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N496 Nursing Leadership and Management Full Course

N496 Nursing Leadership and Management Full Course

Module 1 Assignment – Leadership and Managing

This week you reflected upon the difference between a “manager” and a “leader” and discussed this concept with your classmates and professor in the discussion board. In a written essay please answer the following questions:

• What are the differences between leaders and managers? What characteristics are similar and what are different?  N496 Nursing Leadership and Management Full Course
• Provide a total of three examples. First, of someone who has great managerial skills. Second, another individual with great leadership skills. Third, another person with poor managerial skills. These can be made up individuals or examples you have seen without any identifying information. Discuss how the staff of each individual would be affected by the skills of the leader/manager. N496 Nursing Leadership and Management Full Course
• Complete the Emotional Intelligence Test Discuss your scores and what they mean. What did you learn about yourself as a leader? (Note that a 10 on the EI test means strong. On the score page, click on the blue “here” under “interpreting your GEIT scores, click here” for more information on each section and what it means.

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Assignment Expectations:

• Length: 1500 to 2000 words total (at least 500 words per question prompt)
• Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required for this assignment.
• Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
• Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
• File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment 1.docx)

Submission: Submit to the D2L dropbox for grading prior to Monday at 11:59pm PST

N496 Nursing Leadership and Management

Module 2 Assignment (N496 Nursing Leadership and Management Full Course)

Professional Platform for Ethics and Leadership

The role of the health care professional includes being a moral agent or a person whose actions affect themselves and others at a moral level. It is important to have a personal ethic or moral framework in which you ground your practice and professional relationships.

The purpose of this assignment is to explore and create a foundation for leadership and ethics in your professional practice N496 Nursing Leadership and Management Full Course.

Write a reflection on the nature, sources, and implications of your values, beliefs, and ethical perspectives that guide your personal life and nursing practice N496 Nursing Leadership and Management Full Course.

Please note, grading is based on the clarity and depth of your writing and the apparent effort given the assignment, not on the rightness or wrongness of your position. You are encouraged to be honest in your self-assessments and conclusions.

Each of the following points must be addressed in your essay:

• Primary influences (childhood and adult)
• Ethical principles that influence you personally and professionally
• Ethical practice of professional nursing
• Ethical leadership and professional development plan. Include both positive and negative aspects of your character that emerge when you are in a position of authority

Assignment Expectations:

• Length: 1500 to 2000 words total.
• Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. Your assignment should include at least two (2) scholarly sources PLUS the textbook.
• Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
• Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
• File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment 1.docx)
• Submission: Submit to the D2L dropbox for grading prior to Monday at 11:59pm PST

N496 Nursing Leadership and Management Full Course

Module 3 Assignment – Power in Organizations

Have you ever been involved in union organizing, collective bargaining, or worked in a union shop? If so, share your experience. If not, locate a scholarly journal article that describes collective bargaining and describe how it works within an organization N496 Nursing Leadership and Management Full Course.

Have you ever worked in a healthcare facility that had Magnet accreditation, or had experience with shared governance? If so, share your experience. If not, locate a scholarly journal article that describes shared governance and explain how it could be implemented in your current facility N496 Nursing Leadership and Management Full Course.

Assignment Expectations:

• Length: 1000 – 1250 words
• Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. At least two (2) scholarly sources should be utilized in this assignment.
• Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
• Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
• File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment 1.docx)
• Submission: Submit to the D2L dropbox for grading prior to Monday at 11:59pm PST

N496 Nursing Leadership and Management Full Course

Module 4 Assignment (N496 Nursing Leadership and Management Full Course)

Effective Communication

The Joint Commission reported that [poor] communication was the root cause of 66% of Sentinel Events between 1995-2005. Examine the communication and collaboration in your workplace. Include these aspects:

• The components necessary for effective interpersonal communication.
• Discuss the importance of interprofessional collaboration.
• Apply components of interpersonal communication to interprofessional collaboration.
• Discuss strategies to promote interprofessional collaboration.
• Describe effective strategies to build interprofessional teams.
• Cultural competence

Assignment Expectations:

• Length: Between 1500 and 2000 words
• Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. You should utilize at least two scholarly sources in addition to your textbook.
• Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
• Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf
• File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment 1.docx)
• Submission: Submit to the D2L dropbox for grading prior to Monday at 11:59pm PST

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N496 Nursing Leadership and Management Full Course

Module 5 Assignment – Delegation in Practice

What does your State Board of Nursing say about Unlicensed Assistive Personnel and their role, and the role of the Registered Nurse? Describe the responsibilities of the Registered Nurse when delegating patient care tasks.

How does the ICU environment differ from a general medical-surgical unit as far as assigned responsibilities for Unlicensed Assistive Personnel?

Assignment Expectations:

• Length: 750 to 1000 words
• Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. Please include at least one reference in addition to the textbook.
• Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
• Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
• File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment 1.docx)
• Submission: Submit to the D2L dropbox for grading prior to Monday at 11:59pm PST

N496 Nursing Leadership and Management Full Course

Module 6 Assignment (N496 Nursing Leadership and Management Full Course)

Qualities of a Nurse Leader

It is important for nurse leaders to engage with other nurse leaders to understand professional roles; a practice experience is assigned to achieve this end N496 Nursing Leadership and Management Full Course.

It is expected that you will spend 8-10 hours with the nurse leader, shadowing them in their position, observing them go about their day, and interviewing them. The interview can take place before, during, or after the shadow period or can be on a different day.

**All students are to submit a completed Practice Hour Log of at least 8-10 hours into the Mod 6 dropbox.

Note: Students who hold an RN license in the state of Washington must complete a minimum of 10 hours of practice experience as noted on their Log. Upload the Log as a separate document. ** N496 Nursing Leadership and Management Full Course

You will engage with and interview a nurse leader in person. You should begin thinking about this activity as soon as possible and identify how you will identify and gain access to the interview. You may include photos, graphs, or charts.

Choose a nurse leader who holds a leadership nursing position in their organization who have direct reports (they supervise other employees). Examples of this include Director of Nursing, Director, Unit Manager. *You may not be employed in the same facility as your interviewee or shadow during personal work hours* (If special accommodations need to be made, approval by your instructor is required first).

Develop an interview guide before conducting the interview. Identify information that you want to know before the interview and plan clarifying questions. You must include at least one question about technology/informatics N496 Nursing Leadership and Management Full Course.

Conduct an interview regarding their professional role in the organization, and a current health care issue that is of interest to you (ethics, conflict management, budget, staffing, culture of safety, “just culture”, career advancement, quality improvement, etc.). Identify the name of the organization and use names of all involved (no anonymity).

Prepare a written report of the interview.

Sample questions below. Feel free to vary the content of the questions to fit your interview:

• Please describe the nursing and inter-professional teams that operate in this facility/on this unit.
• Can you provide an example of a nursing practice that has been changed in the last year based on current best evidence?
• What do you consider your biggest challenge?
• What do you love most about your job?
• Why did you choose this job?
• What other kinds of nursing/other job did you ever do?
• How would you describe your company’s culture?
• How would you describe your role in admission and staffing decisions?
• What is your leadership style?

