NRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion Paper Example

NRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion AssignmentNRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion Assignment

NRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion Assignment Brief

Course: NRNP 6665 – Psychiatric Mental Health Nurse Practitioner Care Across the Lifespan I

Assignment Title: NRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion Assignment

Assignment Instructions Overview

In this discussion assignment, you will explore a topic that has significant ethical and legal implications for Psychiatric-Mental Health Nurse Practitioner (PMHNP) practice. The aim is to deepen your understanding of these issues and how they influence clinical decision-making for both adult and child/adolescent patients. You will conduct a literature review to identify key ethical and legal considerations related to your chosen topic, and discuss how these considerations apply in your state and to your clinical practice.

Understanding Assignment Objectives

The primary objectives of this assignment are to:

  • Analyze critical ethical and legal issues in psychiatric-mental health practice.
  • Understand the impact of cultural considerations on ethical and legal decision-making in advanced practice nursing.
  • Prepare for the nurse practitioner national certification examination by evaluating your knowledge and application of nurse practitioner principles.

The Student’s Role

As a student, your role is to critically examine a selected topic that intersects ethical and legal dimensions in PMHNP practice. You are expected to:

  • Select one of the provided ethical/legal topics.
  • Conduct a thorough literature review, locating four relevant scholarly or professional resources.
  • Summarize the ethical and legal issues for both adult and child/adolescent patients based on your selected topic.
  • Apply this information to your clinical practice, considering specific state regulations.
  • Participate in discussions with peers to share insights and cultural considerations related to the ethical and legal issues.

Competencies Measured

This assignment measures the following competencies:

  • Critical thinking and analytical skills in evaluating ethical and legal issues.
  • Research skills in identifying and synthesizing relevant scholarly resources.
  • Application of ethical and legal principles to clinical practice.
  • Communication skills in discussing and presenting findings.
  • Cultural competence in recognizing and integrating cultural considerations into ethical and legal decision-making.

You Can Also Check Other Related Assessments for the NRNP 6665 – Psychiatric Mental Health Nurse Practitioner Care Across the Lifespan I Course:

NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment Example

NRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion Paper Example

Discussion: Ethical and Legal Foundations of PMHNP Care

Topic: Restraints

Ethical Considerations of Restraints for Adult Patients

Restraints in psychiatric settings present significant ethical dilemmas. Restraints, whether physical, chemical, or environmental, are typically employed as a last resort to prevent patients from harming themselves or others. However, the use of restraints conflicts with the ethical principle of autonomy, which emphasizes respect for patients’ self-governance. Ethical practice necessitates that restraints be used only when absolutely necessary and that their use is minimized and justified through evidence-based guidelines. Restraints must never be used for the convenience of caregivers or as a punitive measure. Instead, the decision to use restraints should involve thorough professional training, constant reassessment, and a commitment to discontinue their use as soon as it is safe to do so. This approach aligns with the ethical principles of beneficence and non-maleficence, ensuring that the benefits outweigh the risks and potential harm to patients (Salehi et al., 2019).

Legal Considerations for Restraints for Adult Patients

Legally, the use of restraints is heavily regulated to protect patients’ rights and ensure their safety. According to federal regulations, restraints should only be applied when necessary to prevent imminent harm and must be used in the least restrictive manner possible. The attending physician must be consulted promptly, and each restraint order must be reassessed and renewed within specific timeframes (every 4 hours for adults, expiring within 24 hours). Additionally, patients must be monitored continuously, and their rights, such as privacy and protection from abuse, must be upheld. Legal frameworks also mandate that patients and their families are informed about the use of restraints and involved in the decision-making process (Public Health, 2018).

Ethical Considerations of Restraints on Children/Adolescents

The use of restraints on children and adolescents in mental health settings introduces further ethical complexities. Children are particularly vulnerable, and restraints can cause long-lasting psychological trauma. Ethical considerations must include the potential physical and psychological harm and the impact on the therapeutic relationship. Providers must prioritize less restrictive interventions and ensure that any use of restraints is justified, well-documented, and continuously reassessed. The principle of beneficence must guide decisions, ensuring that the use of restraints is always in the best interest of the child or adolescent (Nielson et al., 2021).

Legal Considerations for Restraints on Children/Adolescents

Legally, the use of restraints on minors is subject to strict scrutiny. Federal and state laws aim to provide the highest level of protection for minors. Providers are required to inform parents or legal guardians immediately and obtain written acknowledgment of the restraint policy. The application of restraints must be closely monitored, and any use must be thoroughly documented and justified to prevent claims of improper detention or harm. Legal considerations also emphasize the importance of safeguarding the minor’s rights and ensuring that all actions taken are in their best interest (Neiman et al., 2016).

Application to Clinical Practice

In clinical practice, PMHNPs must navigate the complex interplay of ethical and legal considerations regarding the use of restraints. Understanding and adhering to ethical principles and legal regulations is crucial for ensuring patient safety and upholding professional standards. In my state, regulations closely mirror federal guidelines, emphasizing the protection of patients’ rights and the necessity of using the least restrictive interventions. Continuous education and training on the ethical and legal aspects of restraint use are essential for all healthcare providers to ensure that they can make informed and justifiable decisions in the best interests of their patients.

References

Neiman, E., Pelkey, E., & Holloway, M. (2016). An Analysis of Legal Issues-Child and Adolescent Behavioral Health, Part III: Patient Safety-Identifying and Addressing Legal Issues Involved When Treating Pediatric Patients with Behavioral Health Needs. Teaching Hospitals and In-House Counsel Practice Groups. Link

Nielson, S., Bray, L., Carter, B., & Kiernan, J. (2021). Physical restraint of children and adolescents in mental health inpatient services: A systematic review and narrative synthesis. Journal of Child Health Care, 25(3), 342–367. https://doi.org/10.1177/1367493520937152

Public Health. (2018, October 1). Code of Federal Regulations. Link

Salehi, Z., Najafi Ghezeljeh, T., Hajibabaee, F., & Joolaee, S. (2019). Factors behind ethical dilemmas regarding physical restraint for critical care nurses. Nursing Ethics, 27(2), 598–608. https://doi.org/10.1177/0969733019858711

Detailed Assessment Instructions for the NRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion Assignment

Week 2: Ethical and Legal Foundations of PMHNP Care Across the Lifespan

In your role as a PMHNP, you will regularly encounter situations that require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear-cut answer of how to address the issue, but your ethical decision making must be based on evidence-based practice and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their background or worldview. You must be prepared to critically analyze ethical situations and develop an appropriate plan of action.

Learning Objectives

Students will:

  • Analyze salient ethical and legal issues in psychiatric-mental health practice
  • Analyze the impact of cultural considerations on ethical/legal decision making in advanced practice nursing
  • Evaluate mastery of nurse practitioner knowledge in preparation for the nurse practitioner national certification examination*

*Assessed in Week 3 Assignment

Reminder: Keep Your Library of Advanced Practice Nursing Texts at Your Fingertips

Several textbooks are assigned in multiple courses in your program. That is, you will see reading assignments from the books assigned in the Learning Resources of more than one course. You should, however, keep all prior textbooks—not just the ones explicitly assigned—readily accessible. The expectation is that you will independently consult these prior textbooks to synthesize information needed to complete your final courses. This is your time to “put it all together” and to more fully embrace the advanced practice nursing role. Part of the responsibility of advanced practice is developing information literacy skills to know where to locate needed information for your clinical practice.

Discussion: Ethical and Legal Foundations of PMHNP Care

Advanced practice nursing in all specialties is guided by codes of ethics that put the care, rights, duty, health, and safety of the patient first and foremost. PMHNP practice is also guided by ethical codes specifically for psychiatry. These ethical codes are frameworks to guide clinical decision making; they are generally not prescriptive. They also represent the aspirational ideals for the profession. Laws, on the other hand, dictate the requirements that must be followed. In this way, legal codes may be thought to represent the minimum standards of care, and ethics represent the highest goals for care.

Photo Credit: [Hero Images]/[Hero Images]/Getty Images

For this Discussion, you select a topic that has both legal and ethical implications for PMHNP practice and then perform a literature review on the topic. Your goal will be to identify the most salient legal and ethical facets of the issue for PMHNP practice, and also how these facets differ in the care of adult patients versus children. Keep in mind as you research your issue, that laws differ by state and your clinical practice will be dictated by the laws that govern your state.

TO PREPARE

  • Select one of the following ethical/legal topics:
    • Autonomy
    • Beneficence
    • Justice
    • Fidelity
    • Veracity
    • Involuntary hospitalization and due process of civil commitment
    • Informed assent/consent and capacity
    • Duty to warn
    • Restraints
    • HIPPA
    • Child and elder abuse reporting
    • Tort law
    • Negligence/malpractice
  • In the Walden library, locate a total of four scholarly, professional, or legal resources related to this topic. One should address ethical considerations related to this topic for adults, one should be on ethical considerations related to this topic for children/adolescents, one should be on legal considerations related to this topic for adults, and one should be on legal considerations related to this topic for children/adolescents.

By Day 3 of Week 2

Briefly identify the topic you selected. Then, summarize the articles you selected, explaining the most salient ethical and legal issues related to the topic as they concern psychiatric-mental health practice for children/adolescents and for adults. Explain how this information could apply to your clinical practice, including specific implications for practice within your state. Attach the 4 PDFs of your articles.

Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond to at least two of your colleagues on 2 different days by sharing cultural considerations that may impact the legal or ethical issues present in their articles.

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

Learning Resources

Required Readings (click to expand/reduce)

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/practice-policy/nursi…

American Psychological Association. (2017). Ethical principles of psychologists and diagnostic formulationhttp://www.apa.org/ethics/code/

American Academy of Child & Adolescent Psychiatry. (2014). Code of ethicshttps://www.aacap.org/App_Themes/AACAP/docs/about_…

American Psychiatric Nurses Association. (2020). APRN psychiatric-mental health nursing practicehttps://www.apna.org/i4a/pages/index.cfm?pageID=38…

Anderson, S. L. (2012). Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents. American Academy of Child and Adolescent Psychiatry51(9). 957–974. https://www.jaacap.org/action/showPdf?pii=S0890-85…

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

  • Chapter 19, “Legal Issues in the Care and Treatment of Children with Mental Health Problems”

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

  • Chapter 1, “Preparing to Pass the Psychiatric-Mental Health Nurse Practitioner Certification Exam”

Ethical and Legal Foundations of PMHNP Care Submission and Grading Information

Ethical and Legal Foundations of PMHNP Care Grading Criteria

Post by Day 3 of Week 2 and Respond by Day 6 of Week 2

To Participate in this Discussion:

Week 2 Discussion

Name:  Ethical and Legal Foundations of PMHNP Care Discussion Rubric

Ethical and Legal Foundations of PMHNP Care Excellent

90–100

Good

80–89

Fair

70–79

Poor

0–69

Main Posting:

Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

40 (40%) – 44 (44%)

Thoroughly responds to the Discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least three current credible sources.

35 (35%) – 39 (39%)

Responds to most of the Discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least three credible references.

31 (31%) – 34 (34%)

Responds to some of the Discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Cited with fewer than two credible references.

0 (0%) – 30 (30%)

Does not respond to the Discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible references.

Main Posting:

Writing

6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main Discussion by due date.

8 (8%) – 8 (8%)

Meets requirements for full participation.

Posts main Discussion by due date.

7 (7%) – 7 (7%)

Posts main Discussion by due date.

0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main Discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic and may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

First Response:

Writing

6 (6%) – 6 (6%)

is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

5 (5%) – 5 (5%)

is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic and may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

Second Response:
Writing
6 (6%) – 6 (6%)

is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

5 (5%) – 5 (5%)

is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:
Timely and full participation
5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

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NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Example

NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion AssignmentNRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment

NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment Brief

Course: NRNP 6665 – Psychiatric Mental Health Nurse Practitioner Care Across the Lifespan I

Assignment Title: NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment

Assignment Instructions Overview

This assignment involves a critical analysis of a comprehensive, integrated psychiatric assessment for an adolescent. You will review a provided video vignette and evaluate the assessment techniques used, identifying areas of strength and potential improvement. Additionally, you will discuss the importance of thorough psychiatric assessments for children/adolescents, suitable symptom rating scales, and treatment options specific to this population.

Understanding Assignment Objectives

The primary goal of this assignment is to enhance your understanding of psychiatric assessment techniques tailored for children and adolescents. By engaging in this exercise, you will develop the ability to critically evaluate clinical practices and apply appropriate diagnostic tools and treatment strategies for younger patients.

The Student’s Role

As a student, your role is to:

  • Review and analyze the provided video vignette.
  • Identify and critique the assessment methods demonstrated by the practitioner.
  • Discuss the significance of comprehensive psychiatric assessments for the pediatric population.
  • Propose relevant symptom rating scales and treatment options for children/adolescents.
  • Engage with peers by offering insights and alternative perspectives on their analyses.

Competencies Measured

This assignment measures the following competencies:

  • Ability to evaluate and critique psychiatric assessment techniques for children and adolescents.
  • Skill in recommending effective assessment questions for this demographic.
  • Understanding the importance of comprehensive psychiatric assessments in developing accurate diagnoses and treatment plans.
  • Knowledge of appropriate symptom rating scales for pediatric psychiatric assessments.
  • Identification of suitable psychiatric treatments for children and adolescents.
  • Comprehension of the vital role parents/guardians play in the assessment and treatment process of young patients.

You Can Also Check Other Related Assessments for the NRNP 6665 – Psychiatric Mental Health Nurse Practitioner Care Across the Lifespan I Course:

NRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion Assignment Example

NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Example

Week 1 Discussion: Comprehensive Integrated Psychiatric Assessment

What did the practitioner do well? In what areas can the practitioner improve?

Practitioner Strengths:

  • Open-Ended Questions: The practitioner used open-ended questions, which facilitated detailed responses from the adolescent, Tony. This approach helped gather comprehensive information about Tony’s feelings and behaviors.
  • Exploring Emotions: The practitioner effectively explored Tony’s emotional state, including feelings of hopelessness and anger, which are crucial in assessing depression and anxiety.
  • Summarizing Statements: The practitioner summarized Tony’s statements, which validated his feelings and ensured understanding.

Areas for Improvement:

  • Confidentiality and Consent: The practitioner did not address confidentiality, privacy, and consent at the beginning of the session. It is essential to explain these aspects to establish trust and clarify the boundaries of the therapeutic relationship.
  • Family Involvement: There was no mention of involving Tony’s family or obtaining collateral information from them. Family input can provide additional context and support for the adolescent.
  • Environment: Creating a more child-friendly environment could make the session more comfortable for young patients. This could include having art on the walls or other engaging elements.

