Healthy People Initiative (graded) As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic woman who is in her second year of nursing school. She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. After doing her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. She is married with two school-age children. She is in class a total of 15 hours per week, plus 12 hours of labs and clinical. She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children. She states that she is lucky to get 6 hours of sleep per night, but that is okay with her. She lives 1hour from campus and commutes each day. Using .healthypeople.gov/”>Healthy People 2020as a guide: What additional information would you like to gather from Maria? What are Maria’s real and potential health risks? Pick one of Maria’s health risks. What would be one reasonable short-term goal for this risk? Cultural Bias (graded) Understanding cultural phenomena is essential to the completion of an accurate health assessment. Please choose a cultural group from Table 4.1 from your text and describe the cultural differences pertinent to that group. Remember, the table may not include all cultural groups. Let’s try to include all the groups listed in the discussion, so please do not choose a group that has already been done. To expedite this, please use the group name in the title of your post. week 2 Pain Assessment (graded) John, a 46-year-old African-American male presents for admission to your hospital for hemi-colectomy for colon polyps. He is complaining of chronic back pain. Patient is on disability from work related injury. History of two (2) previous back surgeries with relief of numbness in RLE but pain has not been relieved. His current medications include Methadone, Neurontin and Norco. John states he takes Benadryl PM every night in addition to his prescribed medications. John is a smoker and smokes 1 PPD. John confides in you that he is considering a spinal cord stimulator for the chronic pain. What risk factors does John have for risk of opioid withdrawal during this hospitalization? Is there a stigma connected to being disabled and or methadone? Does the nurse need to be concerned about acetaminophen use? What are the differences in acute and chronic pain? Nutritional Assessment (graded) Yulang Lei, an 82-year-old Vietnamese man, was admitted to your floor with dehydration and a urinary tract infection following a fall at home. He is alert and oriented, but weak. He appears frail. His admission history includes the following. He lives alone; his wife died 6 months ago. He states he ran a traditional Vietnamese family, unlike his children, who are married and have now moved away. His wife did all the cooking and he hasn’t had much of an appetite since she died. He eats rice and some vegetables, but rarely “bothers to cook meat for just one person.” Usual daily activity is reading the Vietnamese community newspaper with his morning tea for breakfast. He says he usually eats lunch, but can’t remember what he usually eats. He has rice and a few vegetables for dinner. You notice that his clothes fit very loosely. He states he weighed 140 pounds at his doctor’s office 5 months ago. When you weigh him, he weighs 123 pounds and is 5’8″ tall. Look at the list of nursing diagnoses in Appendix A of your text. What nursing diagnoses would you choose for Mr. Lei? What additional questions would you ask to confirm your diagnosis? What physical examination and laboratory findings would you expect Mr. Lei to have? What psychosocial and cultural factors should you consider when assessing Mr. Lei? General Survey and Health History (graded) Casey is a 17-year-old high school student admitted to the ER with a compound fracture of the left leg obtained falling at the local skateboard park while practicing for a national competition. He has never been hospitalized before. His mother has been notified and is on her way. The EMTs gave him morphine and he reports his pain level as “okay.” What part of the interview and examination can be done prior to his mother’s arrival? As you enter the room for the first time, what should you observe as part of the general survey? As you complete his history, what areas are especially important? What are the important developmental considerations for Casey? The Older Adult (graded) Jean is a 68-year-old female admitted for a total hip replacement. In her interview you learn that she has a history of obstructive sleep apnea (OSA) with a neck circumference of 16 inches and snores much of the night. She is 5’7” and weighs 265 pounds. She states she is sleepy throughout the day. Her other medical history includes: hypertension treated with angiotensin II receptor blockers (ARB), Diabetic with an Hgb A1c over 8%. Hypercholesteremia treated with a Statin drug. Coronary Artery Disease (CAD) with a history of a drug eluting cardiac stent placed 14 months ago and currently on Plavix and ASA. History of