Week 1 discussion

Competencies for Nurse Practitioners

The Consensus Model for APRN Regulation has brought about changes in the competencies for nurse practitioners. There are Core Competencies for all nurse practitioner populations and include both MSN and DNP degrees. Review your Learning Resources Page to examine the Core Competencies.

Family/Across the Lifespan competencies

Adult-Gerontology NP competencies

The major categories of family/across the lifespan competencies include the following: Scientific Foundation; Leadership; Quality; Practice Inquiry; Technology and Information Literacy; Policy; Health Delivery System; Ethics; and Independent Practice. In this Discussion, you explore the nine competencies, and their application to the clinical setting.

The adult-gerontology NP competencies are different and students in that specialty should become familiar with them.

To prepare:

Review this week’s media presentation with Dr. Terry Buttaro, as well as the “Nurse Practitioner Self-Appraisal Guide” in the Learning Resources. Review the Consensus Model for APRN Regulation and the National Organization for Nurse Practitioner Faculties Core Competencies and population foci competencies.

Consider the following nine competencies (Note: By Day 1 of this week, your Instructor will assign you to post on one of these nine competencies):

Scientific Foundation

Leadership

Quality

Practice Inquiry

Technology and Information Literacy

Policy

Health Delivery System

Ethics

Independent Practice

Reflect on the category that was assigned to you by the Course Instructor. Think about how you would implement this competency in a clinical setting. Consider evidence-based clinical practice.

Post on or before Day 3 a brief description of the competency that was assigned to you. With your competency description in mind, explain how you would implement it in a clinical setting. Support your rationale with evidence from current research.

 

 

Week 2 discussion

Diagnosing Skin, Eye, Ear, and Throat Disorders

When entering examination rooms, advanced practice nurses often immediately begin assessing patients by looking for external abnormalities such as skin irritations or cloudy eyes. By making these simple observations, they can determine how to proceed with their patient evaluations. During the patient evaluation, advanced practice nurses will use initial observations to guide them in acquiring the necessary medical history, performing additional assessments, and ordering the appropriate diagnostics. The information obtained during this evaluation process will help in the development of a differential diagnosis. Once a diagnosis is made, the advanced practice nurse can consider potential treatment options and work with the patient to develop a plan of care. For this Discussion, consider the following four case studies of patients presenting with skin, eye, ear, and throat disorders

Case Study 1:

A 46-year-old male presents to the office complaining of a pruritic skin rash that has been present for a few weeks. He initially noted the rash on his chest, but it then spread to his back and arms. He notes that it does not seem to be on his legs. He recently came home from a trip to Florida, but denies fever, chills, new soaps or detergents, other travel, or known insect bites. He takes occasional ibuprofen for knee pain, but denies taking other medications or having other health problems. He has no known drug allergies. The physical examination reveals a male with a deep tan and notable scattered 1–1.5-centimeter, flat, circular, light-colored patches on his chest, back, and upper extremities.

Case Study 2:

An 86-year-old widowed female is brought to the office by her daughter-in-law. The patient complains of constant tearing and an itchy, burning sensation in both eyes. The patient states this is not a new problem, but it has worsened in the past week and is affecting her vision. The patient complains that her eyes are dry. She thinks the problem must be caused by one of her medications. Her patient medical history is positive for hypertension, atrial fibrillation, and heart failure. She has an allergy to erythromycin that causes rash and elevated liver enzymes. Medications currently prescribed include Furosemide 40 milligrams po twice a day, diltiazem 240 milligrams po daily, lisinopril 20 milligrams po daily, and warfarin 3 milligrams po daily. The physical examination reveals a frail older female with some facial dryness and slight scaling. Her visual acuity is 20/60 OU, 20/40 OD, 20/60 OS. The eyelids are erythematous and edematous with yellow crusting around the lashes. Sclera are injected, conjunctiva are pale, and pupils are equal and reactive to light and accommodation.

Case Study 3:

A middle-aged male presents to the office complaining of a two-day history of a left earache. The onset was gradual, but has steadily been increasing. It has been constantly aching since last night, and his hearing seems diminished to him. Today he thinks the left side of his face may even be swollen. He denies upper respiratory infection, known fever, or chills. His patient medical history is positive for Type 2 diabetes mellitus, hypertension, and hyperlipidemia. The patient has a known allergy to Amoxicillin that results in pruritus. Medications currently prescribed include Metformin 1,000 milligrams po twice a day, lisinopril 20 milligrams po daily, Aspirin 81 milligrams po daily, and simvastatin 40 milligrams po daily. The physical exam reveals a middle aged male at a weight of 160 pounds, height of 5’8”, temperature of 98.8 degrees Fahrenheit, heart rate of 88, respiratory rate of 18, and blood pressure of 138/76. Further examination reveals the following:

Face: Faint asymmetry with left periauricular area slightly edematous

Eyes: sclera clear, conj wnl

L ear: + tenderness L pinna, + edema, erythema, exudates left external auditory canal, TM not visible

R ear: no tenderness, R external auditory canal clear without edema, erythema, exudates

+ tenderness L preauricular node, otherwise no lymphadenopathy

Cardiac: S1 S2 regular. No S3 S4 or murmur.