At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

Yes, there are compelling concerns. Tony expressed feelings of anger, hopelessness, and a lack of interest in activities he used to enjoy, such as basketball and school. He also mentioned thoughts of not wanting to be alive. These symptoms are indicative of depression and possible suicidal ideation, which require immediate attention and intervention.

What would be your next question, and why?

The next question should be: “Can you tell me more about your thoughts of not wanting to be alive? Have you ever thought about how you might hurt yourself?” This question is crucial to assess the severity of Tony’s suicidal ideation and to determine the level of immediate risk.

Additional Discussion Points:

Explain why a thorough psychiatric assessment of a child/adolescent is important.

A thorough psychiatric assessment of a child or adolescent is essential because it allows for accurate diagnosis and effective treatment planning. Children and adolescents are at a developmental stage where mental health issues can significantly impact their growth, education, social relationships, and overall well-being. Early and precise assessment can prevent the progression of mental health disorders and improve long-term outcomes (Hilt & Nussbaum, 2016).

Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.

  • Pediatric Symptom Checklist (PSC): This is a brief screening questionnaire that helps identify psychosocial problems in children. It is widely used in primary care settings and has versions for different age groups.
  • Strengths and Difficulties Questionnaire (SDQ): This tool measures emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. It is suitable for children aged 4-17 and can be completed by parents, teachers, or the adolescents themselves.

Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.

  • Play Therapy: This form of therapy uses play to help children express their feelings and deal with psychological issues. It is particularly effective for younger children who may not have the verbal skills to articulate their emotions.
  • Family-Based Treatment (FBT): This approach involves the family in the treatment process, which is especially important for conditions like eating disorders. FBT empowers parents to support their child’s recovery, which may not be as relevant in adult treatments.

Explain the role parents/guardians play in assessment.

Parents and guardians play a critical role in the assessment process by providing historical context, observations of behavior, and information about the child’s development and family dynamics. Their involvement helps ensure a comprehensive understanding of the child’s issues and supports the implementation of treatment plans (Srinath et al., 2019).

References

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158–175.

Graf, M., Lederman, S., Raphael, E., & Kafri, R. (2023). Home-based treatment for children and adolescents with acute mental health disorders: A literature review. Journal of Child and Adolescent Psychiatric Nursing, 36(2), 681-686.

Detailed Assessment Instructions for the NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment

NRNP 6665 Week 1 Discussion: Comprehensive Integrated Psychiatric Assessment

Photo Credit: Seventyfour / Adobe Stock

Many assessment principles are the same for children and adults; however, unlike with adults/older adults, where consent for participation in the assessment comes from the actual client, with children it is the parents or guardians who must make the decision for treatment. Issues of confidentiality, privacy, and consent must be addressed. When working with children, it is not only important to be able to connect with the pediatric patient, but also to be able to collaborate effectively with the caregivers, other family members, teachers, and school counselors/psychologists, all of whom will be able to provide important context and details to aid in your assessment and treatment plans.

Some children/adolescents may be more difficult to assess than adults, as they can be less psychologically minded. That is, they have less insights into themselves and their motivations than adults (although this is not universally true). The PMHNP must also take into consideration the child’s culture and environmental context. Additionally, with children/adolescents, there are lower rates of neurocognitive disorders superimposed on other clinical conditions, such as depression or anxiety, which create additional diagnostic challenges.

In this Discussion, you review and critique the techniques and methods of a mental health professional as the practitioner completes a comprehensive, integrated psychiatric assessment of an adolescent. You also identify rating scales and treatment options that are specifically appropriate for children/adolescents.

TO PREPARE

  • Review the Learning Resources and consider the insights they provide on comprehensive, integrated psychiatric assessment. Watch the Mental Status Examination B-6 and Simulation Scenario-Adolescent Risk Assessment videos.
  • Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.

By Day 3 of Week 1

Based on the YMH Boston Vignette 5 video, post answers to the following questions:

  • What did the practitioner do well? In what areas can the practitioner improve?
  • At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
  • What would be your next question, and why?

Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.

  • Explain why a thorough psychiatric assessment of a child/adolescent is important.
  • Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
  • Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
  • Explain the role parents/guardians play in assessment.

Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

Read a selection of your colleagues’ responses.

BY DAY 6 OF WEEK 1

Respond to at least two of your colleagues on 2 different days by offering additional insights or alternative perspectives on their analysis of the video, other rating scales that may be used with children, or other treatment options for children not yet mentioned. Be specific and provide a rationale with evidence.

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

Week 1: Child and Adolescent Assessment

All diagnoses, from infancy to adulthood, begin with an examination. While an organic basis for most medical disorders can be determined through the use of diagnostic testing, the field of psychiatry is different in that patients cannot be sent to the lab for blood tests to determine the degree of depression. Similarly, patients cannot be sent to the radiology department for a “scan” to determine the severity of their bipolar disorder. Instead, the field of psychiatry must use psychiatric assessments, such as the comprehensive integrated physical exam, diagnostic interviews, and questionnaires to make diagnoses. These tools must be specialized to address the needs of children and adolescents.

Diagnostic assessment of the child and adolescent is a specialized area of expertise. The PMHNP will often see children who have already been seen by a primary care provider. Many PCPs are comfortable handling attention-deficit/hyperactivity disorder (ADHD) and other straightforward childhood disorders. That means that the PMHNP will often treat the more complicated patients. This week, you explore psychiatric assessment techniques and tools for children and adolescents. You also examine the role of the parent/guardian in the assessment process for this patient population.

Learning Objectives

Students will:

  • Evaluate comprehensive integrated psychiatric assessment techniques for children and adolescents
  • Recommend assessment questions for child and adolescent patients
  • Explain the importance of thorough psychiatric assessment for children and adolescents
  • Identify rating scales that are appropriate for child/adolescent psychiatric assessment
  • Identify psychiatric treatments appropriate for children and adolescents
  • Explain the role of the parent/guardian in child/adolescent psychiatric assessment

Optional Discussion Forum: PMHNP Study Support Lounge

The PMHNP Study Support Lounge is offered throughout the course as a place of academic refuge where you can ask questions, offer insights, and interact with your peers. Your Instructor may also weigh in to provide global feedback to the group based on trends, common problems, and common strengths in student posts.

You are encouraged to provide constructive, helpful feedback to your peers. Advanced practice nurses always benefit from the feedback of others. Your Study Support Lounge posts may be procedural (“How do I attach a Kaltura video to a Discussion post?”), conceptual (“How does this relate to the other therapy approaches we have studied?”), or analytical (“What do these diagnostic results actually mean in the context of this specific patient case?”). Although not mandatory, this is an opportunity to interact and study together as you navigate the assignments, so you are highly encouraged to take part in this activity. Full participation in activities like this is a statistically significant predictor of success.

To Participate in this Optional Discussion:

  • PMHNP Study Support Lounge
  • Acknowledgment
  • 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.

  • Field Experience: MSN Nurse Practitioner Practicum Manual

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.

Learning Resources

Required Readings (click to expand/reduce)

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158–175. http://doi.org/10.4103/psychiatry.IndianJPsychiatr…

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

  • Chapter 32, “Clinical assessment and diagnostic formulation”

Required Media (click to expand/reduce)

Symptom Media. (2014). Mental status exam B-6. [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/mental-status-exam-b-6/cite?context=channel:volume-2-new-releases-assessment-tools-mental-status-exam-series

Western Australian Clinical Training Network. (2016, August 4). Simulation scenario-adolescent risk assessment [Video]. YouTube. 

YMH Boston. (2013, May 22). Vignette 5 – Assessing for depression in a mental health appointment [Video]YouTube. 

Recommended Reading (click to expand/reduce)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

  • Chapter 31, “Child Psychiatry”

NRNP 6665 Week 1 Assignment: Child and Adolescent Assessment Rubric

Name:  Assignment Rubric

Excellent Good Fair Poor
Summarize your interpretation of the frequency data provided in the output for respondent’s age, highest school grade completed, and family income from prior month. 32 (32%) – 35 (35%)

The response accurately and clearly explains, in detail, a summary of the frequency distributions for the variables presented.

The response accurately and clearly explains, in detail, the number of times the value occurs in the data.

The response accurately and clearly explains, in detail, the appearance of the data, the range of data values, and an explanation of extreme values in describing intervals that sufficiently provides an analysis that fully supports the categorization of each variable value.

The response includes relevant, specific, and appropriate examples that fully support the explanations provided for each of the areas described.

28 (28%) – 31 (31%)

The response accurately summarizes the frequency distributions for the variables presented.

The response accurately explains the number of times the value occurs in the data.

The response accurately explains the appearance of the data, the range of data values, and explains extreme values in describing intervals that provides an analysis which supports the categorization of each variable value.

The response includes relevant, specific, and accurate examples that support the explanations provided for each of the areas described.

25 (25%) – 27 (27%)

The response inaccurately or vaguely summarizes the frequency distributions for the variables presented.

The response inaccurately or vaguely explains the number of times the value occurs in the data.

The response inaccurately or vaguely explains the appearance of the data, the range of data values, and inaccurately or vaguely explains extreme values.

An analysis that may support the categorization of each variable value is inaccurate or vague.

The response includes inaccurate and irrelevant examples that may support the explanations provided for each of the areas described.

0 (0%) – 24 (24%)

The response inaccurately and vaguely summarizes the frequency distributions for the variables presented, or it is missing.

The response inaccurately and vaguely explains the number of times the value occurs in the data, or it is missing.

The response inaccurately and vaguely explains the appearance of the data, the range of data values, and an explanation of extreme values, or it is missing.

An analysis that does not support the categorization of each variable values is provided, or it is missing.

The response includes inaccurate and vague examples that do not support the explanations provided for each of the areas described, or it is missing.

Summarize your interpretation of the descriptive statistics provided in the output for respondent’s age, highest school grade completed, race and ethnicity, currently employed, and family income from prior month. 45 (45%) – 50 (50%)

The response accurately and clearly summarizes in detail the interpretation of the descriptive statistics provided.

The response accurately and clearly evaluates in detail each of the variables presented, including an accurate and complete description of the sample size, the mean, the median, standard deviation, and the size and spread of the data.

40 (40%) – 44 (44%)

The response accurately summarizes the interpretation of the descriptive statistics provided.

The response accurately explains evaluates each of the variables presented, including an accurate description of the sample size, the mean, the median, standard deviation, and the size and spread of the data.

35 (35%) – 39 (39%)

The response inaccurately or vaguely summarizes the interpretation of the descriptive statistics provided.

The response inaccurately or vaguely evaluates each of the variables presented, including an inaccurate or vague description of the sample size, the mean, the median, the standard deviation, and the size and spread of the data.

0 (0%) – 34 (34%)

The response inaccurately and vaguely summarizes the interpretation of the descriptive statistics provided, or it is missing.

The response inaccurately and vaguely evaluates each of the variables presented, including an inaccurate and vague description of the sample size, the mean, the median, the standard deviation, and the size and spread of the data, or it is missing.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3 (3%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 (0%) – 2 (2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion was provided.

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 or 2) grammar, spelling, and punctuation errors.

3 (3%) – 3 (3%)

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

0 (0%) – 2 (2%)

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, 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 or 2) APA format errors.

3 (3%) – 3 (3%)

Contains several (3 or 4) APA format errors.

0 (0%) – 2 (2%)

Contains many (≥ 5) APA format errors.

Total Points: 100

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NRNP 6540 Psychosocial Disorders Assessing Diagnosing and Treating Dementia Delirium and Depression Assignment Example

NRNP 6540 Psychosocial Disorders Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression AssignmentNRNP 6540 Psychosocial Disorders Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression Assignment

NRNP 6540 Psychosocial Disorders Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression Assignment Brief

Course: NRNP 6540 – Advanced Practice Care of Older Adults

Assignment Title: NRNP 6540 Psychosocial Disorders Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression Assignment

Assignment Instructions Overview

This assignment focuses on assessing, diagnosing, and treating dementia, delirium, and depression in geriatric patients. It requires completion of a SOAP (subjective, objective, assessment, and plan) note based on a provided case study.

Understanding Assignment Objectives

You will evaluate a geriatric patient presenting with symptoms of dementia, delirium, or depression, develop differential diagnoses, and create treatment plans inclusive of diagnostic testing and therapeutic interventions.

The Student’s Role

As an advanced practice nurse, your role involves accurately documenting patient history, conducting thorough physical assessments, and interpreting diagnostic results to formulate effective treatment plans.

Competencies Measured

This assignment assesses your ability to:

  • Evaluate geriatric patients for psychosocial disorders.
  • Develop differential diagnoses based on clinical findings.
  • Design comprehensive treatment plans aligned with evidence-based guidelines.
  • Demonstrate effective communication skills through documentation.

You Can Also Check Other Related Assessments for the NRNP 6540 – Advanced Practice Care of Older Adults Course:

NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment Example

NRNP 6540 Psychosocial Disorders Assessing Diagnosing and Treating Dementia Delirium and Depression Assignment Example

Patient Information:

Ms. P, 70-year-old female, Caucasian

Subjective:

Chief Complaint (CC):

Increased confusion, agitation, and restlessness.

History of Present Illness (HPI):

Ms. P is a 70-year-old female with a known history of dementia, managed with Aricept (Donepezil) 10 mg daily. She presented with acute confusion, more than usual, and increased agitation and restlessness over the past two days. Two days ago, she became more disoriented and yesterday, she could not remember where she was in her own home. Her son, Jared, reports these changes began after her HCTZ dosage was increased to 50 mg three days ago. No falls, traumas, changes in diet or routine, dysuria, fever, nausea, or vomiting reported. Last MMSE score was 18/30, which remained unchanged today.

Current Medications:

  • Multivitamin daily
  • Losartan 50 mg daily
  • HCTZ 50 mg daily (recently increased)
  • Fish Oil 1 tablet daily
  • Glyburide 5 mg daily
  • Metformin 500 mg BID
  • Donepezil 10 mg daily
  • Alendronate 70 mg orally once a week

Allergies:

  • Atorvastatin (angioedema)

Past Medical History (PMHx):

  • Hypertension
  • Diabetes
  • Osteoporosis
  • Chronic allergic rhinitis

Review of Systems (ROS):

  • General: No weight loss, fever, chills, weakness, or fatigue.
  • Head: No headache or trauma.
  • Eyes: No visual loss, blurred vision, or double vision.
  • Ears, Nose, Throat (ENT): No hearing loss, sneezing, congestion, or sore throat.
  • Cardiovascular: No chest pain, pressure, discomfort, or palpitations.
  • Respiratory: No shortness of breath, cough, or sputum.
  • Gastrointestinal: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain or blood in stool.
  • Genitourinary: No dysuria. LMP: N/A.
  • Neurological: Increased confusion and agitation. No dizziness, syncope, paralysis, or ataxia.
  • Musculoskeletal: No muscle pain or joint stiffness. Some balance issues but no falls.
  • Psychiatric: No history of depression or anxiety. No suicidal ideation.
  • Endocrinologic: No sweating, cold or heat intolerance. No polyuria or polydipsia.
  • Reproductive: Not pregnant, not sexually active.
  • Allergies: No history of asthma, hives, eczema, or rhinitis.

