nr305 – Healthy People Initiative

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nr305 – Healthy People Initiative

This week’s graded discussion topic relates to the following

Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of

nursing and related disciplines to explain expected client behaviors, while

differentiating between normal findings, variations, and abnormalities. (PO 1)

CO3 Utilize effective communication when performing a health

assessment. (PO 3)

The topic this week asks you to apply what you have learned

to the following case study.

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As the school nurse working in a college health clinic, you

see many opportunities to promote health. Maria is a 40-year-old Hispanic 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 conducting 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 attends class a total of 15 hours per week, plus she must be

present for 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 1 hour from campus and commutes

each day. Using Healthy People 2020 (Links to an external site.)Links to an

external site. and your text as a guide, answer the following questions.

What additional information would you like to gather from

Maria? nr305 – Healthy People Initiative.

What are Maria’s real and potential health risks?

Why is Maria’s culture important when obtaining the health

assessment?

Pick one of Maria’s health risks. What would be one

reasonable short-term goal for this risk?

What nursing interventions would you incorporate into

Maria’s plan of care to assist her with meeting your chosen goal? Please

provide rationale for your selections.

Week 2 discussion

General

Survey/Skin/Nutrition

This week’s graded discussion topic relates to the following

Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of

nursing and related disciplines to explain expected client behaviors, while

differentiating between normal findings, variations, and abnormalities. (PO 1)

CO3 Utilize effective communication when performing a health

assessment. (PO 3) nr305 – Healthy People Initiative.

Your home health agency has received an order from a local

hospital to evaluate and treat an elderly woman being discharged from its

medical surgical unit.

Millie Gardner, an 83-year-old female patient, is being

discharged home today to the care of her husband Fred (87 years old) following

a 9-day hospitalization for pneumonia, dehydration, and failure to thrive. She

has a history of hypertension (HTN), Type II Diabetes, and cerebral vascular

accident (CVA) with left-sided weakness. Patient is alert and oriented but does

have periods of forgetfulness during the overnight hours. Patient has

intermittent incontinence of bowel and bladder and requires assistance with all

activities of daily living (ADLs).

Medications:

Lopressor

Lisinopril

Plavix

Metformin

Novolin R per sliding scale *NEW*

Multivitamin

Colace

Zithromax *NEW*

Upon arrival you are greeted by Champ, the couple’s

rambunctious miniature Doberman pinscher dog. Millie is in her wheelchair

staring blankly out the window, and Fred is busy in the kitchen preparing the

couple’s lunch.

Based on the scenario above, please use the general survey

process to describe the areas that you would be observing immediately upon

entry to the home. nr305 – Healthy People Initiative.

What, if any, concerns related to Millie’s skin and

nutritional status do you have?

What nursing interventions will you include in the plan of

care to address these concerns?What teaching strategies will you use to educate

Millie and Fred on the new medications?Using the SBAR, please include the

information that you will communicate to the physician’s office at the

completion of the visit.

Week 3 discussion

Assessment of the

Neurological System

This week’s graded discussion topic relates to the following

Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of

nursing and related disciplines to explain expected client behaviors, while

differentiating between normal findings, variations, and abnormalities. (PO 1)

CO2 Recognize the influence that developmental stages have

on physical, psychosocial, cultural, and spiritual functioning. (PO 1)

CO3 Utilize effective communication when performing a health

assessment. (PO 3)

Randy Adams is a 38-year-old male patient of Dr. Joseph

Reynolds who was admitted yesterday morning for 24-hour observation for mild

concussion following a motor vehicle accident. Randy lost consciousness during

the accident and was very confused when he arrived in the ER after EMS

transport. He is an Iraq war veteran and he seemed to think after the accident

that this all happened in Iraq. Dr. Reynolds is concerned that Randy has some

residual problems from a couple of explosive incidents that occurred while he

was in Iraq. The physician is unsure whether Randy’s current symptoms are from

the car accident or from prior injuries so he has referred him for

consultations to both a neurologist and to a behavioral health specialist. nr305 – Healthy People Initiative.

Based on the above please discuss the following.

