WK 6 NURSING PHYSICAL ASSESSMENT QUESTION?

1-  What are some ways to create a physically and psychologically comfortable environment for both patient and practitioner during breast exams?

2-  A 22-year-old female complains of 3 days of watery diarrhea with 7 to 8 stools per day. She is drinking approximately “3 sodas a day” because she is “trying not to get dehydrated.” She has had very little other intake because “eating makes me have to go to the bathroom.” She denies other symptoms or allergies.From the information provided, list your differential diagnoses in the order of “most likely” to “possible but unlikely.”

 

3-A 19-year-old male complains of “burning sometimes, when I pee.” He is sexually active and denies using any contraceptive method. He denies other symptoms, significant history, or allergies.From the information provided, list your differential diagnoses in the order of “most likely” to “possible but unlikely.”

4- A 23-year-old female complains of severe left lower abdominal/pelvic pain for 6 hours. She states her last menstrual period was “about 3 or 4 weeks ago.”She is sexually active and denies using any contraceptive method. She denies other symptoms, significant history, or allergies.In order of importance, describe three (3) questions that you would like to ask this patient and give a brief explanation of why? Which lab or imaging tests would you order for this patient and give a brief explanation of why?

 

5- A 28-year-old female presents with a “severe headache” for the past 9 hours. She states the pain is over the left temporal area and is “throbbing” in nature. These symptoms have occurred before but not as bad.What are some clinical assessment tools or techniques that you could use to help diagnose this patient’s condition?In order of importance, describe three (3) questions that you would like to ask this patient and give a brief explanation of why?

6- A 58-year-old obese man complains of pain in his left knee. The pain seems to be unrelenting. He says his knee is better when he rests, but it gets stiff when he rests too long. He denies other symptoms, significant history, or allergies.From the information provided, list your differential diagnoses in the order of “most likely” to “possible but unlikely.”

Coughs are the body’s way of clearing airways via forceful expiration.

Respond on two different days who selected a different scenario than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the disorder your colleague identified.

Ask a probing question regarding the disorder that your colleague identified.

Suggest an alternative disorder for the scenario your colleague selected.

Main Post

Scenario 3:

 

Maria is a 36-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately 3 weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Maria has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.

Acute Cough

Coughs are the body’s way of clearing airways via forceful expiration.  Inflammation, inhaled particles, accumulated mucus, or foreign bodies stimulate a cough reflex by irritant receptor stimulation in the airway.  An acute cough is classified as lasting 2-3 weeks, and chronic cough is greater than three weeks in a non-smoker. Frequent cough causes are allergic rhinitis, upper respiratory infections, pneumonia, aspiration, pulmonary embolus, and congestive heart failure.  Due to the above-listed scenario, this cough would be diagnosed as acute cough due to timeframe, cough characteristics, and patient history (Huether & McCance, 2019).

Green Sputum

Sputum contains immune cells and white blood cells from the lower respiratory tract that protect the airway from infections.  Sputum can be clear or colored.  Color sputum may be yellow, white, green, red or blood-tinged, or pink.  Neutrophils are white blood cells that can take on a green color.  This color sputum can be indicative of bacterial infections of the lower respiratory tract.  Pneumonia and cystic fibrosis can produce this color sputum.  To indeed rule out something benign, a sputum culture would need to be obtained and tested (Verywell Health, 2019).  At three weeks in, it would likely be premature to order cultures with limited symptoms.

Treatment

Due to the timeframe of cough and only accompanying symptom being green sputum, as a practitioner, I would prescribe an expectorant and schedule a follow up if symptoms persist or worsen.  Teaching should include that adverse effects of expectorants might be GI upset, headache, drowsiness, and dizziness.  Advise patient that expectorants are designed to be short-term (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Additional home treat to loosen secretions would be a humidifier, staying adequately hydrated and warm salt water gargles if sore throat should appear (Barkley, 2018).

Patient Factors- Behavior and Age

Maria is an otherwise, healthy 36-year-old female.  Due to her age and symptom status, Maria would be treated conservatively.  Maria is a non-smoker and takes no prescribed medications.  Further investigation would be required if she was a smoker, currently on prescriptions medications, had current disease processes that may factor into the treatment plan.

References

Arcangelo,  V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.).  (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams  & Wilkins.

Barkley, T.  (2018).  Adult-gerontology primary care nurse practitioner.  West Hollywood, CA:  Barkley & Associates.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Verywell Health.  (2019). What causes the amount of sputum to increase?  Retrieved from https://www.verywellhealth.com/what-is-sputum-2249192

located in the Student Success Center.

Search the GCU Library and find two new health care articles that use quantitative research. Do not use articles from a previous assignment, or articles that appear in the Topic Materials or textbook.

Complete an article analysis for each using the “Article Analysis: Part 2” template.

Refer to the “Patient Preference and Satisfaction in Hospital-at-Home and Usual Hospital Care for COPD Exacerbations: Results of a Randomised Controlled Trial,” in conjunction with the “Article Analysis Example 2,” for an example of an article analysis.

