidal urges?

Mood Disorder Questionnaire


  • Finding:

    Asked about perception of mental health


  • Finding:

    Reports feeling like his depression is over

    (Found)

    Pro Tip: Utilizing the Mood Disorder Questionnaire (MDQ) is an effective means of gathering relevant information about a patient’s mental health, helping you screen them for signs of Bipolar Disorder. By discussing these relevant topics such as mood changes, associated behaviors, and changes to lifestyle and relationships, you can determine what diagnosis, education, and interventions the patient needs.

    Example Question:

    How do you feel about your depression?

  • Finding:

    Reports feeling like mental health is exceptional

    (Found)

    Pro Tip: Utilizing the Mood Disorder Questionnaire (MDQ) is an effective means of gathering relevant information about a patient’s mental health, helping you screen them for signs of Bipolar Disorder. By discussing these relevant topics such as mood changes, associated behaviors, and changes to lifestyle and relationships, you can determine what diagnosis, education, and interventions the patient needs.

    Example Question:

    How would you describe your mental health?

  • Finding:

    Reports feeling mental health treatment is unnecessary

    (Available)

    Pro Tip: Utilizing the Mood Disorder Questionnaire (MDQ) is an effective means of gathering relevant information about a patient’s mental health, helping you screen them for signs of Bipolar Disorder. By discussing these relevant topics such as mood changes, associated behaviors, and changes to lifestyle and relationships, you can determine what diagnosis, education, and interventions the patient needs.

    Example Question:

    Do you think you need mental health treatment?

  • Finding:

    Asked if others notice mood or energy shifts


  • Finding:

    Reports not paying attention to others’ perception of him

    (Found)

    Pro Tip: Utilizing the Mood Disorder Questionnaire (MDQ) is an effective means of gathering relevant information about a patient’s mental health, helping you screen them for signs of Bipolar Disorder. By discussing these relevant topics such as mood changes, associated behaviors, and changes to lifestyle and relationships, you can determine what diagnosis, education, and interventions the patient needs.

    Example Question:

    Has anyone commented on your mood and energy shifts?

  • Finding:

    Asked about excessive irritability or anger


  • Finding:

    Reports feeling angry only when people “interfere with the vibes” Lucas Callahan Bipolar Disorder Subjective Data Collection

NURS 510 Budget Analysis Millway University Nurse-Managed Clinic (MNC)

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NURS 510 Budget Analysis Millway University Nurse-Managed Clinic (MNC)

NURS 510 Budget Analysis Millway University Nurse-Managed Clinic (MNC)

NURS510

Budget Analysis

Millway University Nurse-Managed Clinic (MNC)

 

The budget below is an example of a statistics based budget used for planning and projection of the UOS (units of service) that represents utilization of health services in a nurse-managed clinic.  A statistics budget is prepared prior to developing an operating budget because health care revenue and expenses are most often based on volume (this is true in acute care settings as well).  The volume statistics are also linked to the settings capacity or the maximum UOS that can be managed by the available staff.  Since health care environments are so variable, performance targets are most often set below capacity.

The budget below represents past budget performance for 2015 and 2016, and the projected budget for 2017. NURS 510 Budget Analysis Millway University Nurse-Managed Clinic (MNC) NURS 510 Budget Analysis Millway University Nurse-Managed Clinic (MNC)

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Background and projections:

-the  NP capacity is based on performance targets for 4 encounters/day/NP for 2015 and 6 encounters/day/NP for 2016 and 2017.  This increase in capacity is due to the addition of administrative support which frees up the NPs to focus on patient care.

-the encounter per day are multiplied by the 224 days each NP is budgeted to work

-actual performance  is reported as actual encounters per day and the total encounters from ACO contracts and self pay encounters

-the performance target is for the NPs to work 95% of capacity, which is the level that the NPs function most efficiently.

-the 2017  budget projects 3,830 patient encounters, or 95% of the 4,032 capacity.

-the nurse managers and NPs decided to maintain the ACO contract fro disease management and wellness care. NURS 510 Budget Analysis Millway University Nurse-Managed Clinic (MNC)

-a contract for immunizations with Bigtown school district  decreases immunizations from 500 to 300 in 2017.  The NPs will focus on immunizing preschool children entering the school system rather than on school age children

-an increase in self-pay encounters is projected for 2017

 

Analysis questions:

 

  1. Based on the projections above provide your analysis of why these decisions might have been made for this clinic. Do you agree or disagree with the changes?  Why?
  2. Assume that the nurses working in the MNC have a 5% salary increase for the following budget year. Calculate the change to personnel expenses and the impact on total expenses and the impact on MNC profits.
  3. Discuss at least one (1) internal and one (1) external change or event that might affect the MNC budget in the next year.