Pathophysiology of concussive injuries and treatment

Neurological assessment tools used in your current practice

setting (if not presently working, please describe one used during prior

employment or schooling)

Current best practices associated with post-traumatic stress

disorder (PTSD)

Nursing interventions you would include in this patient’s

plan of care

Week 4 discussion

Assessment of Cardiac

Status

This week’s graded discussion topic relates to the following

Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of

nursing and related disciplines to explain expected client behaviors, while

differentiating between normal findings, variations, and abnormalities. (PO 1)

CO3 Utilize effective communication when performing a health

assessment. (PO 3)

Esther Jackson is a 56-year-old black female who is 1-day

post-op following a left radical mastectomy. During morning rounds, the

off-going nurse shares with you during bedside report that the patient has been

experiencing increased discomfort in her back throughout the night and has

required frequent help with repositioning. She states that the patient was

medicated for pain approximately 2 hours ago but is voicing little relief and

states that you might want to mention that to the doctor when he rounds later

this morning. With the patient appearing to be in no visible distress, you

proceed on to the next patient’s room for report.

Approximately 1 hour later, you return to Ms. Jackson’s room

with her morning pills and find her slumped over the bedside stand in tears. The

patient states, “I don’t know what is wrong, I don’t feel right. My back

hurts and I’m just so tired. What is wrong with me?” The patient refuses

to take her medications at this time stating that she is starting to feel sick

to her stomach. nr305 – Healthy People Initiative.

Just then the nursing assistant comes into the patient’s

room to record Ms. Jackson’s vital signs, you take this opportunity to quickly

research the patient’s medication record to determine if she has a medication

ordered for nausea. Upon return, the nursing assistant hands you the following

vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the

patient’s pulse because “it is all over the place.“

Please address the following questions related to the

scenario.

What do you suspect is the cause of the patient’s symptoms?

Describe the course of action that you will take to confirm

this suspicion and prevent further decline.

What further assessments, lab values, and tests will likely

be ordered for this patient and how often? If testing is to be completed more

than once, please explain the rationale for doing so.

While you are caring for this patient, how will you ensure

that the needs of your other patients are being met?

Week 5 discussion

Assessment of

Respiratory Status

This week’s graded discussion topic relates to the following

Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of

nursing and related disciplines to explain expected client behaviors, while

differentiating between normal findings, variations, and abnormalities. (PO 1)

CO3 Utilize effective communication when performing a health

assessment. (PO 3)

CO4 Identify teaching/learning needs from the health history

of an individual. (PO 2)

Please review the video above as it will provide you with an

opportunity to immerse yourself in the role of a nurse addressing tobacco use

during routine patient care. Click to review a transcript (Links to an external

site.)Links to an external site. of this recording.

While viewing, reflect on what you have learned about

tobacco use and the role that nurses and other interdisciplinary team members

play in helping to assist tobacco users with quitting. While viewing, it is

also important to keep in mind that tobacco users move through stages of change

in the process of quitting. They move from pre-contemplation to contemplation,

contemplation to preparation; preparation to abstinence; abstinence to

maintenance. Every stage requires a different strategy by a nurse.

After watching the video, and reflecting on the information

presented, address each of the following questions.

What are the common symptoms associated with an exacerbation

of COPD? nr305 – Healthy People Initiative.

What assessment techniques will you use to assess Mary?

Identify smoking strategies that would be appropriate for

each of the encounters that Mary had with the nurse throughout the video that

could have been used to assist Mary in quitting smoking.

Find a resource in your community that could assist Mary.

Start by searching the Internet for your local health department’s website.

What services are available to Mary? Briefly describe the services that the

state quit line provides. Does it meet the 4 As? Is it accessible, acceptable,

affordable, or available for Mary?

What will you do to follow-up on Mary’s smoking cessation

process?

Week 6 discussion

Assessment of the

Abdomen and Genitourinary System

This week’s graded discussion topic relates to the following

Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of

nursing and related disciplines to explain expected client behaviors, while

differentiating between normal findings, variations, and abnormalities. (PO 1)

CO2 Recognize the influence that developmental stages have

on physical, psychosocial, cultural, and spiritual functioning. (PO 1)

CO3 Utilize effective communication when performing a health

assessment. (PO 3)

Amira is a 27-year-old Syrian refugee who has been residing

in a local homeless shelter since her arrival here in the United States 4 weeks

ago. She was brought into the emergency room this morning via squad after being

found by a shelter employee sitting in a pool of blood on the bathroom floor

crying and holding her abdomen. Due to her limited English speaking abilities,

she is unable to provide specific details as to her complaints but the shelter

employee states that she has recently stopped eating and has not looked well

for the past couple of days. nr305 – Healthy People Initiative.

