Category: Nursing

Evidence summary

Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star Model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes Evidence summary. The evidence summary will be conducted through the ’breaking down’ of a systematic review on your topic for your change project.

Course Outcomes

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This assignment enables the student to meet the following course outcomes:

CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO4)

CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO8)

Due Dates

Milestone 1 consists of the completion of ONE form with two worksheets. Complete both worksheets and submit the form by Sunday, 11:59 p.m. MT at the end of Week 3.

Points

Milestone 1 is worth 175 points (75 points for the Practice Issue and 100 points for the Evidence Summary) Evidence summary.

You are required to use the linked article and Worksheets or you will earn a ”0” for the assignment. In addition, assignments that do not follow the current guidelines or use the required Worksheet or article 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.

Practice Issue Worksheet Directions

A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.

Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..

Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.

Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions.

Your practice issue will be the same for all three Milestone assignments in this course.

Please type your answers directly into the worksheet.

Evidence Summary Worksheet Directions

Develop an evidence summary by following the grading criteria below.

Document this on the evidence summary portion of the worksheet.

You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.

Please type your answers directly into the worksheet.

Capstone Project Milestone 1:

Practice Issue and Evidence Summary Worksheets

For Use March 2018

Student Name: Date:

Directions

1. Refer to the guidelines for specific details on how to complete this assignment.

2. Type your answers directly into the worksheets below.

3. Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT.

4. Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response.

Practice Issue Worksheet

List the topic and include the citation for the systematic review you have selected from our approved list (optional: an additional scholarly source of support): Evidence summary.

What is the nursing practice issue you have identified related to the topic you have chosen?

Fully describe the scope of the practice issue:

What is the practice area?

___ Clinical

___ Education

___ Administration

___ Other (List):

How was the practice issue identified? (check all that apply)

___ Safety/risk management concerns

___ Unsatisfactory patient outcomes

___ Wide variations in practice

___ Significant financial concerns

___ Difference between hospital and community practice

___ Clinical practice issue is a concern

___ Procedure or process is a time waster Evidence summary

___ Clinical practice issue has no scientific base

__ Other:

Describe the rationale for your checked selections:

What evidence must be gathered? (check all that apply)

___ Literature search

___ Guidelines

___ Expert Opinion

___ Patient Preferences

___ Clinical Expertise

___ Financial Analysis

___ Standards (Regulatory, professional, community)

___ Other

Describe the rationale for your checked selections:

Evidence Summary Worksheet

Directions: Please type your answers directly into the worksheet.

Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms: Evidence summary.

Type the complete APA reference for the systematic review article you chose from the list provided. It must be relevant to the practice issue you described above. Include the APA reference for any additional optional supplemental scholarly source related to the review you wish to use.

Identify the objectives of the article:

Provide a statement of the questions being addressed in the work and how these relate to your practice issue:

Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes Evidence summary.

Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome. Consider the relevance to your project proposal for the Milestone 2 project paper. (If an optional supplemental source is also used, include a statement of relevance to it as well.)

Outline evidence-based solutions that you will consider for your project.

Discuss any limitations to the studies that you believe impacts your ability to utilize the research in your project Evidence summary.

Week 5 Social Movements Assignment

A grassroots way to facilitate change in society is through a social movement. Often these movements are created after an injustice to change the way a society thinks and acts towards a sect of people.  Your assignment this week focuses on using social psychology concepts to explain the development of a social movement and the change in society that has occurred from the social movement.

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Some examples of social movements you may want to research are:

Black Lives Matter                  Blue Lives Matter                   Pro-Choice

Defend Science                       LGBTQ                                     Human Rights

Environment                           Animal Rights                          Anti-Bullying

 

 

Your assignment for this week is to find two articles that discuss one social movement. Social Movements Assignment. To help guide your analysis, complete the following steps:

 

– Summarize each article, focusing on main ideas and primary examples (2-4 Paragraphs)

– Discuss the relationship between the articles and key terms and ideas in social psychology (2-3 Paragraphs)

– Describe social change that has come about from the movement and utilize social psychology ideas to support your recommendation (1-2 paragraphs)

– Provide APA citations for both articles and additional references.

 

Grading:

50 points – summarizes two articles related to a specific social movement Social Movements Assignment.