(eg: maternity leave for one of the NPs,  a pandemic that closes                                                         schools,  ??????)

from Penner, S. (2017). Economics and Financial Management for Nurses and Nurse Leaders (3rd ed).  New York:  Springer Publishing Company. Order NURS 510 Budget Analysis Millway University Nurse-Managed Clinic (MNC ) NURS 510 Budget Analysis Millway University Nurse-Managed Clinic (MNC)

NRNP 6645: Psychotherapy with Multiple Modalities Final Exam

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NRNP 6645: Psychotherapy with Multiple Modalities Final Exam

Question 1

The Gestalt Therapist working with a patient notices that every time a sensitive issue come up the patient will change the topic and tell a joke.  The therapist recognizes this interruption as which of the following?NRNP 6645: Psychotherapy with Multiple Modalities Final Exam

A. Introjection
B. Projection
C. Deflection
D. Retroflection

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Question 2

A patient whose husband had recently died suddenly expresses remorse regarding an argument they  had shortly before his death. The Gestalt Therapist would likely use which of the following techniques to complete unfinished business?

A. Focusing
B. Dreamwork
C.  Empty-chair dialogue
D. Language of responsibility
 

Question 3

In child psychotherapy consideration of systems that promote a child’s ongoing development include which of the following? NRNP 6645: Psychotherapy with Multiple Modalities Final Exam

A. Peers
B. Family
C. School
D. Community

 

Question 4

Which of the following is a philosophical approach to psychotherapy which deals with universal  themes of life?

A. Gestalt Therapy
B. Psychoanalysis
C. Existential psychotherapy
D. Person-Centered Psychotherapy

Question 5

The patient in Dialectical Behavior Therapy (DBT) expresses frustration that the skills taught don’t work, the process is taking too long, and is struggling to complete homework. The advanced practice psychiatric nurse using a DBT model would do which of the following?

A. Validate the patient ‘s frustration while encouraging and reinforcing use of skills.
B. Analyze the behaviors and consequences of the behaviors with the patient.
C. Focus on behavioral control and management with emotions as a contextual element.
D. All of the above

 

Question 7

Which of the following is not consistent with Eye Movement Desensitization and Reprocessing (EMDR) literature in treating PTSD?

A. Treatment effects are long lasting.
B. EMDR involves extended exposure
C. EMDR treatment for trauma is less time intensive.
D. The aim is to reduce the subject distress and strengthen adaptive beliefs related to the traumatic event.

 

Question 8

In working with an older adult female patient, the advanced practice psychiatric nurse notices that the patient starts bringing her baked goods, and says “You remind me so much of my daughter, you are so easy to talk to.” The advanced practice psychiatric nurse recognizes this as

A. Gerotranscendence
B. Transference
C. Countertransference
D. Time for termination

 

Question 9

The situation in which increasing amounts of a substance is needed to achieve the same desired effect  is known as which of the following? NRNP 6645: Psychotherapy with Multiple Modalities Final Exam

A. Addiction
B. Tolerance
C. Withdrawal
D. Dependence

 

Question 10

Which of the following therapeutic approaches would be a better choice for an older adult who presents with chronic depression, mild cognitive impairment expressing concerns about a negative life event and perceives himself as helpless?

A. Interpersonal Psychotherapy (IPT)
B. Cognitive Behavioral Therapy (CBT)
C. Cognitive Behavioral Therapy for Mild Dementia (CBT-MD)
D. Reminiscence Therapy (RT)

D

Question 11

Stigma of mental illness in the elderly:

A. Has contributed to psychiatric symptoms being expressed with physical symptoms.
B. Is much more severe in baby boomers than in other elderly cohorts.
C. Is much less an issue in baby boomers than in other elderly cohorts
D. Leads to more discussion of emotions in primary care settings.

 

Question 12

The person-centered therapist who is genuine and authentic during the therapy session is exhibiting       which psychological condition?

A. Congruence
B. Actualizing tendency
C. Belief of human nature NRNP 6645: Psychotherapy with Multiple Modalities Final Exam
D. Accurate empathic understanding

 

Question 13

Which of the following is not consistent with a family-centered approach in child therapy?

A. In family-centered treatment, the family is the focus of treatment.
B. Family- centered treatment is appropriate to improve family interactions.
C. Family-centered treatment is appropriate to keep families engaged in services
D. Family-centered treatment is appropriate to increase family knowledge about mental health.

 

Question 14

Which of the following does the advanced practice psychiatric nurse need to consider when treating older adults with Substance Use Disorders?

A. Co-existing medical or psychiatric disorder
B. Age-related physiological and psychological changes
C. Collaboration with primary care providers
D. All of the above NRNP 6645: Psychotherapy with Multiple Modalities Final Exam

 

Question 15

Which of the following is true about the therapeutic alliance when working with children?

A. The therapeutic alliance is a core factor that creates change in therapy.
B. The therapeutic alliance/bond with the child is all that is really needed.
C. The advanced practice psychiatric nurse must develop a strong therapeutic alliance with the child’s parents prior to attempting to engage the child in therapy.
D. As the therapy is really about the child, parents/family, the advanced practice psychiatric nurse focuses on facilitating healthy family interactions.

 

Question 16

The underlying assumptions of Trauma Resiliency Model therapy include which of the following?

A. Human response to threat are subcortical in nature.
B. Response to trauma is likely transient and should go away with or without treatment.
C. The mind has no bias; thus, we make sense of the world in a symmetrical manner.
D. Current psychiatric concepts adequately account for the impact of multiple or long-term

Question 17

The advanced practice psychiatric nurse realizes a basic assumption of Dialectical Behavior Therapy (DBT) is that therapists treating the difficult patient need support. This support includes which of the following?