Objective:

Vital Signs:

  • Temperature: 98.1°F
  • Blood Pressure: 120/64 mmHg
  • Heart Rate: 72 bpm
  • Respiratory Rate: 20 bpm

Physical Exam:

  • General: Alert but easily distracted.
  • Head: Normocephalic, atraumatic.
  • Eyes: PERRLA (pupils equal, round, reactive to light and accommodation), no nystagmus.
  • ENT: Oral mucosa moist, no lesions.
  • Neck: Supple, no lymphadenopathy.
  • Cardiovascular: Regular rate and rhythm, no murmurs or gallops.
  • Respiratory: Clear to auscultation bilaterally.
  • Abdomen: Soft, non-tender, no hepatosplenomegaly.
  • Musculoskeletal: No joint swelling or deformities. Balance issues noted.
  • Neurological: Alert but disoriented to place and time, speech clear but tangential.
  • Psychiatric: No visual or auditory hallucinations, denies suicidal ideation.

Diagnostic Results:

  • CXR: No cardiopulmonary findings. WNL.
  • CT Head: Diffuse cerebral atrophy.
  • MMSE: 18/30, indicating moderate dementia.
  • Hemoglobin A1C: 7.2%
  • Basic Metabolic Panel:
    • Glucose: 90 mg/dL
    • Sodium: 130 mmol/L (low)
    • Potassium: 3.4 mmol/L (low)
    • Chloride: 104 mmol/L
    • CO2: 29 mmol/L
    • Calcium: 9.0 mg/dL
    • BUN: 20 mg/dL
    • Creatinine: 1.00 mg/dL
    • eGFR: 77 mL/min/1.73m2

Assessment:

Primary Diagnosis:

  1. Delirium – Acute onset of confusion, agitation, and restlessness in a patient with baseline dementia, likely precipitated by a medication change (increased HCTZ).

Differential Diagnoses:

  1. Worsening Dementia – Progressive confusion and disorientation typical of dementia; however, acute exacerbation suggests an additional factor.
  2. Electrolyte Imbalance (Hyponatremia and Hypokalemia) – Low sodium and potassium levels could contribute to confusion and agitation.

Plan:

Diagnostics:

  • Repeat electrolytes in 48 hours to monitor for further changes.
  • Consider urinalysis to rule out UTI, which could exacerbate confusion.

Medications:

  • Review and potentially adjust HCTZ dosage considering recent increase and onset of symptoms.
  • Consider switching HCTZ to an alternative antihypertensive not listed on the Beers Criteria for elderly patients.

Therapeutic Interventions:

  • Hydration to correct potential dehydration contributing to electrolyte imbalance.
  • Cognitive stimulation activities tailored to dementia patients.

Referrals:

  • Referral to a neurologist for further evaluation of dementia progression.
  • Referral to a dietitian to assess and manage nutritional needs impacting blood glucose and electrolytes.

Education:

  • Educate son on signs of delirium versus dementia exacerbation and importance of medication adherence and monitoring.

Follow-Up:

  • Follow-up visit in one week to reassess symptoms and evaluate lab results.
  • Immediate follow-up if symptoms worsen.

Health Promotion and Disease Prevention:

  • Encourage a balanced diet to manage diabetes and blood pressure.
  • Regular physical activity to improve balance and overall health.
  • Ensure home safety modifications to prevent falls.

Reflection:

This case highlights the importance of monitoring medication changes and their impact on elderly patients, particularly those with dementia. The overlap of symptoms between dementia, delirium, and other medical conditions necessitates a comprehensive and multidisciplinary approach to patient care.

References

American Geriatrics Society. (2019). Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society, 67(4), 674-694.

Inouye, S. K., Westendorp, R. G. J., & Saczynski, J. S. (2014). Delirium in elderly people. Lancet, 383(9920), 911-922.

Marcum, Z. A., & Hanlon, J. T. (2012). Commentary on the New American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. The American Journal of Geriatric Pharmacotherapy, 10(2), 151-159.

Detailed Assessment Instructions for the NRNP 6540 Psychosocial Disorders Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression Assignment

Week 2: Psychosocial Disorders

In so many countries, to be old is shameful; to be mentally ill as well as old is doubly shameful. In so many countries, people with elderly relatives who are also mentally ill are ashamed and try to hide what they see as a disgrace on the family.

—Dr. Nori Graham, Psychiatrist and Honorary Vice President of Alzheimer’s Disease International

In this quote, Dr. Graham is expressing her observations and experiences in her work with numerous international organizations. Many patients and their families experience feelings of anxiety and shame upon receiving a diagnosis of dementia, delirium, or depression. Among caregivers, 36% report having tried to hide the dementia diagnosis of their family member (Alzheimer’s Disease International, 2019). As an advanced practice nurse providing care to patients presenting with dementia, delirium, and depression, it is critically important to consider the impact of these disorders on patients, caregivers, and their families. A thorough understanding of the health implications of these disorders, as well as each patient’s personal concerns, will aid you in making effective treatment and management decisions.

This week, you explore geriatric patient presentations of dementia, delirium, and depression. You also examine assessment, diagnosis, and treatment for these disorders and complete a SOAP (subjective, objective, assessment, and plan) note.

Reference:
Alzheimer’s Disease International. (2019). World Alzheimer report 2019: Attitudes to dementia. Author. https://www.alz.co.uk/research/world-report-2019

Learning Objectives

Students will:

  • Evaluate patients presenting with symptoms of dementia, delirium, or depression
  • Develop differential diagnoses for patients with psychosocial disorders
  • Develop appropriate treatment plans, including diagnostics and laboratory orders, for patients with psychosocial disorders 

Assignment: Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression

Photo Credit: Getty Images

With the prevalence of dementia, delirium, and depression in the growing geriatric population, you will likely care for elderly patients with these disorders. While many symptoms of dementia, delirium, and depression are similar, it is important that you are able to identify those that are different and properly diagnose patients. A diagnosis of one of these disorders is often difficult for patients and their families. In your role as an advanced practice nurse, you must help patients and their families manage the disorder by facilitating necessary treatments, assessments, and follow-up care. 

To prepare:

  • Review the case study provided by your Instructor. Reflect on the way the patient presented in the case, including whether the patient might be presenting with dementia, delirium, or depression.
  • Reflect on the patient’s symptoms and aspects of disorders that may be present. What distinct symptoms or factors would lead you to a diagnosis of dementia, delirium, or depression?
  • Consider how you might assess, perform diagnostic tests, and recommend medications to treat patients presenting with the symptoms in the case.
  • Access the Focused SOAP Note Template in this week’s Resources.

The Assignment:

Complete the Focused SOAP Note Template provided for the patient in the case study. Be sure to address the following:

  • Subjective: What was the patient’s subjective complaint? What details did the patient provide regarding their history of present illness and personal and medical history? Include a list of prescription and over-the-counter drugs the patient is currently taking. Compare this list to the American Geriatrics Society Beers Criteria®, and consider alternative drugs if appropriate. Provide a review of systems.
  • Objective: What observations did you note from the physical assessment? What were the lab, imaging, or functional assessments results? How would you interpret and address the results of the Mini-Mental State Examination (MMSE)?
  • Assessment: Provide a minimum of three differential diagnoses. List them from top priority to least priority. Compare the diagnostic criteria for each, and explain what rules each differential in or out. Explain you critical thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Plan: Provide a detailed treatment plan for the patient that addresses each diagnosis, as applicable. Include documentation of diagnostic studies that will be obtained, referrals to other healthcare providers, therapeutic interventions, education, disposition of the patient, caregiver support, and any planned follow-up visits. Provide a discussion of health promotion and disease prevention for the patient, taking into consideration patient factors, past medical history (PMH), and other risk factors. Finally, include a reflection statement on the case that describes insights or lessons learned.
  • Provide at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines, which relate to this case to support your diagnostics and differentials diagnoses. Be sure they are current (no more than 5 years old) and support the treatment plan in following current standards of care. Follow APA 7th edition formatting. 

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

By Day 7

Learning Resources

 

Rubric Detail Tutor needs to FOLLOW

 Select Grid View or List View to change the rubric’s layout.

Name: NRNP_6540_Week2_Assignment_Rubric

 

  Excellent Fair Poor
Create documentation in the Focused SOAP Note Template about the patient in the case study to which you were assigned.

In the Subjective section, provide:
• Chief complaint
• History of present illness (HPI)
• Current medications, checked against Beers Criteria
• Allergies
• Patient medical history (PMHx)
• Review of systems

9 (9%) – 10 (10%)

The response throughly and accurately describes the patient’s subjective complaint, history of present illness, current medications, allergies, medical history, and review of all systems that would inform a differential diagnosis. A thorough cross-check of medications against the Beers Criteria has been completed and appropriate alternative drugs recommended if applicable.

7 (7%) – 7 (7%)

The response describes the patient’s subjective complaint, history of present illness, current medications, allergies, medical history, and review of all systems that would inform a differential diagnosis, but is somewhat vague or contains minor innacuracies. A cross-check of medications against the Beers Criteria has been completed but alternatives may be missing.

0 (0%) – 6 (6%)

The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history of present illness, current medications, allergies, medical history, and review of all systems that would inform a differential diagnosis. A cross-check of medications against the Beers Criteria has not been completed. Or, subjective documentation is missing.

In the Objective section, provide:
• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses
9 (9%) – 10 (10%)

The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.

7 (7%) – 7 (7%)

Documentation of the patient’s physical exam is somewhat vague or contains minor innacuracies. Diagnostic tests and their results are documented but contain minor innacuracies.

0 (0%) – 6 (6%)

The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or, objective documentation is missing.

In the Assessment section, provide:
• At least three (3) differentials with supporting evidence. Explain what rules each differential in or out, and justify your primary diagnosis selection. Include pertinent positives and pertinent negatives for the specific patient case.
23 (23%) – 25 (25%)

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

18 (18%) – 19 (19%)

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

0 (0%) – 17 (17%)

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

In the Plan section, provide:
• A detailed treatment plan for the patient that addresses each diagnosis, as applicable. Includes documentation of diagnostic studies that will be obtained, referrals to other health-care providers, therapeutic interventions, education, disposition of the patient, and any planned follow up visits.
• A discussion related to health promotion and disease prevention taking into consideration patient factors, PMH, and other risk factors.
• Reflections on the case describing insights or lessons learned.
27 (27%) – 30 (30%)

The response thoroughly and accurately outlines a treatment plan for the patient that addresses each diagnosis and includes diagnostic studies neeed, referrals, therapeutic interventions, patient education and disposition, and planned follow-up visits. A thorough and accurate discussion of health promotion and disease prevention related to the case is provided. Reflections on the case demonstrate strong critical thinking and synthesis of ideas.

21 (21%) – 23 (23%)

The response somewhat vaguely or inaccurately outlines a treatment plan for the patient. The discussion on health promotion and disease prevention related to the case is somewhat vague or contains innaccuracies. Reflections on the case demonstrate adequate understanding of course topics.

0 (0%) – 20 (20%)

The response does not address all diagnoses or is missing elements of the treatment plan. The discussion on health promotion and disease prevention related to the case is vague, innaccurate, or missing. Reflections on the case are vague or missing.

Provide at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines which relate to this case to support your diagnostics and differentials diagnoses. Be sure they are current (no more than 5 years old) and support the treatment plan in following current standards of care. 9 (9%) – 10 (10%)

The response provides at least three current, evidence-based resources from the literature to support the treatment plan for the patient in the assigned case study. Each resource represents the latest in standards of care and provides strong justification for treatment decisions.

. 7 (7%) – 7 (7%)

Three evidence-based resources are provided to support treatment decisions, but may not represent the latest in standards of care or may only provide vague or weak justification for the treatment plan.

0 (0%) – 6 (6%)

Two or fewer resources are provided to support treatment decisions. The resources may not be current or evidence-based, or do not support the treatment plan.

Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

3 (3%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 (0%) – 2 (2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.

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.

3 (3%) – 3 (3%)

Contains several (three or four) grammar, spelling, and punctuation errors.

0 (0%) – 2 (2%)

Contains many (≥ five) 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 heads, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%)

Uses correct APA format with no errors.

3 (3%) – 3 (3%)

Contains several (three or four) APA format errors.

0 (0%) – 2 (2%)

Contains many (≥ five) APA format errors.

Total Points: 100

Name: NRNP_6540_Week2_Assignment_Rubric

 

Week 2: Psychosocial CASE SCENARIO

Week 2 Case 1: Dementia

HPI: Ms. Peters is a 70-year-old female who is brought to your office by her son with reports of acute confusion (more than usual) and some agitation and restlessness. She has a known history of dementia, managed with Aricept 10 mg. daily. Her son, Jared, reports that 2 days ago she began to become more confused than usual and very easily agitated. He reports that yesterday, she couldn’t remember where she was in her own home. She had a doctor’s appointment 3 days ago and her HCTZ (hydrochlorothiazide) was increased to 50 mg. due to increased bp’s.

Ms. Peter’s last Mini-Mental State Exam (MMSE) score was 18/30. The assessment was repeated, and the score remained unchanged.

Ms. Peters and her son denies her having any falls or contributing traumas recently. She denies any changes in diet or routine regimens. No reported dysuria, no fever, nausea, or vomiting.

Note: Be sure to review the MMSE and how to interpret results (Mental State Assessment Tests). Make sure you document the patient’s score in your SOAP note document. Also review the Geriatric Depression Assessment (Geriatric Depression Scale [GDS]).

Ms. Peters is a 70-year-old female who is alert but easily distracted, at times, during today’s clinical interview. Her eye contact is fair. Speech is clear and coherent but tangential at times. She makes no unusual motor movements and demonstrates no tics. She denies any visual or auditory hallucinations. She denies any suicidal thoughts or ideations. She is alert but disoriented to place and time. She denies any falls, denies any pain. Her son does say she has had some “stumbling” and balance issues but no reported falls.

All other Review of System and Physical Exam findings are negative other than stated.