Lungs: CTA w/o rales, wheezes, or rhonchi.

Case Study 4:

A middle-aged female presents to the office complaining of strep throat. She states she suddenly developed a sore throat yesterday afternoon, and it has gotten worse since then. During the night she felt like she was chilled and feverish. She denies known recent contact with anyone else who had strep throat, but states she has had strep before and it feels like she has strep now. She takes no medications, but is allergic to penicillin. The physical examination reveals a slender female lying on the examination table. She has a temperature of 101 degrees Fahrenheit, heart rate of 112, respiratory rate of 22, and blood pressure of 96/64. The head, eyes, ears, nose, and throat evaluation is positive for bilateral tonsillar swelling without exudates. Her neck is supple with bilateral, tender, enlarged anterior cervical nodes.

To prepare:

Review this week’s media presentations and Parts 5–8 of the Buttaro et al. text.

Select one of the four case studies provided. Reflect on the provided patient information including history and physical exams.

Think about a differential diagnosis. Consider the role the patient history and physical exam played in your diagnosis.

Reflect on potential treatment options based on your diagnosis.

Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study that you selected. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis.

 

Week 3 discussion

Hypertension

In clinical settings, advanced practice nurses frequently use various strategies to treat and manage patients with hypertension and other cardiovascular disorders. These strategies often include pharmacologic and nonpharmacologic therapies, natural remedies, and/or changes in patient behavior. For hypertension patients, behavioral changes including increased exercise, healthier diet, and smoking cessation have proven to be particularly beneficial. However, it is important to recognize that treatment and management plans centered around changes in behavior often require greater patient commitment. This creates the need for patient-provider collaboration, as well as appropriate patient education. When patients are actively involved in their own care and better understand implications of their disorders, they are more likely to adhere to treatment plans.

To prepare:

Review Part 11 of the Buttaro et al. text and the National Heart Lung Blood Institute article in this week’s Learning Resources.

Reflect on your Practicum Experiences and observations. Select a case from these experiences that involves a patient who presented with a hypertension problem. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

Think about the patient’s history including drug treatments and behavioral factors such as diet, exercise, smoking, etc.

Review the National Heart Lung Blood Institute article in the Learning Resources. Reflect on health promotion strategies for the patient. Consider ways to reinforce hypertension management.

Post on or before Day 3 a description of a patient who presented with a hypertension problem during your Practicum Experience. Explain the patient’s history including drug treatments and behavioral factors. Then, suggest two health promotion strategies for the patient. Include suggestions for reinforcing hypertension management.

 

 

Week 4 discussion

DQ1

Blood Clots

Blood clots form in various locations of the body and are not unique to any specific age group or gender. While there are certain risk factors that may make a patient more likely to develop blood clots, essentially any patient is a potential candidate. Unfortunately, blood clots often go unrecognized until something happens. Even if the patient identifies a problem and seeks medical care, blood clots are frequently misdiagnosed resulting in serious medical complications and sometimes death. Why does this happen? How can you, as the advanced practice nurse, protect your patients from misdiagnosis?

Consider the following case studies:

Case Study 1:

A 44-year-old African American male had a partial colectomy to have a cancerous tumor removed. The patient did really well after surgery and was discharged from post-op recovery to the surgical unit at a medical center. Approximately one hour after surgery, the patient complained of gas pains and shortness of breath. The patient continued to complain of gas pains after administration of morphine sulfate. Providers failed to diagnose a pulmonary embolism that resulted in the loss of the patient’s life.

Case Study 2:

A 50-year-old white male went to the emergency department with complaints of right leg pain. The patient is an avid runner, and knowing this, the provider diagnosed the patient with a right leg muscle strain. The patient was sent home with Flexeril as needed and Motrin 800 mg q8h as needed. One week later, the patient followed up with his primary care doctor with continued right leg pain. His doctor instructed him to continue to take the muscle relaxant and Motrin, and advised that the pain should subside in 5–10 days. The following day the right leg pain increased, prompting the patient to return to the emergency department. Multiple providers failed to diagnose a blood clot in the patient’s right leg.

To prepare:

Review Part 11 of the Buttaro et al. text in this week’s Learning Resources.