A. The support is provided through case management
B. The support is designed to focus on clinical issues of the patient
C. The DBT therapist in solo practice does not need a consultation group for support. NRNP 6645: Psychotherapy with Multiple Modalities Final Exam
D. The support includes a consultation group to treat the therapist by using the same skills the patient is asked to use.

 

Question 31

The advanced practice psychiatric nurse realizes which of the following with respect to individuals with personality disorders of traits?

A. Often these individuals will see their problems as independent of their own behaviors.
B. These individuals will often describe themselves as a victim.
C. These individuals often present for treatment at the request of a significant other or other external pressure.
D. All the above.

 

Question 32

Addiction is now recognized as which of the following?

A. A preventable personality disorder
B. A family disorder due to poor parenting
C. A volitional behavior that can be managed independently’
D. A primary disease of the brain’s neurocircuitry.

 

Question 40

Which of the following are psychotherapeutic techniques used in person centered psychotherapy?

A. A highly structured approach is used.
B. Process interventions are widely used.
C. Directive, interpretive techniques are used.
D. A nondirective-facilitative counseling approach is used.

 

Question 41

When referring a patient to a 12-step group the advanced practice psychiatric nurse realizes which of the following supports successful patient engagement in 12-step group participation?

A. Provide an overview of the 12-step approach, explain the concept of powerlessness and spirituality within the 12-step tradition.
B. Use MI to contract for attendance at several different groups to find the right “fit” and encourage attendance.
C. Encourage patient to not worry about going to the groups because due to high attrition rates, most groups have many new patients at each session.
D. A and B only

 

Question 42

The advanced practice psychiatric nurse notices in working with a patient with a dissociative disorder that the person appears to be doing worse after significant gains are made. The advanced practice psychiatric nurse explains the reason for this is likely which of the following?

A. This indicates the change(s) really did not take
B. The patient is unconsciously sabotaging the therapy.
C. This indicates process is trying to force a change too fast.
D. As positive changes occur they may be followed by a temporary increase in sadness, anger, or anxiety because even positive change may be experienced as a loss.

 

Question 43

Which of the following medications may be recommended for patients with insomnia due to PTSD?

A. Any antidepressant can offer as first-line treatment in adults for PTSD.
B. Non-benzodiazepines such as trazodone (Desyrel)
C. Prazosin (Minipress) may be helpful if nightmares are present.
D. B and C

 

Question 44

Which of the following is not true about self-regulation as it applies to therapy with children?

A. Self-regulation is a developmental milestone of childhood in which the child controls behavior in the service of socially desirable conduct.
B. Self-regulation is a pivotal developmental process of integrating emotion, memory and behavior.
C. Self-regulation mechanisms from a neuroscience perspective are basic mechanisms predominantly located in the globus pallidus.
D. Self-regulation issues are often seen in various child psychopathology.

 

Question 45

Stress inoculation therapy (SIT) can be helpful for patients with phobic avoidance due to trauma. The advanced practice psychiatric nurse using SIT would do which of the following?

A. Artistic endeavors such as sculpting, drawing painting.
B. Movement therapies such as dance.
C. Tapping on acupressure points
D. Cognitive skills such as thought stopping and guided self-dialogue.

 

Question 48

The advanced practice psychiatric nurse using Dialectical Behavior Therapy with a patient with borderline personality disorder uses persuasive dialogue to do which of the following?

A. Invite the patient to new ways of viewing a situation
B. Guiding patient to develop more skills to achieve a greater quality of life.
C. Engage the patient in change talk
D. A and B

 

Question 55

Which of the following is not consistent with the Dialectical Behavior Therapy approach to boundary maintenance?

A. Clarify explicitly the boundaries of the therapeutic relationship.
B. The therapist will maintain confidentiality within the limits of the law and ethical practice.
C. Explain a professional relationship is based on mutual respect and the desire to help the patient.
D. Maintain a rigid distant relationship with the patient to avoid any mixed messages to the patient.

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Question 98

One of the problems when meeting with children individually is that it can create secrets. Which of the following responses would the advanced practice psychiatric nurse do to address this concern?

A. Do nothing, maintaining the child’s privacy protects the therapeutic relationship.
B. Decide what the parents need to know and give them a summary of the individual session in with the child in the room.
C. Decide what the parents need to know and give them a summary privately to avoid any awkwardness for the child.
D. Discuss with the child what he or she wants to share with the parents and facilitate the process as needed.

D

Question 99

Sleep disturbances are common for those who have experienced trauma. Which of the following  would not be recommended when teaching patients about good sleep hygiene?NRNP 6645: Psychotherapy with Multiple Modalities Final Exam

A. Regular daily exercise
B. Avoid napping during the day.
C. Maintain a quiet cool bedroom
D. Put bedroom TV on a timer so it will automatically go off after you are asleep.

 

Question 100

Which best describes gerotranscendence?