Vital Signs: 98.1 120/64 HR-72 20

PMH: Hypertension, Diabetes, Osteoporosis, Chronic Allergic Rhinitis

Allergies: Atorvastatin

Medications:

  • Multivitamin daily
  • Losartan 50mg daily
  • HCTZ 50mg daily
  • Fish Oil 1 tablet daily
  • Glyburide 5mg daily
  • Metformin 500mg BID
  • Donepezil 10mg daily
  • Alendronate 70mg orally once a week

Social History: As stated in Case Study

ROS: As stated in Case study

Diagnostics/Assessments done:

  1. CXR—no cardiopulmonary findings. WNL
  2. CT head—diffuse Cerebral Atrophy
  3. MMSE—Ms. Peters scored 18 out of 30 with primary deficits in orientation, registration, attention and calculation, and recall at a previous visit. At today’s visit, there is no change. The score suggests moderate dementia.
  4. Hemoglobin A1C7.2%
  5. Basic Metabolic Panel as shown below
TEST RESULT REFERENCE RANGE
GLUCOSE 90 65–99
SODIUM 130 135–146
POTASSIUM 3.4 3.5–5.3
CHLORIDE 104 98–110
CARBON DIOXIDE 29 19–30
CALCIUM 9.0 8.6–10.3
BUN 20 7–25
CREATININE 1.00 0.70–1.25
GLOMERULAR FILTRATION RATE (eGFR) 77 >or=60 mL/min/1.73m2

Focused SOAP Note Template

Patient Information:

Initials, Age, Sex, Race

S (subjective)

CC (chief complaint): a BRIEF statement identifying why the patient is here, stated in the patient’s own words (for instance “headache,” NOT “bad headache for 3 days”).

HPI (history of present illness): This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the HPI might look like the following example:

  • Location: Head
  • Onset: 3 days ago
  • Character: Pounding, pressure around the eyes and temples
  • Associated signs and symptoms: Nausea, vomiting, photophobia, phonophobia
  • Timing: After being on the computer all day at work
  • Exacerbating/relieving factors: Light bothers eyes; Aleve makes it tolerable but not completely better
  • Severity: 7/10 pain scale

Current Medications: Include dosage, frequency, length of time used, and reason for use; also include over the counter (OTC) or homeopathic products.

Allergies: Include medication, food, and environmental allergies separately, including a description of what the allergy is (i.e., angioedema, anaphylaxis, etc.). This will help determine a true reaction versus intolerance.

PMHx: Include immunization status (note date of last tetanus for all adults), past major illnesses, and surgeries. Depending on the CC, more info is sometimes needed.

Soc and Substance Hx: Include occupation and major hobbies, family status, tobacco and alcohol use (previous and current use), and any other pertinent data. Always add some health promo question here, such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system.

Fam Hx: Illnesses with possible genetic predisposition, contagious, or chronic illnesses. Reason for death of any deceased first-degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent.

Surgical Hx: Prior surgical procedures.

Mental Hx: Diagnosis and treatment. Current concerns (anxiety and/or depression). History of self-harm practices and/or suicidal or homicidal ideation.

Violence Hx: Concern or issues about safety (personal, home, community, sexual (current and historical).

Reproductive Hx: Menstrual history (date of LMP), Pregnant (yes or no), Nursing/lactating (yes or no), contraceptive use (method used), types of intercourse (oral, anal, vaginal, other, any sexual concerns).

ROS (review of symptoms): Cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows:

  • General:
  • Head:
  • EENT (eyes, ears, nose, and throat):
  • Etc.:

Note: You should list these in bullet format, and document the systems in order from head to toe.

Example of Complete ROS:

GENERAL: No weight loss, fever, chills, weakness, or fatigue.

HEENT:

  • Eyes: No visual loss, blurred vision, double vision or yellow sclerae.
  • Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.

SKIN: No rash or itching.

CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema.

RESPIRATORY: No shortness of breath, cough or sputum.

GASTROINTESTINAL: No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.

GENITOURINARY: Burning on urination. Last menstrual period (LMP), MM/DD/YYYY.

NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL: No muscle, back pain, joint pain or stiffness.

HEMATOLOGIC: No anemia, bleeding or bruising.

LYMPHATICS: No enlarged nodes. No history of splenectomy.

PSYCHIATRIC: No history of depression or anxiety.

ENDOCRINOLOGIC: No reports of sweating, cold or heat intolerance. No polyuria or polydipsia.

REPRODUCTIVE: Not pregnant and no recent pregnancy. No reports of vaginal or penile discharge. Not sexually active.

ALLERGIES: No history of asthma, hives, eczema or rhinitis.

O (objective)

Physical exam: From head-to-toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head to toe format (i.e., General: Head: EENT: etc.).

Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines).

A (assessment)

Differential diagnoses: List a minimum of three differential diagnoses. Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence-based guidelines.

P (plan)

Includes documentation of diagnostic studies that will be obtained, referrals to other health-care providers, therapeutic interventions, education, disposition of the patient, and any planned follow up visits. Each diagnosis or condition documented in the assessment should be addressed in the plan. The details of the plan should follow an orderly manner.

Also included in this section is the reflection. Reflect on this case, and discuss what you learned, including any “aha” moments or connections you made.

Also include in your reflection, a discussion related to health promotion and disease prevention taking into consideration patient factors (such as, age, ethnic group, etc.), PMH, and other risk factors (e.g., socio-economic, cultural background, etc.).

References

You are required to include at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines, which relate to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.

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NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Example

NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion AssignmentNRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment

NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment Brief

Course: NRNP 6540 – Advanced Practice Care of Older Adults

Assignment Title: NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment

Assignment Instructions Overview

This assignment involves creating an evaluation plan for an elderly patient based on a case study provided by the instructor. The focus is on assessing the patient’s health and functional ability to determine if their needs are being met. Students are required to use comprehensive geriatric assessments to identify age-related changes that may interfere with the patient’s functional status.

Understanding Assignment Objectives

The primary objective of this assignment is to develop a detailed evaluation plan for an elderly patient. Students must:

  • Assess the patient’s health and functional stability.
  • Identify appropriate assessment tools to evaluate wellness and functional ability.
  • Consider factors such as the setting of the evaluation, involvement of other professionals or family members, and potential challenges like language barriers or cognitive impairment.
  • Determine immunization requirements relevant to the patient’s health promotion and disease prevention.

The Student’s Role

Students will assume the role of a nurse practitioner responsible for evaluating the health and functional status of an elderly patient. This involves:

  • Reviewing the provided case study thoroughly.
  • Developing an evaluation plan that includes specific assessment tools.
  • Justifying the choice of assessment tools and considering their validation for the patient population.
  • Addressing potential issues during the assessment, such as cognitive impairment or sensory deprivation.
  • Recommending necessary immunizations for health promotion and disease prevention.

Competencies Measured

This assignment measures several key competencies essential for advanced practice nurse practitioners, including:

  • Clinical reasoning and decision-making skills.
  • Ability to conduct comprehensive geriatric assessments.
  • Proficiency in using validated assessment tools for elderly patients.
  • Understanding of immunization requirements for older adults.
  • Communication skills, particularly in explaining the evaluation plan and addressing potential challenges.

You Can Also Check Other Related Assessments for the NRNP 6540 – Advanced Practice Care of Older Adults Course:

NRNP 6540 Psychosocial Disorders Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression Assignment Example

NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Example

As individuals age, they are more likely to develop various chronic health conditions that can significantly impact their quality of life. Advanced practice nurse practitioners (APNPs) frequently interact with elderly patients, and it is crucial to evaluate and address these conditions to maintain the patients’ functional ability. Common age-related health issues include obstructive sleep apnea (OSA), hypertension, chronic anemia, restless leg syndrome, osteoporosis, and cognitive impairment. Comprehensive assessments are essential to identify and manage these conditions effectively.

Case Study Overview

Mr. Raymond Young, a 92-year-old retired college professor, presents a case that exemplifies the complexity of caring for elderly patients. Despite his advanced age and several chronic health issues, Mr. Young is able to perform all basic activities of daily living independently. His medical history includes obstructive sleep apnea, hypertension managed with lifestyle modifications, mild chronic anemia, restless leg syndrome, and osteoporosis. He has also experienced falls and has reported instances of getting lost while driving to familiar locations. These issues suggest potential underlying problems related to immobility, sensory deprivation, and cognitive dysfunction that require thorough evaluation.

Evaluation Plan

Developing an evaluation plan for Mr. Young involves several critical steps. First, the assessment should be conducted in a setting that ensures the patient’s comfort and safety, such as his home or a familiar clinical environment. Involving family members, particularly his wife, in the evaluation process can provide additional insights into his daily functioning and any changes observed over time. Collaboration with other healthcare professionals, including a geriatrician, neurologist, and physical therapist, may also be necessary to provide a comprehensive evaluation.

Assessment Tools

Several assessment tools are appropriate for evaluating Mr. Young’s cognitive function, mobility, and overall health status. The Mini-Mental State Examination (MMSE) is a widely used tool for assessing cognitive function in older adults. It evaluates attention, orientation, memory, registration, recall, calculation, language, and visuospatial skills through a series of 30 questions (Arevalo-Rodriguez et al., 2021). Given Mr. Young’s history of cognitive impairment, the MMSE is suitable for monitoring any progression of cognitive decline. However, it is important to note that while the MMSE is validated for use in older adults, it may have limitations in patients with varying educational backgrounds or language barriers (Arevalo-Rodriguez et al., 2021).

The Comprehensive Geriatric Assessment (CGA) is another essential tool, incorporating multiple scales to evaluate various aspects of an elderly patient’s health. This multidisciplinary instrument includes the Berg Balance Scale to assess balance, the Falls Efficacy Scale to evaluate the fear of falling, and the Timed Up and Go Test to measure mobility (Appeadu & Bordoni, 2023). Given Mr. Young’s history of falls, these assessments can help identify specific risk factors and guide interventions to prevent future incidents.

For evaluating Mr. Young’s driving competency, performance-based road tests and driving simulation studies can be utilized. These tests assess the coordination of cognitive and physical tasks required for safe driving. Additionally, psychometric evaluations, such as the MMSE, can provide insights into cognitive functions relevant to driving (Toups et al., 2022).

Addressing Potential Issues

Several factors might present challenges during Mr. Young’s assessment. Cognitive impairment could affect his ability to recall past events accurately, which may hinder the history-taking process. Ensuring that questions are clear and straightforward can help mitigate this issue. Additionally, his educational background and any language barriers should be considered when administering cognitive tests to ensure accurate results. Cultural competency is crucial, as cultural beliefs and practices can influence how symptoms are perceived and reported by the patient (Khanna & Metgud, 2020).

Immunization Requirements

Vaccinations play a vital role in promoting health and preventing disease among older adults. Mr. Young should receive recommended vaccines to protect against common infections that can have severe consequences in the elderly. These include the annual influenza vaccine, pneumococcal vaccine, tetanus, and polio vaccines (Michel & Frangos, 2022). Ensuring that Mr. Young is up-to-date with his immunizations can help prevent infections that may exacerbate his existing health conditions.

Conclusion

A comprehensive and multidisciplinary approach is essential for evaluating and managing the health of elderly patients like Mr. Young. Utilizing appropriate assessment tools and considering potential issues related to cognitive function, educational background, and cultural factors can enhance the accuracy of the evaluation. Additionally, maintaining up-to-date immunizations is crucial for promoting overall health and preventing disease in older adults.

References

Appeadu, M., & Bordoni, B. (2023, June 4). Falls and Fall Prevention in the Elderly. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560761/

Arevalo-Rodriguez, I., Smailagic, N., Roqué-Figuls, M., Ciapponi, A., Sanchez-Perez, E., Giannakou, A., Pedraza, O. L., Bonfill Cosp, X., & Cullum, S. (2021). Mini-Mental State Examination (MMSE) for the Early Detection of Dementia in People with Mild Cognitive Impairment (MCI). Cochrane Database of Systematic Reviews, 2021(7). https://doi.org/10.1002/14651858.cd010783.pub3

Khanna, A., & Metgud, C. (2020). Prevalence of cognitive impairment in elderly population residing in an urban area of Belagavi. Journal of Family Medicine and Primary Care, 9(6), 2699. https://doi.org/10.4103/jfmpc.jfmpc_240_20

Michel, J.-P., & Frangos, E. (2022). The Implications of Vaccines in Older Populations. Vaccines, 10(3), 431. https://doi.org/10.3390/vaccines10030431

Toups, R., Chirles, T. J., Ehsani, J. P., Michael, J. P., Bernstein, J. P. K., Calamia, M., Parsons, T. D., Carr, D. B., & Keller, J. N. (2022). Driving Performance in Older Adults: Current Measures, Findings, and Implications for Roadway Safety. Innovation in Aging, 6(1), igab051. https://doi.org/10.1093/geroni/igab051

Detailed Assessment Instructions for the NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment

NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Instructions

As patients age, they are more likely to develop health issues. While some of these health issues are normal changes due to aging, some of them are abnormal and require further evaluation. Consider a 92-year-old patient who has been diagnosed with several disorders, including obstructive sleep apnea, hypertension, mild chronic anemia, restless leg syndrome, and osteoporosis. Despite these disorders, he can independently perform all basic activities of daily living, walk a quarter mile without difficulty, and pass functional and cognitive assessments. However, he did report that he fell a few times and had lost his way while driving to a familiar location (Carr & Ott, 2010).

As an advanced practice nurse caring for geriatric patients, you will likely encounter patients like this. While he can pass the basic assessments, the report of falls and confusion might indicate underlying issues of immobility, sensory deprivation, and/or cognitive dysfunction that require further attention. To identify these potential underlying issues and distinguish between normal and abnormal changes due to aging, healthcare providers use a variety of assessments. These assessments are a key tool in the care of geriatric patients.

This week, you examine assessment tools and evaluation plans used to assess geriatric patients presenting with potential issues of immobility, sensory deprivation, and cognitive dysfunction.

Reference:
Carr, D. B., & Ott, B. R. (2010). The older adult driver with cognitive impairment: “It’s a very frustrating life.” Journal of the American Medical Association, 303(16), 1632–1641. 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915446/

NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Learning Objectives

Students will:

  • Analyze assessment tools used to assess older adults
  • Design evaluation plans for patients with immobility, sensory deprivation, and/or cognitive dysfunction
  • Identify immunization requirements related to health promotion and disease prevention for older adults

Learning Resources

Required Readings (click to expand/reduce)

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Changes with aging. In Advanced practice nursing in the care of older adults (2nd ed., pp. 2–5). F. A. Davis.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Health promotion. In Advanced practice nursing in the care of older adults (2nd ed., pp. 6–18). F. A. Davis.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Exercise in older adults. In Advanced practice nursing in the care of older adults (2nd ed., pp. 19–24). F. A. Davis.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Comprehensive geriatric assessment. In Advanced practice nursing in the care of older adults (2nd ed., pp. 26–33). F. A. Davis.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Symptoms and syndromes. In Advanced practice nursing in the care of older adults (2nd ed., pp. 34–94). F. A. Davis.