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

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Recognize the influence that developmental stages have on physical

Purpose

This week’s graded topics relate to the following Course Outcome (CO).

  • CO 2 – Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO #1)

The Assignment

This week you have two options for your initial discussion post. Select the option that is best for you! Please remember to use and credit the lesson or required NIH website (there was not a textbook reading this week), AND one outside scholarly source.

Option #1 – Case Study to Consider

Ann and Michael have been married for 55 years. Ann is 80 years-old, and suffers from lung cancer and advanced Alzheimer’s disease. She currently resides in a nursing home, and often does not recognize Michael when he visits. Last night she was admitted to the hospital with difficulty breathing. Today, you are the nurse caring for Ann, and her physician is suggesting surgery to remove part of her lung to potentially slow the progression of her cancer. Michael is feeling unsure about this course of treatment, and asks for your advice and guidance.

How would you respond to Michael and serve as advocate for your patient?

Option #2 – Share a Related Experience

Share with your classmates a time when you cared for a patient at the end of their life. This may be a time when you assisted the patient (or their support system) with decisions related to end of life care; or a time when you were present for the death of a patient.

What were your observations related to this experience? Do you believe it was a peaceful death? What went well? Can you think of anything that could have made the experience better for the patient and/or family?

Week 5: Assignment 1: “Captain Of The Ship” Project – Bipolar Disorders

In 4 pages, write a treatment plan for your client. In which you do the following:

Introduction and Theses statement

Describe the HPI and clinical impression for the client.

Recommend psychopharmacologic treatments and describe specific and therapeutic end points for your psychopharmacologic agent. (This should relate to HPI and clinical impression.).

Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.

Identify medical management needs, including primary care needs, specific to this client.

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.

Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

Summary

Discussion: Brittany Maynard Case

After reading the Brittany Maynard case, create an original post that compares your professional and personal positions on the case. What are the code of ethics, professional regulations, and policies that support your professional position? Explain how to work through ideas when your professional and personal positions come into conflict.

In your responses to at least two peers, suggest codes of ethics, professional regulations, or policies that contradict the position proposed in their post.

Brittany Manyard Case Link

https://time.com/3678199/brittany-maynard-death-with-dignity-legislation-california/

This video contains a news story about 29-year-old Brittany Maynard and physician-assisted suicide.

https://www.youtube.com/watch?v=KcuRh-zQB6o

Apply improvement methods, based on data from the outcomes of care processes

Purpose

This week’s graded discussion topic relates to the following Course Outcome (CO).

  • CO 5: Apply improvement methods, based on data from the outcomes of care processes, to design and test changes to continuously improve the quality and safety of healthcare. (PO 8)

The Assignment

In Huston’s (2010) brief, but impressive article (required reading this week), the author outlines several leadership competencies that EVERY nurse leader will need for 2020. That year is not too far in the future, is it?

  1. Select one of the eight leadership competencies Huston described and relate it to your own leadership of nurses and nursing. This should promote a robust discussion as we come from different clinical and nonclinical perspectives.
  2. Discuss how the BSN-prepared nurse can assist a nurse leader in the budgeting process by contributing data readily available to the staff nurse.

Huston, C. (2010). What skills will the nurse leaders of 2020 need? (2010). Kai Tiaki Nursing New Zealand, 16(6), 14–15. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105060080&site=ehost-live&scope=site (Links to an external site.)Links to an external site.

Discuss the use of Evidence-based Guidelines in Practice by Patient Provider, Healthcare Agency

Discuss the use of Evidence-based Guidelines in Practice by Patient Provider, Healthcare Agency

 

. 250-word minimum

·  At least 1 outside scholarly reference is required besides the course textbook .

·  Must answer the discussion question

. Turnit it similarity maximum 20%

Transcultural Perspectives In The Nursing Care Of Children

Read chapter 6 of the class textbook and review the attached PowerPoint presentation.  Once done, answer the following questions;

1.  Write a two to three -pages summary of the demographics of children in the United States and the priority health issues that nurses should be aware for policy and health promotion teaching.

a.  Include ethnic and cultural trends and health-related challenges.

b.  Discuss the socioeconomic status and determinants of health.

c.  Imagine the future decades and discuss how transcultural nursing can influence policy and children’s health.

As stated in the syllabus present your assignment in a word document, Arial 12 font APA format attached to the forum in the discussion tab of the blackboard titled “Week 4 discussion questions” and in Turnitin to verify originality.  You must cite at least two evidence-based references (excluding the class textbook) and post two replies to any of your peer’s assignments sustained with the proper references. A minimum of 900 words is required.

Communicate therapeutically with patients

The benchmark assesses the following competency:

4.2 Communicate therapeutically with patients.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Note:  The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

Select one of the following as the focus for the teaching plan:

  1. Primary Prevention/Health Promotion
  2. Secondary Prevention/Screenings for a Vulnerable Population
  3. Bioterrorism/Disaster
  4. Environmental Issues

Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.

  1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.
  2. Request feedback (strengths and opportunities for improvement) from the provider.
  3. Complete the “Community Teaching Experience” form with the provider. You will submit this form in Topic 5.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

You are required to submit this assignment to Turn it in.