* If you are employed in a large healthcare facility that has more than one location, you may interview the nurse leader in that organization with prior permission from your instructor. The purpose of this is to get you out of your organization and explore other nursing leadership roles than you might be familiar with. N496 Nursing Leadership and Management Full Course

Assignment Expectations:

• Length: 1500 to 1750 words in length; Upload log Separately
• Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. Your essay should have at least two scholarly references in addition to the textbook. Please be sure to cite the interview in APA format.
• Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
• Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
• File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment 1.docx)
• Submission: Submit to the D2L dropbox for grading prior to Monday at 11:59pm PST

N496 Nursing Leadership and Management Full Course

Module 7 Assignment – A Culture of Patient Safety

Read this article:

Sammer, C. & James, B. (2011, September 30). Patient safety culture: The nursing unit leader’s role. OJIN: The Online Journal of Issues in Nursing,16(3), Manuscript 3.

In the Hospital Hope scenario, what do you think was the most important factor that led to the change in practice in the SICU?

If you worked in a facility that needed a practice change, what framework would you use and why?

Assignment Expectations:

• Length:1000 to 1250 words in length
• Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two scholarly sources plus the textbook are required.
• Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
• Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
• File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment 1.docx)
• Submission: Submit to the D2L dropbox for grading prior to Monday at 11:59pm PST

N496 Nursing Leadership and Management Full Course

Module 8 Assignment (N496 Nursing Leadership and Management Full Course)

Signature Assignment Title: What Makes a Good Leader?

Signature Assignment Description/Directions:

• Choose one or more leadership topic(s) from your textbook or from a scholarly source from a previous discussion or assignment from this course and write about its application to nursing practice. Provide definitions, history/background, and major concepts of chosen topic.
• Describe the topic’s function in nursing practice by examining at least three different nursing roles (for example, bedside nurse, public health nurse, CNO, unit manager, etc.). Discuss how the leadership topic can be used in your own practice.
• Discuss your personal growth in regard to your chosen leadership topic. Evaluate personal strengths, weaknesses, opportunities, and threats to your career advancement.
• Then, discuss the top three traits you feel makes a good nurse leader. Support your statements with examples from your practice experience and scholarly sources.

Assignment Expectations:

• Length: 1750 to 2000 words in length
• Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three scholarly sources plus the textbook are required.
• Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
• Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
• File name: Name your saved file according to your first initial, last name, and the assignment number (for example RHall Assignment 1.docx)

N496 Nursing Leadership and Management Full Course

Module 1 Discussion

From your assigned readings and outside research on the topic, consider the difference between a “manager” and a “leader.” What do you feel are the three biggest differences? What are two benefits and disadvantages of each?

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Module 2 Discussion (N496 Nursing Leadership and Management Full Course)

Read this article: Austin, S. (2011). Stay out of court with proper documentation. Nursing, 41(4), 24-30. Of the four elements that must be proven to determine negligence, do you think that any of them is harder to prove than others?

If you have ever come close to committing nursing negligence, what would your advice be for others? If not, have you ever seen someone commit negligence, and if so, what is the lesson in it? If no for each, make up a scenario to share your professional advice.

Choose scenario 1, 2, or 3 in the article. Summarize the lesson to be learned, and what you would have done to avoid the error.

Module 3 Discussion

Describe the organizational characteristics of a facility in which you currently work. Include the following: the type of organization, its organizational culture, its structure, and its formal and informal goals and processes.

Define three different kinds of power, and describe how power affects the relationships between people of different disciplines (e.g., between staff in nursing, medicine, physical therapy, housekeeping, administration, finance, social work) in a health-care organization.

Module 4 Discussion (N496 Nursing Leadership and Management Full Course)

Give an example of the difference between being assertive and being aggressive. What is the importance of this in communication? In leadership?

Give an example of passive aggressive communication.

What do you think of the statement, “assertiveness is unfeminine”?

What kind of advice would you give to be assertive? What role does being assertive play in handling criticism? In effective communication?

N496 Nursing Leadership and Management

Module 5 Discussion

Below are some common delegation issues with examples. Give your own examples of over-delegation, under-delegation, and refusal to accept a legitimate delegation, and explain what you would do in each case.

Over-delegation. (Would you pass my medications for me and sign off my orders? I’m really busy).

Under-delegation. (I’ll do it myself. The nursing assistant argues with me when I ask her to do something/I always have to do it over).

Refusal to accept assignment of legitimate delegation. (I don’t know how to do that very well/I have too much work already/It’s always me that gets the work; ask someone else/I’m too busy/I won’t be able to do a very good job, but if that’s what you want…)

N496 Nursing Leadership and Management

Module 6 Discussion (N496 Nursing Leadership and Management Full Course)

This week you will shadow and interview a nurse leader. Please post your questions for the interview and offer some background as to why these questions were chosen.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length.

N496 Nursing Leadership and Management

Module 7 Discussion

Have you ever worked with someone who caused problems with you or others? (Explain how the problem manifested itself and how it was managed).

What are the common signs of bullying in nursing?

What are common stressors in the nursing workplace? What are some strategies to manage personal and professional stress?

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length.

N496 Nursing Leadership and Management

Module 8 Discussion (N496 Nursing Leadership and Management Full Course)

It is critical to synthesize all of the knowledge, skills, and abilities of nursing into an integrated whole that moves nurses from task completers to an overall demonstration of compassion and caring.

Thinking of nursing first as a job of caring and making a difference, as well as the work of giving medications on time, checking an X-ray to see if the doctor needs to be called, or taking an admission at 2:00 a.m. with a smile on our faces, reminds us of the synthesized whole of nursing work.

Write a reflection about this thought. Incorporate elements from this module’s objectives, as well as what you have learned in this course about leadership. You may include personal experiences and professional opinions if you wish.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length. N496 Nursing Leadership and Management Full Course

N512-19A Module 4 Disorders of the Nervous System Across the Life Span Discussion

N512-19A Module 4 Disorders of the Nervous System Across the Life Span Discussion

Discussion 4

Marisol Arroyo, age 23 y.o., and unmarried, accompanies her mother, Julia, who is a 68 y.o., divorced Latina female, to her appointment with her primary care Nurse Practitioner.  Both Marisol and her mother, who live together, have noted that her ever-present forgetfulness seems to be worsening.

Just yesterday she walked to the corner store for a few items, which she obtained, but even though she had been to this store many times over the years, she found herself unable to get home without directions.

Marisol also notes that her mother’s hygiene is changing, that she is becoming more and more quarrelsome, and that she forgets information she had been told as little as 10 minutes earlier.  The Nurse Practitioner is attempting to rule out whether this patient may have some form of dementia or delirium.

In this discussion:

1. Describe and discuss the unique pathophysiology of Dementia of the Alzheimer’s Type.
2. If this patient is diagnosed with Alzheimer’s dementia, describe and discuss with your colleagues a potential clinical course, and prognosis for her.
3. Describe and discuss your plan of care for this patient with both short-term and long-term plans considering current social supports and health-care access.

Include citations from the text or the external literature in your discussion posts.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.

N512-19A Module 4 Disorders of the Nervous System Across the Life Span Discussion: Sample Discussion 4 Solution

Alzheimer’s Disease is the most common cause of dementia and accounts for more than 50%of its cases (Hammer 2019). the pathology of Alzheimer’s Disease is characterized by extracellular neuritic plaques in the cerebral cortex and in the walls of meningeal and cerebral blood vessels (Hammer 2019).

Dementia of the Alzheimer’s type is a noncurable progressive disease causing neurological deficits. A potential clinical course of action will be maintaining a medication regimen, home care planning, and end-of-life care preparations.