Centers for Disease Control and Prevention. (2020). Recommended adult immunization schedule for ages 19 years or older. https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf

Coll, P. P., Costello, V. W., Kuchel, G. A., Bartley, J., & McElhaney, J. E. (2019). The prevention of infections in older adults: Vaccination. Journal of the American Geriatrics Society, 68(1), 207–214. https://doi.org/10.1111/jgs.16205

Hartford Institute for Geriatric Nursing. (2020). General assessment series. In Try This: Series. Author. https://consultgeri.org/try-this/general-assessment

U.S. Preventive Services Task Force. (n.d.). Information for health professionals. Retrieved June 8, 2020 from https://www.uspreventiveservicestaskforce.org/uspstf/information-health-professionals

U.S. Preventive Services Task Force. (2019). Appendix III. USPSTF LitWatch process. https://www.uspreventiveservicestaskforce.org/uspstf/procedure-manual-appendix-iii-uspstf-litwatch-process

Recommended Reading (click to expand/reduce)

Goldberg, C. (2019). Role of physical exam, general observation, skin screening and vital signs. https://meded.ucsd.edu/clinicalmed/assets/docs/Vital%20Signs%20and%20Introduction%20to%20the%20Exam.pdf

Recommended Media (click to expand/reduce)

Engage-IL (Producer). (2017m). Geriatric health promotion and disease prevention [Video]. https://engageil.com/modules/geriatric-health-promotion-and-disease-prevention/

Note: View the Geriatric Health Promotion and Disease Prevention video module available in this free course. If you choose to view the Engage-IL media, you will need to create a free account at the Engage-IL website. 

Engage-IL (Producer). (2017w). The process of aging [Video]. https://engageil.com/modules/the-process-of-aging/

Note: View the Process of Aging video module available in this free course.

Discussion: Evaluation Plan

As geriatric patients age, their health and functional stability may decline resulting in the inability to perform basic activities of daily living. In your role as a nurse practitioner, you must assess whether the needs of these aging patients are being met. Comprehensive geriatric assessments are used to determine whether these patients have developed or are at risk of developing age-related changes that interfere with their functional status. Since the health status and living situation of older adult patients often differ, there are a variety of assessment tools that can be used to evaluate wellness and functional ability. For this Discussion, you will consider which assessment tools would be appropriate for a patient in a case scenario.

Photo Credit: LIGHTFIELD STUDIOS / Adobe Stock

To prepare:

  • Review this week’s Learning Resources, considering how assessment tools are used to evaluate patients.
  • Your Instructor will assign a case study to use for this Discussion. Review the case study and, based on the provided information, think about a possible patient evaluation plan. As part of your evaluation planning, consider where the evaluation would take place, whether any other professionals or family members should be present, appropriate assessment tools and guidelines, and any other relevant information you may wish to address.
  • Consider whether the assessment tool you identified was validated for use with this specific patient population and if this poses issues. Think about additional factors that might present issues when performing assessments such as language, education, prosthetics, missing limbs, etc.
  • Consider immunization requirements that may be needed for this patient.

By Day 3

Post an explanation of your evaluation plan for the patient in the case study provided, and explain which type of assessment tool you might use for the patient. Explain whether the assessment tool was validated for use with this patient’s specific patient population and whether this poses issues. Include additional factors that might present issues when performing assessments, such as language, education, prosthetics, etc. Also explain the immunization requirements related to health promotion and disease prevention for the patient.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the following ways:

  • Suggest alternative assessment tools and explain why these tools might be appropriate for your colleagues’ patients.
  • Recommend strategies for mitigating issues related to use of the assessment tools your colleagues discussed.
  • Explain other health promotion considerations for patients in this population or with related issues.

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

NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Rubric Detail

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Name: NRNP_6540_Week1_Discussion_Rubric

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List View

Excellent

Point range: 90–100       Good

Point range: 80–89         Fair

Point range: 70–79         Poor

Point range: 0–69

Main Posting:

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

40 (40%) – 44 (44%)

Thoroughly responds to the discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least 3 current credible sources.

35 (35%) – 39 (39%)

Responds to most of the discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least 3 credible references.

31 (31%) – 34 (34%)

Responds to some of the discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with fewer than 2 credible references.

0 (0%) – 30 (30%)

Does not respond to the discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only 1 or no credible references.

Main Posting:

Writing

6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Further adheres to current APA manual writing rules and style.

5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main discussion by due date.

8 (8%) – 8 (8%)

Posts main discussion by due date.

Meets requirements for full participation.

7 (7%) – 7 (7%)

Posts main discussion by due date.

0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic, may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.

First Response:

Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

4 (4%) – 4 (4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic, may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.

Second Response:

Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

4 (4%) – 4 (4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

Name: NRNP_6540_Week1_Discussion_Rubric

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NRNP 6566 Branching Exercise Cardiac Case 1 Assignment Example

NRNP 6566 Branching Exercise: Cardiac Case 1 AssignmentNRNP 6566 Branching Exercise: Cardiac Case 1 Assignment

NRNP 6566 Branching Exercise Cardiac Case 1 Assignment Brief

Course: NRNP 6566 – Advanced Care of Adults in Acute Settings I

Assignment Title: NRNP 6566 Branching Exercise: Cardiac Case 1 Assignment

Assignment Instructions Overview

This assignment requires you to engage with an interactive media piece focusing on a cardiac patient case. You will be responsible for reviewing the patient presentation, including vital signs, past medical history (PMH), home medications, and diagnostic results. Based on this information, you will develop a comprehensive set of admission orders as the admitting provider, ensuring all aspects of patient care are addressed.

Understanding Assignment Objectives

The primary objective of this assignment is to apply your clinical knowledge and critical thinking skills to assess and treat a patient presenting with specific symptoms. You will develop a complete set of admission orders, ensuring no assumptions are made about prior treatments or protocols. The orders should include additional lab tests, diagnostics, medication adjustments, and rationales for each decision made.

The Student’s Role

As a student, you will take on the role of the admitting provider, responsible for the initial assessment and treatment plan for the patient. You must use the provided admission orders template, ensuring that each order is specific and leaves no room for interpretation by the nursing staff. Your role also involves justifying your decisions with evidence-based references, demonstrating an understanding of current guidelines and standards of care.

Competencies Measured

This assignment will measure your ability to:

  • Analyze patient data critically and develop appropriate treatment plans.
  • Apply current clinical guidelines and evidence-based practices in patient care.
  • Write clear and precise medical orders.
  • Justify clinical decisions with appropriate rationale and references.
  • Address all aspects of patient care, from immediate medical needs to long-term health promotion and discharge planning.

You Can Also Check Other Related Assessments for the NRNP 6566 – Advanced Care of Adults in Acute Settings I Course:

NRNP 6566 Impact of Pharmacokinetics on Medication Selection and Administration Assignment Example

NRNP 6566 Branching Exercise Cardiac Case 1 Assignment Example

Admission Orders for Cardiac Case 1: 63-Year-Old Female

Primary Diagnosis

Atrial Fibrillation with Rapid Ventricular Response

Status/Condition

Critical

Code Status

Full Code

Allergies

Penicillin

Admit to Unit

Intensive Care Unit (ICU)

Activity Level

Ambulate as tolerated

Diet

  • Clear liquids, advance as tolerated to a cardiac diet and low carbohydrate diet

IV Fluids

  • 0.9% Normal Saline at 75 mL/hr for hydration. Discontinue once the patient starts oral intake adequately.

Critical Drips

  • None required at this time as the patient’s rate is controlled with Metoprolol tartrate IV bolus. Monitor closely and reassess need for additional bolus if the rate increases again.

Respiratory

  • Oxygen via nasal cannula at 2 L/min. Wean if oxygen saturation remains >95% and the patient does not experience shortness of breath.

Medications

  • Heparin 5000 units subcutaneously BID for anticoagulation to prevent thromboembolic events (source: Harris, 2023).
  • Metoprolol tartrate 50 mg PO BID for ongoing rate control (source: Barkley & Myers, 2020).
  • Lisinopril 10 mg PO daily (reduce from home dose of 20 mg due to addition of Metoprolol) for hypertension management (source: Fuller & McCauley, 2023).
  • Metformin 500 mg PO BID, continue as home medication for diabetes management.

Nursing Orders

  • Vital signs every 15 minutes for 1 hour, then every 30 minutes for 1 hour, then hourly if stable.
  • Continuous cardiac monitoring.
  • Strict intake and output monitoring.
  • Daily weight.
  • Skin care and reposition every 2 hours.
  • Encourage use of incentive spirometer every hour while awake.

Follow-Up Lab Tests

  • Repeat CBC: To monitor hemoglobin, hematocrit, and platelet levels.
  • Repeat CMP: To assess electrolyte balance, renal function, and liver enzymes.
  • TSH: To rule out thyroid-related causes of atrial fibrillation.
  • INR: To monitor anticoagulation status with Heparin.

Diagnostic Testing

  • Echocardiogram: To evaluate cardiac function and structure, particularly to assess for any valvular disease or cardiomyopathy.
  • Chest X-ray: To rule out any pulmonary causes for the shortness of breath and to assess cardiac silhouette.

Consults

  • Cardiology: For evaluation and management of new-onset atrial fibrillation, including consideration for potential cardioversion or ablation if rhythm does not stabilize with medical management.

Patient Education and Health Promotion

  • Educate the patient on the importance of medication adherence, particularly the new anticoagulant and rate control medications.
  • Discuss lifestyle modifications for heart health, including a low-sodium, heart-healthy diet, regular physical activity, and smoking cessation if applicable.
  • Explain the need for regular follow-up appointments to monitor the condition and adjust treatment as necessary.

Discharge Planning and Required Follow-Up Care

  • Plan for discharge once the patient is hemodynamically stable, with controlled heart rate and without symptoms.
  • Schedule follow-up with primary care provider and cardiology within one week of discharge.
  • Arrange for outpatient monitoring of INR if the patient continues on anticoagulation therapy.

References

Barkley, T. W., Jr., & Myers, C. M. (2020). Practice considerations for the adult-gerontology acute care nurse practitioner (3rd ed.). Barkley & Associates.

Fuller, V. J., & McCauley, P. S. (2023). Textbook for the adult-gerontology acute care nurse practitioner: Evidence-based standards of practice. Springer Publishing Company.

Harris, C. (2023). Adult-gerontology acute care practice guidelines (2nd ed.). Springer Publishing Company.

Detailed Assessment Instructions for the NRNP 6566 Branching Exercise Cardiac Case 1 Assignment

Description

Assignment: Branching Exercise: Cardiac Case 1

For this Assignment, you will review the interactive media piece/branching exercise provided in the Learning Resources. As you examine the patient case, consider how you might assess and treat patients with the symptoms and conditions presented.

Photo Credit: [IMAGEMORE Co., Ltd.]/[none]/Getty Images

To prepare:

  • Review the information provided in the case (patient presentation, vital signs, pmh, home meds, results of labs and diagnostics. With this information, critically think about what is happening with the patient.
  • Use your critical thinking skills and current guidelines to develop orders. Include additional labs/diagnostics, what needs repeated and followed up on. Medications that need to be ordered or changed.

The Assignment:

  • Using the required admission orders template found under the Learning Resources: Required Reading.
  • Develop a set of orders as the admitting provider.
  • Be sure to address each aspect of the order template
  • Write the orders as you would in the patient’s chart. Be specific. Do not leave room for the nurse to interpret your orders.
  • Do not assume anything has already been done/order. Use the information given. Example: If the case does not mention fluids were given, the patient did not receive fluids. You may have to start from scratch as if you are working in the ER. And you must provide orders if the patient needs to be admitted.
  • Make sure the order is complete and applicable to the patient.
  • Make sure you provide rationales for your labs and diagnostics and anything else you feel the need to explain. This should be done at the end of the order set – not included with the order.
  • Please do not write per protocol. We do not know what your protocol is and you need to demonstrate what is the appropriate standard of care for this patient.
  • A minimum of three current (within the last 5 years), evidenced based references are required

By Day 7 of Week 2

Submit your completed Assignment by Day 7 of Week 2 in Module 2.

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “MD2Assgn1+last name+first initial.(extension)” as the name.
  • Click the Module 2 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Module 2 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “MD2Assgn1+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.

 CASE STUDY INFORMATION:

BACKGROUND

Scenario #1 63 year old female (Branching Exercise: Cardiac Case 1: 63 Year Old Female)

    • 63-year-old female presents to the Emergency Department complaining of dizziness and shortness of breath.

VITAL SIGNS

    • PMH: HTN, Diabetes, TIA
    • Home Meds: Lisinopril, Metformin
    • Allergies: Penicillin
    • HR: 180, O2 Sat 94%, BP: 107/78, RR: 21
    • The patient is a full code 
    • Atrial Fibrillation with Rapid Ventricular Response
    • 12 lead EKG, TSH, CBC,CMP, INR
    • Metoprolol tartrate 2.5mg IV bolus over 2 minutes (Rate control in this patient is the first priority in order to enable ventricular filling and cardiac output. Anticoagulation is indicated unless there is a contraindication. Rate control and anticoagulation are the priority then Cardiology will advise on TEE/Cardioversion.)

Learning Resources – Branching Exercise: Cardiac Case 1: 63 Year Old Female

Required Readings (click to expand/reduce)

Barkley, T. W., Jr., & Myers, C. M. (2020). Practice considerations for the adult-gerontology acute care nurse practitioner (3rd ed.). Barkley & Associates.

  • Chapter 21, “Arrhythmias” (pp. 263–290)

Fuller, V. J., & McCauley, P. S. (2023). Textbook for the adult-gerontology acute care nurse practitioner: Evidence-based standards of practice. Springer Publishing Company.

Tachycardia’s, pp. 106-109

Harris, C. (2023). Adult-gerontology acute care practice guidelines (2nd ed.). Springer Publishing Company.

Arrhythmias, pp. 54-58

Document: Admission Orders Template (Word document)Download Admission Orders Template (Word document)

Document: Admission Orders Template (Word document)

Required Media (click to expand/reduce)

MedCram. (2019, June 9). ECG interpretation explained clearly and succinctly – arrhythmias, blocks, hypertrophy [Video file]. Retrieved from https://www.youtube.com/watch?v=Rv6l0ViRJDQ

MedCram. (2018, July 15). ST elevation – EKG/ECG interpretation case 12 (STEMI, MI, ACS) [Video file]. Retrieved from https://www.youtube.com/watch?v=8ajWCLqz3VQ

MedCram. (2017, July 23). EKG/ECG practice strip interpretation explained clearly – case 10 [Video file]. Retrieved from https://www.youtube.com/watch?v=zA1Dpwnzrxg

Walden University (Producer). (2019a). Branching exercise: Cardiac case 1 [Interactive media file]. Minneapolis, MN: Author.