A. Erik Erikson’s ninth stage of development
B. Emphasizes ongoing growth over decrements
C. Focuses on the transition to old-old (80 years and older). NRNP 6645: Psychotherapy with Multiple Modalities Final Exam
D. Focuses on letting go and coming to terms with end of one’s life NRNP 6645: Psychotherapy with Multiple Modalities Final Exam

Discussion: Review of Current Healthcare Issues

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Discussion: Review of Current Healthcare Issues

Discussion: Review of Current Healthcare Issues

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue Discussion: Review of Current Healthcare Issues.

To Prepare:

  • Review the Resources and select one current national healthcare issue/stressor to focus on.
  • Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

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By Day 3 of Week 1

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor Discussion: Review of Current Healthcare Issues

CLC – Health Promotion and Community Resource Teaching Project

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CLC – Health Promotion and Community Resource Teaching Project

This is a Collaborative Learning Community (CLC) assignment.

An important role of nursing is to provide health promotion and disease prevention. Review the topics and related objectives provided on the Healthy People 2030 website. Choose a topic of interest that you would like to address, in conjunction with a population at-risk for the associated topic. Submit the topic and associated group to your instructor for approval CLC – Health Promotion and Community Resource Teaching Project.

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Create a 15-20 slide PowerPoint presentation for your topic and focus group. Include speaker notes and citations for each slide, and create a slide at the end for References.

Address the following:

  1. Describe the approved topic and associated population your group has selected. Discuss how this topic adversely affects the population. How does health disparity affect this population?
  2. Explain evidence-based approaches that can optimize health for this population. How do these approaches minimize health disparity among affected populations? CLC – Health Promotion and Community Resource Teaching Project
  3. Outline a proposal for health education that can be used in a family-centered health promotion to address the issue for the target population. Ensure your proposal is based on evidence-based practice CLC – Health Promotion and Community Resource Teaching Project.
  4. Present a general profile of at least one health-related organization for the selected focus topic. Present two resources, national or local, for the proposed education plan that can be utilized by the provider or the patient.
  5. Identify interdisciplinary health professionals important to include in the health promotion. What is their role? Why is their involvement significant?

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style CLC – Health Promotion and Community Resource Teaching Project.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Materials if you need assistance.