gastroesophageal reflux disease (GERD) and is on Prilosec. Her husband has a history of cerebral vascular accident (CVA) several years ago. What medications should she take pre-op and what should she hold? Should Jean be allowed to continue ASA pre-operatively? Should cardiology be consulted on this matter? What are Jean’s risks for diabetes complications? What concerns do you have about her social support system? week 4 Assessment of the Skin (graded) Describe a patient with an abnormal skin symptom or group of symptoms such as a rash, an itch, redness, a lesion, or wounds. Do not limit yourself to these examples. What questions would you ask as part of your focused assessment? What history might be associated with the symptom, if any? What are the known risk factors for this condition? What physical examination techniques would you use? What patient education would you give the patient? Find a nursing journal article about these symptoms. Assessment of the Head and Neck (graded) Choose one area of the head and neck and then select a common complaint (symptom or group of symptoms) patients may have in that area. For example, you may select headaches, earaches, ringing in the ears (tinnitus), sinus drainage and pain, sore throat and cough, and so on. Do not limit yourself to these examples. What questions would you ask as part of your focused assessment? What history would be associated with the symptom? What are the risk factors for this condition? What physical examination techniques would you use? What patient education would you give the patient? Find a nursing journal article about this symptom or condition. unit 5 Assessment of the Abdomen (graded) Describe a patient with an abdominal symptom or group of symptoms, such as bloating, flatus, and eructation; constipation; nausea and vomiting; diarrhea; or abdominal pain. Do not limit yourself to these examples. Remember that there are different types and locations of abdominal pain. What questions would you ask as part of your focused assessment? What history might be associated with the symptom, if any? What are the known risk factors for this condition? What physical examination techniques would you use? What patient education would you give the patient? Find a nursing journal article about these symptoms. Assessment of the Genitourinary System (graded) Describe a patient with a genitourinary symptom or group of symptoms; such as incontinence, burning on urination, irregular menses, pain in the scrotum, erectile dysfunction, and so on. Do not limit yourself to these; for example, there are different types of incontinence. What questions would you ask as part of your focused assessment? What history might be associated with the symptom, if any? What are the known risk factors for this condition? What physical examination techniques would you use? What patient education would you give to the patient? Find a nursing journal article about these symptoms. unit 6 Assessment of Cardiac Status (graded) Describe a patient with a cardiac symptom or group of symptoms, such as palpitations, hypertension, hypotension, tachycardia, or bradycardia. Do not limit yourself to these examples. What questions would you ask as part of your focused assessment? What history might be associated with the symptom, if any? What are the known risk factors for this condition? What physical examination techniques would you use? What patient education would you give to the patient? Find a nursing journal article about this symptom or condition. Assessment of Respiratory Status (graded) Choose one area of the respiratory system and then select a common complaint (symptom or group of symptoms) patients may have in that area. For example, you may select wheezes, pulmonary congestion, absence of breath sounds on one side, productive cough, and so on. Do not limit yourself to these examples. What questions would you ask as part of your focused assessment? What history would be associated with the symptom? What are the risk factors for this condition? What physical examination techniques would you use? What patient education would you give the patient? Find a nursing journal article about this symptom or condition. unit 7 Assessing the Musculoskeletal System (graded) Describe a patient with a musculoskeletal symptom or group of symptoms, such as joint pain, back pain, neck pain, and so on. Do not limit yourself to these examples. Remember: There are different types and locations of joint pain. What questions would you ask as part of your focused assessment? What history might be associated with the symptom, if any? What are the known risk factors for this condition? What physical examination techniques would you use? What patient education would you give the patient? Find a nursing journal article about these symptoms. unit 7 Assessing the Nervous System (graded) Choose one common complaint (symptom or group of symptoms) related to the neurological system. For example, you