Walden University (Producer). (2019a). Branching exercise: Cardiac case 1.[Interactive media file]. Minneapolis, MN: Author.

Antiarrhythmic Drugs for the AGACNP

Dr. Tony Anno, core faculty for the AGACNP program at Walden University reviews that cardiac cycle and arrythmia pathophysiology. A review and discussion on the use of antiarrhythmic drugs that the AGACNP may encounter in practice is also provided. (18m)

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript

ECG Review for the AGACNP

Dr. Tony Anno reviews important concepts and skills needed in understanding and interpreting ECGs for the AGACNP in practice. This review will also build upon you previous knowledge and expertise in diagnosing and treating cardiac disorders. (14m)

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript

LEARNING RESOURCES

Required Media

The assignment this week is the branching exercise.  You can go through the exercise as much as you want, until it is submitted.  You can only submit the assignment one time for grading.   Your assignment at the end of the exercise is to write orders that reflect your treatment plan for this patient.  The template for your order set is located in the required reading. Please be sure that you are writing specific orders exactly as you would in a patient’s chart.    The assignment is due by Sunday. 

Admission Orders Template

Primary Diagnosis:

Status/Condition (Critical, Guarded, Stable, etc.):

Code Status:

Allergies:

Admit to Unit:

Activity Level:

Diet:

IV Fluids:

 Critical Drips (If ordered, include type and rate. Do not defer to ICU protocol.):

Respiratory: Oxygen (If ordered, include type and rate.), pulmonary toilet needs, ventilator settings:

Medications (include ALL, tx of primary condition, underlying conditions, pain, comfort needs, etc., dose and route):

Nursing Orders (vital signs, skin care, toileting, ambulation, etc.):

Follow-Up Lab Tests:

 Diagnostic testing (CXR, US, 2D Echo, etc.):

Consults:

NOTE: (Do not defer management to a specialist. As an ACNP, you must manage the patient’s acute needs for at least a 24-hour period]. Include indication for consult. For example: “Cardiology consult for evaluation of new-onset atrial fibrillation,” or “Nutrition consult for TPN recommendations.”

Patient Education and Health Promotion (address age-appropriate patient education. if applicable):

Discharge Planning and Required Follow-Up Care:

References (minimum of three timely references that prove this plan follows current standards of care):

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NRNP 6566 Impact of Pharmacokinetics on Medication Selection and Administration Paper Example

NRNP 6566 Impact of Pharmacokinetics on Medication Selection and Administration AssignmentNRNP 6566 Impact of Pharmacokinetics on Medication Selection and Administration Assignment

NRNP 6566 Impact of Pharmacokinetics on Medication Selection and Administration Assignment Brief

Course: NRNP 6566 – Advanced Care of Adults in Acute Settings I

Assignment Title: NRNP 6566 Impact of Pharmacokinetics on Medication Selection and Administration Assignment

Assignment Instructions Overview

This assignment aims to enhance your understanding of how pharmacokinetics influences medication selection and administration. As an advanced practice nurse (APN), you will be responsible for prescribing medications, and a thorough understanding of pharmacokinetics is essential for effective decision-making. This assignment will explore how knowledge of drug absorption, distribution, metabolism, and elimination can inform your prescribing practices to ensure optimal patient outcomes.

Understanding Assignment Objectives

The primary objective of this assignment is to analyze the impact of pharmacokinetics on medication selection and administration. You will reflect on how pharmacokinetic principles can guide you in adjusting dosages, selecting appropriate drug administration routes, and anticipating potential drug interactions and adverse effects. The goal is to integrate pharmacokinetic knowledge into your clinical practice to improve patient care and safety.

The Student’s Role

As a student, your role is to demonstrate your understanding of pharmacokinetic concepts and their practical application in clinical settings. You will be expected to review the provided learning resources, engage in discussions, and provide specific examples of how pharmacokinetics influences your medication prescribing decisions. Your initial post should be well-researched, clearly articulated, and supported by relevant literature.

Competencies Measured

This assignment will assess your ability to:

  • Apply pharmacokinetic principles to clinical decision-making.
  • Identify factors that affect drug absorption, distribution, metabolism, and elimination.
  • Analyze the implications of pharmacokinetic interactions on medication safety and efficacy.
  • Utilize evidence-based knowledge to optimize medication regimens for diverse patient populations.
  • Communicate your understanding effectively through a structured and well-supported discussion post.

You Can Also Check Other Related Assessments for the NRNP 6566 – Advanced Care of Adults in Acute Settings I Course:

NRNP 6566 Branching Exercise: Cardiac Case 1 Assignment Example

NRNP 6566 Impact of Pharmacokinetics on Medication Selection and Administration Paper Example

Introduction

As advanced practice nurses (APNs), it is crucial to have a thorough understanding of pharmacokinetics when prescribing medications. Pharmacokinetics involves the study of how a drug is absorbed, distributed, metabolized, and eliminated by the body. This knowledge helps in making informed decisions regarding medication selection and administration, ensuring optimal therapeutic outcomes and minimizing adverse effects.

Importance of Pharmacokinetics in Prescribing Medications

Understanding pharmacokinetics is vital in selecting the appropriate medication and determining the correct dosage and administration route. Factors such as age, gender, and ethnicity can significantly influence pharmacokinetic processes and affect drug efficacy and safety. For instance, elderly patients may have reduced renal function, necessitating dosage adjustments to prevent toxicity (Doogue & Polasek, 2013).

Consider the case of warfarin and amiodarone, where co-administration can increase the levels of both medications. Amiodarone, an antiarrhythmic agent, inhibits the metabolism of warfarin, leading to increased anticoagulant effects and a higher risk of bleeding (Haverkamp et al., 2017). Monitoring and dosage adjustments are essential to manage this interaction safely.

Case Example: Nitroglycerin Administration

Nitroglycerin is a potent vasodilator used primarily for angina pectoris. It is typically administered sublingually rather than orally due to its high first-pass metabolism. When taken orally, nitroglycerin undergoes extensive hepatic metabolism, significantly reducing its bioavailability and effectiveness (Willenbring et al., 2018). Sublingual administration bypasses the liver, allowing rapid absorption and onset of action, which is crucial during angina attacks.

The sublingual route is preferred because the thin sublingual epithelium allows for quicker absorption into the systemic circulation compared to the thicker buccal mucosa (Akhter et al., 2022). This method ensures that sufficient drug levels are achieved promptly, providing rapid relief from angina symptoms.

Other Medications with Non-Oral Administration Routes

Some medications are not suitable for oral administration due to poor absorption or significant first-pass metabolism. For example, vaginally administered medications like progestogens, estrogens, and antifungals are used to treat conditions such as yeast infections. The vaginal route provides a local effect and avoids the first-pass metabolism, ensuring higher drug concentrations at the site of action (Leyva-Gómez et al., 2019).

Conclusion

In summary, understanding pharmacokinetics is crucial for APNs in prescribing and administering medications. It allows for personalized treatment plans that consider individual patient factors, ensuring effective and safe therapeutic outcomes. By being aware of how drugs are absorbed, distributed, metabolized, and eliminated, APNs can make informed decisions that optimize patient care.

References

Akhter, A. S., Gumina, R., & Nimjee, S. (2022). Sublingual Nitroglycerin Administration to Relieve Radial Artery Vasospasm and Retrieve Wedged Catheter: A Consideration in Neuroangiography. Stroke: Vascular and Interventional Neurology. https://doi.org/10.1161/svin.121.000155

Doogue, M. P., & Polasek, T. M. (2013). The ABCD of clinical pharmacokinetics. Therapeutic Advances in Drug Safety, 4(1), 5-7. https://doi.org/10.1177/2042098612469335

Haverkamp, W., Breithardt, G., Camm, A. J., Janse, M. J., Rosen, M. R., Antzelevitch, C., … & Hoffman, B. F. (2017). The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Report on a policy conference of the European Society of Cardiology. European Heart Journal, 21(15), 1216-1231. https://doi.org/10.1053/euhj.2000.2518

Leyva-Gómez, G., Del Prado-Audelo, M. L., Ortega-Peña, S., Mendoza-Muñoz, N., Urbán-Morlán, Z., González-Torres, M., … & Cortés, H. (2019). Modifications in Vaginal Microbiota and Their Influence on Drug Release: Challenges and Opportunities. Pharmaceutics, 11(5), 217. https://doi.org/10.3390/pharmaceutics11050217

Willenbring, B. A., Schnitker, C. K., & Stellpflug, S. J. (2018). Oral Nitroglycerin Solution May Be Effective for Esophageal Food Impaction. The Journal of Emergency Medicine, 54(5), 678-680. https://doi.org/10.1016/j.jemermed.2018.01.024

Detailed Assessment Instructions for the NRNP 6566 Impact of Pharmacokinetics on Medication Selection and Administration Assignment

Discussion: Pharmacokinetics and Pharmacodynamics

Impact of Pharmacokinetics on Medication Selection and Administration

As an advanced practice nurse, you will likely be responsible for selecting and prescribing pharmaceuticals to address your patients’ health needs and concerns. To what extent is understanding the pharmacokinetics of a certain medication important in your decision-making process when prescribing a medication for your patient?

Knowing the pharmacokinetic effects of medications—such as how long will the medication be absorbed and exert an effect on the body before it is eliminated—can have important implications for addressing your patient’s health needs.

Photo Credit: Getty Images/Ingram Publishing

For this Discussion, think about the types of decisions you might make, with an understanding of pharmacokinetics, when prescribing medications for your patients. Reflect on how having a working knowledge of pharmacokinetics of medications is important in your role as an advanced practice nurse.

To Prepare

  • Review the Learning Resources on pharmacokinetics.
  • Review the Discussion Prompt and Response Prompt assigned by your Instructor.

By Day 3 of Week 1

Post your response to the Discussion Prompt assigned by your Instructor. Be specific and provide examples.

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

Learning Resources

Required Readings (click to expand/reduce)

Doogue, M. P., & Polasek, T. M. (2013). The ABCD of clinical pharmacokinetics. Therapeutic Advances in Drug Safety, 4(1), 5–7. doi:10.1177/2042098612469335

Sakai, J. B. (2008). Practical pharmacology for the pharmacy technician. Philadelphia, PA: Jones & Bartlett Learning. • Chapter 3, “Pharmacokinetics: The Absorption, Distribution, and Excretion of Drugs” (pp. 27–40).

Required Media (click to expand/reduce)

Speed Pharmacology. (2015, April 7). Pharmacology – pharmacokinetics (made easy) [Video file]. Retrieved from https://www.youtube.com/watch?v=NKV5iaUVBUI

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NURS 6512 Assessing the Abdomen Lab Assignment Example

NURS 6512 Assessing the Abdomen Lab AssignmentNURS 6512 Assessing the Abdomen Lab Assignment

NURS 6512 Assessing the Abdomen Lab Assignment Brief

Course: NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning

Assignment Title: NURS 6512 – Assignment 1: Lab Assignment: Assessing the Abdomen

Assignment Instructions Overview

In this lab assignment, you will analyze an episodic note case study describing abnormal findings in patients presenting with abdominal symptoms. Your task is to thoroughly assess the provided patient scenario, identifying essential history elements, performing appropriate physical examinations, and recommending diagnostic tests to aid in formulating a differential diagnosis.

Understanding Assignment Objectives

This assignment aims to evaluate your ability to:

  • Analyze subjective and objective data in an episodic note.
  • Apply concepts from advanced health assessment to assess abdominal and gastrointestinal conditions.
  • Formulate a differential diagnosis based on clinical findings and evidence-based literature.

The Student’s Role

As a student, your role is to:

  • Review the provided episodic note case study and associated learning resources.
  • Determine relevant patient history details crucial for accurate assessment.
  • Recommend appropriate physical exams and diagnostic tests based on the patient’s clinical presentation.
  • Formulate a differential diagnosis considering potential conditions aligned with the patient’s symptoms and clinical data.

Competencies Measured

This assignment assesses the following competencies:

  • Ability to collect comprehensive patient history related to abdominal and gastrointestinal symptoms.
  • Proficiency in conducting systematic physical examinations to assess abdominal findings.
  • Skill in recommending evidence-based diagnostic tests to aid in accurate diagnosis.
  • Capacity to critically evaluate and justify differential diagnosis based on clinical evidence.

You Can Also Check Other Related Assessments for the NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning Course:

NURS 6512 Diversity and Health Assessments Discussion Assignment Example

NURS 6512 Differential Diagnosis for Skin Conditions Lab Assignment Example

NURS 6512 Building a Comprehensive Health History Discussion Assignment Example

NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment Example

NURS 6512 Assessing the Head, Eyes, Ears, Nose, and Throat Case Study Assignment Example

NURS 6512 Assessing the Abdomen Lab Assignment Example

NURS 6512 – Assignment 1: Lab Assignment: Assessing the Abdomen

SOAP Note

S:

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

HPI: M.N, a 47-year-old woman, presents with an abdominal pain complaint that began three days ago. She hasn’t taken any medicines since she didn’t know what to take. She states her pain rate is 5/10 better than it first began.

PMH: Hypertension, Diabetes, GI bleeding history four years back.

Medications: Amlodipine 5 mg, Lisinopril 10mg, and Metformin 1000mg.

Allergies: NKDA

Family History: No history of colon cancer, Father has DMT2, Hypertension, Mother as well has HTN, Hyperlipidemia, and GERD

Social: Doesn’t smoke, married with three kids (2 girls and a boy)

O:

Vital signs: Temp 99.8; RR 16; P 92; BP 160/86; Height 5’10”; Weight 248lbs

Heart: No murmurs

Lungs: Clear chest walls

Skin: Intact without urticaria and lesions

Abdomen: hyperactive bowel sounds, soft

Assessment:

Gastroenteritis

Subjective Portion Analysis

The subjective portion of the SOAP note details the patient’s symptoms and history. It is crucial for understanding the patient’s current condition and guiding further examination and treatment. The covered areas include chief complaints, history of present illness, past medical history, current medications, social history, allergies, and family history. However, additional information should be gathered to complete the history, such as the patient’s location and recent dietary intake which could contribute to symptoms (Colyar, 2015).

Objective Portion Analysis

The objective part of the SOAP note provides the physician’s findings from the physical examination. While it includes vital signs, cardiovascular, respiratory, and abdominal assessments, a more comprehensive head-to-toe examination is necessary. This would encompass evaluation of additional areas like neurological and musculoskeletal systems to rule out other potential causes of symptoms (LeBlond et al., 2014).