20 points – discusses the issues the topics of the articles in relation to social psychology terminology

15 points – conclusion using social psychology ideals on changes that have come about due to the social movement discussed

15 points – for orderly presentation in subsections, freedom from spelling and grammar errors, and use of APA style citations and reference page.

 

Expectation

Points Possible

Summaries

Summaries are included for two articles and provide specific details about main arguments, key claims, and examples.

50

Social Psychology Terminology and Use

The analysis includes a strong use of social psychology terminology and thoughtful applies concepts to current events.

20

Conclusion

Conclusion includes recommendations for social change and provides a specific plan of action to support a culture of change.

15

APA Format and Style

Paper uses APA format and utilizes style and grammar to promote clarity. Social Movements Assignment.

15

Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients

Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?

Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.

Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain. Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.

If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

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Please include a brief introduction with the purpose

Conclusion

The references should be most recent (2-3years)

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed? Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

Voluntary and Involuntary Commitment Regarding Pediatric Psychiatric Patients

Concerning psychiatric patients, voluntary commitment means the patient chooses to be admitted for treatment. On the other hand, involuntary commitment is a legal process through which the patient is ordered to go for treatment by the court (Rayesteijn et al. 2017). In either case, the care is done through an inpatient facility and sometimes through an outpatient basis. For the instance of those who cannot make decisions for themselves like children, the admission to a medical facility will be voluntary when the parents or guardians accept the voluntary (Shields, Borba, & Trinh, 2017). Most entries are often voluntary: involuntary admission is rare. This paper discusses voluntary and involuntary commitment from a scenario where I am a PMHNP.

I strongly oppose voluntary commitment of the client due to the selected reasons herein. First, the patient is overwhelmed by suicidal thoughts hence he cannot voluntarily opt for pediatric psychiatric admission. According to Pfiffner et al., admission to healthcare for suicidal thinking is the last resort and most often treating people in the community is better for such clients (2014). However, the chances of the patient being safe in the community setting are low. Additionally, the client’s parents have conflicts of interest over their son’s assistance. Notably, the mother uses threats to demand that the client be discharged while the father requires that the child be hospitalized because of the suicide. In search of a scenario, the voluntary commitment will fail thus involuntary commitment should be advocated for. Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

However, in the United States, only forty-five states have laws which authorize the use of court-ordered treatment which is in the Mental Health Care Act. In my state, the client is eligible for involuntary commitment. The criteria for one to be involuntarily committed, the client should have a mental illness, the client’s disease and the problem should be requiring instant treatment. Also, the anticipated treatment should be accessible at the accredited mental healthcare institution and that there is a looming risks that the patient may source injury to him or herself (Masood et al. 2017). In my scenario, the patient wants to commit suicide which is the mental illness. Also, his problem needs immediate attention since if left alone, he will continue taking diphenhydramine hydrochloride. Conversely, the client can cause harm since he is overwhelmed by thoughts of suicide. Not to mention, our medical facility is in a position to offer necessary treatment. Having said all these, the client qualifies for involuntary commitment Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

Accordingly, my understanding of the state laws confirms my recommendation about involuntary committing the patient. Following the client’s stunt actions, I was unable to engage voluntarily commit him having a well understanding of the factors seen from the patient. Furthermore, the patient was at imminent risk of taking away his life in which he had already taken Benadryl which suggests that when discharged from the hospital, he will continue taking the tablets. Although the mother is using her clerical staff for the state board of nursing’s position, however, she is not concerned with what the son is capable of doing with her life. Following the nursing policies, ethics and the state laws, I could not bow to pressure to discharge the son before ailment is complete.

Nonetheless, if the client were not eligible for involuntary treatment, I would suggest and take the following course of actions to support voluntary commitment. First, I would recommend a psychotherapist who will be checking on the client’s health progress as well as offering guidance and counseling while at home. When the client-therapist relationship exists, care is provided to the client at the time of the alleged wrongdoing hence reducing chances of harmful actions (Townsend & Morgan, 2017). Also, I will work with the client minimize his risk of feeling shameful and also recommend care which is in line with the principles of cultural safety and competence. Additionally, I will provide hope for the father who thinks that the son will be at risk if discharged as well as encouraging the client that I will take an initiative of talking to the parents of the girlfriend to allow him to date the girl. Doing all these gives the client hope as well as his parents Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

Conversely, my initial actions to begin treatment would be assessing the client’s mental status which includes mood and the effect along with other signs of depression. I will also determine the patient’s feeling of hopelessness as well as obtaining the suicidal behavior history which include threats and ideation, earlier attempts and lethality of these events. For instance, the patient may be experiencing impulsivity symptoms like acting and reacting to situations without putting into account the possible consequences (Davison, Mackay, & McGivern, 2017). Considering all these risk factors will aid me in accurately determining if the patients with romance relationship issues are at risk of suicide thus I can give the right medication.