Select one of the cased studies provided. Reflect on what went wrong in this case study, as well as why patient blood clots continue to be misdiagnosed.

Think about how you might have prevented the misdiagnosis of the patient the case study. Consider strategies for obtaining patient history, ordering diagnostics, and recommending potential treatment options.

Post on or before Day 3 a description of what went wrong in the case study that you selected, as well as why patient blood clots continue to be misdiagnosed. Then, explain how you might have prevented the misdiagnosis of the patient in the study. Include strategies for obtaining patient history, ordering diagnostics, and recommending potential treatment options.

 

DQ2

Types of Anemia

In clinical settings, patients often present with many different types of anemia. Each type of anemia has its own causes and implications. For this reason, you must be able to differentiate between types of anemia as well as identify factors that put patients at greater risk of experiencing related complications. As you prepare for this Discussion, consider the following patient case studies:

Case Study 1:

An 82-year-old female presents to the office complaining of fatigue, dizziness, weakness, and increasing dyspnea on exertion. She has a past medical history of atrial fibrillation, hypertension, and hyperlipidemia. Medications include warfarin 2 milligrams po daily, lisinopril 10 milligrams po daily, and simvastatin 10 milligrams po daily. There are no known drug allergies. The physical exam reveals a 5’2” older female. Her weight is 128 pounds, blood pressure is 144/80, heart rate is 98, temperature is 98 degrees Fahrenheit, and O2 saturation is 98%. Further examination reveals the following:

Eyes: + pallor conjunctiva

Cardiac: irregular rhythm. No S3 S4 or M. NO JVD

Lungs: CTA w/o rales, wheezes, or rhonchi

Abdomen: soft, BS +, + epigastric tenderness. No organomegaly, rebound, or guarding

Rectal: no stool in rectal vault

Case Study 2:

A 28-year old female presents for a routine physical. She has no complaints. Her personal medical history reveals asthma that is well controlled with an albuterol inhaler prn and Advair 250/50 1 puff BID. Social history reveals she is a nursing student who is a non-smoker, rarely uses alcohol, and is mostly vegetarian. Her physical exam is negative, and she is sent for a CBC/differential and lipid profile. Laboratory results reveal the following: Hemoglobin 10, Hematocrit 30.1, MCV increased.

Case Study 3:

A 78-year-old female presents to the emergency room after a fall 3 days ago. She recently had a right above-the-knee amputation and was leaning over to pick something up when she fell. She did not want to come to the hospital, but she is having difficulty managing at home because of the pain in her left leg where she fell. Her patient medical history reveals RAKA, peripheral vascular disease, Type 2 diabetes, and stage 3 chronic kidney disease. Current medications include quinapril 20 milligrams PO daily, Lantus 30 units at bedtime, and Humalog to scale before meals. There are no known drug allergies. The physical exam is negative and x-rays reveal no acute injuries. Laboratory studies reveal a normal white blood cell count: Hgb of 8 and HCT 24. The MCV is normal.

To prepare:

Review Chapter 213 in Part 18 of the Buttaro et al. text.

Select one of the three case studies. Reflect on the provided patient information including history, physical exams, and lab reports.

Think about a differential diagnosis. Consider the role the patient history, physical exam, and lab reports played in the diagnosis.

Reflect on the pathophysiology of the type of anemia that you diagnosed, as well as potential treatment options. Consider the causes of this type of anemia. Think about whether the patient should be referred for specialized care.

 

Week 5 discussion

Examining Chest X-Rays

Chest x-rays are an invaluable diagnostic tool as they can help identify common respiratory disorders such as pneumonia, pleural effusion, and tumors, as well as cardiovascular disorders such as an enlarged heart and heart failure. As an advanced practice nurse, it is important that you are able to differentiate a normal x-ray from an abnormal x-ray in order to identify these disorders. The ability to articulate the results of a chest x-ray with the physician, radiologist, and patient is an essential skill when facilitating care in a clinical setting. In this Discussion, you practice your interprofessional collaboration skills as you interpret chest x-rays and exchange feedback with your colleagues.

Consider the four patient x-rays (Note: By Day 1 of this week, your Instructor will assign you to post on one of these x-rays):

X-ray 1

Note: Please view the Week 5 Discussion area to view the image for X-ray 1.

X-ray 2:

Note: Please view the Week 5 Discussion area to view the image for X-ray 2.

X-ray 3:

Note: Please view the Week 5 Discussion area to view the image for X-ray 3.

X-ray 4:

Note: Please view the Week 5 Discussion area to view the image for X-ray 4.

To prepare:

Review Part 10 of the Buttaro et al. text in this week’s Learning Resources, as well as the provided x-rays.