Assessment

The assessment is supported by both the subjective and objective data. Subjective data supports the diagnosis through the patient’s reported symptoms and history. Objective findings include abdominal tenderness and hyperactive bowel sounds, aligning with the diagnosis of gastroenteritis (Dains et al., 2019).

Diagnostic Tests

Appropriate diagnostic tests for this case include stool culture to identify infectious agents causing gastroenteritis. Endoscopy or colonoscopy may also be considered to evaluate for other gastrointestinal conditions presenting similarly to gastroenteritis (LeBlond et al., 2014).

Current Diagnosis

The current diagnosis of gastroenteritis is well-supported by the patient’s symptoms and objective findings. Symptoms include abdominal pain, diarrhea, and nausea, which are typical manifestations of gastroenteritis. The absence of severe complications and improvement without treatment further supports this diagnosis (Bányai et al., 2018).

Differential Diagnosis

  1. Amebiasis: Parasitic infection causing symptoms similar to gastroenteritis, including diarrhea and abdominal pain (Bányai et al., 2018).
  2. Bacterial gastroenteritis: Infection of the gut by bacterial pathogens presenting with severe abdominal cramps and diarrhea (Barrett & Fhogartaigh, 2017).
  3. Food poisoning: Toxin-mediated illness from contaminated food, leading to gastrointestinal symptoms like vomiting and diarrhea (Barrett & Fhogartaigh, 2017).

References

Bányai, K., Estes, M. K., Martella, V., & Parashar, U. D. (2018). Viral gastroenteritis. The Lancet, 392(10142), 175-186. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0140673618311280

Barrett, J., & Fhogartaigh, C. N. (2017). Bacterial gastroenteritis. Medicine, 45(11), 683-689. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1357303917302177

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

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

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

Detailed Assessment Instructions for the NURS 6512 Assessing the Abdomen Lab Assignment

Week 6: Assessment of the Abdomen and Gastrointestinal System

On your way home from dinner, you start experiencing sharp pains in your abdomen. You ate seafood—could you have food poisoning? What else might be causing your pain? Appendicitis? Should you head to the emergency room, or should you wait and see how you feel in the morning?

Numerous ailments can affect the GI system and the abdomen. Because the organs are so close, it can be difficult to conduct an accurate assessment. Also, pain in another area of the body can affect the GI system. For example, patients with chronic migraines often report nausea.

This week, you will explore how to assess the abdomen and gastrointestinal system.

Learning Objectives

Students will:

  • Evaluate abnormal abdomen and gastrointestinal findings
  • Apply concepts, theories, and principles relating to health assessment techniques and diagnoses for the abdomen and gastrointestinal system
  • Identify concepts, theories, and principles related to advanced health assessment

Learning Resources

Required Readings

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

  • Chapter 6, “Vital Signs and Pain Assessment”

This chapter describes the experience of pain and its causes. The authors also describe the process of pain assessment.

  • Chapter 18, “Abdomen”

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

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

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

  • Chapter 3, “Abdominal Pain”

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

  • Chapter 10, “Constipation”

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

  • Chapter 12, “Diarrhea”

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

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

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

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

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

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

Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487)

Chapter 115, “X-Ray Interpretation of Abdomen” (pp. 514–520)

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

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

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

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

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

Document: Midterm Exam Review (Word document)

Optional Resource

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

  • Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid” (pp. 445–527)

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

  • Chapter 10, “The Urinary System” (pp. 528–540)

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

Required Media

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

Online media for Seidel’s Guide to Physical Examination

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

Assignment 1: Lab Assignment: Assessing the Abdomen

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

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

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

To Prepare

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

  • With regard to the Episodic note case study provided:
    • Review this week’s Learning Resources, and consider the insights they provide about the case study.
    • Consider what history would be necessary to collect from the patient in the case study.
    • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
    • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Assignment

  1. Analyze the subjective portion of the note. List additional information that should be included in the documentation.
  2. Analyze the objective portion of the note. List additional information that should be included in the documentation.
  3. Is the assessment supported by the subjective and objective information? Why or why not?
  4. What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
  5. Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

By Day 7 of Week 6

Submit your Lab Assignment.

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK6Assgn1+last name+first initial. (extension)” as the name.
  • Click the Week 6 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 6 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn1+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 6 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 6 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7 of Week 6

To participate in this Assignment:

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NURS 6512 Assessing the Head Eyes Ears Nose and Throat Case Study Assignment Example

NURS 6512 Assessing the Head, Eyes, Ears, Nose, and Throat Case Study AssignmentNURS 6512 Assessing the Head, Eyes, Ears, Nose, and Throat Case Study Assignment

NURS 6512 Assessing the Head Eyes Ears Nose and Throat Case Study Assignment Brief

Course: NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning

Assignment Title: NURS 6512 Assessing the Head, Eyes, Ears, Nose, and Throat Case Study Assignment

Assignment Instructions Overview

In this assignment, you will engage in a case study focusing on assessing conditions related to the head, eyes, ears, nose, and throat (HEENT). The goal is to apply clinical reasoning skills to differentiate between benign and potentially life-threatening conditions, thereby determining appropriate diagnostic tests and differential diagnoses.

Understanding Assignment Objectives

The objective of this assignment is to simulate a clinical scenario where you will evaluate abnormal findings in patients presenting with HEENT issues. You will formulate an episodic/focused SOAP note, detailing the patient’s history, physical exams, diagnostic tests, and differential diagnoses based on evidence from the literature.

The Student’s Role

As a student, your role is to critically analyze the provided case study, identify pertinent patient data, and apply clinical assessment skills to recommend appropriate diagnostic procedures. You will demonstrate proficiency in constructing an episodic/focused SOAP note format, integrating findings from scholarly sources to support your clinical decisions.

Competencies Measured

This assignment measures competencies in clinical assessment, differential diagnosis formulation, evidence-based practice application, and effective communication through the episodic/focused SOAP note format. It evaluates your ability to integrate theoretical knowledge with practical clinical scenarios in the context of HEENT assessments.

You Can Also Check Other Related Assessments for the NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning Course:

NURS 6512 Diversity and Health Assessments Discussion Assignment Example

NURS 6512 Differential Diagnosis for Skin Conditions Lab Assignment Example

NURS 6512 Building a Comprehensive Health History Discussion Assignment Example

NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment Example

NURS 6512 Assessing the Abdomen Lab Assignment Example

NURS 6512 Assessing the Head Eyes Ears Nose and Throat Case Study Assignment Example

NURS 6512 – Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat Episodic/Focused SOAP Note Template

Patient Information:

  • Age/Gender/Race: 65-year-old African American male
  • Chief Complaint (CC): Chest pain

History of Present Illness (HPI):

The patient, a 65-year-old African American male, presented with sudden onset crushing chest pain early in the morning, rated 9/10 in severity. The pain is located centrally in the chest and is accompanied by shortness of breath and nausea. Despite taking antacids, the symptoms have not significantly improved. The patient has a history of GERD and well-controlled hypertension. Family history includes the mother’s death at 78 due to breast cancer and the father’s death at 75 due to CVA. There is no known premature cardiac disease in immediate family members. Socially, the patient consumes moderate alcohol and does not use tobacco.

Review of Systems (ROS):

  • General: Denies fever, chills, or fatigue.
  • Cardiovascular: No orthopnea; positive for sporadic lower extremity edema.
  • Gastrointestinal: Positive for nausea without vomiting.

Objective (O):

  • Vital Signs (VS): BP 186/102 mmHg, P 94 bpm, R 22 bpm, T 97.8°F, O2 saturation 96%, Weight 235 lbs, Height 70 inches.
  • Physical Exam:
    • Cardiovascular: Diaphoretic and restless, PMI in 5th intercostal space at mid-clavicular line, grade 2/6 systolic decrescendo murmur at 2nd right intercostal space radiating to neck, third heart sound at apex, bilateral 2+ lower extremity edema.
    • Abdominal: No distention or masses, normal bowel sounds, bruit in right paraumbilical area, mid-epigastric tenderness on deep palpation.
  • Diagnostic Results: EKG, CXR, CK-MB tests conducted.

Assessment (A):

Differential Diagnoses:

  • GERD (Gastroesophageal Reflux Disease): Chronic acid reflux causing chest pain.
  • Hypertrophic Cardiomyopathy: Thickening of the heart muscle leading to chest pain, shortness of breath, and potential murmurs.
  • Myocardial Ischemia: Reduced blood flow to the heart causing oxygen deprivation, resulting in chest pain and dyspnea.
  • Pulmonary Embolism: Blockage of pulmonary arteries by blood clots, leading to chest pain and shortness of breath.
  • COPD (Chronic Obstructive Pulmonary Disease): Chronic lung disease causing airflow obstruction, chest discomfort, and dyspnea.

Plan (P):

  • Further diagnostics: Recommend continuation of EKG monitoring, CXR review, and CK-MB analysis to assess cardiac function and rule out pulmonary issues.
  • Management: Initiate treatment for suspected conditions based on diagnostic findings, including potential adjustments to antacid therapy and consideration of cardiac medications.
  • Referral: Consult with cardiology for comprehensive evaluation and management of suspected cardiovascular conditions.
  • Patient education: Provide guidance on lifestyle modifications to manage GERD symptoms and hypertension, including dietary changes and stress reduction techniques.

References

Balogh E, Miller B, Ball J. The Diagnostic Process. Retrieved from [source].

Chamley R, Holdsworth D, Rajappan K, Nicol E. ECG interpretation. European Heart Journal, 40(32), 2663-2666. doi: 10.1093/eurheartj/ehz559

Haber J et al. Putting the Mouth Back in the Head: HEENT to HEENOT. Am J Public Health, 105(3), 437-441. doi: 10.2105/ajph.2014.302495

Heusch G. Myocardial Ischemia. Circ Res, 119(2), 194-196. doi: 10.1161/circresaha.116.308925

Marian A, Braunwald E. Hypertrophic Cardiomyopathy. Circ Res, 121(7), 749-770. doi: 10.1161/circresaha.117.311059

Qureshi H, Sharafkhaneh A, Hanania N. Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. Ther Adv Chronic Dis, 5(5), 212-227. doi: 10.1177/2040622314532862

Detailed Assessment Instructions for the NURS 6512 Assessing the Head Eyes Ears Nose and Throat Case Study Assignment

Assignment 1: Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat

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

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

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

To Prepare

  • By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
  • Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.

With regard to the case study you were assigned:

  • Review this week’s Learning Resources and consider the insights they provide.
  • Consider what history would be necessary to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
  • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Assignment

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

By Day 6 of Week 5

Submit your Assignment.

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK5Assgn1+last name+first initial.(extension)” as the name.
  • Click the Week 5 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 5 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn1+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 5 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 5 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 6 of Week 5

To participate in this Assignment:

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NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment Example

NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children AssignmentNURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment

NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment Brief

Course: NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning

Assignment Title: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment

Assignment Instructions Overview

In this assignment, you will explore the application of assessment tools and diagnostic tests used by advanced practice nurses to evaluate patient health conditions. Understanding the validity and reliability of these tools is crucial for accurate diagnosis and patient management. For pediatric cases, considerations such as growth, measurements, and nutrition play significant roles in assessing health risks and recommending interventions.

Understanding Assignment Objectives

The primary objective of this assignment is to assess your understanding of assessment tools and diagnostic tests in healthcare settings, both for adults and children. You will evaluate the purpose, conduct, and information gathered by these tools. Additionally, you will critically analyze factors influencing their validity, reliability, sensitivity, specificity, and predictive values. For child health cases, you will identify relevant health risks, determine necessary information for comprehensive assessment, and develop strategies to engage parents or caregivers in proactive health management.

The Student’s Role

As a student, your role is to conduct comprehensive research on the assigned assessment tool or diagnostic test. You will analyze its clinical utility, strengths, and limitations based on current literature. For child health cases, you will identify potential health risks and formulate sensitive approaches to gather necessary information from parents or caregivers.

Competencies Measured

This assignment assesses your ability to:

  • Analyze the purpose and use of assessment tools and diagnostic tests in healthcare.
  • Evaluate the validity, reliability, sensitivity, specificity, and predictive values of selected tools.
  • Identify and assess health risks relevant to pediatric patients.
  • Develop effective communication strategies to engage parents or caregivers in proactive health practices.

You Can Also Check Other Related Assessments for the NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning Course:

NURS 6512 Diversity and Health Assessments Discussion Assignment Example

NURS 6512 Differential Diagnosis for Skin Conditions Lab Assignment Example

NURS 6512 Building a Comprehensive Health History Discussion Assignment Example

NURS 6512 Assessing the Head, Eyes, Ears, Nose, and Throat Case Study Assignment Example

NURS 6512 Assessing the Abdomen Lab Assignment Example

NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment Example

Uses of BMI in Healthcare

Body Mass Index (BMI) serves as a widely used anthropometric measurement to estimate body fat by comparing an individual’s weight to their height. This metric is essential for public health purposes, providing clear indications of whether individuals have an ideal weight for their height (Hall & Cole, 2016). Primarily, BMI categorizes individuals into groups such as underweight, normal weight, overweight, and obese, helping identify those at risk for chronic conditions like type 2 diabetes, cardiovascular diseases, and hypertension (Hall & Cole, 2016). For adults, BMI remains unaffected by age or sex. However, for children and adolescents, age and sex are critical factors due to the different growth rates and body fat levels in boys and girls. Consequently, BMI measurements for this younger population must be plotted on a sex-specific BMI-for-age growth chart (Centers for Disease Control and Prevention [CDC], 2018). Children are classified as obese if their BMI-for-age is at or above the 95th percentile and overweight if it is between the 85th and 94th percentiles (CDC, 2018).

BMI’s Validity and Reliability

The validity and reliability of BMI as a tool for assessing body fat and obesity risk are subjects of ongoing debate. Validity refers to the tool’s accuracy in measuring what it intends to measure, while reliability denotes the consistency of these measurements. The accuracy of BMI in estimating body fat across different populations and individuals is often questioned. Factors such as age, physical activity, ethnicity, and gender can significantly influence the relationship between BMI and actual body fat percentage (Freedman & Sherry, 2015). As individuals age, changes in body composition, such as decreased muscle mass and increased visceral fat, can occur even if overall body weight remains stable (Zhang et al., 2018). Health risks correlate more closely with visceral fat, which BMI does not measure accurately. Thus, BMI may not always reliably indicate an individual’s health, particularly in children who exhibit significant variations in body composition based on sex and developmental stage. Moreover, ethnic differences in body composition mean that BMI thresholds may not equally predict health risks across various racial groups (Freedman & Sherry, 2015).