may select syncope, hand tremors, seizures, right/left-sided weakness or paralysis, abnormalities of gait or posture, changes in mental status, and so on. Do not limit yourself to these examples. What questions would you ask as part of your focused assessment? What history would be associated with the symptom? What are the risk factors for this condition? What physical examination techniques would you use? What patient education would you give to the patient? Find a nursing journal article about this symptom or condition. Journal Article Review: Guidelines and Grading Rubric Purpose The student will read an assigned nursing article and write a critique related to a selected topic. Course Outcomes This assignment enables the student to meet the following course outcomes: CO #3: Utilize effective communication when performing a health assessment. (PO #3) CO #5: Explore the professional responsibilities involved in conducting a comprehensive health assessment and providing appropriate documentation. (PO #6) Points This assignment is worth a total of 100 points. Due Date The completed Journal Article Review file is to be submitted to the Dropbox by 11:59 p.m. MT Sunday of Week 2. Post questions to the weekly Q & A Forum. Contact your instructor if you need additional assistance.See the Course Policies regarding late assignments. Failure to submit your paper to the Dropbox on time may result in a deduction of points. Directions 1. Download the following article from the Chamberlain library. See “Searching Databases-Tips for finding Assigned Articles.docx” from the Doc Sharing tab if you are unfamiliar with downloading articles from the library. The APA formatted reference is below: Fawcett, T., & Rhynas, S. (2012) Taking a patient history: The role of the nurse. Nursing Standard, 26(24), 41-46. The elements of the reference are: Authors: Fawcett, T., & Rhynas, S. Date: 2012 Title: Taking a patient history: the role of the nurse. Journal: Nursing Standard, Volume 26, Issue 24, pages 41-46. 2. Read the article carefully and take notes. Highlight important points in the article that are helpful to you and other students. 3. Use Microsoft Word 2010 (or later) to type the paper. 4. The length of the paper is to be no longer than four (4) pages excluding title page and reference page. Extra pages will not be read and will not count toward your grade. 5. APA format is required. Include a title page and a reference page. The body of the paper should have four sections with these headings: a. Introduction b. Summary of the Article c. Evaluation of the Article d. Conclusion 6. Use scholarly writing including correct English grammar, syntax and sentence structure. 7. Submit the paper to the Journal Article Review basket in the Drop Box by Sunday, 11:59 p.m. MT, at the end of Week 2. Please post questions about this assignment to the weekly Q & A Forums so the entire class may view the answers. week 3 Guidelines for Family Genetic History Assignment Purpose This assignment is to help you gain insight regarding the influence of genetics on an individual’s health and risk for disease. You are to obtain a family genetic history on a willing, non-related, adult participant. Course Outcomes This assignment enables the student to meet the following course outcomes: CO #3: Utilize effective communication when performing a health assessment. (PO #3) CO #5: Explore the professional responsibilities involved in conducting a comprehensive health assessment and providing appropriate documentation. (PO #6) Points This assignment is worth a total of 100 points. Due Date The Family Genetic History Assignment is to be submitted at the end of Week 3. There is a MS Word document form in Doc Sharing that you need to download, fill in, and submitto the Family Genetic History Dropboxby Sunday, 11:59 p.m. MT at the end of Week 3. Post questions to the weekly Q & A Forum. Contact your instructor if you need additional assistance.See the Course Policies regarding late assignments. Failure to submit your paper to the Dropbox on time may result in a deduction of points. Disclaimer When taking a family genetic history on an actual client, it is essential that the information is accurate. Please inform the person you are interviewing that they do NOT need to disclose information that they wish to keep confidential. If the adult participant decides not to share information, please write, “Does not want to disclose.” Directions 1. Refer to the examples in Chapter 10 of your textbook discusses development of a genogram. 2. Download the NR305_Family_Genetic_History_Form from Doc Sharing. You will document the adult participant’s family genetic history using this MS Word document. 