Reflect on what you see in the x-ray assigned to you by the Course Instructor.Consider whether the patient in your assigned x-ray has an enlarged heart, enlarged blood vessels, fluid in the lungs, and/or pneumonia in the lungs

 

Week 6 discussion

Diagnosing Gastrointestinal Disorders

In primary care settings, patients often present with abdominal pain. Although this is frequently a sign of a gastrointestinal (GI) disorder, abdominal pain could also be the result of other systemic disorders, making this type of pain difficult to assess. While abdominal pain is most common, many other GI symptoms also overlap multiple disorders, further increasing the difficulty in diagnosing and treating patients. This makes provider-patient communication essential. You must be able to formulate questions that will prompt the patient to provide the necessary information, as this will guide your assessment and diagnosis. For this Discussion, consider potential diagnoses for the patients in the following case studies.

Case Study 1:

A 49-year-old man presents to the office complaining of vague abdominal discomfort over the past few days. He states he does not feel like eating and has not moved his bowels for the last 2 days. His patient medical history includes an appendectomy at age 22 and borderline hypertension, which he is trying to control with diet and exercise. He takes no medications and has no known allergies. Positive physical exam findings include a temperature of 99.9 degrees Fahrenheit, heart rate of 98, respiratory rate of 24, and blood pressure of 150/72. The abdominal exam reveals abdominal distention, diminished bowel sounds, and lower left quadrant tenderness without rebound.

Case Study 2:

A 40 year-old female presents to the office with the chief complaint of diarrhea. She has been having recurrent episodes of abdominal pain, diarrhea, and rectal bleeding. She has lost 9 pounds in the last month. She takes no medications, but is allergic to penicillin. She describes her life as stressful, but manageable. The physical exam reveals a pale middle- aged female in no acute distress. Her weight is 140 pounds (down from 154 at her last visit over a year ago), blood pressure of 94/60 sitting and 86/50 standing, heart rate of 96 and regular without postural changes, respiratory rate of 18, and O2 saturation 99%. Further physical examination reveals:

Skin: w/d, no acute lesions or rashes

Eyes: sclera clear, conj pale

Ears: no acute changes

Nose: no erythema or sinus tenderness

Mouth: membranes pale, some slight painful ulcerations, right buccal mucosa, tongue beefy red, teeth good repair

Neck: supple, no thyroid enlargement or tenderness, no lymphadenopathy

Cardio: S1 S2 regular, no S3 S4 or murmur

Lungs: CTA w/o rales, wheezes, or rhonchi

Abdomen: scaphoid, BS hyperactive, generalized tenderness, rectal +occult bloo

Case Study 3:

A 52-year-old male presents to the office for a routine physical. The review of symptoms reveals anorexia, heartburn, and weight loss over the past 6 months. The heartburn is long standing, occurring most days during the week. He takes TUMS or Rolaids to relieve the discomfort. The patient describes occasional use of ibuprofen for back pain, but denies other medications including herbals. He has no known allergies. He was adopted so does not know his family history. Social history reveals that, although he stopped smoking ten years ago, he smoked for 20 years. He occasionally consumes alcohol on the weekends only. The only positive physical exam finding for this patient was slight epigastric tenderness. The remainder of his exam was negative and the rectal exam was negative for blood.

To prepare:

Review this week’s media presentations and Part 12 of the Buttaro et al. text in the Learning Resources.

Select one of the three case studies listed above. Reflect on the provided patient information including history and physical exams.

Think about a differential diagnosis. Consider the role the patient history and physical exam played in diagnosis.

Reflect on potential treatment options based on your diagnosis.

 

Week 7 discussion

Urinary Frequency

Urinary frequency is a genitourinary disorder that presents problems for adults across the lifespan. It can be the result of various systemic disorders such as diabetes, urinary tract infections, enlarged prostates, kidney infections, or prostate cancer. Many of these disorders have very serious implications requiring thorough patient evaluations. When evaluating patients, it is essential to carefully assess the patient’s personal, medical, and family history prior to recommending certain physical exams and diagnostic testing, as sometimes the benefits of these exams do not outweigh the risks. In this Discussion, you examine a case study of a patient presenting with urinary frequency. Based on the provided patient information, how would you diagnose and treat the patient?

Consider the following case study:

A 52-year-old African American male presents to an urgent care center complaining of urinary frequency and nocturia. The symptoms have been present for several months and have increased in frequency over the past week. He has been unable to sleep because of the need to urinate at least hourly all day and night. He does not have a primary care provider and has not seen a doctor in more than 10 years. His father died when he was a child in an automobile accident, and his mother is 79 years old and has hypertension. The patient has no siblings. His social history includes the following: banker by profession, divorced father of two grown children, non-smoker, and occasionally consumes alcohol on weekends only.