Health Issues/Risks Relevant to the 5-Year-Old Overweight African American Boy

The 5-year-old African American boy faces significant health risks due to his overweight status and low physical activity levels. These risks include elevated cholesterol levels, high blood pressure, and a predisposition to cardiovascular diseases. Additionally, respiratory issues such as sleep apnea and asthma pose significant concerns. The boy also risks developing impaired glucose tolerance, potentially leading to type 2 diabetes, as well as fatty liver disease, musculoskeletal discomfort, gastroesophageal reflux, and gallstones (Gibbs & Chapman-Novakofski, 2012).

Additional Information Needed

To thoroughly assess the boy’s weight-related health, gathering detailed information about his dietary habits is essential. This includes data on the types of food consumed, meal frequency, portion sizes, nutritional quality, snack consumption, food preparation methods, and the mealtime environment (Gibbs & Chapman-Novakofski, 2012). Understanding his physical activity levels, including the types and frequency of physical activities, is also crucial.

Identification of Risks to the Child’s Health

Examining the child’s dietary intake and social behaviors, such as playing with friends, enables healthcare providers to identify specific health risks. A diet high in fast foods and processed snacks, combined with a lack of physical activity, increases the child’s susceptibility to obesity and related health issues. Gathering this sensitive information from parents can be achieved by clearly explaining the study’s objectives and the benefits it can bring to their child’s health. Ensuring confidentiality will also encourage parental cooperation (Ball et al., 2019).

Specific Questions Relating to the Child

  1. How many meals does the child consume daily?
  2. What is the composition of the meals consumed throughout the day?
  3. Is the child involved in any physical activities? How frequently?

Strategies to Help Parents Control the Child’s Weight and Health

Promoting physical activity and providing nutritional guidance are essential strategies for parents. Encouraging the child to engage in daily physical activities, such as walking, cycling, or swimming, ideally involving the parents, fosters a supportive environment. Providing educational materials like a food pyramid can assist parents in planning balanced and nutritious meals, thereby guiding healthier food choices and controlling portion sizes. These measures contribute to gradual and sustainable weight loss (Ball et al., 2019).

References

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

Centers for Disease Control and Prevention. (2018). Childhood overweight and obesity. Retrieved from http://www.cdc.gov/obesity/childhood.

Freedman, D. S., & Sherry, B. (2015). The validity of BMI as an indicator of body fatness and risk among children. Pediatrics, 124(Supplement 1), S23–S34. https://doi.org/10.1542/peds.2008-3586e

Gibbs, H., & Chapman-Novakofski, K. (2012). Exploring nutrition literacy: Attention to assessment and the skills clients need. Health, 4(3), 120–124.

Hall, D. M., & Cole, T. J. (2016). What use is the BMI?. Archives of Disease in Childhood, 91(4), 283–286. https://doi.org/10.1136/adc.2005.077339

Zhang, L., Fos, P. J., Johnson, W. D., Kamali, V., Cox, R. G., Zuniga, M. A., & Kittle, T. (2018). Body mass index and health-related quality of life in elementary school children: A pilot study. Health and Quality of Life Outcomes, 6, 77. https://doi.org/10.1186/1477-7525-6-77

Detailed Assessment Instructions for the NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment

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

Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

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

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

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

To Prepare

  • Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
  • By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
  • Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
  • Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
  • If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
    • Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
    • Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment

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

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:

Include the following:

  • A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
    • What is its purpose?
    • How is it conducted?
    • What information does it gather?
  • Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.
Assignment Option 2: Child Health Case:

Include the following:

  • An explanation of the health issues and risks that are relevant to the child you were assigned.
  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
  • Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

By Day 6 of Week 3

Submit your Assignment.

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK3Assgn1+last name+first initial.(extension)” as the name.
  • Click the Week 3 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 3 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn1+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 3 Assignment 1 Option 1 Rubric

To access your rubric:

Week 3 Assignment 1 Option 2 Rubric

To check your Assignment draft for authenticity:

Submit your Week 3 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 6 of Week 3

To participate in this Assignment:

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NURS 6512 Building a Comprehensive Health History Discussion Paper Example

NURS 6512 Building a Comprehensive Health History Discussion AssignmentNURS 6512 Building a Comprehensive Health History Discussion Assignment

NURS 6512 Building a Comprehensive Health History Discussion Assignment Brief

Course: NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning

Assignment Title: NURS 6512 Building a Comprehensive Health History Discussion Assignment

Assignment Instructions Overview

Effective communication is vital for constructing an accurate and detailed patient history. Various factors, including age, gender, ethnicity, and environmental setting, significantly influence a patient’s health or illness. Advanced practice nurses must tailor their communication techniques to these factors to establish rapport and effectively gather information. This discussion involves building a health history for a newly assigned patient, considering their unique characteristics and health risks.

Understanding Assignment Objectives

The primary objective of this assignment is to develop skills in collecting comprehensive health histories through effective communication. This involves understanding the importance of individualized communication strategies that address the specific needs of patients based on their demographic and environmental contexts. The assignment also aims to enhance the ability to utilize appropriate risk assessment tools and identify potential health-related risks.

Competencies Measured

This assignment measures competencies in several key areas:

  • Communication Skills: Demonstrates the ability to tailor interview techniques to individual patient needs.
  • Cultural Competency: Shows awareness and integration of the patient’s cultural, ethnic, and socioeconomic background into the health history.
  • Risk Assessment: Proficient in identifying and utilizing appropriate risk assessment instruments.
  • Critical Thinking: Develops targeted questions that effectively probe health risks and concerns.

You Can Also Check Other Related Assessments for the NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning Course:

NURS 6512 Diversity and Health Assessments Discussion Assignment Example

NURS 6512 Differential Diagnosis for Skin Conditions Lab Assignment Example

NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children Assignment Example

NURS 6512 Assessing the Head, Eyes, Ears, Nose, and Throat Case Study Assignment Example

NURS 6512 Assessing the Abdomen Lab Assignment Example

NURS 6512 Building a Comprehensive Health History Discussion Paper Example

Building a Comprehensive Health History for a 38-Year-Old Native American Pregnant Female

Effective communication skills are crucial for obtaining an accurate and comprehensive health history from patients. These skills not only foster a positive patient-provider relationship but also ensure higher patient satisfaction and compliance (Berman & Chutka, 2016). According to Berman and Chutka (2016), patients often express dissatisfaction with healthcare providers who do not listen attentively. Communication encompasses not only verbal exchanges but also active listening and nonverbal cues, such as facial expressions, nodding, and body posture, which convey empathy and support (Hashim, 2017). This discussion will focus on the specific techniques and considerations necessary for interviewing a 38-year-old Native American pregnant female living on a reservation.

Communication Techniques with Rationale

The interview with this patient must prioritize cultural competence and sensitivity. Native American communities often face significant health disparities, unemployment, and overcrowded living conditions, which impact overall health and access to care (Native American Aid, 2015). Understanding the patient’s cultural background is essential for building trust and ensuring effective communication. The healthcare provider must use language and literacy levels appropriate for the patient and ensure the availability of professional interpreter services if necessary. This approach will help in gathering comprehensive information regarding the patient’s medical history, family health history, and environmental and behavioral risk factors (Sullivan, 2019).

Selected Risk Assessment Instrument with Rationale

In this scenario, the HEEADSSS screening tool is particularly appropriate for assessing the patient’s health risks. The HEEADSSS interview framework evaluates the home environment, education and employment, eating habits, peer-related activities, drug use, sexuality, mental health (suicide/depression), and safety from injury and violence (Klein, Goldenring, & Adelman, 2015). Given the higher prevalence of substance use and mental health issues in Native American communities (Park-Lee, Lipari, Bose, & Hughes, 2018), this tool is effective in identifying potential health threats to both the mother and her unborn child.

The following targeted questions are designed to assess the health risks of the patient and begin building a comprehensive health history:

  1. Is this your first pregnancy?
  2. How are you feeling about being pregnant?
  3. When was your last menstrual cycle?
  4. When was the last time you consumed alcohol or used illicit drugs?
  5. Do you have any existing health problems or medical conditions?

Introducing oneself to the patient and any accompanying individuals is the first step in the interview. Addressing the patient by their preferred name and ensuring that the consultation is not rushed are essential for building rapport and trust (Berman & Chutka, 2016). The healthcare provider must maintain consistent eye contact and use nonverbal communication effectively to demonstrate interest and empathy (Hashim, 2017). Open-ended questions will facilitate understanding of the patient’s perspective and provide opportunities for the patient to express concerns (Hashim, 2017).

In addition to verbal communication, the provider must be aware of the patient’s unspoken issues and gently probe when necessary. The “ask-tell-ask” approach is recommended to avoid overwhelming the patient with information and to ensure they understand the information provided (Berman & Chutka, 2016). Proper closure of the interview, with an invitation for the patient to ask additional questions, is important to address any lingering concerns (Hashim, 2017).

In summary, building a comprehensive health history for a 38-year-old Native American pregnant female requires cultural competence, effective communication skills, and appropriate use of risk assessment tools. The HEEADSSS screening tool is particularly useful for identifying health risks in this context. Through a combination of verbal and nonverbal communication techniques, the healthcare provider can gather the necessary information to ensure the patient’s health and well-being.

References

Berman, A. C., & Chutka, D. S. (2016). Assessing effective physician-patient communication skills: “Are you listening to me, doc?” Mayo Clinic Proceedings, 91(2), 173-181.

Hashim, M. J. (2017). Patient-centered communication: Basic skills. American Family Physician, 95(1), 29-34.

Klein, D. A., Goldenring, J. M., & Adelman, W. P. (2015). HEEADSSS 3.0: The psychosocial interview for adolescents updated for a new century fueled by media. Contemporary Pediatrics, 32(1), 16-28.

Native American Aid. (2015). Living conditions. Retrieved June 2, 2020, from http://www.nativepartnership.org/site/PageServer?pagename=naa_livingconditions

Park-Lee, E., Lipari, R. N., Bose, J., & Hughes, A. (2018). Substance use and mental health issues among U.S.-born American Indians or Alaska natives residing on and off tribal lands. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/DRAIANTribalAreas2018/DRAIANTribalAreas2018.pdf

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

Response to Colleague 1: Interview Techniques and Health Risks for an Adolescent Hispanic Male

The approach to constructing a comprehensive health history for an adolescent Hispanic male demonstrates a thorough understanding of culturally sensitive communication. Enhancing this strategy with additional interview and communication techniques may further improve patient outcomes.

Additional Interview and Communication Techniques

Implementing motivational interviewing can significantly engage adolescents in identifying their motivations for behavior change, which is crucial for addressing issues like substance use or risky behaviors (Miller & Rollnick, 2013). Additionally, involving family members in the interview process, with the adolescent’s consent, aligns with the cultural significance of family in decision-making within Hispanic communities (Cabassa, 2010). Utilizing visual aids such as diagrams, charts, or videos to explain medical concepts can enhance understanding and retention, particularly for discussing complex issues like sexual health or substance abuse.

Additional Health-Related Risks

Identifying potential mental health issues is vital, given the higher risk for depression and anxiety among Hispanic adolescents, often linked to acculturation stress and discrimination (Lorenzo-Blanco et al., 2012). Moreover, the increased risk of obesity and type 2 diabetes within this demographic necessitates inquiries about dietary habits, physical activity, and family history of these conditions (Cruz, 2019).

References

Cabassa, L. J. (2010). Latino immigrant men’s perceptions of depression and attitudes toward help seeking. Hispanic Journal of Behavioral Sciences, 32(3), 345-363.

Cruz, M. L. (2019). The increasing prevalence of obesity and diabetes among Hispanics in the United States. Journal of Health Disparities Research and Practice, 12(2), 82-90.

Lorenzo-Blanco, E. I., Unger, J. B., Oshri, A., Baezconde-Garbanati, L., & Soto, D. (2012). Acculturation, enculturation, and symptoms of depression in Hispanic youth: The roles of gender, Hispanic cultural values, and family functioning. Journal of Youth and Adolescence, 41(10), 1350-1365.

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.

Response to Colleague 2: Interview Techniques and Health Risks for an Elderly African American Male with Cardiovascular Disease

The outlined strategies for interviewing an elderly African American male with cardiovascular disease are effective. Expanding on these techniques and considering additional health risks will enhance patient care.

Additional Interview and Communication Techniques

Using the teach-back method ensures the patient comprehends the provided information by having them repeat it in their own words, which is particularly important for managing chronic conditions like cardiovascular disease (Schillinger et al., 2003). Addressing cultural health beliefs helps tailor care plans to be more acceptable and effective, considering some African American patients might use home remedies or have specific dietary practices impacting cardiovascular health (Mayo Clinic, 2020). Engaging the patient’s social support systems, such as family, friends, or community organizations, improves adherence to treatment plans, especially for elderly patients who might struggle with isolation or transportation to appointments (Berkman et al., 2000).

Additional Health-Related Risks

Given the higher prevalence of hypertension among African American males, hypertension management through regular monitoring and adherence to antihypertensive medications is crucial (Lackland, 2014). Additionally, due to the increased risk for chronic kidney disease associated with hypertension and diabetes, regular screening for kidney function should be prioritized (Norris & Agodoa, 2005). Addressing medication adherence challenges, often due to polypharmacy, side effects, or cognitive decline, can be managed through strategies like simplifying medication regimens or using pill organizers (Krousel-Wood et al., 2004).

References

Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51(6), 843-857.

Krousel-Wood, M., Thomas, S., Muntner, P., & Morisky, D. (2004). Medication adherence: A key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Current Opinion in Cardiology, 19(4), 357-362.

Lackland, D. T. (2014). Racial differences in hypertension: Implications for high blood pressure management. American Journal of the Medical Sciences, 348(2), 135-138.

Mayo Clinic. (2020). Cardiovascular disease in African Americans. Retrieved from https://www.mayoclinic.org

Norris, K., & Agodoa, L. (2005). Unraveling the racial disparities associated with kidney disease. Kidney International, 68(3), 914-924.

Schillinger, D., Piette, J., Grumbach, K., Wang, F., Wilson, C., Daher, C., … & Bindman, A. B. (2003). Closing the loop: Physician communication with diabetic patients who have low health literacy. Archives of Internal Medicine, 163(1), 83-90.

Detailed Assessment Instructions for the NURS 6512 Building a Comprehensive Health History Discussion Assignment

Discussion: Building a Health History

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

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

Photo Credit: Sam Edwards / Caiaimage / Getty Images

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

  • By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
  • How would your communication and interview techniques for building a health history differ with each patient?
  • How might you target your questions for building a health history based on the patient’s social determinants of health?
  • What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
  • Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
  • Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
  • Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history Building a Health History NURS 6512 week 1 Discussion Post.

By Day 3 of Week 1

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

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

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

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

  • Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
  • Suggest additional health-related risks that might be considered.
  • Validate an idea with your own experience and additional research.

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