3. Complete the family genetic history using the information that the adult participant is willing to share with you. The focus of this course is on the normal “healthy” individual so your paper does not need to contain much medical/nursing detail. Refer to your textbook or the internet to learn what impact the family’s health history may have on the adult participant’s personal state of wellness both now and in the future. This paper does not require APA formatting, but you are expected to write clearly and use proper grammar and spelling. Developing a pictorial genogram using symbols to identify certain relationships, e.g., divorced, sibling, deceased, etc., may provide more insight, however, drawing may be difficult to accomplish with MS Word, therefore you are not expected to use symbols, lines or other drawing elements. Instead, describe the relationships among the various people in the adult participant’s family’s genetic history. Remember, the goal is not to learn how to draw with Word, but to gather information about the family and recognize its significance to the adult participant and that person’s health. 4. Save the completed form by clicking on “Save as” and add your last name to the file name, e.g., “NR305_Family_Genetic_History_Form_Smith” 5. Submit the completed form to the Family Genetic History basket in the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 3. Please post questions about this assignment to the weekly Q & A Forums so the entire class may view the answers. Family Member Description Paternal grandfather First and last initials: RL Birthdate: 1921 Death date: 1981 Occupation: Retired as a coal miner Education: 6th grade Primary language: English Health summary: He was diagnosed with chronic lung disease, diabetes, and hypertension. He died from a heart attack. Paternal grandmother First and last initials: ML Birthdate: 1932 Death date: 1998 Occupation: House wife Education: Does not want to disclose Primary language: English Health summary: Diagnosed with chronic lung disease from smoking cigarettes. Died from heart failure. This example points to common problems among this generation on both sides of the family. Consider the implications this would have for the adult participant’s health if these were that person’s family members. Complete the family genetic history form below. Indicate if any information is N/A (not applicable) or unknown. Indicate any information the person did not want to disclose by noting “Does not want to disclose.” Family Member Description Paternal grandfather First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Paternal grandmother First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Father First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Father’s siblings (write a brief summary of any significant health issues) Maternal grandfather First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Maternal grandmother First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Mother First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Mother’s siblings (write a brief summary of any significant health issues) Adult Participant First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Adult participant’s siblings (write a brief summary of any significant health issues) Adult participant’s spouse/significant other First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Adult participant’s children (write a summary for each child, up to four children) Child #1 first and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Child #2 first and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Child #3 first and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Child #4 first and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: 2. Evaluation of family genetic history (25 points) Evaluate the impact of the family’s genetic history on your adult participant’s health. For example, if the adult participant’s mother and both sisters have diabetes, hypertension, or cancer, what might that mean for the adult participant’s future health? 3. Planning for future wellness (35 points) Plan changes based on the evaluation of the adult participant’s family’s health history that will promote an optimal level of wellness both now and in the future. Include what information you would provide to the adult participant regarding the results of the family genetic histor weekj 4 Guidelines for Course Project Milestone 1: Health History Purpose The student will obtain a health history on a willing, non-related, adult participant in order to generate written documentation that is clear and accurate. Course Outcomes This assignment enables the student to meet the following course outcomes: CO #3: Utilize effective communication when performing a health assessment. (PO #3) CO #4: Identify teaching/learning needs from the health history of an individual. (PO #2) CO #5: Explore the professional responsibilities involved in conducting a comprehensive health assessment and providing appropriate documentation. (PO #6) Points This assignment is worth a total of 175 points. Due Date The Course Project Milestone 1: Health History assignment is to be submitted to the Dropbox by Sunday, 11:59 p.m. MT at the end of this Week 4. The guidelines and grading rubric may be found in Doc Sharing. Post questions to the Q&A Forum. Contact your instructor if you need additional assistance. Disclaimer The focus of this assignment is on communicating details within the written client record. When taking a health history on an actual client, it is essential that the information is accurate. Please inform the person you are interviewing that they do NOT need to disclose information that they wish to keep confidential. If the interviewee decides not to share information, please write, “Does not want to disclose.” Directions 1. Find an adult who is not related to you who is willing to let you take a health history. 