I would suggest the patient have their medications prepared by a family member or a pharmacy that will distribute the medications in prepackaged daily containers. Medications are not a cure; however, they may help to slow disease progression. The patient’s memory will be affected, and these actions will help prevent missing medication doses or overdosing on medications.

Home care planning will be necessary, working with a home health company; an evaluation will be conducted to ensure a safe home environment. The provider will consider a need to order medical supplies such as a bedside commode or an adjustable bed. Marisol Arroyo, age 23 y.o., and unmarried, accompanies her mother, Julia, a 68 y.o., divorced Latina female, to her appointment with her primary care Nurse Practitioner.

Both Marisol and her mother, who live together, have noted that her ever-present forgetfulness seems to be worsening. Julia will need a home care provider to keep her safe and prevent her from becoming lost.A provider will help with hygiene, and Julia will have more dignity having her care provided by a professional as opposed to a close family member.

A medical power of attorney will need to be established along with an advanced directive. In the beginning stages of dementia, the patient and their family can have conversations about resuscitation and wishes. This conversation will take the burden of stress off Marisol. She will be fulfilling her mother’s wishes and avoid wondering what she should do and feeling guilt for prolonging her mother’s life or giving up too soon.

At the end-of-life stage, a hospice evaluation can be made to guide the family in palliative care. Goals to establish in one week of Julia’s visit will be to get the medications organized in a daily pill container by Marisol or a pharmacy the can prepackage morning and evening doses. In the first week, the patient will be seen by a case manager from a home health company that can provide Julia’s home care when Marisol is working or out of the house.

In six months, Julia and Marisol will openly discuss and have an established advanced directive and living will and legally binding power of attorney. The purpose of a treatment plan will be to reduce stress for the patient and family. The care plan will create a safe environment for the patient by preventing falls and ensuring that Julia does not get lost when leaving the house. Julia and Marisol will make this period in time a special period that will help them cope and grieve.

Management of vascular dementia should focus on identifying and managing comorbidities, ensuring that vascular risk factors are optimally managed, ensuring appropriate recognition and management of non-cognitive symptoms, and appropriate psychosocial and other support to optimise quality of life for patients and carers (O’Brien 2015).

Reference

• Hammer, G.,& McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed). McGraw-Hill O’Brien, J.,T., & Thomas, A. (2015). Vascular dementia. The Lancet, 386(10004), 1698-1706. doi:http://dx.doi.org.americansentinel.idm.oclc.org/10.1016/S0140-6736(15)00463-8

In reply to LD

N512-19A Module 4 Disorders of the Nervous System Across the Life Span

by Amanda – Sunday, August 9, 2020, 2:53 PMLinda,It is really sad and heart wrenching watching a family member decline due to a disease such as Alzheimer’s. Alzheimer’s affects so many people and unfortunately there is no cure for Alzheimers, there is only some drug therapies which may help control or minimize symptoms (Rebar, 2019). Having a pharmacy prepackage medications is a great idea to help ensure a patient takes all their medications at a given time; this could help prevent forgetting a dose or even prevent an overdose if a patient forgets if a medication was taken.

I like your idea of having a provider or caregiver come into Julia’s home to help with bathing and other cares. This will reduce Marisol’s stress of having to provide cares on her mother she is uncomfortable with and as you mentioned give Julia a little more dignity than having a family member provide care that may feel uncomfortable. Having a medical power of attorney along with an advanced directive in place is also a great idea; this will relieve the stress of not knowing Julia’s wishes.Amanda

Reference

• Rebar, C., Heimgartner, N., & Gersch, C. (2019). Pathophysiology made incredibly easy (6th ed). Wolters Kluwer

N512 Advanced Pathophysiology Assignment 1

The purpose of this paper is to address the following clinical scenario with the use of your textbook, external credible literature, and/or reliable electronic sources. Use the guide below to draft your paper and review the rubric to ensure you have met the assignment criteria. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s).

Lisa Anderson, a 22 y.o., Caucasian single parent, is referred for genetic counseling by her pediatric Nurse Practitioner. She has a 3-year-old boy with developmental delay and small joint hyperextensibility. The pediatric Nurse Practitioner has diagnosed fragile X-associated mental retardation. She is currently pregnant with her second child at 14 weeks of gestation. The family history is unremarkable.

Please use the following headings/subheadings as a guide to draft your paper:

1. Introduction (including a brief purpose statement)
2. Identify the genetic mutation responsible for fragile X-associated mental retardation.
3. Describe and discuss how it causes the clinical syndrome of developmental delay, joint hyperextensibility, large testes, and facial abnormalities.
4. Identify which parent is the probable carrier of the genetic mutation?
5. Explain why this parent and the grandparents are phenotypically unaffected.
6. Discuss the likelihood that the unborn child will be affected?

VII. Conclusion

In regards to APA format, please use the following as a guide:

• Include a cover page and running head (this is not part of the 4-5 page limit)
• Include transitions in your paper (i.e. headings or subheadings)
• Use in-text references throughout the paper
• Use double space, 12 point Times New Roman font
• Spelling, grammar, and organization are appropriate
• Include a reference list (this is not part of the 4-5 page limit)
• Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. ANA)

Assignment 1 Rubric – N512 Advanced Pathophysiology Assignment 1

Criteria

60 Points

55 Points

50  Points

40 Points

Earned Points

Content: Application & Analysis

Responds correctly and/or appropriately to all questions and criteria. Content is excellent.Demonstrates a high level of critical thinking, shows significant insight or creative thought about the topic, and does not merely recite the text/resources. Uses concepts and terminology correctly.  Detail rich and specific.Responds correctly and/or appropriately to all questions and criteria. Content is good.Demonstrates some critical thinking throughout the paper and may also show some insight or creative thinking about the topic. Mostly uses concepts and terminology correctly (1-2 issues). Minor detail inconsistencies (1-2).Responds correctly and/or appropriately to at least one question OR if only one question, partially responds to question. Does not address all criteria. Content is minimal.Demonstrates at least one critical thinking skill in the paper.  Attempts to use concepts and terminology correctly.  Several detail inconsistencies (3-5).Paper is unclear and does not address the questions and/or criteria. Content does not meet requirements. Many inconsistencies and conflicting information (6+).