Course Code Class Code Assignment Title Total Points
NRS-429VN NRS-429VN-O502 CLC – Health Promotion and Community Resource Teaching Project 160.0
Criteria Percentage Unsatisfactory (0.00%) Less than Satisfactory (75.00%) Satisfactory (79.00%) Good (89.00%) Excellent (100.00%)
Content 100.0%
Approved Topic, Associated Population and Health Disparity 10.0% Topic and associated population selected is not approved; topic and associated population are not relevant to the scope of the assignment. Topic and associated population are omitted. Approved topic and associated population are partially presented. It is unclear how the topic adversely affects the selected population. Health disparities are partially described, or are not relevant to selected population. There are significant inaccuracies. Approved topic and associated population are summarized. A general correlation of how the topic adversely affects the selected population is presented. Relevant health disparities are summarized. There are some inaccuracies. More evidence or rationale is needed for support. Approved topic and associated population are described. A correlation of how the topic adversely affects the selected population is established and discussed. Relevant health disparities are discussed. There are minor inaccuracies. Some evidence or rationale is needed for support. Approved topic and associated population are thoroughly described. A strong correlation of how the topic adversely affects the selected population is established and discussed in detail. Relevant health disparities are clearly presented and discussed. Strong evidence and compelling rationale is offered for support.
Evidence-Based Approaches to Optimize Health for Population 10.0% Evidence-based approaches to optimize health for this population are not presented. Evidence-based approaches to optimize health for this population are partially presented; some approaches presented are not evidence-based, or are not relevant for this population. Explanation of how these approaches minimize health disparity is incomplete, or are not relevant for the affected population. There are significant inaccuracies. Evidence-based approaches to optimize health for this population are summarized; it is unclear how some approaches presented are relevant for this population.  A general explanation of how these approaches minimize health disparity is presented. There are some inaccuracies. More evidence or rationale is needed for support. Evidence-based approaches to optimize health for this population are discussed. Explanation of how these approaches minimize health disparity is presented. Some evidence or rationale is needed for support. Evidence-based approaches to optimize health for this population are discussed, and approaches are accurately represented and highly relevant to the population. Explanation of how these approaches minimize health disparity is well-developed. Strong evidence and rationale are provided throughout. An understanding of the importance of evidence-based approaches in the optimization of health for an at-risk population is demonstrated.
Proposal for Health Education for Family-Centered Health Promotion CLC – Health Promotion and Community Resource Teaching Project 10.0% A proposal for health education for a family-centered health promotion to address the issue for the target population is omitted. The proposal is not supported by evidence-based practice. A proposal for health education for a family-centered health promotion to address the issue for the target population is partially presented. The proposal is not entirely relevant to the target population. The proposal requires more support relevant to evidence-based practice. There are significant inaccuracies. A proposal for health education for a family-centered health promotion to address the issue for the target population is presented. It is generally supported by evidence-based practice; there are some inaccuracies, or some areas need more support using evidence-based practice. Overall, the proposal is relevant to the target population. A proposal for health education for a family-centered health promotion to address the issue for the target population is presented. It is supported by evidence-based practice and relevant to the target population. There are minor inaccuracies. A well-developed proposal for health education for a family-centered health promotion to address the issue for the target population is presented. It is strongly supported by evidence-based practice and highly relevant to the target population. The ability to apply evidence-based practice to health education for a target population is clearly demonstrated.
Resources and Organizations for Proposed Education Plan 5.0% Resources and organizations to support the proposed education plan are omitted. One health-related organization for the selected topic is presented. The profile is incomplete, or it is unclear how the organization is relevant to the focus topic. Two resources (national or local) are presented. It is unclear how the resources are supposed to be used, or how the resources are relevant to the focus topic. A general profile for a health-related organization relevant to the selected topic is summarized. Two relevant resources (national or local) are presented, and there is a general explanation for how the resources are supposed to be used by the patient or provider. A general profile for a health-related organization relevant to the selected topic is presented. Two relevant resources (national or local) are presented, and there is an explanation for how the resources are supposed to be used by the patient or provider. A general profile for a health-related organization relevant to the selected topic is well presented. Two relevant resources (national or local) are presented, and there is a clear explanation for how the resources are supposed to be used by the patient or provider.
Interdisciplinary Health Professional Involvement 5.0% Interdisciplinary health professionals important to the health promotion are not included. At least one significant interdisciplinary health professional is presented. It is unclear how the professional important to the health promotion, and what the role of the professional would be. Support for the suggested member is needed. Some significant interdisciplinary health professionals are presented. A summary of their role and importance to the health promotion is provided. Some support for the suggested members is needed. Key interdisciplinary health professionals are presented A discussion of their role and importance to the health promotion is provided. All significant interdisciplinary health professionals are presented. A clear discussion of their role and importance to the health promotion is provided.
Presentation of Content 40.0% The content lacks a clear point of view and logical sequence of information. Includes little persuasive information. Sequencing of ideas is unclear. The content is vague in conveying a point of view and does not create a strong sense of purpose. Includes some persuasive information. The presentation slides are generally competent, but ideas may show some inconsistency in organization or in their relationships to each other. The content is written with a logical progression of ideas and supporting information exhibiting a unity, coherence, and cohesiveness.  Includes persuasive information from reliable sources. The content is written clearly and concisely. Ideas universally progress and relate to each other. The project includes motivating questions and advanced organizers. The project gives the audience a clear sense of the main idea.
Layout 5.0% The layout is cluttered, confusing, and does not use spacing, headings, and subheadings to enhance the readability.  The text is extremely difficult to read with long blocks of text, small point size for fonts, and inappropriate contrasting colors. Poor use of headings, subheadings, indentations, or bold formatting is evident. The layout shows some structure, but appears cluttered and busy or distracting with large gaps of white space or a distracting background. Overall readability is difficult due to lengthy paragraphs, too many different fonts, dark or busy background, overuse of bold, or lack of appropriate indentations of text. The layout uses horizontal and vertical white space appropriately. Sometimes the fonts are easy to read, but in a few places the use of fonts, italics, bold, long paragraphs, color, or busy background detracts and does not enhance readability. The layout background and text complement each other and enable the content to be easily read. The fonts are easy to read and point size varies appropriately for headings and text. The layout is visually pleasing and contributes to the overall message with appropriate use of headings, subheadings, and white space. Text is appropriate in length for the target audience and to the point. The background and colors enhance the readability of the text.
Language Use and Audience Awareness (includes sentence construction, word choice, etc.) 5.0% Inappropriate word choice and lack of variety in language use are evident. Writer appears to be unaware of audience. Use of primer prose indicates writer either does not apply figures of speech or uses them inappropriately. Some distracting inconsistencies in language choice (register) or word choice are present. The writer exhibits some lack of control in using figures of speech appropriately. Language is appropriate to the targeted audience for the most part. The writer is clearly aware of audience, uses a variety of appropriate vocabulary for the targeted audience, and uses figures of speech to communicate clearly. The writer uses a variety of sentence constructions, figures of speech, and word choice in distinctive and creative ways that are appropriate to purpose, discipline, and scope.
Mechanics of Writing  (includes spelling, punctuation, grammar, language use) 5.0% Slide errors are pervasive enough that they impede communication of meaning. Frequent and repetitive mechanical errors distract the reader. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Slides are largely free of mechanical errors, although a few may be present. Writer is clearly in control of standard, written, academic English.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

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NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Week 1: Competencies of Advanced Nursing Practice

Advanced nursing practice competencies focus on the unique practice knowledge, skills, and attitudes a nurse practitioner must demonstrate as they work with adults across the lifespan in clinical settings. They are developed by experts in the field and provide clarity about what is needed to be successful in your career. Competencies need to be practiced so they can be used to effectively address a wide range of situations. In addition to real-world settings, there are virtual opportunities that can facilitate the development of competencies. For example, throughout this course, you will complete case study simulation assignments with virtual i-Human patients presenting a variety of medical conditions. These types of virtual simulations provide you with the formative practice needed to help guide and prepare you for the real-world clinical experience. NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

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For this week, you will examine advanced nursing practice competencies and reflect on your strengths and challenges related to the competencies. In light of your reflection, you will consider how this course may help you attain your career goals or objectives.