2. Download the NR305_Milestone1_Form from Doc Sharing. You will type your answers directly into this Word document. Your paper does NOT need to follow APA formatting, however, you are expected to be clear in your communication by using correct medical terminology, grammar and spelling. 3. Review the examples in Chapter 10 of your textbook to gain insight into how to document the health history. Avoid words like frequently, improved, increased, decreased, good, poor, normal, or WNL as they may have different meanings for different people. Instead, document the specific data that led you to these conclusions, e.g., 3x/day instead of “frequently,” or consuming 4 servings of vegetables/day instead of “increased” vegetable servings. 4. Save the file by clicking “Save as” and adding your last name to the file name, e.g., “NR305_Milestone1_Form_Smith” 5. Submit the completed form to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 4. Please post questions in the weekly Q & A Forums so the entire class may view the answers. All required criteria included. No errors. 12-15 points No more than three required elements missing 5-11 points More than three required elements missing. 0-4 points Ethnicity and Culture 10 points All required criteria included. No errors. 10 points No more than one required elements missing 8 points More than two required elements missing. 0-7 points Spirituality 5 points All required criteria included. No errors. 5 points No more than one required elements missing 4 points More than two required elements missing. 0-3 points Self-Concept 5 points All required criteria included. No errors. 5 points No more than one required elements missing 4 points More than two required elements missing. 0-3 points Review of Systems 20 points All required criteria included. No errors. 16-20 points No more than three required elements missing did not include information about functional patterns of each system. 10-15 points More than three required elements missing. Total body systems and/or functional patterns missing. 0-9 points Clarity of writing 5 points Organized logically and written clearly with good structure 4-5 points Lacks some organization & clarity. Uses words such as frequently, increased, decreased. 2-3 points Lacks logical organization; difficult to read. Uses words such as frequently, increased, decreased. 0-1 points Total Points Possible = 175 points Course Project Milestone 1: Health History Form Your Name: Date: Your Instructor’s Name: Directions: Refer to the Milestone 1: Health History guidelines and grading rubric found in Doc Sharing to complete the information below. This assignment is worth 175 points, with 5 points awarded for clarity of writing, which means the use of proper grammar, spelling and medical language. Type your answers on this form. Click “Save as” and save the file with the assignment name and your last name, e.g., “NR305_Milestone1_Form_Smith” When you are finished, submit the form to the Milestone #1 Dropbox by the deadline indicated in your guidelines. Post questions in the Q&A Forum or contact your instructor if you have questions about this assignment. Disclaimer:The focus of this assignment is on communicating details within the written client record. When taking a health history on an actual client, it is essential that the information is accurate. Please inform the person you are interviewing that they doNOTneed to disclose information that they wish to keep confidential. If the interviewee decides not to share information, please write, “Does not want to disclose.” BIOGRAPHICAL DATA (10 pts) Date: Initials: Age: Date of birth: Birthplace: Gender: Marital status: Race: Religion: Occupation: Health insurance: Source of information: Reliability of source of information: PRESENT HEALTH HISTORY/ILLNESS (15 pts) Reason for seeking care: Health patterns: Health goals: HEALTH BELIEFS AND PRACTICES (15 pts) Beliefs and practices: Factors influencing healthcare decisions: Related traits, habits or acts: MEDICATIONS (15 pts) Prescription medications: Over-the-counter medications: Herbals: PAST HISTORY (15 pts) Childhood diseases: Immunizations: Allergies: Blood transfusions: Major illnesses: Injuries: Hospitalizations: Labor