nsg6340 all week discussions latest 2018 january
Week 1 discussion
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The discussion assignment provides a forum for discussing
relevant topics for this week based on the course competencies covered.
For this assignment, post a response to one question in the
Discussion Area by the due date assigned. You may respond to your classmates’
postings for either question.
To support your work, use your course and text readings and
also use the South University Online Library. As in all assignments, cite your
sources in your work and provide references for the citations in APA format.
Start reviewing and responding to the postings of your
classmates as early in the week as possible. Respond to at least two of your
classmates’ initial postings. Participate in the discussion by asking a
question, providing a statement of clarification, providing a point of view
with a rationale, challenging an aspect of the discussion, or indicating a
relationship between two or more lines of reasoning in the discussion. Cite
sources in your responses to other classmates. Complete your participation for
this assignment by the end of the week.
You are an adult gerontology nurse practitioner working in a
community health center. You are seeing a 14-year-old adolescent patent for an
annual visit. The patient’s mother is also present during the visit and notes
that the patient’s grades in school have been declining. Her son is also
hanging out with a group of kids that she has concerns about. The mother has
concerns for what is going on with her son. Answer the following questions
using course resources (texts) and two other evidence-based sources (current
guidelines and/or scholarly articles that are within a 3-5 year time frame).
What are the components of an annual exam for an adolescent
patient?
Is the mother required to be present during your exam?
Describe 1 health promotion idea that you would discuss with
your middle adolescence patient. Why is this idea important?
What are some screening tools that might be of importance in
this situation? (hint: do you suspect drug or alcohol abuse here?)
Week 2 discussion
This week you learned about common conditions in the
adolescent client. Please review the
following case study and answer the following questions.
A fifteen-year-old female presents to your clinic
complaining of shortness of breath and a nonproductive nocturnal cough. She
states she used to feel this way only with extreme exercise, but lately, she
has felt this way continuously. She denies any other upper respiratory
symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her
past medical history is significant only for seasonal allergies, for which she
takes a nasal steroid spray but is otherwise on no other medications. She has
had no surgeries. Her mother has allergies and eczema, and her father has high
blood pressure. She is the only child. She denies smoking and illegal drug use.
On examination, she is in no acute distress and her vital signs are: T 98.6, BP
120/80, pulse 80, and respirations 20. Her head, eyes, ears, nose, and throat
examinations are essentially normal. Inspection of her anterior and posterior
chest shows no abnormalities. On auscultation of her chest, there is decreased
air movement and high-pitched whistling on expiration in all lobes. Percussion
reveals resonant lungs.
What is the chief complaint?
Based on the subjective and objective information provided
what are your 3 top differential diagnosis listing the presumptive final
diagnosis first?
What treatment plan would you consider utilizing current
evidence based practice guidelines?
Submission Details:
Post your response to the Discussion Area by the due date
assigned. Respond to at least two posts by the end of the week.
Week 3 discussion
In Week 3 you learned about other common adolescent health
conditions. Review the following case
study and answer the following questions:
An 18 year old white female presents to your clinic today
with a 2 week history of intermittent abdominal pain. She also is positive for periodic cramping
and diarrhea as well as low grade fever.
She also notes reduced appetite. She notes that She admits smoking ½ PPD
for the last 2 years. Denies any illegal drug or alcohol use. Does note a
positive history of Crohn’s Disease.
Based on the information provided answer the following questions:
What are the top 3 differentials you would consider with the
presumptive final diagnosis listed first?
What focused physical exam findings would be beneficial to
know?
What diagnostic testing needs completed if any to confirm
diagnosis?
Using evidence based treatment guidelines note a treatment
plan.
Submission Details:
Post your response to the Discussion Area by the due date
assigned. Respond to at least two posts by the end of the week.
Week 4 discussion
This week’s content addressed common chronic diseases. Please review the case study below and answer
the following questions:
A sixty-year-old baker presents to your clinic, complaining
of increasing shortness of breath and nonproductive cough over the last month.
She feels like she can’t do as much activity as she used to do without becoming
tired. She even has to sleep upright in her recliner at night to be able to
breathe comfortably. She denies any chest pain, nausea, or sweating. Her past
medical history is significant for high blood pressure and coronary artery
disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is
married and is retiring from the local bakery soon. She denies any tobacco,
alcohol, or drug use. Her mother died of a stroke, and her father died from
prostate cancer. She denies any recent upper respiratory illness, and she has
had no other symptoms. On examination, she is in no acute distress. Her blood
pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory
rate is 16. With auscultation, she has distant air sounds and she has late
inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2
are distant and an S3 is heard over the apex.
What is the chief complaint?
Based on the subjective and objective information provided
what are your 3 top differential diagnosis listing the presumptive final diagnosis
first?
What treatment plan would you consider utilizing current
evidence based practice guidelines?
Submission Details:
Post your response to the Discussion Area by the due date
assigned. Respond to at least two posts by the end of the week.
Week 5 discussion
The discussion assignment provides a forum for discussing
relevant topics for this week based on the course competencies covered.
For this assignment, go to the Discussion Area and post a
response to one question in the Discussion Area by the due date assigned. You
may respond to your classmates’ posts for either question.