 

/60

Criteria

20 Points

16 Points

14 Points

12 Points

Earned Points

Quality: Supporting Research & Sources

All work is accurately cited (where applicable) and appropriately supports content with research, text, multimedia, and/or other resources.  References are relevant and enhance the topic.Most of the work is accurately cited (where applicable) and adequately supports content with research, text, and/or resources.  One issue with reference or use of one inappropriate reference.  References are relevant to the topic.2-3 issues with references, including the use of inappropriate references to support content. May fail to provide references to support content.  1-2 references are not relevant to the topic and/or distract from the topic at hand.4 or more issues with references, including the use of inappropriate references to support content OR failure to include references (where applicable).  No supporting references are used OR they are used but 3+ references are not relevant to the topic./20

Criteria

10 Points

8 Points

7 Points

6 Points

Earned Points

Organization

Paper is well-organized. Ideas are clear and arranged logically. Transitions are smooth, no flaws in logic.Paper is organized. Ideas are usually clear and arranged in an acceptable sequence (1-2 issues). Transitions are usually smooth (1-2 issues), good support.Paper lacks organization. There are many problems with the approach (3-5 issues with organization). Some difficulty understanding ideas.  Issues with support and transitions (3-5).Paper is poorly organized and difficult to understand. Many issues with support and transitions (6+). Ideas are arranged illogically and do not make sense. /10

Accuracy & Basic Writing Mechanics

Error-free, including APA formatting, reflecting clear understanding of various forms of expression and careful editing.Very few (less than 3) errors in spelling, grammar, syntax, and/or punctuation. Very few (less than 3) issues with APA formatting. Occasional poor choice of word.4-5 errors in spelling, grammar, syntax, and/or punctuation. 4-5 issues with APA Formatting. Writing may be difficult to understand at times.More than 5 errors in spelling, grammar, syntax, and/or punctuation.  Many (6+ issues with APA formatting.  Writing is difficult to understand in many instances. /10

Discussion 1

See Van, a 35-year-old married Hmong-American woman recently underwent an annual Papanicolaou test (Pap smear) at her Certified Nurse Midwife’s practice, and the results were abnormal.  Her provider diagnosed her with low-grade cervical dysplasia.  What alterations at the cellular level would you expect to see with this diagnosis? Provide and discuss with your colleagues S. V.’s prognosis. Support your discussion with citations from the textbook, external credible literature and/or reliable electronic sources.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.

Sample Discussion Approach

In women, anatomically, the cervix is the lower part of the uterus where it meets the vagina. When healthy cells in the cervix undergo abnormal changes, it is called cervical dysplasia (Cooper, D. & McCathran, C., 2020). Contracting human papillovirus (HPV), a type of sexually transmitted infection (STI), is the most common reason why these changes happen and may be seen through a Papanicolaou (Pap) smear test. Many times, it goes away within 8 months to 2 years from exposure, however, it is considered a precursor to cervical cancer if left unmonitored and untreated. (Cooper, D. & McCathran, C., 2020).

Low-grade cervical dysplasia, or squamous intraepithelial lesion (LSIL), is categorized under CIN 1 or mild dysplasia, it usually does not need any treatment other than close monitoring which includes annual pap smear with HPV testing (Cooper, D. & McCathran, C., 2020). According to National Cancer Institute (2019), for any abnormal pap test results as well as HPV test, further testing and other treatments are needed such as a colposcopy.

It is an exam done by the provider that uses a colposcope to take a closer look into the cervix and obtain a tissue sample for biopsy (National Cancer Institute, 2019). This is also very important especially if the patient has a strong family history of cancer. Nonetheless, S.V.’s prognosis is fairly good provided that it is being closely monitored. Procedures such as a cold knife conization, cryotherapy, laser therapy or loop electrosurgical excision procedure (LEEP), may all be considered in the future if needed (National Cancer Institute, 2019).

Cooper, D. & McCathran, C. (2020). Cervical Dysplasia. Treasure Island (FL): StatPearls Publishing; 2020 Jan. https://www.ncbi.nlm.nih.gov/books/NBK430859/

National Cancer Institute (2019). Understanding Cervical Changes: Next Steps After an Abnormal Screening Test. https://www.cancer.gov/types/cervical/understanding-cervical-changes#6

N512 Advanced Pathophysiology Assignment 1 Re: PE discussion 1

by Faye – Thursday

Hi Maria,

Thanks for your post. As you’ve stated our patient does not need treatment at this time. The guidelines related to cervical dysplasia state that patients with CIN I (also known LSIL) should undergo co-testing after 12 months. Co-testing will include: a repeat Pap smear for cervical cytology and a high-risk HPV test (Levine, n.d.). High-risk HPV testing determines whether there is presence of the human papillomavirus, especially for the genotype that are at high risk for development of genital warts, cervical dysplasia, or cervical cancer (Mayo Clinic, 2020). This is only available in women and is recommended if one is 30 years or older (Mayo Clinic, 2020).

N512 Advanced Pathophysiology Assignment 1 References:

Levine, E.M. (n.d.). Management of cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS). Dynamed Plus. https://www.dynamed.com/management/management-of-cervical-intraepithelial-neoplasia-cin-and-adenocarcinoma-in-situ-ais#CIN_1

Mayo Clinic. (2020). HPV test. https://www.mayoclinic.org/tests-procedures/hpv-test/about/pac-20394355

N512 Advanced Pathophysiology Assignment 1 Re: PE discussion 1

by Maria  – Thursday

high-risk HPV testing is important and goes hand in hand with pap smear tests. There are over 40 types of HPV that can infect the genitals and is commonly acquired in sexually active late teens to early 20’s. Although most go away on their own, some may cause cervical cancer (Center for Disease Control and Prevention {CDC}, 2016). HPV vaccination is recommended for 11-12 years old to get 2 doses of HPV vaccine to prevent from getting cancer caused by the virus. It is also recommended by CDC got girls to get vaccinated before they become sexually active to fully utilize the benefit (CDC, 2016).

Center for Disease Control and Prevention. (2016). HPV Vaccine Information for Young Women. https://www.cdc.gov/std/hpv/stdfact-hpv-vaccine-young-women.htm

N521 Assignment 3 Restless Leg Syndrome Paper

LP is a 23-year-old Hispanic female college graduate who was advised by her workplace colleague to seek medical care following a condition they thought was a ‘fatigue syndrome’ because of suspected symptoms of anemia. LP reports feeling restless and fatigued for nine months now. She has difficulty falling asleep and sometimes her mind ‘goes blank.’ She also reports irritability. These complaints have caused her to be anxious about her life quality and work performance that she thinks have deteriorated since the onset of the symptoms. She has been on contraceptive pills for the past four years and have not caused her any adversities. The disease has not caused disturbances in social life. This paper describes the best possible course of management for this patient.

Most Likely Diagnosis

The patient’s most likely diagnosis is restless leg syndrome. LP’s case is an early onset restless syndrome because the symptoms appear before the age of 45 (Guo et al., 2017). Restless leg syndrome is a neurological disorder, most usually sensorimotor, that has psychological sequelae (Levin & Chauvel, 2019). Restless leg syndrome (RLS) is the most possible diagnosis in this patient because of her “restless” and “on edge” feeling for the nine months, sleep disturbances, fatigue, and irritability. RLS, also known as Willis-Ekbom Disease (WED), is characterized by symptoms worsening later in the day during periods of tranquility especially in the evening or at night (Romero-Peralta et al., 2020). This explains the sleep disturbances in this patient. Her risk factors include female gender (Fred, 2020; Seeman, 2020) and adult age. This condition is more common in adults than children. However, older adults are at more risk of RLS (Guo et al., 2017). The fatiguability in this patient can be attributed to an iron deficiency that is usually considered among the main physiological risks of RLS as mentioned later.

Pharmacotherapeutic Treatment Goals for LP

Identification of specific risk factors is important in determining the management path for patients with RLS. The goals of management of this patient will include reduction in the frequency of restlessness, alleviation of anxiety, improvement in fatigue and irritability, improvement in sleep patterns and durations, and maintenance of proper functional social life. Achievement of these goals will require ruling out extrinsic causes of restless leg syndrome, pharmacological interventions, and proper supportive relationships.