In conclusion, from the scenario, the client qualifies for involuntary commitment. The client is capable of doing anything to take his life away. However, offering therapy to him is likely to improve the situation. Furthermore, the patient needs to be given hope that his parents or clinicians will take the initiative to talk to the parents of his girlfriend to sort out issues thus he should not commit suicide Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

 

References

Davison, J., Mackay, B., & McGivern, M. J. (2017). The Potential of Simulation to Enhance Nursing Students’ Preparation for Suicide Risk Assessment: A Review. 
Open Journal of Nursing
, 
7
(02), 129.

Masood, B., O’Ceallaigh, S., Thekiso, T., Nichol, M., Kowalska-Beda, P., Murphy, M., … & Kennedy, N. (2017). Clinical predictors of involuntary detention among voluntary inpatients in St Patrick’s University Hospital (SPUH). 
Irish Journal of Psychological Medicine
, 
34
(1), 13-18.

Pfiffner, C., Steinert, T., Kilian, R., Becker, T., Frasch, K., Eschweiler, G., & Jaeger, S. (2015). Rehospitalization risk of former voluntary and involuntary patients with schizophrenia. 
Social psychiatry and psychiatric epidemiology
, 
49
(11), 1719-1727 Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

Ravesteijn, B., Schachar, E. B., Beekman, A. T., Janssen, R. T., & Jeurissen, P. P. (2017). Association of cost sharing with mental health care use, involuntary commitment, and acute care. 
JAMA Psychiatry
, 
74
(9), 932-939.

Shields, M. C., Borba, C. P., & Trinh, N. H. T. (2017). Quality of Inpatient Psychiatric Care and Consumers’ Trust in the Mental Health Care System. 
Psychiatric Services
, 
68
(6), 642-643.

Townsend, M. C., & Morgan, K. I. (2017). 
Psychiatric mental health nursing: Concepts of care in evidence-based practice
. FA Davis Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay

Course Project: Part 1- Identifying a Researchable Problem

Prescription drug abuse can affect an individual during any stage of their life.  Some of the populations that are most at-risk for prescription drug abuse are adolescents, the elderly, and women.  One population in particular, patients with chronic pain, are at an exceptionally high risk to abuse or misuse prescription medications (Manchikanti, 2006).  NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay. Many times, chronic pain goes unrecognized and untreated in patients of racial and ethnic minorities, women, the elderly, patients with cognitive impairments, and those with cancer and at the end of life (CDC, 2016).  The purpose of this paper is to develop feasible research questions in order to explore the issue pain management poses to nursing practice.

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Area of Interest

Chronic pain is defined as pain that lasts longer than six months.  The American Academy of Pain Medicine (2016) estimates that approximately 100 millions Americans suffer from chronic pain.  There are four common types of chronic pain- back pain, migraine pain, neck pain, and facial pain.  Approximately 26 million Americans between the ages of 20-64 experience back pain (The American Academy of Pain Medicine, 2016) NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

The American Academy of Pain Medicine (2016) believes that prescription painkillers are a major contributor to the total number of drug deaths in America.  Approximately 28,000 Americans died from unintentional drug poisoning in 2007 and nearly 12,000 of these deaths involved prescription pain relievers.  From 1998 to 2008, the proportion of all substance abuse treatment admissions that reported any pain reliever abuse increased more than fourfold (The American Academy of Pain Medicine, 2016).   According to the CDC (2016), 20% of patients presenting to physician offices receive an opioid prescription.  In 2012, health care providers wrote 259 million prescriptions for opioid pain medication (CDC, 2016). NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

Generated Questions and Their Feasibility

For this assignment, we were asked to formulate five research questions based on our topic of interest and then evaluate them to decide which questions are the most feasible.  The following are the five research questions that I have developed:

In patients with chronic pain, what is the effect of utilizing a combination of pharmacological and non-pharmacological methods to manage their pain?