and deliveries: Surgeries: Use of alcohol: Use of tobacco: Use of illicit drugs: EMOTIONAL HISTORY (15 pts) Mental, emotional or psychiatric problems: FAMILY HISTORY (15 pts) Father: Mother: Siblings: Grandparents: PSYCHOSOCIAL/ OCCUPATIONAL HISTORY (15 pts) Occupational history: Educational level: Financial background: ROLES AND RELATIONSHIPS (15 pts) Significant others: Support systems: ETHNICITY AND CULTURE (10 pts) Ethnicity and culture: Physical and social characteristics that influence healthcare decisions: SPIRITUALITY (5 pts) Religious and spiritual needs: SELF-CONCEPT (5 pts) View of self-worth: Future plans: REVIEW OF SYSTEMS (20 pts) Skin, hair, nails: Head, neck, related lymphatics: Eyes: Ears, nose, mouth, and throat: Respiratory: Breasts and axillae: Cardiovascular: Peripheral vascular: Abdomen: Urinary: Reproductive: Musculoskeletal: Neurologic: Guidelines for Course Project Milestone 2: Nursing Diagnosis and Care Plan Assignment Purpose This activity will be a continuation of the Milestone 1: Health History that you submitted in Week 4. In this part of the assignment you will take the information you gathered, analyze the data, and develop a nursing care plan. Course Outcomes This assignment enables the student to meet the following course outcomes: CO #3: Utilize effective communication when performing a health assessment. (PO #3) CO #4: Identify teaching/learning needs from the health history of an individual. (PO #2) CO #5: Explore the professional responsibilities involved in conducting a comprehensive health assessment and providing appropriate documentation. (PO #6) Points This assignment is worth a total of 250 points. Due Date The assignment is to be submitted to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 6.Post questions to the weekly Q & A Forum. Contact your instructor if you need additional assistance.See the Course Policies regarding late assignments. Failure to submit your paper to the Dropbox on time may result in a deduction of points. Directions 1. Download the NR305_Milestone2_Form from Doc Sharing. You will type your answers directly into this Word document. Your paper does NOT need to follow APA formatting; however, you are expected to use correct grammar, spelling, syntax and write in complete sentences. 2. Save the file by clicking “Save as” and adding your last name to the file name, e.g., “NR305_Milestone2_Form_Smith” 3. Submit the completed form to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 6. Please post questions in the weekly Q & A Forums so the entire class may view the answers. Course Project Milestone #2: Nursing Diagnosis and Care Plan Form Your Name: Date: Your Instructor’s Name: Directions: Refer to the Milestone 2: Nursing Diagnosis and Care plan guidelines and grading rubric found in Doc Sharing to complete the information below. This assignment is worth 250 points, with 10 points awarded for clarity of writing, which means the use of proper grammar, spelling and medical language. Type your answers on this form. Click “Save as” and save the file with the assignment name and your last name, e.g., “NR305_Milestone2_Form_Smith” When you are finished, submit the form to the Milestone 2 Dropbox by the deadline indicated in your guidelines. Post questions in the Q&A Forum or contact your instructor if you have questions about this assignment. 1: Analyze Assessment Data: Based on the health history information, identify the following: A. Areas for focused assessment (30 points) Provide a brief overview of those areas of strength and weakness noted from Milestone 1: Health History. B. Client’s strengths (30 points) Expand on areas identified as strengths related to the person’s overall health. Support your conclusions with data from the textbook. C. Areas of concern (30 points) Expand on areas previously identified as abnormal and those that place the person at a health risk. Support your observations with data from the textbook. D. Health teaching topics (30 points) Identify health education needs. Support your statements with facts from the Health History and information from your textbook. 2: Nursing Care Plan Next, plan your care based on your analysis of your assessment data: A. Diagnosis (30 points) Write one nursing diagnosis that reflects a priority need for this person. Remember a wellness diagnosis is a possibility. B. Plan (30 points) Write one goal and one measurable expected outcome related to your nursing diagnosis. Explain why this goal and outcome is a priority. Include cultural considerations for this client. C. Intervention (30 points) Write as many nursing orders or nursing interventions that you need in order to achieve the outcome. Provide the rationale for each intervention listed. D. Evaluation (30 points) You will not carry out your care plan so you cannot evaluate the effectiveness of your nursing interventions. Instead, comment on what you would look for in order to evaluate your effectiveness.