Learning Objectives

Students will:

  • Analyze strengths and challenges related to nursing practice competencies
  • Describe professional career goals or objectives NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course
  • Learning Resources
Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Class Café: Introductions

Photo Credit: nakophotography / Adobe Stock

This Class Café is a place for discussions that do not necessarily relate to the formal content of this course and will not be assessed. However, we encourage you to get to know your colleagues and familiarize yourselves with everyone’s background and personal history. Note: If your posting is of a personal nature or involves issues that are of concern only to you and require an individual response from the Instructor, please email the Instructor directly.

By Day 2

Post and introduce yourself to your colleagues and ask any questions you might have about the course or questions in general.

Respond to your colleagues and answer any questions or ask any questions that you might have.

Note: This Class Café is not required and will not be assessed; however, you are encouraged to get to know your colleagues. NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Submission and Grading Information

Post by Day 2

To Participate in this Discussion:

Class Café: Introductions NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

An advanced practice nurse collaborates and communicates with patients, families, doctors, nurses, and specialists to ensure patients receive the care they need. As they diagnose, treat, manage, and educate patients, they are responsible for ensuring patient safety and maintaining ethical behavior. Competencies have been developed to help the advanced practice nurse to understand the practice knowledge, skills, and attitudes they need to be successful.

Photo Credit: michaeljung / Adobe Stock

For this Discussion, you will examine advanced nursing practice competencies and reflect on your strengths and challenges related to the competencies. In light of your reflection, you will consider how this course may help you attain your career goals or objectives.

To prepare:

  • Review the Learning Resources for this week, specifically the advanced nursing practice competencies. As you review the competencies, reflect on your own strengths and challenges when working with adults across the lifespan.

By Day 3

Post a summary of your expectations of this course. Also, include a brief explanation of your strengths and challenges as they relate to nursing practice competencies when working with adults. Describe any career goals or objectives this course may help you accomplish in the Family Nurse Practitioner (FNP) or Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) role and explain why. Use your research to support your explanations by providing credible and scholarly sources NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days by offering a suggestion or resources to help your colleagues in addressing their personal strengths or challenges, or their career goals. Use your research to support your suggestions. Provide at least 3 credible and current scholarly sources. NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

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 Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To Participate in this Discussion:

Week 1 Discussion

Assignment

Practicum Manual Acknowledgment

The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

What’s Coming Up in Week 2?

Practicum – Upcoming Deadline

In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via Meditrek .

For information on the practicum application process and deadlines, please visit the Field Experience: College of Nursing: Application Process – Graduate web page.

Please take the time to review the Appropriate Preceptors and Field Sites for your courses.

Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the Field Experience: College of Nursing: Student Resources and Manuals web page.

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will analyze an i-Human simulation case study about an adult patient with an integumentary condition and formulate a differential diagnosis, based on the patient’s information. Using the findings of your analysis, you will evaluate treatment options and then create an appropriate treatment plan for the patient NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Looking Ahead:

In this course and beginning in Week 2, you will be required to complete case study assignments using the web-based software i-Human. You should have received an email with your i-Human Patients login and password information. If you have not received this information, please contact the Course Instructor.

Ensure that you are able to log in to the software and review the i-Human Patients Case Player Student Manual as needed to familiarize yourself about how to navigate i-Human. NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Week 3: Evaluation and Management of HEENT Conditions

Last week, observing external characteristics of a patient was introduced as an important initial component of a physical examination. In addition to those observations, additional patient information can be learned by examining the head, eyes, ears, nose and throat, referred to as the HEENT system. Abnormal or disease manifestations may cause changes to one or more parts of the HEENT system, and understanding those manifestations is a critical skill for the advanced practice nurse.

For this week, you will not have a simulation case study however, it will be important for you to recognize that your continued observations and additional patient information are critical to your advanced nursing skills. This Week 3 concludes Module 1, and you will complete a Knowledge Check assessment covering the Module 1 topics examined in Weeks 1–3.

Learning Objectives

Students will:

  • Identify key terms, concepts, and principles related to the primary care of adults across the lifespan NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course
  • Learning Resources
Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)
Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions

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In this exercise, you will complete a 10- question Knowledge Check to gauge your understanding of this module’s content.  Please note that this is a formative practice to help you better prepare for your Midterm and Final Exam as well as your Nurse Practitioner (NP) certification exam. The questions in this Knowledge Check are related to the topics from Weeks 1, 2, and 3 Topics include:

  • Nursing competencies
  • Billing and coding
  • Integumentary conditions
  • HEENT conditions

It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

Photo Credit: [DirtyDog_Creative]/[Vetta]/Getty Images

By Day 7

Complete and submit your Knowledge Check.

Submission Information

Submit Your Knowledge Check by Day 7

To submit your Knowledge Check:

Week 3 Knowledge Check

What’s Coming Up in Module 2?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 2, you will examine the evaluation and management of cardiovascular conditions in Week 4 and respiratory conditions in Week 5. You will consider how to assess, diagnose, and treat two i-Human patients—one presenting a cardiovascular condition and one presenting a respiratory condition.