In patients with chronic pain, does pharmacologic use only influence their dependence on narcotics?

In patients with chronic pain, what are the common complaints of pain that these patients seek treatment for? NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

In patients with chronic pain, what are the patient’s expectations regarding pain control and pain management?

In patients with chronic pain, what percentages of physicians are utilizing other methods of pain management besides medications?

Sufficient research questions are utilized to establish a foreground for Evidence-Based Practice, or EBP, inquiry.  Research questions should identify key variables of the study, the relationships among the variables, and the population in which the study is researching.  With these requirements in mind, all of my questions identify key variables of the study I am proposing- pharmacological and non-pharmacological pain management.  The questions also focus on the population the study is examining- patients with chronic pain.  Finally, the questions also aim to explore the relationship between pain management using pharmacological and non-pharmacological methods (Polit & Beck, 2017) NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

PICOT Question

The PICOT question I have developed is as follows:  In patients with chronic pain, what is the effect of a multi-modal pain management system compared to pharmacological use only on pain management over a year? (Walden Student Center for Success, 2012)

In my PICOT question, the population (P) is patients with chronic pain.  The intervention (I) is a multi-modal pain management system.  The comparison (C) is the use of only a pharmacological method of treating pain.  The outcome (O) is pain management, and the time frame (T) is over a year. (Walden Student Center for Success, 2012)

Keyword Searches

According to the Walden Student Center for Success (2012), once you develop your PICOT and research questions, it is time to brainstorm key search terms that will help you to find research relevant to your topic.  The Walden Student Center for Success (2012) gives us three distinct tips for developing key search words: brainstorm synonyms, expand acronyms, and look at subjects.  In order to brainstorm synonyms, you will need to think of other words or phrases that have similar meaning to your research topic.  NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay. Next, to expand out acronyms, you will need to search both the acronym and the actual phrase of the topic.  Finally, you will need to look at subjects.  In order to do this, you will need to search the main topics that the database you are researching through uses to categorize your research topic (Walden Student Center for Success, 2012).

By keeping these guidelines in mind, I developed the following research terms for my topic: “non-pharmacological methods for controlling chronic pain,”  “pain management without narcotics,” “non-pharmacologic pain management,” “chronic pain,” “chronic pain management,” “pain management,” “ending chronic pain,” “long-term pain management,” “narcotic pain management,” and “controlling pain.”

Summary

           
Throughout this paper we have discuss various methods of establishing a research topic, developing research questions, and focusing research terms in order to find the most relevant information for your research topic.  By utilizing feasible research questions, establishing a PICOT question, and creating key research terms, I will now be able to focus my evidence-based practice research on information that is significant to my research topic. NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

References

Centers for Disease Control and Prevention.  (2016).  CDC Guideline for Prescribing Opioids for Chronic Pain.  Retrieved from dhttp://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

Manchikanti, Laxmaiah.  (2006).  Prescription Drug Abuse: What is Being Done to Address this New Drug Epidemic?
Pain Physician. 
Retrieved from https://www.asipp.org/documents/PrescriptiondrugabuseWhatisbeing.pdf

Polit, D. F., & Beck, C. T. (2017).
Nursing research: Generating and assessing evidence for nursing practice
(10th ed.). Philadelphia, PA: Wolters Kluwer. NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

The American Academy of Pain Medicine.  (2016).  AAPM Facts and Figures on Pain.  Retrieved from http://www.painmed.org/patientcenter/facts_on_pain.aspx

Walden Student Center for Success. (2012).
Clinical Question Anatomy
. Retrieved from http://academicguides.waldenu.edu/content.php?pid=183871&sid=2950360 NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

Child Abuse Case Study Essay

Introduction on child abuse

What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.

How might exposure to the media and/or social media affect the patient?

What type of mandatory reporting (if any) is required in this case? Why? Child Abuse Case Study Essay.

Conclusion

Please address each sentence separately

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Child Abuse Case Study

NURS 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child

and Adolescent

Morgan, a 19-year-old male comes to your office to discuss his current mood and

symptoms. This is his first visit to a mental health clinic. “I’ve had 26 jobs in the last 2

years; I finally have a job that I like and I want to make it work.” As you begin to get to

know him, he tells you that his mood is down and that he also has times where he has

“more energy and motivation”: “That’s when I am able to get a new job.” He says that he

has difficulty interacting with coworkers. “I feel like I can’t talk to them.” If it wasn’t for

his supportive girlfriend, he wouldn’t be able to function. “She understands me and

accepts me; she knows what I have been through.” Child Abuse Case Study Essay.