Need for Laboratory Investigations

The Certified Nurse Practitioner (CNP) will require to order laboratory tests for LP. As aforementioned, ruling out extrinsic or physiological causes of RLS would be essential for the achievement of the set therapeutic goals. RLS is associated with iron deficiency and uremia of various causes (Levin & Chauvel, 2019). As a result, the CNP will order for complete blood count and hemoglobin, blood ferritin and iron levels, vitamin B12 levels, serum electrolytes and urea levels, serum creatinine levels, and liver function tests (Ferré et al., 2019). Therefore, performing these investigations in this patient may identify anemia that would have been overlooked and enable directing of treatment towards the elimination of the cause rather than managing the symptomatology.

The Best Drug Therapy for LP

Management of RLS using pharmacotherapy will be determined by the physiology identified. In case there will be unidentified causes, dopamine agonists will remain the best treatment for this patient. This is because she is not on any medications for restless leg syndrome and there is no documented history of adverse reactions to dopamine agonists. LP will be prescribed ropinirole 0.25 mg OD daily NOCTE, 3 hours before bedtime. This dosage may be adjusted depending on the quality of control of the symptoms. Tolerability and patient’s response to the medication would indicate the need to either increase, reduce, or terminate the therapy.

Parameters for Monitoring the Success of the Therapy

The success of the therapy would be monitored by subjective and objective indices. Objective monitoring will include regular assessments of blood pressure and heart rates. These signs would be assessed with posture changes and patient position to watch out for orthostatic blood pressure alterations. Assessment of risk of fall will also be monitored (Guo et al., 2017). Subjective assessment of skin pigmentation and color changes, alertness during the day, symptoms of central nervous system depression, and changes in behavior will also be monitored. Personalized monitoring of frequencies of restlessness symptoms, daily onset, and duration of these symptoms will also be required.

Specific Patient Monitoring Based on the Prescribed Therapy

Monitoring for an overdose would be indicated in this patient as the dose adjustments would be made as appropriate and maximum doses might be required in poor response situations. The presence of hallucinations may indicate serious overdose (Carvalheiro & Maia, 2021). In this patient, specific monitoring of iron stores through serum iron and ferritin levels would be required as they may worsen an impending augmentation due to ropinirole. Even though a disturbance in sleep was a major concern for the patient, daytime somnolence may not indicate positive therapeutic achieving but adverse effect. The presence of daytime drowsiness may require adjustments in dosages. The monitoring of the therapy will be judged by the achievement of the mentioned management goals. Symptom recurrence or worsening may be a major turning point in patient management.

Adverse Reactions that may Require Therapy Change or Termination

Augmentation in ropinirole therapy represents worsening or recurrence of the patient major complaints and symptomatology. This would be shown by an increase in the frequency of occurrence of symptoms or spread of restlessness to other body parts. Pleural and peritoneal fibrosis are some of the adverse effects that may warrant discontinuation of the therapy. Psychotic symptoms and behavioral aggravations such as aggression and delusions would require dose adjustments. Impulse control disorders are major concerns that the CNP should be aware of in ropinirole therapy. These disorders include hypersexuality, pathological gambling, and binge eating. Their presence may signify augmentation or adverse drug reactions that will need discontinuation. In presence of augmentations, the addition of other drugs such as opioids may be required. However, the commonest adverse effects include gastrointestinal (GI) upset such as nausea and vomiting, and other non-GI effects including fatigue and drowsiness.

Anxiety after Six Weeks and Use of Klonopin

LP’s anxiety may persist and when she comes back six weeks later with opinions of using Klonopin, my response would be as follows. LP, in this situation, would be advised that Klonopin would have drug interactions with ropinirole that would worsen her symptoms. She might develop confusion, drowsiness, and an increase in restlessness. Klonopin has been known to cause sleep apnea in some patients (Drugs.com, 2020). As a result, she would not be advised to use Klonopin/clonazepam as it would interfere with her work and social life. Therefore, she would be put on other anxiolytics other than benzodiazepines such as zopiclone or buspirone. Klonopin would only be used as last-line medications for LP.

Health Promotion Activities for LP

Health promotion activities for LP will mainly include lifestyle modifications. She would be advised to do stretching aerobic exercises more often to relieve stress and mild symptoms associated with RLS. She would avoid caffeine, tobacco, and alcohol as these may worsen the symptoms of RLS. The National Institute of Neurological Diseases and Stroke (NINDS) recommends the use of an ice pack or warm bath for the affected part usually the limbs. LP will also be encouraged to do daily massages of the limbs (National Institute of Neurological Disorders and Stroke, n.d.). Dietary improvement will also be encouraged to prevent iron deficiency anemia that would aggravate her condition.

LP’s Long-Term Prognosis

LP’s condition has no cure and the medications and nonpharmacological interventions that are used only improve the quality of life and improve the symptoms. Therefore, LP’s condition is a lifelong disease (Manconi, 2017). Using ropinirole in the long term also risks higher chances of augmentations that would require additional medications that would manage her symptoms. As a result, other medications such as alpha-2-delta agonists may be required and this might increase pill burden that would affect the adherence and treatment compliance.

Conclusion

The most likely diagnosis supported by LP’s presentation is early-onset Restless Leg Syndrome (RLS), also Willis-Ekbom Disease (WED). The presence of sleep disturbance is associated with worsening of restlessness and an urge to move limbs during rest hours. This condition had impacted greatly on her work life and pharmacological interventions would be the best management modality of choice. Therefore, ropinirole, a dopaminergic agonist would be administered, and the dose adjusted appropriately. However, laboratory investigations are required to rule out iron deficiency, uremia, and vitamin deficiencies that are associated with this disease. Adverse effects and augmentation may warrant discontinuation of ropinirole therapy. Unfortunately, this disease is lifelong and there is no cure.

References

• Carvalheiro, A. M., & Maia, J. (2021). Ropinirole overdose: Visual hallucinations following misuse: case report. Reactions Weekly, 1846(1), 288–288. https://doi.org/10.1007/s40278-021-92536-6
• Drugs.com. (2020). Ropinirole. Drugs.Com. https://www.drugs.com/ppa/ropinirole.html
• Ferré, S., García-Borreguero, D., Allen, R. P., & Earley, C. J. (2019). New insights into the neurobiology of restless legs syndrome. The Neuroscientist: A Review Journal Bringing Neurobiology, Neurology and Psychiatry, 25(2), 113–125. https://doi.org/10.1177/1073858418791763
• Fred, P. (2020). Restless leg syndrome: The complete encyclopedia on everything you need to know about restless leg syndrome causes, cure, prevention, and management. Independently Published.
• Guo, S., Huang, J., Jiang, H., Han, C., Li, J., Xu, X., Zhang, G., Lin, Z., Xiong, N., & Wang, T. (2017). Restless legs syndrome: From pathophysiology to clinical diagnosis and management. Frontiers in Aging Neuroscience, 9. https://doi.org/10.3389/fnagi.2017.00171
• Levin, K. H., & Chauvel, P. (2019). Clinical neurophysiology: Diseases and disorders: Volume 161: Handbook of clinical neurology series. Elsevier Science.
• Manconi, M. (Ed.). (2017). Restless legs syndrome/Willis Ekbom disease: Long-term consequences and management (1st ed.). Springer.
• National Institute of Neurological Disorders and Stroke. (n.d.). Restless legs syndrome fact sheet. Nih.Gov. Retrieved April 26, 2021, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet

N522PE-20A Advanced Physical Assessment Course Papers

N522PE-20A Advanced Physical Assessment Course Papers

Module One: Introduction to the Course & Implementing Clinical Reasoning in Practice

N522PE-20A Advanced Physical Assessment Course Papers Discussion 1

Post to the discussion board a planned approach to communicating with someone who speaks another language.  What type of questions will you need to ask?  Was there any communication issues discussed this week in Shadow Health?