To prepare:

Review Part 13 of the Buttaro et al. text in this week’s Learning Resources.

Review the case study and reflect on the information provided about the patient.

Think about the personal, medical, and family history you need to obtain from the patient in the case study. Reflect on what questions you might ask during an evaluation.

Consider types of physical exams and diagnostics that might be appropriate for evaluation of the patient in the study.

Reflect on a possible diagnosis for the patient.

Review the Marroquin article in this week’s Learning Resources. If you suspect prostate cancer, consider whether or not you would recommend a biopsy.

Think about potential treatment options for the patient.

Post on or before Day 3 a description of the history that you need to obtain from the patient in the case study. Include a list of questions that you might ask the patient. Then, describe types of physical exams and diagnostics that might be appropriate for evaluation of the patient. Finally, explain a possible diagnosis, as well as potential treatment options for the patient based on this diagnosis.

 

Week 8 discussion

Electrolyte Disorders

When an electrolyte disorder occurs, it disrupts the balance of ionized salts in the blood. Since electrolytes regulate physiological functions in the body, if left untreated, electrolyte disorders can cause harm to multiple body systems. This results in a variety of symptoms which are sometimes severe and life threatening. In this Discussion, you explore common electrolyte disorders and their potential causes, as well as the impact of the disorders on patients.

To prepare:

Review Chapters 207, 208, and 241 of the Buttaro et al. text, as well as the Adams et al. and Assadi articles in this week’s Learning Resources.

Select one of the following electrolyte disorders: hyperkalemia and hypokalemia; hypercalcemia and hypocalcemia; hypernatremia and hyponatremia; hypermagnesemia and hypomagnesemia. Reflect on signs and symptoms of this disorder.

Consider potential causes of the disorder that you selected. Reflect on whether that disorder is iatrogenic or a result of prescribed drugs.

Think about the impact of this electrolyte disorder on patients. Consider how the disorder affects other body systems.

Post on or before Day 3 a description of the electrolyte disorder that you selected as well as signs and symptoms. Then, explain potential causes of the disorder including whether it is iatrogenic or a result of prescribed drugs. Finally, describe the impact of the disorder on patients and their body systems.

 

Week 9 discussion

Chronic Back Pain

Patients frequently present with complaints of pain such as chronic back pain. They often seek medical care with the intent of receiving drugs to manage the pain. Typically, for this type of pain, narcotic drugs are often prescribed. This can pose challenges for you as the advanced practice nurse prescribing the drugs. While there is a process for evaluating back pain, it can be difficult to assess the intensity of a patient’s pain because pain is a subjective experience. Only the person experiencing the pain truly knows whether there is a need for drug treatments. This makes it important for you, as the prescriber, to watch for red flags and warning signs of abuse. In this Discussion, you explore the ethical implications of prescribing narcotics to patients with chronic back pain.

To prepare:

Review this week’s media presentation on evaluating back pain, as well as Chapter 15 of the Buttaro et al. text in the Learning Resources. Reflect on the evaluation process for a patient with a history of back pain.

Consider how you might evaluate a patient that presents with back pain. Think about potential red flags and warning signs of drug abuse.

Reflect on the ethical implications of prescribing narcotics for chronic back pain.

Think about what you would prescribe and why.

Post on or before Day 3 a description of how you might evaluate a patient who presents with back pain. Then, describe potential red flags and warning signs of drug abuse. Explain the ethical implications of prescribing narcotics for chronic back pain. Finally, explain what you would prescribe for patients and why.

 

 

 

Week 10 discussion

Stroke Prevention Media

Note: You will complete this week’s Discussion after you complete this week’s Assignment

In this Discussion, you provide and receive feedback on the stroke prevention media created in this week’s Assignment. This exchange between you and your colleagues is an opportunity to practice your interprofessional collaboration skills, which are an essential rudiment of nursing practice. In clinical settings, you must be able to articulately express your thoughts and communicate with colleagues. This Discussion is designed to help you improve this skill, as well as encourage you to listen to your colleagues and acknowledge that all views are valid and worthy of consideration. As you review the stroke prevention media piece created by your colleagues, keep the best interests of the specific patient population in mind. Use the feedback you receive to refine your own stroke prevention media prior to submitting the final Assignment in Week 11.

Post on or before Day 4 a description of the stroke prevention media piece that you created. Include the details of your educational media, and if possible, a copy of the actual media piece. Explain why you selected the particular type of media and how and why it is suitable for your patient population.