As the PMHNP listens to the client and explores what he means by some of his

statements, you try to put together his story. He mentions that he has been having

nightmares and is not sleeping well. He says he startles easily. He becomes withdrawn

when he begins to talk about the reason for the nightmares.

“This all started a few weeks ago when a cousin of mine got out of jail.” He haltingly tells

the story of his parents’ mental illness and how he had to live with various relatives.

“One cousin who I stayed with a lot took advantage of me. He molested me.” They

found out he also molested other children and he went to jail. “It gives me the creeps

that he is out of jail. I have to face what he did to me.”

Morgan asks about his diagnosis. The PMHNP tells him that he has some symptoms

that sound like depression and anxiety, and that when a child has a traumatic

experience, it can reoccur and stay with a person for many years. He acknowledges

that he thought about PTSD but wasn’t sure what the symptoms look like.

As you think about Morgan’s story, consider the following questions: Where did he fall

between the cracks? Are there agencies who advocate for children like him?

There are thousands of children like Morgan. They were in a vulnerable family situation

and the “responsible” adult was not able to care for the child. Sometimes it takes years

for clients to remember and disclose the abuse. Child Abuse Case Study Essay.

Child Abuse Essay

Introduction on child abuse

Child abuse refers to the actual maltreatment of a child or potential for harm through psychological, sexual or physical approaches. It is notable that the agent of the abuse is the child’s parent, caregiver or guardian who is supposed to be responsible for protecting the child but either fails to protect the child or perpetrates the abuse (Gelles & Perlman, 2012). As a result, child abuse refers to a situation where the child is psychologically, sexually or physically harmed Child Abuse Case Study Essay.

What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.

Four strategies are available for assessing a child for abuse. The first strategy collects information from the child at risk of being abused on whether he or she is being abused. The second strategy interviews the parents, guardians and caretakers who are likely to be abusing the child. The third strategy collects information from the child’s environment to include neighbors and friends who may have witnessed the child being abused. The fourth strategy uses clinician-completed assessments. The final strategy entails conducting a physical examination on the child (Gilbert, Parton & Skiveness, 2011).

How might exposure to the media and/or social media affect the patient?

Exposure to the media is likely to have a negative effect on the patient by taking a toll on their development. In fact, it places the child under pressure resulting in an increased risk for emotional behavioral problems that would be exhibited as fear, problems with academics, depression and anxiety. In addition, it could prevent the child from recovery and even forgetting about the abuse by always acting as a reminder of what happened (Pecora et al., 2010). Child Abuse Case Study Essay.

What type of mandatory reporting (if any) is required in this case? Why?

Legal provisions designate a group of persons who are obligated to report all suspected and confirmed cases of child abuse. These groups include law enforcement officers, coroners, medical personnel, child care providers, mental health professionals (such as therapists and counsellors), medical professional (such as nurses and physicians), school personnel, and social workers. These individuals are identified for mandatory reporting because they have regular or frequent contact with children and their professional experiences allow them to identify cases of abuse. As such, they can act as credible sources of information on child abuse (Gilbert, Parton & Skiveness, 2011).

Conclusion

One must accept that child abuse is a worrying since it exposes vulnerable children to indefensible harm or failure to protect from a parent, caregiver or guardian who is supposed to protect the child. Still, there is a need to confirm a case of abuse using assessment strategies. Additionally, the information on an abuse case should not be exposed to the media since it increases the risk for the child experiencing emotional behavioral problems. Besides that, professions that have frequent contact with children should proactively fight child abuse by reporting all suspected cases. In this respect, child abuse refers to a situation where the child is psychologically, sexually or physically harmed. Child Abuse Case Study Essay.

 

References

Gelles, R. & Perlman, S. (2012).
Total Estimated Cost of Child Abuse and Neglect in the United States
. Chicago, IL: Prevent Child Abuse America.

Gilbert, N., Parton, N. & Skiveness, M. (2011).
Child protection systems: international trends and orientations
. New York, NY: Oxford University Press.