Based on the limited information provided, please answer the

following questions.

How will you prioritize your care of Amira, what assessments

will you complete, and in what order? Please provide rationale for choosing

this order.

Are there any cultural beliefs/practices that must be taken

into consideration when planning her care?

Considering her symptoms of abdominal pain and bleeding, is

it possible that her status as a homeless refugee is a causative or

contributing factor to her illness? Please provide rationale for your response.

Week 7 discussion

Assessment of the

Musculoskeletal System and Pain

This week’s graded discussion topic relates to the following

Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of

nursing and related disciplines to explain expected client behaviors, while

differentiating between normal findings, variations, and abnormalities. (PO 1)

CO2 Recognize the influence that developmental stages have

on physical, psychosocial, cultural, and spiritual functioning. (PO 1)

CO3 Utilize effective communication when performing a health

assessment. (PO 3)

Fred is an 83-year-old male who is being admitted to the

medical-surgical unit status post fall. He is alert and oriented and reports

that while visiting a local casino with his wife Margaret earlier this evening,

he tripped over a curb and fell landing on his right side. After receiving

morphine in the emergency room prior to transfer to your unit, Fred is rating

his pain at 6/10. He has multiple bruises from his jawbone to his knee as well

as a slight rotation of his right leg.

Past medical history includes: myocardial infarction (MI) x

2, peripheral vascular disease (PVD) with bilateral iliac stents,

non-insulin-dependent diabetes mellitus (NIDDM), sleep apnea, and degenerative

joint disease.

Medications include: aspirin, Plavix, Lopressor, Lisinopril,

and Metformin.

After reviewing the above scenario please answer the

following questions.

Based on the information provided, how will you prioritize

your care, what assessments will you include and in what order? Please provide

rationale for your response.

Considering this patient’s age, injury, past medical

history, and list of current medications, what, if any, concerns do you have

related to his potential need for surgery?

Should surgery to repair his right femur be required; what

type of clearance and pre-op orders would you anticipate receiving related to

his diet, meds, lab work, and so on? nr305 – Healthy People Initiative.

Week 8 discussion

Rapid Assessment of a

Client

This week’s graded discussion topic relates to the following

Course Outcomes (COs).

CO1 Utilize prior knowledge of theories and principles of

nursing and related disciplines to explain expected client behaviors, while

differentiating between normal findings, variations, and abnormalities. (PO 1)

CO2 Recognize the influence that developmental stages have

on physical, psychosocial, cultural, and spiritual functioning. (PO 1)

CO3 Utilize effective communication when performing a health

assessment. (PO 3)

CO5 Explore the professional responsibilities involved in

conducting a comprehensive health assessment and provide appropriate

documentation. (PO 6)

Please choose one of the patient scenarios below. Next,

complete a rapid assessment, and provide a SBAR report to a classmate. Remember

to include all concepts of patient safety, standard precautions, and

professional standards.

You are covering for a coworker who is off the floor for

lunch, when you suddenly hear a loud crash coming from a nearby patient room.

You quickly run in and discover Mr. Johnson who was admitted yesterday with a

diagnosis of cerebral vascular accident (CVA) unconscious on the floor between

the bed and the bathroom. nr305 – Healthy People Initiative.

You are called to the room of 2-year-old Jonah by his mother

who states the child has suddenly started breathing very loudly and does not

look right. Upon entering the room you quickly recognize that the child is in

respiratory distress as his lips are cyanotic and the use of accessory muscles

is evident.

You are in the process of admitting Ashley, a 27 year old

who is 28 weeks pregnant with her first child, to the obstetric unit for

complaints of headache, dizziness, and swelling of her lower extremities when

she suddenly begins seizing.

Week 2

Family Genetic History

Family Genetic History Guidelines

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, nonrelated, adult participant.