How does communication impact the concept of clinical reasoning in nursing? Please discuss the issues completely, citing your sources so that your classmates can reference the information. Include one insight gained this week from your readings or interaction in Shadow Health.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria.

Assignment 1

N522PE-20A Advanced Physical Assessment Course Papers Assignment Instructions:

Write a three-page paper on the use of clinical reasoning in developing and applying advanced health history and physical assessment skills at the graduate level. Consider contemporary nursing literature on the development of clinical reasoning and decision-making.

How does the use of the nursing process enhance critical thinking, clinical reasoning, and clinical judgment in professional nursing practice at the graduate level. Please use the submission parameters and rubric below to guide you when completing this assignment.

N522PE-20A Advanced Physical Assessment Course Papers Submission Parameters:

For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 3 pages, which does not include the cover page and reference page(s).

I.        Introduction (including purpose statement)

II.        Clinical Reasoning

• Describe how clinical reasoning is used in developing and applying advanced health history and physical assessment skills at the graduate level.

III.        Nursing Process

• Describe how the use of the nursing process enhance critical thinking, clinical reasoning, and clinical judgment in professional nursing practice at the graduate level.

IV.        Clinical Example

• Discuss an example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning.
• Discuss how nursing care is provided when each of these concepts are evidenced in nursing care of the patient.

V.        Conclusion

VI.        References (consider contemporary nursing research studies or reliable electronic sources)

 

In regards to APA format, please use the following as a guide:

• Include a cover page and running head (this is not part of the 3 pages limit)
• Include transitions in your paper (i.e. headings or subheadings)
• Use in-text references throughout the paper
• Use double space, 12 point Times New Roman font
• Apply appropriate spelling, grammar, and organization
• Include a reference list (this is not part of the 3 pages limit)
• Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP)

N522PE-20A Advanced Physical Assessment Course Papers: Assignment 1 Rubric

Competency

30

27

25

0

Points

Define, compare and contrast clinical reasoning and decision-making. How is this related to critical thinking and clinical judgment in graduate level nursing practice?Defines, compares, and contrasts clinical reasoning and decision-making with cited references in addition to course readings for Week 1.
Answers posed questions.Defines, compares, and contrasts clinical reasoning and decision-making with cited references from course readings for Week 1.
Answers posed questions.Describes clinical reasoning and decision-making. Briefly answers how is this related to critical thinking and clinical judgment in graduate level nursing practice?Does not define, compare and contrast clinical reasoning and decision-making. Does not answer how is this related to critical thinking and clinical judgment in graduate level nursing practice?/303027250 Consider contemporary literature and apply the concept of clinical reasoning to advanced physical assessment in nursing.Considers contemporary literature and applies the concept of clinical reasoning to advanced physical assessment in nursing.Considers textbook literature and references within text book without further consideration of external literature support.Considers and applies concept of clinical reasoning to advanced physical assessment in nursing without reference to expert opinion or research literature.Does not consider and apply concept of clinical reasoning to advanced physical assessment in nursing./303027250 Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. How is nursing care provided or modified when each of these concepts are evidenced in nursing care of the well-adult, family, and one special population?Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. Discusses how nursing care was provided or modified when each of these concepts were evidenced in nursing care of the well-adult, family, and one special population.Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. Discusses how nursing care was provided or modified when each of these concepts were evidenced in nursing care of the well-adult, family, or one special population.Demonstrates the nurse’s use of critical thinking, clinical judgment, or clinical reasoning. Discusses how nursing care was provided or modified when these concepts were evidenced in nursing care of the well-adult, family, or one special population.Does not demonstrate the nurse’s use of critical thinking, clinical judgment, or clinical reasoning. Does not discuss how nursing care was provided or modified when these concepts were evidenced in nursing care of the well-adult, family, or one special population./3010980 APA Format, grammar, punctuation and spelling.APA Format, grammar, punctuation and spelling is accurate with no errors.APA Format, grammar, punctuation and spelling is accurate with less than two types of errors.APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors.APA Format, grammar, punctuation and spelling is accurate with more than five types of errors./10

Module Two: HEENT and Skin Assessment

Discussion 2 – N522PE-20A Advanced Physical Assessment Course Papers

This week you have studied advanced physical assessment of the eyes, ears, nose, throat, head, neck and skin (HEENT). Describe the classification of rashes.  What additional resources for HEENT advanced health assessment skills have you found beneficial in developing your knowledge and psychomotor skills this week? Post a concept to the discussion board that you have had difficulty with and note where you are with resolution of your difficulties.

Please describe the issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls”. In other words, please include primary sources and/or reliable electronic sources to support your arguments.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria.

Sample Approach to Discussion 2

Skin rashes are temporary disruptions of the skin.  Dermatological disorders are classified according to lesion type (Primary), lesion configuration (Secondary), texture, location and distribution, and color.

A. Primary lesions – acquired

1. Macules – flat, <10 mm; large macula is called patch (rubella)

2. Papules – elevated, <10 mm (acne)

3. Plaques – elevated/depressed, >10 mm (psoriasis)

4. Nodules – firm papules extending to dermis or subcutaneous tissue (cysts)

5. Vesicles – clear, vesicle, fluid-filled blisters <10 mm (herpes infections)

6. Bullae – clear fluid-filled blister >10 (allergic contact dermatitis)

7. Pustules – pus-filled vesicle (pustular psoriasis)

8. Urticaria – red pruritic wheals or hives (medication allergies)

9. Scale -horny epithelium (seborrheic dermatitis)

10. Crusts /Scabs – (impetigo)

11. Erosions – open skin areas (excoriation)

12. Ulcers – epidermal loss (decubitus)

13. Petechiae – hemorrhage (vasculitis)

14. Purpura – palpable hemorrhage (ecchymoses/bruises)

15. Atrophy – skin thinning (lupus)

16. Scars – fibrotic skin (keloid)

17. Telangiectases – small dilated blood vessels (rosacea)

 

B. Secondary lesions – develops overtime as a result of disease progression

1. Annular – center-cleared rings (tinea)

2. Target (bull’seye or iris) – rings w/centered duskiness (erythema multiforme)

3. Serpiginous  – linear, branched, curving; fungal and parasitic infections  (cutaneous larva migrants)

4.Numular – coin-shaped (numular eczema)

5. Herpetiform – grouped papules or vesicles (herpes simplex)

6. Reticulated – lacy, networked (cutis marmorata)

6. Zosteriform – dermatomal clustered lesions (herpes zoster)

C. Texture – skin appearance or consistency

1. Verrucous lesions – irregular pebbly rough surface (warts)

2.Lichenification -skin thickening (repeated rubbing)