Week 5 Knowledge Check

In Week 5, you will experience your next Knowledge Check which covers the Module 2 topics from Weeks 4 and 5. Refer to the Week 5 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Week 4: Evaluation and Management of Cardiovascular Conditions

Many of the factors that contribute to cardiovascular conditions are preventable or manageable. Addressing the modifiable risk factors and adopting healthier lifestyle habits early in life can dramatically reduce the risk of developing cardiovascular conditions. The advanced practice nurse plays an important role in educating and advising their patients about ways to reduce modifiable risk factors, as well as encouraging and supporting their efforts.

However, if cardiovascular conditions are left unmanaged, patients may suffer from serious complications. When evaluating patients, it is important to consider individual patient factors and behaviors that might increase patient risk of conditions, such as hypertension. There are also other conditions that require advanced practice nurses to use appropriate and critical thinking to correctly diagnose cardiovascular or other vascular-related conditions. For this reason, as the advanced practice nurse caring for patients, it is critical that you immediately identify signs and symptoms of blood clots and other cardiovascular conditions.

For this week, you will analyze an i-Human simulation case study about an adult patient with a cardiovascular condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Learning Objectives

Students will:

  • Formulate differential diagnoses for adult patients with cardiovascular conditions
  • Analyze pattern recognition in adult patient diagnoses
  • Analyze the role of patient information in differential diagnosis
  • Evaluate pharmacologic and non-pharmacologic treatment options for adult patients
  • Create an appropriate treatment plan that includes health education and follow-up care
  • Learning Resources
Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)
Assignment: i-Human Case Study: Evaluating and Managing Cardiovascular Conditions

Because cardiovascular conditions are preventable and manageable, it is important that the advanced practice nurse use both their understanding of the cardiovascular system and the impact of patient factors and behaviors that might increase patient risk of such conditions. This critical information can guide you in immediately identifying signs and symptoms that can inform differential diagnoses and lead to identification of appropriate treatment options and a treatment plan.

Photo Credit: yodiyim / Adobe Stock

For this Case Study Assignment, you will analyze an i-Human simulation case study about an adult patient with a cardiovascular condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

To prepare:

  • Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with cardiovascular conditions.
  • Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.
  • Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with cardiovascular conditions.

Assignment

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform. NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

By Day 7

Complete and submit your Assignment in i-Human.

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 4 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment draft and review the originality report NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Submit Your Assignment by Day 7

To participate in this Assignment:

Week 4 Assignment

What’s Coming Up in Week 5?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will complete the next Knowledge Check which covers the topics from Weeks 4 and 5 of Module 2. Refer to the Week 5 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly.

Week 5: Evaluation and Management of Respiratory Conditions

Respiratory conditions can often be well managed when properly diagnosed and treated. Despite the existence of effective pharmacological treatments, lack of patient adherence to those treatments can negatively affect patient outcomes. As an advanced practice nurse, you play a critical role in the management of respiratory conditions, including providing education to patients about treatment options and their potential side effects and helping them weigh the benefits and risks. You must know when to treat, when to order diagnostics, and when to refer for specialized care. Failure to implement the appropriate actions can negatively impact the diagnosis and treatment of a patient, including the possible loss of their life. NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

For this week, you will complete a Knowledge Check assessment covering the Module 2 topics examined in Weeks 4 and 5.

Learning Objective

Students will:

  • Identify key terms, concepts, and principles related to the primary care of adults across the lifespan (KC)

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Knowledge Check: Module 2: Cardiovascular and Respiratory Conditions

In this exercise, you will complete a 10-question Knowledge Check to gauge your understanding of this module’s content. Please note that this is a formative practice to help you better prepare for your Midterm and Final Exam as well as your NP certification exam. The questions in this Knowledge Check are related to the topics from Weeks 4 and 5. Topics include:

  • acute bronchitis
  • asthma
  • chronic obstructive pulmonary disease (COPD)
  • other respiratory conditions
  • myocardial infarction (MI)
  • hypertension (HTN)
  • thrombotic events

Photo Credit: [ismagilov]/[iStock / Getty Images Plus]/Getty Images

It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

By Day 7

Complete and submit your Knowledge Check.

Submission Information

Submit Your Knowledge Check by Day 7

To submit your Knowledge Check:

Week 5 Knowledge Check NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

What’s Coming Up in Module 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 3, you will examine the evaluation and management of gastrointestinal conditions in Week 6, genitourinary and endocrine conditions in Week 7, and hematologic conditions in Week 8. In Weeks 7 and 8, you will also analyze an i-Human simulation case study about an adult patient presenting a condition and consider how to assess, diagnose, and treat the patient.

Week 6 Midterm Exam

In Week 6, you will not participate in a Discussion or complete an Assignment; however, you will take a Midterm Exam. Please, take this time to review the topics and resources covered in Weeks 1–6 to prepare for your exam. Plan your time accordingly.