NOTE: failing to complete this assignment using an adult participant other than

yourself will result in a 20% penalty deduction being applied.

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)

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.” If the client fails to

disclose answers to several items, you will need to find another client who is

willing to share. nr305 – Healthy People Initiative.

You are required to use the linked form for the Family

Genetic History or you will earn a “0” for the assignment. In

addition, assignments that do not follow the current guidelines or use the

required form will be evaluated for evidence of an academic integrity

violation.

After the due date, there will be no opportunity for

revision or resubmission of assignments that have been uploaded to the

submission area. It is your responsibility to submit the correct assignment to

the correct submission area.

Directions

Refer to the examples in Chapter 4 of your textbook that

discuss development of a genogram.

Download the required NR305_Family_Genetic_History_Form (Links

to an external site.)Links to an external site.. You will document the adult

participant’s family genetic history using this MS Word document.

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.

Save the completed form by clicking on Save as and add your

last name to the file name, for example,

NR305_Family_Genetic_History_Form_Smith.

Submit the completed form to the Family Genetic History form

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. nr305 – Healthy People Initiative.

Week 4

Course Project Milestone 1

Course Project Milestone 1: Health History Guidelines

Purpose

The student will obtain a health history on a willing,

nonrelated, adult participant in order to generate written documentation that

is clear and accurate. Note: Failing to complete this assignment using an adult

participant other than yourself will result in a 20% penalty deduction being

applied.

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)

The Course Project Milestone 1: Health History assignment is

to be submitted by Sunday, 11:59 p.m. MT at the end of Week 4. 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.” If the client

fails to disclose answers to several items, you will need to find another

client who is willing to share.

You are required to use the linked form for Milestone 1 or

you will earn a “0” for the assignment. In addition, assignments that

do not follow the current guidelines or use the required form will be evaluated

for evidence of an academic integrity violation.

After the due date, there will be no opportunity for

revision or resubmission of assignments that have been uploaded to the

submission area. It is your responsibility to submit the correct assignment to

the correct submission area. nr305 – Healthy People Initiative.

Directions

Find an adult who is not related to you who is willing to

let you take a health history.

Download the required NR305_Milestone1_Form (Links to an

external site.)Links to an external site.. 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.

Review the examples in Chapter 4 of your textbook to gain

insight into how to document the health history. Remember this is a health

history, not a physical examination. 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, for example, 3x/day instead of frequently, or consuming

four servings of vegetables/day instead of increased vegetable servings.

Save the file by clicking Save as and adding your last name

to the file name, for example, NR305_Milestone1_Form_Smith.

Submit the completed form by Sunday, 11:59 p.m. MT at the

end of Week 4.

Please post questions in the Q & A Forum so the entire

class may view the answers.

Week 6

Course Project Milestone 2

Course Project Milestone 2: Patient Teaching Plan Guidelines

The purpose of this paper is to apply information gathered

from the Family Genetic History and Milestone 1 assignments to identify one

modifiable risk factor and develop an evidence-based teaching plan that

promotes health as well as improves patient outcomes.

Course Outcomes

This assignment enables the student to meet the following

Course Outcomes. nr305 – Healthy People Initiative.

CO4: Identify teaching/learning needs from the health

history of an individual. (PO2)

This assignment is worth a total of 225 points.

Rubric

Click to view and download the Milestone 2 Grading Rubric

(Links to an external site.)Links to an external site..

The assignment is to be submitted by Sunday, 11:59 p.m. MT

at the end of Week 6.

General Directions & Project Guidelines

Application: Use Microsoft Word 2010™ or later to create

this assignment.

This paper is to be written in APA format. Please use the

recommended assignment specific APA Template (Links to an external site.)Links

to an external site. linked here to type on. The SSPRNBSN resource has a great

section on writing scholarly papers and APA formatting (to find resource watch:

http://www.brainshark.com/devry/Student_Success_Strategies/zHszgnQAKzBXqbz0

(Links to an external site.)Links to an external site.)

APA formatting helps you to format your paper in a

professional manner and provides consistent methods for citing your sources

within the paper and providing the complete reference on the reference page.

See the documents in the APA category in Course Resources for assistance with

APA formatting.

This paper is expected to be no more than four pages in

length (not including the title page and reference list).