 

 

Week 11 discussion

Diabetes

In the United States, 25.6 million adults age 20 years or older have diabetes (American Diabetes Association, 2011). If not properly treated and managed, these millions of diabetic patients are at risk for several alterations including heart disease, stroke, kidney failure, neuropathy, and blindness. Proper treatment and management is the key for diabetic patients, and as the advanced practice nurse providing care for these patients, it is your responsibility to facilitate this process. Patient education is critical, as is working with patients to establish a regular pattern for daily activities such as eating and taking medications. When developing care plans for patients, you must keep the projected outcomes of treatment in mind, as well as patient preferences and other factors that might impact adherence to treatment and management plans. In this Discussion, you draw from your Practicum Experience and consider factors that impact the education and treatment of patients with diabetes.

To prepare:

Review Chapter 205 in Part 17 of the Buttaro et al. text.

Reflect on the clinical presentation of diabetes, as well as your Practicum Experiences and observations. Select a case from these experiences that involve a diabetic patient. When referring to the patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

Recall the medical details of the patient in the case that you selected including patient history, clinical presentation, physical exams, diagnostics, and the recommended treatment plan.

Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the treatment plan and patient education strategies.

Post on or before Day 3 a description of the case that you selected including the diabetic patient’s medical details. Then, explain how the factor that you selected might impact the treatment plan and patient education strategies.

 

 

 

Week 4 assignment

Week 1 question

Assignment: Practicum Experience – Journal Entry

As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your Practicum Experience. By applying the concepts that you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment such as Journal Entries and SOAP Notes that prompts you to reflect on your Practicum Experiences and relate them to the material presented in the classroom. This week, you begin documenting your Practicum Experiences in your Practicum Journal.

To prepare for this course’s Practicum Experience, address the following in your Practicum Journal:

Select and describe a nursing theory to guide your practice.

Develop goals and objectives for your Practicum Experience in this course. When developing your goals and objectives, be sure to keep the seven domains of practice in mind.

Create a timeline of practicum activities based on your practicum requirements.

By Day 7 of Week 4

This Assignment is due. You will submit this Week 1 Journal Entry, along with the Week 2 Journal Entry, the Week 3 SOAP Note, and Week 4 Journal Entry by Day 7 of Week 4.

Week 2 question

Assignment: Practicum Experience – Journal Entry

After completing this week’s Practicum Experience, reflect on pattern recognition in diagnoses. Explain how pattern recognition of patient symptoms might help lead to a diagnosis. If you have not yet been placed at a practicum site, please contact your Instructor.

By Day 7 of Week 4

This Assignment is due. You will submit this Week 2 Journal Entry, along with the Week 1 Journal Entry, the Week 3 SOAP Note, and Week 4 Journal Entry by Day 7 of Week 4.

Week 3 question

Journal

In addition to Journal Entries, SOAP Note submissions are a way to reflect on your Practicum Experiences and connect these experiences to your classroom experience. SOAP Notes, such as the ones required in this course, are often used in clinical settings to document patient care. Please refer to the Seidel, et. al. book excerpt and the Gagan article located in this week’s Learning Resources for guidance on writing SOAP Notes.

After completing this week’s Practicum Experience, select a patient that you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

Subjective: What details did the patient provide regarding his or her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management including alternative therapies?

Reflection notes: What would you do differently in a similar patient evaluation?

By Day 7 of Week 4

This Assignment is due. You will submit this Week 3 SOAP Note along with your Journal Entries (Weeks 1, 2, and 4) by Day 7 of Week 4.

Week 4 question

Assignment: Practicum Experience – Journal Entry

After completing this week’s Practicum Experience, reflect on a patient with a known history of a cardiovascular disorder such as a blood clot or arrhythmia. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. If you did not evaluate a patient with this background during the last four weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

By Day 7 of Week 4

This Assignment is due. You will submit this Week 4 Journal Entry along with the Week 1 and Week 2 Journal Entries, and the Week 3 SOAP Note by Day 7.

Note: Be sure to submit your Assignment to the appropriate submission link below.

Submissions should match the following:

Week 1 Theory for Practice: Submit to the Assignment Part 1 – Week 4 submission link.

Week 2 Pattern Recognition: Submit to the Assignment Part 2 – Week 4 submission link.

Week 3 SOAP Note: Submit to the Assignment Part 3 – Week 4 submission link.

Week 4 CV Disorder: Submit to the Assignment Part 4 – Week 4 submission link

The Journal Entries are assessed with a Satisfactory (S) or Unsatisfactory (U) score. This concept also applies to Weeks 7 and 10.

Submission and Grading Information

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

Please save your Assignment using the following naming convention: “WK4PTXAssgn+lastname+first initial”.