Photo Credit: [triloks]/[E+]/Getty Images

Week 8 Knowledge Check

Photo Credit: ARTQU / iStock / Getty Images Plus / Getty Images

In Week 8, you will complete the next Knowledge Check, which covers the topics from Weeks 6, 7, and 8 of Module 3. Refer to the Week 8 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.Week 6: Evaluation and Management of Gastrointestinal Conditions

Diagnosis of gastrointestinal conditions often begins with assessing the gastrointestinal tract. If it appears normal, but is not working correctly, the condition can often be a manifestation of an issue with the patient’s exercise regimen, diet, and/or medications. Other times, the gastrointestinal tract appears abnormal, does not work correctly, and may necessitate surgery to remove or repair the source of the manifestation. Patients with gastrointestinal conditions face many daily challenges as they adhere to treatment and management plans. For example, for some, it impacts their social life due to the potential complications related to the medications or diet restrictions that may be part of the treatment plan. They may feel that they are unable to tell others about the adverse effects, such as intense pain, nausea, bowel obstructions, dehydration, fatigue, and depression. As the advanced practice nurse, you must not only evaluate and treat patients experiencing these challenges but also help them to develop management plans that will minimize daily challenges related to their conditions.

For this week, you will not participate in a Discussion or complete an Assignment; however, you will examine the evaluation and management of gastrointestinal conditions through the variety of Learning Resources available to you. Additionally, you will complete and submit the Midterm Exam. Take this time to review the topics and resources covered in Weeks 1–6 and prepare for your exam. Plan your time accordingly NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Learning Objective

Students will:

  • Synthesize key terms, concepts, and principles related to the primary care of adults across the lifespan

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Midterm Exam

This 100-question exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will be on topics covered in Weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 150 minutes for completion.

Photo Credit: [triloks]/[E+]/Getty Images

By Day 7

Submit your Midterm Exam.

Submission Information

Submit Your Exam by Day 7

To submit your Exam:

Week 6 Midterm Exam

What’s Coming Up in Week 7?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will analyze an i-Human simulation case study about an adult patient with a gastrointestinal condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient. NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

To go to the next week:

Week 7 NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Assignment: Policy/Regulation Fact Sheet

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Assignment: Policy/Regulation Fact Sheet

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate Assignment: Policy/Regulation Fact Sheet.

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To Prepare:

  • Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
  • Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
  • Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page not including the title and reference page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

  • Briefly and generally explain the policy or regulation you selected.
    Address the impact of the policy or regulation you selected on system implementation.
  • Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
  • Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.
  • Use APA format and include a title page, in-text citations, and reference page.
  • Use the Safe Assign Drafts to check your match percentage before submitting your work.

NURS_5051_Module06_Week11_Assignment_Rubric

Excellent Good Fair Poor
Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following: 

·   Briefly and generally explain the policy or regulation you selected.

·   Address the impact of the policy or regulation you selected on system implementation.

·   Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

·   Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.
77 (77%) – 85 (85%)

A fully developed and detailed Fact Sheet is provided for the Assignment.

The responses accurately and thoroughly explain in detail the policy and regulation selected.

The responses accurately and thoroughly explain in detail the impact of the policy or regulation selected on system implementation.

The responses accurately and thoroughly explain in detail the impact of the policy or regulation selected on clinical care, patient/provider interactions, and workflow.

Specific and accurate responses thoroughly highlight in detail the organizational policies and procedures that are/will be in place at a healthcare organization to address the policy or regulation selected.

Includes: 3 or more peer-reviewed sources and 2 or more course resources.
68 (68%) – 76 (76%)

A developed Fact Sheet is provided for the Assignment.

The responses explain the policy or regulation selected.

The responses explain the impact of the policy or regulation selected on system implementation.

The responses explain the impact of the policy or regulation selected on clinical care, patient/provider interactions, and workflow.

Accurate responses highlight the organizational policies and procedures that are/will be in place at a healthcare organization to address the policy or regulation selected.

Includes: 2 peer-reviewed sources and 2 course resources.
60 (60%) – 67 (67%)

A vague or inaccurate Fact Sheet is provided for the Assignment.

The responses explaining the policy or regulation selected are vague or inaccurate.

The responses explaining the impact of the policy or regulation selected on system implementation are vague or inaccurate.

The responses explaining the impact of the policy or regulation selected on clinical care, patient/provider interactions, and workflow are vague or inaccurate.

The responses highlighting the organizational policies and procedures that are/will be in place at a healthcare organization to address the policy or regulation selected are vague or inaccurate.

Includes: 1 peer-reviewed source and 1 course resource.
0 (0%) – 59 (59%)

A vague and inaccurate Fact Sheet is provided for the Assignment, or is missing.

The responses explaining the policy or regulation selected are vague and inaccurate, or are missing.

The responses explaining the impact of the policy or regulation selected on system implementation are vague and inaccurate, or are missing.

The responses explaining the impact of the policy or regulation selected on clinical care, patient/provider interactions, and workflow are vague and inaccurate, or are missing.

The responses highlighting the organizational policies and procedures that are/will be in place at a healthcare organization to address the policy or regulation selected are vague and inaccurate, or are missing.

Includes: 1 or fewer resources.
Written Expression and Formatting – Paragraph Development and Organization: 

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.
Written Expression and Formatting – English writing standards: 

Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
4 (4%) – 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.
0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 (5%) – 5 (5%)
Uses correct APA format with no errors.
4 (4%) – 4 (4%)
Contains a few (1-2) APA format errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) APA format errors.
0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.