Please use the categories listed below as the first level

headings for each section of your paper (Exception: Instead of

“Introduction” please use the title of your paper).

Content Guidelines

Using the information gathered in your Genetic Family

History and Milestone 1 assignments, you will identify and research one

modifiable risk factor. You will develop an evidence-based teaching plan that

promotes health, with the aim of improving patient outcomes related to this

modifiable risk factor.

Introduction (1 paragraph): The introduction should be

interesting and capture the reader’s attention.

State one preventable disease your adult participant is at

risk for developing (obesity, Type 2 Diabetes, etc.), based on the information

you have gathered during this course.

Introduce one modifiable risk factor (diet, smoking,

sedentary lifestyle, etc.) associated with the preventable disease you

described.

Clearly state the purpose of your paper. The purpose

statement should relate to developing a patient teaching plan.

Preventable Disease Overview (1-2 paragraphs): Please use

course materials and scholarly sources to complete this section. Be sure to

paraphrase and include citations as needed!

Describe briefly the preventable disease you identified in

the introduction.

What are the signs and symptoms associated with this

disease?

How is it diagnosed? Notable information from Health History

and General Survey? Signs and symptoms? Risk assessments? Lab values?

What physical assessment findings would be associated with

this disease?

How did you identify your adult participant’s risk for this

disease?

Specific information gathered in the Genetic Family History?

Specific information gathered in the Milestone 1 assignment?

Evidence Based Intervention (1-2 paragraphs):

Choose and describe one evidence based intervention related

to the modifiable risk factor you have chosen. (One that has been shown to be

effective at reducing an individual’s risk for developing the preventable

disease.) nr305 – Healthy People Initiative.

Describe this intervention in detail, and provide rationale

for your intervention utilizing:

At least one scholarly peer-reviewed journal article. Go to

the Chamberlain library at http:/library.chamberlain.edu (Links to an external

site.)Links to an external site.. Search peer reviewed journals to find a

scholarly article that discusses interventions associated with the modifiable

risk factor you have chosen as the focus of your paper. Summarize what you

learned from this article and cite the source in the text and reference page

(Author, year). The article must be less than 10 years old. You may include and

cite your textbook or other scholarly sources as well, but they do not count as

the scholarly journal article.

You must summarize and analyze the information from your

sources in your own words. Avoid direct quotations. If you do include a short

quotation, be sure to cite it properly.

List short and long term goals you have for your participant

related to this intervention.

Implementation: Teaching Plan (1-2 paragraphs):

Discuss in this section what methods you will use to teach

your participant how to implement the intervention.

What is it that you are asking them to do? (For example, if

your intervention is “quit smoking”, what specific steps will you

recommend your participant take to achieve this goal?)

Describe any resources you would provide to the participant

to help them understand and be successful (websites, community services,

handouts, etc.).

Evaluation (1 paragraph):

Describe at least one method (weight, lab values, etc.) you

would use to evaluate whether your intervention was effective.

How would you revise you plan if it proved to be

unsuccessful?

Summary (1 paragraph):

Summarize the main points of your paper.

Reiterate what you hope to accomplish by implementing this

intervention.

End with a concluding statement.

Reference Page:

The Reference Page should start on a new page (insert a page

break).

All references should be cited within the body of the paper

as (Author, year) and the full reference should be included in APA format on

the reference page. nr305 – Healthy People Initiative.

A URL link alone is not an adequate reference.

See the Chamberlain Guidelines for Writing Professional

Papers in Course Resources for examples of properly formatted references.

Best Practices – Tips for Writing a Great Paper!

Review the directions, guidelines, and grading rubric

thoroughly.

Use the APA template provided.

Be clear. Write about one preventable disease, one

modifiable risk factor, and one related intervention.

Proofread prior to final submission. Having another person

review your work is often helpful to catch grammar and spelling errors. (Spell

check is not perfect!)

Abide by the CCN academic integrity policy – use the

Turnitin Draft Submission link found in the Introduction & Resources Module

to ensure that your similarity index is less than 24%, if not, revise and

resubmit prior to the deadline. Please review the documents related to TurnItIn

in Course Resources. nr305 – Healthy People Initiative.

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