Click the Week 4 Assignment Part X links.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4PTXAssgn+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

 

 

Week 5 assignment

Assignment 1: Application – Pulmonary Function Testing

Patients with respiratory disorders often require short-term and long-term treatment. While short-term treatments may successfully relieve a patient’s current symptoms, long-term treatment and management is a necessary component of the care plan. Prior to establishing a care plan, it is essential to complete a thorough patient evaluation. Patients presenting with symptoms of respiratory disorders such as chronic obstructive pulmonary disease (COPD) frequently require pulmonary function testing. These pulmonary function tests are designed to assess patient lung function. Results of these tests can be used in conjunction with the COPD guidelines to develop effective treatment and management plans for patients.

 

To prepare:

Review the COPD guidelines in the Global Initiative for Chronic Obstructive Lung Disease article in this week’s Learning Resources.

Reflect on COPD diagnosis, management, and prevention strategies suggested in the guidelines. Consider how to implement these strategies in a clinical setting.

Locate and select a case study from a reputable source on a patient whose condition required pulmonary function testing.

Consider the COPD guidelines for diagnosis and think about a potential diagnosis for the patient in the case study that you selected.

Reflect on treatment and management options based on the patient’s diagnosis.

To complete:

Write a 2- to 3-page paper that addresses the following:

Describe COPD diagnosis, management, and prevention strategies suggested in the COPD guidelines. Explain how to implement these strategies in a clinical setting.

Explain your diagnosis for the patient in the case study that you selected. Compare the patient’s pulmonary function test results to the COPD guidelines when making your diagnosis.

Describe treatment and management options based on the patient’s diagnosis.

By Day 7 of Week 5

This Assignment is due.

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

Submission and Grading Information

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

Please save your Assignment using the following naming convention: “WK5PTXAssgn1+lastname+first initial”.

Click the Week 5 Assignment 1 Part 1-3 links.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5PTXAssgn1+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

 

Week 7 assignment

Week 5 question

Assignment 2: Practicum Experience – Journal Entry

After completing this week’s Practicum Experience, reflect on a patient with a known history of asthma. Explain potential predisposing genetic and environmental factors associated with asthma. If you did not evaluate a patient with this background during the last 5 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

By Day 7 of Week 7

This Assignment is due. You will submit this Week 5 Journal Entry along with the Week 6 Journal Entries and the Week 7 SOAP Note by Day 7 of Week 7

Week 6 question

Assignment: Practicum Experience – Journal Entry

After completing this week’s Practicum Experience, reflect on a patient who presented with abdominal pain. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. If you did not evaluate a patient with this background during the last 6 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

By Day 7 of Week 7

This Assignment is due. You will submit this Week 6 Journal Entry along with the Week 5 Journal Entry and the Week 7 SOAP Note by Day 7 of Week 7

Week 7 question

Assignment: Practicum Experience – SOAP Note and Journal

After completing this week’s Practicum Experience, select a patient whom you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

Subjective: What details did the patient provide regarding his or her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management including alternative therapies?

Reflection notes: What would you do differently in a similar patient evaluation?

Please refer to the Learning Resources in Week 3 for guidance on writing SOAP Notes.

 

By Day 7

This Assignment is due. You will submit the Week 7 SOAP Note and your Journal Entries (Weeks 5, and 6) by Day 7.

Note: Be sure to submit your Assignment to the appropriate submission link below.

Submissions should match the following:

Week 5 Asthma: Submit to the Assignment Part 1 – Week 7 submission link.

Week 6 Abdominal Pain: Submit to the Assignment Part 2 – Week 7 submission link.

Week 7 SOAP Note: Submit to the Assignment Part 3 – Week 7 submission link.

Submission and Grading Information

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

Please save your Assignment using the following naming convention: “WK7PTXAssgn+lastname+first initial”.

Click the Week 7 Assignment Part X links.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7PTXAssgn+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

 

Week 9 assignment

Week 8 question

Assignment 1: Application– Chronic Kidney Disease

According to the National Kidney Foundation, 26 million adults in the United States have chronic kidney disease with millions of others at risk (National Kidney Foundation, 2012). Over time, this disorder will become progressively worse, and patients will eventually experience a loss of renal function. Early detection and prevention is key for patients with this disorder. For this reason, it is important for you, as the provider, to be aware of various signs, symptoms, and risk factors of chronic kidney disease. In this Assignment, you explore the disorder including the role that patient history, physical exams, and diagnostics play in diagnosis and treatment.

To prepare:

 

Review Chapter 149 in Part 13 of the Buttaro et al. text in this week’s Learning Resources. Reflect on the clinical presentation of chronic kidney disease.

Think about how you might diagnose a patient with chronic kidney disease. Consider the role that patient history, physical exams, and diagnostics play in diagnosis.

Reflect on potential treatment options for chronic kidney disease including the implications of prescribed drugs.

Consider the following patient factors: genetics, gender, ethnicity, age, and behavior. Think about how these factors might impact the diagnosis and treatment of patients with chronic kidney disease.

