Posts in category: Nursing Papers

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM Discussion 6

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM Discussion 6.

In Week 1, you developed your practicum professional development objectives. How have your experiences thus far in the practicum contributed to your growth as nurse leader-manager or nurse informaticist? What difficulties, if any, have you experienced, and how might this affect the achievement of your objectives?

In this Discussion, you assess your progress toward fulfilling your practicum professional development objectives and consider how you could enhance or alter your activities to achieve your aims.
To prepare:
Reflect on the practicum professional development objectives you developed and outlined in your Practicum Professional Experience Plan in Week 1.
Keeping in mind the practicum activities you have engaged in thus far, consider the following questions:
How have these activities helped to promote your professional development?
Are you satisfied with your progress toward meeting your objectives? If not, what will you do to ensure you achieve them before the end of your Practicum Experience? As a reminder, you must complete all of your practicum hours on or before Day 5 of Week 11.
What challenges or unexpected opportunities have arisen at your practicum site? How has this affected your professional development?
Think about the experiences you may have in the forthcoming weeks. Do you foresee any particular challenges on the horizon? If so, what is your plan for addressing those challenges?
Think about the time you have spent with your Preceptor. How has this time enhanced or changed your understanding of the role and functions of the nurse leader-manager or nurse informaticist?
Post an assessment of your progress toward achieving your practicum professional development objectives, including how your involvement in specific practicum activities has contributed to your development. Explain what you will do to ensure you achieve your objectives by the end of your practicum. Summarize challenges or unexpected opportunities that have arisen, as well as any challenges that you anticipate may arise. Explain how you will address those challenges. Finally, summarize what you have learned about the role and functions related to your specialization through time spent with your Preceptor.
Read a selection of your colleagues’ responses.
Respond to at least two of your colleagues on two different days, using one or more of the following approaches:
Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Validate an idea with your own experience and additional research.
Required Readings
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Cipriano, P. F., & Murphy, J. (2011). The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 286–289.
Note: Retrieved from the Walden Library databases.

“Technology tools will continue to revolutionize how we plan, deliver, document, review, evaluate, and derive the evidence about care” (p. 289). This article examines how nurses can use information technology to transform nursing and redesign the health care system. It focuses on the use of technology to promote quality and notes that technology can also be used to address challenges in education, research, leadership, and policy.
McKimm, J., & Swanwick, T. (2009). Setting learning objectives. British Journal of Hospital Medicine, 70(7), 406–409.
Note: Retrieved from the Walden Library databases.

This article clarifies the terminology associated with learning objectives and explains how learning objectives relate to professional development and the transformation from novice to expert. It also introduces common pitfalls when setting learning objectives and provides suggestions for avoiding them.
Murphy, J. (2011). The nursing informatics workforce: Who are they and what do they do? Nursing Economic$, 29(3), 150–153.
Note: Retrieved from the Walden Library databases.

The author examines the nursing informatics workforce, explaining that professionals in this well-established specialty area can play an integral role in transforming health care.
Sørensen, E. E., Delmar, C., & Pedersen, B. D. (2011). Leading nurses in dire straits: Head nurses’ navigation between nursing and leadership roles. Journal of Nursing Management, 19(4), 421–430.
Note: Retrieved from the Walden Library databases.

“Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity” (p. 421). In this article, the authors examine how individuals in key professional roles negotiate between and apply nursing and leadership skills.
Warm, D., & Thomas, B. (2011). A review of the effectiveness of the clinical informaticist role. Nursing Standard, 25(44), 35–38.
Note: Retrieved from the Walden Library databases.

The authors investigate the application of specialized knowledge and expertise to facilitate the appropriate use of emerging technologies in clinical settings. They argue for informaticists’ involvement in strategic development and delivery of information management and technology initiatives to promote patient-centered outcomes.
Wilkinson, J. E., Nutley, S. M., & Davies, H. T. O. (2011). An exploration of the roles of nurse managers in evidence-based practice implementation. Worldviews on Evidence-Based Nursing, 8(4), 236–246.
Note: Retrieved from the Walden Library databases.