3. Induration – deep skin thickening (paniniculitis)

4. Umbilical – central indentation; viral (molluscum contagiosum)

5. Xanthomas – yellowish waxy (lipid disorders)

D. Location and Distribution 

1. Psoriasis – scalp, elbows, kneees, umbilicus, gluteal cleft

2. Lichen planus – wrists, forearms, genitals, Lower legs

3. Vitiligo – patchy isolated; distal extremities and face, peri-orbital and peri-oral

4. Discoid lupus erythomatosus -sun-exposed area, forehead, nose, cochal bowl of the ear

5. Hidradenitis suppurativa – apocrie gland-dense skin areas; axilla, groin, ulcer breasts

E. Color

1. Red – Erythema

2. Orange – Hypercarotenemia

3. Yellow – Xanthomas

4. Green fingernails – pseudomonas aeruginosa

5. Violet – cutaneous hemorrhage (kaposi sarcoma)

6. Blue, silver and gray – drug/metal deposits ( mini cyclone. Amiodarone); argyria (silver)

7.Black – melanocytes (melanoma), infarction (anthrax)

F. Other Clinical signs

1. Dermatologist – urticaria wheal

2. Carrier sign – rapid swelling when lesion is stroked (mastocytosis)

3. Nikon sky sign – epidermal shear after lateral pressure (bullous disease)

4. Auzpitz sign – pinpoint bleeding appears after scale removal (psoriasis)

5. Koebner phenomenon – lesions within traumatized areas (lichen planus)

There were several communication techniques that I had to use during the interview process to get a quality relevant answer. Rephrasing the questions oftentimes redirect the answer. The Shadow health is of course limited since it’s a digitized one. Communications would have been easier if it was a real clinician-client interaction.

In our profession,  observing nonverbal cues and silence and empathy would garner additional qualifying patient information to our database. Therapeutic communication is not just confined to asking questions to elicit response.  Touch, sharing hope and humor and empathy can help build rapport. Sometimes providing information, clarifications and confrontation are needed when there are inconsistencies in the patient history.

But the latter can only be done when trust and comfort have been established. Reflection and stating patient observation will bring patient attention to one’s demeanor without cultivating embarrassment. Self-disclosure can promote the therapeutic relationship by providing framework for respect and hope.

While all of these communication techniques are helpful, cultural competence and sensitivity will further reinforce the positive patient-provider relationship.

I need to increase my databank for illness scripts to be able to maximize the potential for clinical reasoning skills while doing physical and assessment. During the actual diagnostic testing of the eyes, ears, mouth and nose, I found it handy to have an ample background knowledge of the normal and abnormal anatomical concepts of human body systems.  It helps to focus on the details that may contribute to the current health concern.

However, my limited exposure to the use of otoscope and ophthalmoscope, I unfortunately had to repeat my examination procedure to make sure that I correctly diagnosed the abnormality that I saw specially in the retinal structure. If it was in the real life situation, it would be comfortable for the patient and detrimental to the trusting relationship that has been established. Realistically, professionals can ask colleagues or a physician if there’s something that was unsure of in terms of abnormal findings.

N522PE-20A Advanced Physical Assessment Course Papers References:

• Benedetti, J., By, Benedetti, J., &amp; Last full review/revision Feb 2019| Content last modified  Feb 2019. (n.d.). Description of Skin Lesions – Dermatologic Disorders. Retrieved September 27, 2020, from https://www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/description-of-skin-lesions
• Leoni-Scheiber, C., Mayer, H., &amp; Müller-Staub, M. (2019, November 8). Relationships between the Advanced Nursing Process quality and nurses’ and patient’ characteristics: A cross-sectional study. Retrieved September 28, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6917982/

796 words

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In reply to Honey Variacion Brojan N522PE-20A Advanced Physical Assessment Course Papers

Re: Discussion 2

by Dona – Monday, September 28, 2020, 5:46 PMGreat start. Describe the characteristics of a rash caused by tinea.

11 words

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In reply to Dona Clarin

Re: Discussion 2 – N522PE-20A Advanced Physical Assessment Course Papers

by Honey – Monday, September 28, 2020, 7:59 PM

The term “tinea” exclusively refers to dermatophyte infections. Dermatophyte (tinea) infections are common fungal infections of the skin, hair, and nails and are classified according to body site. Dermatophytes are filamentous fungi that metabolize and subsist upon keratin in the skin, hair and nails.

The major clinical subtypes are tinea capitis (scalp), tinea corporis (skin other than bearded area, feet, groin, face, scalp or beard hair), tinea barbae/sycosis/barber’s itch (beard), tinea pedis (foot), tinea cruris (groin, perineum, and perineal areas), tinea manuum (hands) and tinea unguium (nail) also called dermatophyte onychomycosis.

Dermatophytes cause a red skin rash that forms around a normal-looking skin. Tinea infections or dermatophytosis symptoms include ring-shaped rash, itchy skin, red-scaly cracked skin and hair loss. Clinical picture of the rash is a circular or ovoid in appearance with patches and plaques with sharp marginations and raised erythematous scaly edge which may contain vesicles.

The lesions advance centrifugally from a core, leaving a central clearing and mild residual scaling; this appears as a “ring” like pattern thus the term “ringworm.” Tinea infections are spread by skin-to-skin contact, and usually favors warm weather. Treatment includes topical or oral anti fungal.

Subclassifications of dermatophytosis or tinea infections

Tinea capitis – scaly, itchy red circular bald spot; Rounded, patchy hair loss on scalp, leaving broken-off hairs, pustules, and scales on skin; mostly affects children; can be confused with dandruff or cradle cap.
Tinea barbae – scaly, itchy, red spots on the cheeks, chin, and upper neck; spots may be crusted over or filled with pus, and the affected hair might fall out.
Tinea cruris (jock itch) – scaly, itchy, red spots the moist, warm areas of inner sides of skin folds and thighs; mostly affects boys
Tinea pedis(athlete’s foot) – red, swollen, peeling, itchy skin between the toes; common in adolescents
Tines corporis – hyperpigmented in whites, depigmented in dark-skinned people; on chest, abdomen, back of arms forming multiple circular lesions with clear centers; tinea gladiatorum wrestlers
Tinea unguium – infection of the toenails, and sometimes fingernails; thickened, deformed, and discolored nails instead of a rash.
Tinea manuum – slightly raised red, scaly rash in hands
Tinea versicolor or pityriasis versicolor – caused by a slow-growing fungus (Pityrosporum orbiculare) that is a type of yeast. It is a mild infection that can occur on many parts of the body.

N522PE-20A Advanced Physical Assessment Course Papers Reference:

Benedetti, J. (2019). Last full review/revision Feb 2019| Content last modified  Feb 2019. (n.d.). Description of Skin Lesions – Dermatologic Disorders. Retrieved September 27, 2020, from https://www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/description-of-skin-lesions

420 words

Module 3

Module Three: Cardiovascular, Peripheral Vascular System & Respiratory Assessment

N522PE-20A Advanced Physical Assessment Course Papers Discussion 3

This week you have studied cardiovascular, peripheral vascular, and respiratory advanced physical assessment. What additional resources for these advanced health assessment skills have you found beneficial in developing your knowledge and psychomotor skills this week?

Post a concept to the discussion board that you have had difficulty with and note where you are with resolution of these difficulties.  Please describe the issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls”. In other words, please include primary sources and/or reliable electronic sources to support your arguments.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria.

N522PE-20A Advanced Physical Assessment Course Papers
Assignment 2

Assignment Instructions:

For this 4-5 page assignment, you will conduct a focused health history and physical assessment based upon your Practice Experience work in Shadow Health. Particularly, you will complete a focused assessment on Danny, a child who is complaining of a cough. Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment.