To support your work, use your course and text readings and
also use the South University Online Library. As in all assignments, cite your
sources in your work and provide references for the citations in APA format.
Start reviewing and responding to the postings of your
classmates as early in the week as possible. Respond to at least two of your
classmates’ initial postings. Participate in the discussion by asking a
question, providing a statement of clarification, providing a point of view
with a rationale, challenging an aspect of the discussion, or indicating a
relationship between two or more lines of reasoning in the discussion. Cite
sources in your responses to other classmates. Complete your participation for
this assignment by the end of the week.
As an adult gerontology nurse practitioner you are working
in a rural health clinic. You are evaluating a 16-year-old adolescent patient
who comes in complaining of having a difficulty concentrating in school. On
exam you also note that the patient is very thin and frail in appearance and is
asking you for diet pills.
What are some initial areas for concern? What screening
tools can help lead you closer to your diagnosis?
Describe 1 health promotion strategy you can discuss with
the patient.
Be sure to address the following in your plan of care:
pharmacological and non-pharmacological (OTC) interventions, labs, follow-up,
teaching, and referral/s.
Your work should integrate course resources (text/s) as well
as a minimum of two (2) other evidence-based guidelines and/or articles
published within 3-5 years.
Centers for Disease Control and Prevention. (2013). Youth
risk behavior surveillance system
(YRBSS). Retrieved from http://www.cdc.gov/healthyyouth/data/yrbs/ index.htm
Week 6 discussion
This week’s content discussed common psychiatric disorders
in the Adult and Older Adult client.
Often times a secondary diagnosis is masked due to their psychiatric
disorder. Review the following case study
and answer the following questions.
Mr. White is a 72-year-old man, with a history of
hypertension, COPD and moderate dementia, who presents with 4 days of increased
confusion, nighttime restlessness, visual hallucinations, and urinary
incontinence. His physical exam is unremarkable except for tachypnea, a mildly
enlarged prostate, inattentiveness, and a worsening of his MMSE score from a
baseline of 18 to 12 today.
Mr. White’s presentation is most consistent with an acute
delirium (acute change in cognition, perceptual derangement, waxing and waning
consciousness, and inattention).
What is the most likely diagnosis to frequently cause acute
delirium in patients with dementia?
What additional testing should you consider if any?
What are treatment options to consider with this patient?
Submission Details:
Post your response to the Discussion Area by the due date
assigned. Respond to at least two posts by the end of the week.
Week 7 discussion
This week’s content addressed common techniques and testing
that can be prescribed by the Nurse Practitioner. Review ONE of the following videos and post
for the class what you have learned this week:
Watch the following video on suturing
Suture Skills Course
Watch the following video on EKG rhythms
ecg-simulator
Submission Details:
Post your response to the Discussion Area by the due date
assigned. Respond to at least two posts by the end of the week.
Week 8 discussion
This week’s content discussed in part barriers to health
care. Health literacy is a common
barrier to health care. Please review
the following utube videos on health literacy and answer the following questions:
IOM health literacy video. (2002). Retrieved from
https://www.youtube.com/watch?v=39A9oU-gOOA
Health Literacy: A Prescription to End Confusion – Patients
Health Literacy
What are your initial thoughts after viewing these videos?
What are some strategies you can incorporate in every day
practice to assist with health literacy?
Submission Details:
Post your response to the Discussion Area by the due date
assigned. Respond to at least two posts by the end of the week.
Week 9 discussion
This week’s content addressed professional and legal issues,
state boards of nursing, advanced practice licensure, regulations, scope of
practice, and national certification as an advanced practice nurse. It is your
responsibility to look at your individual board of nursing and remain up to
date with the changes that are carried out in your state. For this week’s discussion review your states
scope of practice and address 3 areas that you were not aware you can do as a
licensed provider in your state.
Submission Details:
Post your response to the Discussion Area by the due date
assigned. Respond to at least two posts by the end of the week.
Week 10 discussion
Evidence-Based Clinical Intervention
By the due date assigned, submit your Evidence-Based
Clinical Intervention to the Discussion Area.
Your Evidence-Based Clinical Intervention should be
submitted in a Microsoft Word document following APA style and should include
the following:
The medical problem/diagnosis/disease.
Typical presenting signs and symptoms including:
Onset, Characteristics, Location, Radiation, Timing,
Setting, Aggravating factors, Alleviating factors, Associated symptoms, Course
since onset, Usual age group affected
Concomitant disease states associated with the diagnosis
The pathophysiology of the problem.
Three differential diagnoses and the usual presenting signs
and symptoms in priority sequence with rationales.
Reference to at least two current journal articles that show
evidence-based practice as how to best treat this disorder related to the primary
differential.
The expected outcomes of the intervention.
Algorithms if available.
A typical clinical note in SOAP format.
Respond to at least two of your classmates’ Evidence-Based
Clinical Interventions using the lessons and vocabulary found in the reading.
Support your answers with examples and research. Your responses should clarify
your understanding of the topic. They should be your own, original, and free
from plagiarism. Follow the APA format for writing style, spelling and grammar,
and citation of sources.
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