In this article, the authors examine the role nurse managers should play in leading and facilitating evidence-based practice.
Armstrong, P. (2013). Bloom’s taxonomy. Retrieved from http://cft.vanderbilt.edu/teaching-guides/pedagogical/blooms-taxonomy/

Vanderbilt University provides this overview of Bloom’s taxonomy. This site also presents the original and updated versions of the taxonomy along with verb suggestions for each level.
Clark, D. (2013). Bloom’s taxonomy of learning domains. Retrieved from http://www.nwlink.com/~donclark/hrd/bloom.html

This article addresses three domains of learning: cognitive, affective, and psychomotor.
University of Central Florida, Office of Experiential Learning (n.d.). Writing SMART learning objectives, Retrieved from http://explearning.ucf.edu/registered-students/tips-for-success/writing-smart-learning-objectives/195

This blog post focuses on the distinction between learning outcomes and objectives. Consider this information as you develop your practicum professional development objectives this week.
The University of North Carolina at Charlotte, Center for Teaching & Learning. (2013). Writing objectives using Bloom’s taxonomy. Retrieved from http://teaching.uncc.edu/articles-books/best-practice-articles/goals-objectives/writing-objectives-using-blooms-taxonomy

This resource outlines elements of Bloom’s Taxonomy.
Document: Practicum Professional Experience Plan (Word Document)

Use this form to develop your Practicum Professional Experience Plan as outlined this week.
Document: Practicum Professional Experience Plan (Word Document)

Use this form to develop your Practicum Professional Experience Plan as outlined this week.
Document: Practicum Journal (Word Document)

During your Practicum Experience, you are  required to submit your time log and three journal entries. You will use this  form to complete your journal reflections.
Document: School of Nursing Practicum Manual: Master of Science in Nursing (MSN): Quarter-Based Programs (PDF)

This comprehensive manual outlines all of the requirements for the Practicum Experience.
Clinical Resources
Document: Introduction to Clinical Experiences (PowerPoint)

NURS-6050N-66/NURS-6050C-66-Policy & Advocacy -For Walden University

NURS-6050N-66/NURS-6050C-66-Policy

NURS-6050N-66/NURS-6050C-66-Policy & Advocacy -For Walden University. Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.
To Prepare:
· Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
· Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
· Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
· Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.
The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)
Part 1: Agenda Comparison Grid
Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:
· Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
· Describe the administrative agenda focus related to the issue you selected.
· Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
· Explain how each of the presidential administrations approached the issue.
Part 2: Agenda Comparison Grid Analysis
Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:
· Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
· How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
· Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
Part 3: Fact Sheet or Talking Points Brief
Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:
· Summarize why this healthcare issue is important and should be included in the agenda for legislation.

Case Study: 76-year-old female patient complains of weight gain

Case Study: 76-year-old female patient complains

Case Study. 76-year-old female patient complains of weight gain, shortness of breath, peripheral edema, and abdominal swelling. She has a history of congestive heart failure and admits to not taking her diuretic, as it makes her “have to get up every couple hours to go to the bathroom.” She now has to sleep on two pillows in order to get enough air.

Case Study Analysis
An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.
Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.
An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.
Assignment (2-3-page case study analysis)
In your Case Study Analysis related to the scenario provided, explain the following

• The cardiovascular and cardiopulmonary pathophysiologic      processes that result in the patient presenting these symptoms.
• Any racial/ethnic variables that may impact      physiological functioning.
• How these processes interact to affect the patient.

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
· Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
· Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
· Chapter 35: Structure and Function of the Pulmonary System; Summary Review
· Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review
Note: The above chapters were first presented in the Week 3 resources. If you read them previously you are encouraged to review them this week.
Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062
MedCram. (2015, September 14). Pneumonia explained clearly by MedCram [Video file]. Retrieved from /orders/www.youtube.com/watch?v=nqyPECmkSeo

NURS 6053 Week 1 Discussion: Review Of Current Healthcare Issues – Completed Sample Paper Included

NURS 6053 Week 1 Discussion: Review Of Current Healthcare Issues

NURS 6053: Discussion 1 Review of Current Healthcare Issues

Student’s Name:

Institutional Affiliation:

Healthcare Challenge

One of the most significant national healthcare issues in the US today is burnout and stress among health care workers. Although health care is an inherently high-stress field due to witnessing patients’ agony and loss of life, there is a worsening rate of stress and burn out. Studies show that nearly half of the US healthcare workers report at least one symptom of burnout, such as emotional and physical exhaustion, low job satisfaction, and depersonalization (Dyrbye, Shanafelt, Sinsky, Cipriano, Bhatt, Ommaya & Meyers, 2017). The healthcare issue may impact the healthcare work setting. It can impair the ability of health workers to connect with patients in meaningful ways and fully concentrate on patient care, resulting in reduced productivity, increased nurse turnover, and risk of suicide among caregivers. This can compromise the quality and safety of care. It can also increase the risk of medical errors and hospital-acquired infections (Jacobs, McGovern, Heinmiller & Drenkard, 2018).