To complete:

Write a 2- to 3-page paper that addresses the following

Describe the clinical presentation of chronic kidney disease.

Explain how you might diagnose a patient with chronic kidney disease including the role that patient history, physical exams, and diagnostics play in diagnosis.

Explain implications of potential treatment options for this disease including prescribed drugs.

Describe how patient factors might impact the diagnosis and treatment of patients with chronic kidney disease.

Week 9 question

Assignment 1: Application – Chronic Kidney Disease (Due)

By Day 7

Submit Assignment: Chronic Kidney Disease. This Assignment was presented in Week 8 and is due by Day 7 of Week 9.

Submission and Grading Information

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

Please save your Assignment using the following naming convention: “WK9Assgn+lastname+first initial”.

Click the Week 9 Assignment link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

 

 

Week 10 assignment

Week 8 question

Assignment 2: Practicum Experience – Journal Entry

After completing this week’s Practicum Experience, reflect on a patient with a known history of a renal disorder. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. If you did not evaluate a patient with this background during the last 8 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

By Day 7 of Week 10

This Assignment is due. You will submit this Week 8 Journal Entry along with the Week 9 Journal Entry and the Week 10 SOAP Note by Day 7 of Week 10.

Week 9 question

Assignment 2: Practicum Experience – Journal Entry

After completing this week’s Practicum Experience, reflect on a patient with a known history of a musculoskeletal disorder. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. If you did not evaluate a patient with this background during the last 9 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

By Day 7 of Week 10

This Assignment is due. You will submit this Week 9 Journal Entry along with the Week 8 Journal Entries, and the Week 10 SOAP Note by Day 7 of Week 10.

Week 10 question

Assignment 2: Practicum Experience – SOAP Note and Journal

After completing this week’s Practicum Experience, select a patient that you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

Subjective: What details did the patient provide regarding his or her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management including alternative therapies?

Reflection notes: What would you do differently in a similar patient evaluation?

Please refer to the Learning Resources in Week 3 for guidance on writing SOAP Notes.

By Day 7

You will submit the Week 10 SOAP Note and your Journal Entries (Weeks 8 and 9) by Day 7.

Note: Be sure to submit your Assignment to the appropriate submission link below.

Submissions should match the following:

Week 8 Renal Disorder: Submit to the Assignment 2 Part 1 – Week 10 submission link.

Week 9 Musculoskeletal Disorder: Submit to the Assignment 2 Part 2 – Week 10 submission link.

Week 10 SOAP Note: Submit to the Assignment 2 Part 3 – Week 10 submission link.

Submission and Grading Information

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

Please save your Assignment using the following naming convention: “WK11PTXAssgn2+lastname+first initial”.

Click the Week 11 Assignment 2 Part X links.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11PTXAssgn2+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

 

 

Week 11 assignment

Week 10 question

Assignment 1: Application – Patient Education on Stroke Prevention

A stroke is a serious disorder that impacts patients quickly, requiring immediate intervention and treatment. Due to implications of this disorder, patient education is essential for patient populations at an increased risk of stroke. According to the National Stroke Association, up to 80% of strokes can be prevented in patients (National Stroke Association, 2012). For this reason, it is essential that you provide patients with the education and tools necessary to reduce their risk as well as identify signs and symptoms of strokes. In this Assignment, you have the opportunity to give back to your practicum site by creating media to educate patients about stroke prevention. When designing patient education media such as flyers, posters, and music, it is important to consider strategies that meet the needs of the patient population you treat at your practicum site.

Note: This Assignment is the focus of the week’s Discussion and should be completed and ready to post by Day 4.

 

To prepare:

Review the stroke prevention articles in this week’s Learning Resources.

Reflect on common lifestyle, behavioral, and cultural choices of the population that you treat within your practicum setting. Consider stroke prevention methods for this population.

Think about ways to educate patients on these prevention methods. Consider educational pieces such as flyers, posters, or other media that might be most effective with your patient population.

To complete:

Design a media piece to educate patients on stroke prevention. You may create a flyer, poster, or any other media that is suitable for your patient population.

By Day 7 of Week 11

This Assignment is due. Prior to your final submission, be sure to use the feedback your colleagues provide in the Discussion to further refine your stroke prevention media.

Week 11 question

Assignment 1: Application – Patient Education on Stroke Prevention (Due)

By Day 7

Submit the Patient Education on Stroke Prevention Assignment. This Assignment was presented in Week 10 and is due by Day 7.

Submission and Grading Information

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

Please save your Assignment using the following naming convention: “WK11Assgn1+lastname+first initial”.

Click the Week 11 Assignment 1 link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn1+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

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