Submission Parameters:

For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s).

1. Introduction (including purpose statement)
2. Focus of the assessment
   1. Describe the focus of this particular assessment on the patient complaining of a cough
3. Subjective Component
   1. Describe the ROS, PMH, and other relevant data in this section.
4. Objective Component
   1. Describe the physical examination findings including techniques of examination
5. Documented evidence to support clinical reasoning
   1. Describe the list of differential diagnoses
6. Plan of care
   1. Describe the plan of care individualized to findings, life-span stage of development with culturally specific considerations for each focused area of assessment.
7. Conclusion
8. References (use primary and/or reliable electronic sources)

In regards to APA format, please use the following as a guide:

• Include a cover page and running head (this is not part of the 4-5 pages limit)
• Include transitions in your paper (i.e. headings or subheadings)
• Use in-text references throughout the paper
• Use double space, 12 point Times New Roman font
• Apply appropriate spelling, grammar, and organization
• Include a reference list (this is not part of the 4-5 pages limit)
• Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP)

Competency

20

18

16

0

Points Earned

Focus of the Assessment is identified with Special Considerations including Documented Focused Health HistoryDocumentation clearly shows student has completed a focused assessment with identified special considerations including a well-documented focused health history.Documentation supports the student has completed the focused assessment with minimal identification of special concerns. The focused health history is documented.Documentation supports the student has completed the focused assessment without identification of special concerns. The focused health history is documented and lacks depth and specificity of weekly topic.Documentation supports the student attempted to complete the focused assessment without identification of special concerns. The focused health history is briefly documented and lacks depth and specificity of weekly topic./202018160Documented Physical Examination Findings including Techniques of ExaminationDocumentation clearly shows student has completed the physical examination and accurately describes the techniques of examination for the week.Documentation supports the student has completed the physical examination and describes the techniques of examination for the week.Documentation supports student completed some of the physical examination for the focused assessment of the week. Documentation is accurate but lacks depth.No evidence that the student is applying read concepts of advanced focused physical assessment. Documentation lacks depth and may lack coherence for understandability of tasks completed in this week./202018160Documented Evidence to Support Clinical Reasoning with External Course ResourcesDiscourse clearly shows the student has studied the topic and has given thought to the focused assessed topic and documentation for the week.Discourse supports the student has studied the topic and has given thought to the focused assessment topic and documentation for the week.Discourse supports student studied some of the topic for the focused assessment topic this week. Discourse is accurate but lacks depth.No evidence that that student has read or studied the topic.
Discourse lacks depth. May be presented in a rambling manner.
Content is inaccurate &/or is unclear./202018160Individualized Plan of Care Based Upon Clinical FindingsAccurately presents an individualized plan of care based upon clinical findings.Presents an individualized plan of care based upon clinical findings. Some minor omissions are noted.Presents a plan of care that is not individualized based upon the clinical findings.A plan of care is not presented or the plan of care presented lacks demonstration of competency or is irrelevant to the clinical findings./205430Developmentally and Culturally SpecificAccurately documents a developmentally and culturally specific assessment and plan of care for the selected patient.Documents a developmentally and culturally specific assessment and plan of care.Presents a developmentally and culturally specific assessment or plan of care and one or both are not based upon the selected patient.A developmentally and culturally specific assessment and plan of care are not presented or based upon the selected patient’s findings./55430Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice

Compliance with the ethical and legal standards of professional nursing practice is explicitly stated in the documentation of the focused physical assessment.

Compliance with the ethical and legal standards of professional nursing practice is stated in the documentation.Compliance with the ethical and legal standards of professional nursing practice is briefly implied in the documentation of the focused physical assessment or inaccuracies are evidenced in the written assessment.Compliance with the ethical and legal standards of professional nursing practice is not included in the documentation of the focused physical assessment./510980Grammar, Spelling, and Punctuation APA FormatAPA Format, grammar, punctuation and spelling is accurate with no errors.APA Format, grammar, punctuation and spelling is accurate with less than two types of errors.APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors.APA Format, grammar, punctuation and spelling is accurate with more than five types of errors./10COMMENTS:TOTAL:/100

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Module Four: Gastrointestinal, Breast and Axilla Assessment

Discussion 4 – N522PE-20A Advanced Physical Assessment Course Papers

As you know, abdominal pain can be a challenging patient complaint because it is frequently benign, but can also herald serious acute pathology. The history and physical examination are critical to narrowing the differential diagnosis of abdominal pain and guiding the evaluation. Acute abdominal pain frequently requires urgent investigation and management. Some patients may require the assessment of their airway, breathing, and circulation, followed by appropriate resuscitation.Many patients will require analgesics, which can be administered judiciously without compromising the physical assessment of peritoneal signs. That said, what are the common differential diagnoses of abdominal pain in emergency situations? Also, does your healthcare institution have a specific policy, algorithm and/or protocol on how to assess, manage, and treat abdominal pain? Please share an example of the protocol for abdominal pain from practice or the literature.

Module 5

Module Five: Neurological & Musculoskeletal Assessment

N522PE-20A Advanced Physical Assessment Course Papers Discussion 5

This week you have studied neurological and musculoskeletal advanced physical assessment. While a diverse set of advanced physical assessment skills where do you place your greatest level of confidence and what areas need more development.

What methods do you use to remember assessment of cranial nerves, mental status, or other important clinical assessments of persons with neurological or musculoskeletal problems? Of these areas of advanced physical assessment what psychomotor skill is most challenging for you to accomplish? Why?

Post a concept to the discussion board that you have had difficulty with and note where you are with resolution of these difficulties.  Please describe the clinical issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls”. In other words, please include primary sources and/or reliable electronic sources to support your arguments.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria.

N522PE-20A Advanced Physical Assessment Course Papers Assignment 3

Assignment Instructions:

For this 4-5 page assignment, you will conduct a focused health history and physical assessment based upon your Practice Experience work in Shadow Health. Particularly, you will complete a focused assessment on Brian, an adult who is complaining of chest pain.

Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment.

Submission Parameters:

For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s).

1. Introduction (including purpose statement)
2. Focus of the assessment
   1. Describe the focus of this particular assessment on the patient complaining of chest pain
3. Subjective Component
   1. Describe the ROS, PMH, and other relevant data in this section.
4. Objective Component
   1. Describe the physical examination findings including techniques of examination
5. Documented evidence to support clinical reasoning
   1. Describe the list of differential diagnoses
6. Plan of care
   1. Describe the plan of care individualized to findings, life-span stage of development with culturally specific considerations for each focused area of assessment.
7. Conclusion
8. References (use primary and/or reliable electronic sources)

 

In regards to APA format, please use the following as a guide:

• Include a cover page and running head (this is not part of the 4-5 pages limit)
• Include transitions in your paper (i.e. headings or subheadings)
• Use in-text references throughout the paper
• Use double space, 12 point Times New Roman font
• Apply appropriate spelling, grammar, and organization
• Include a reference list (this is not part of the 4-5 pages limit)
• Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP)

 

Competency

20

18

16

0

Points Earned

Focus of the Assessment is identified with Special Considerations including Documented Focused Health HistoryDocumentation clearly shows student has completed a focused assessment with identified special considerations including a well-documented focused health history.Documentation supports the student has completed the focused assessment with minimal identification of special concerns. The focused health history