The healthcare challenge can be attributed to various factors. The most significant factor is the rising pressures to produce better outcomes at lower costs in the U.S. health care system. As a result, care providers take the most significant role in implementing the value-based care system. Due to the pressure from the Centre of Medicare Services, healthcare organizations are putting pressure on their employees to change the method of practice. Although the shift is suitable for patients, health workers bear the most significant burden (Park, Gold, Bazemore & Liaw, 2018). In my health system work setting, several initiatives have been implemented to address the issue. Shorter work shifts have been designed to allow health workers time for personal life. Implementing an electronic health record system and employing administrators to handle clerical duties has reduced the care providers’ workload (Shanafelt & Noseworthy, 2017). To improve job satisfaction, participatory decision making where health workers’ views are considered in decision making has been adopted. Additionally, counseling and stress management programs are offered to healthcare workers in the work environment.

References

Dyrbye, L. N., Shanafelt, T. D., Sinsky, C. A., Cipriano, P. F., Bhatt, J., Ommaya, A., … & Meyers, D. (2017). Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care. NAM perspectives.

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: moving from the triple aim to the quadruple aim. Nursing administration quarterly, 42(3), 231-245.

Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the quadruple aim. The Journal of the American Board of Family Medicine, 31(4), 588-604.

Shanafelt, T. D., & Noseworthy, J. H. (2017, January). Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. In Mayo Clinic Proceedings (Vol. 92, No. 1, pp. 129-146). Elsevier.

NURS 6052 Evidence-Based Project Part 1

NURS 6052 Evidence-Based Project Part 1

Identifying Research Methodologies. When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.

• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.

• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.

• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.

A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. NURS 6052 Evidence-Based Project Part 1

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. NURS 6052 Evidence-Based Project Part 1

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NURS 6521 Week 8 Discussion: Decision Making When Treating Psychological Disorders

Discussion: Decision Making When Treating Psychological Disorders

. Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.  For this Discussion, you will select an interactive media piece to practice decision-making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology.

To Prepare

• Review this week’s interactive media pieces and select one to focus on for this Discussion.
• Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.

Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.

Adult/Geriatric Depression Hispanic Male With MDD

BACKGROUND INFORMATION
The client is a 70 year-old Hispanic American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to your office for an initial appointment for complaints of depression. The client was referred by his PCP after “routine” medical work-up to rule out an organic basis for his depression. He has no other health issues with the exception of some occasional back pain and “stiff” shoulders which he attributes to his current work as a laborer in a warehouse.
SUBJECTIVE
During today’s clinical interview, client reports that he always felt like an outsider as he was “teased” a lot for being “black” in high school. States that he had few friends, and basically kept to himself. He describes his home life as “good.” Stating “Dad did what he could for us, there were 8 of us.” He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in “trouble” at work.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and event. He is casually dressed. Speech is clear, but soft. He does not readily make eye contact, but when he does, it is only for a few moments. He is endorsing feelings of depression. Affect is somewhat constricted, but improves as the clinical interview progresses. He denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment and insight appear grossly intact. He is currently denying suicidal or homicidal ideation. You administer the “Montgomery- Asberg Depression Rating Scale (MADRS)” and obtained a score of 51 (indicating severe depression).

Assignment Evidence-Based Project: Part 1

Evidence-Based Project, Part 1: Identifying Research Methodologies. Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.
Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.

A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied

Breast, Genital, Prostate, And Rectal/Genitalia Assessment

Breast, Genital, Prostate, And Rectal/Genitalia Assessment

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

To Prepare

• Review the Episodic note case study for this week’s Assignment.
• Based on the Episodic note case study:
  • Review this week’s Learning Resources, and consider the insights they provide about the case study. Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab Assignment.
  • Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided.
  • Consider what history would be necessary to collect from the patient in the case study.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
  • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Lab Assignment

Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.

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

Week 10 Assignment: Special Examinations—Breast, Genital, Prostate, and Rectal/Genitalia assessment
Subjective:
CC: “I have bumps on my bottom that I want to have checked out.”
HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.
PMH: Asthma
Medications: Symbicort 160/4.5mcg
Allergies: NKDA
FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD
Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)
Objective:
VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs
Heart: RRR, no murmurs
Lungs: CTA, chest wall symmetrical
Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia
Abd: soft, normoactive bowel sounds, neg rebound, neg Murphy’s, neg McBurney
Diagnostics: HSV specimen obtained
Assessment:
Chancre
PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

By Day 7 of Week 10