Pecora, P., Whittaker, J., Maluccio, A., Barth, R., DePanfilis, D. & Plotnick, R. (2010).
The child welfare challenge: policy, practice, and research
(3
rd
ed.). New Brunswick, NJ: Transaction Publishers. Child Abuse Case Study Essay.

NSG 6435 Full Course Latest SU

NSG 6435 Week 1 Discussion

Discussion: Pediatric Health-Care Services

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area .

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

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Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.

Using your course textbook readings and the South University Online Library, perform research on the following:

Sources of pediatric primary care in the United States

Current status of pediatric health-care services in the United States

Barriers to health care for children in the United States

After completing your research, answer the following questions:

What are the sources of pediatric primary care in the United States? Are these sources sufficient for providing health-care services to the pediatric population? Why or why not?

Are there certain pediatric populations that lack access to health-care services? Why?

What are the barriers to children in accessing health-care services in the United States? Why do these barriers exist?

NSG 6435 Week 2 Discussion

Discussion: iHuman Case Study – Developmental Assessment and Biological Functioning

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area NSG 6435.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment .

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content. iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum. NSG 6435. Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Buddy (Theodore, Jr.) VE.”

Apply information from the iHuman Case Study to answer the following questions:

Why is developmental assessment essential in the provision of primary care for infants, children, and adolescents, and what are the essential components of this assessment on the basis of a child’s age?

Which tools will you use to assess specific components of development (such as speech, motor skills, social skills, etc.)? Which tools do you think are the most accurate in assessing the developmental components and why? NSG 6435.

Which components would you consider in assessing the basic biological functioning and well-being of your pediatric patients? Why are these components important in providing primary health-care services to children?

NSG 6435 Week 3 Discussion

Discussion: MedU Case Study – Developmental Evaluation and Screening

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment .

For this assignment, you will complete a MedU case study based on the course objectives and weekly content.MedU cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the MedU case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice. NSG 6435.

The MedU assignments are highly interactive and a dynamic way to enhance your learning.Material from the MedU cases may be present in the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate MedU.

This week, complete the MedU case titled “FmCase 2: Infant well-child (2, 6, and 9 months) – Asia.”

Apply information from the MedU Case Study to answer the following questions:

Discuss the history that you would take on this child in preparation for the well-child visit.Include questions regarding her growth and development that are appropriate for her age.

Describe the developmental tool to be used for Asia, its reliability and validity and how Asia scored developmentally on this tool.Is she developmentally appropriate for her age?

What immunizations will Asia be given at this visit; what is the patient education and follow-up?

NSG 6435 Week 4 Discussion

Discussion: iHuman Case Study – HEENT and Respiratory Infections

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Katherine Harris.”

Apply information from the iHuman Case Study to answer the following questions NSG 6435:

Do you recommend a limited or an involved use of antibiotics in treatment of these diseases and other unconfirmed bacterial illnesses and why? What are the standards regarding the use of antibiotics in pediatric population, and what assessment findings would warrant prescribing an antibiotic for Asthma symptoms?

Using national guidelines and evidence-based literature, develop an Asthma Action Plan for this patient.

Do the etiology, diagnosis, and management of a child who is wheezing vary according to the child’s age? Why or why not? Which objective of the clinical findings will guide your diagnosis? Why? When is a chest x-ray indicated in this case?

NSG 6435 Week 5 Discussion

Discussion: iHuman Case Study – Cardiovascular and Hematologic Disorders in Children

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice NSG 6435.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Robert Ross.”

Apply information from the iHuman Case Study to answer the following questions:

Robert Ross is a 17 year-old male who presents with acute chest pain, palpitations, fever and malaise.He has had symptoms suggestive of a viral syndrome for the past week, but otherwise has no significant past medical history.

What questions would you ask to gather important diagnostic information?

How would you diagnose and manage this 17 year old male whose symptoms include palpitations, fever and malaise NSG 6435?

Which diagnostic studies would you recommend for this patient.Include the rationale for ALL diagnostics and Labs?

What physical exam findings and diagnostic results would be concerning to you and why? What would be three differentials in this case? Identify additional life threatening diagnoses that must be considered when a patient presents with acute chest pain.

What is the treatment (including rationale) for Robert and education for the family?

NSG 6435 Week 6 Discussion

Discussion: iHuman Case Study – Common Pediatric Illnesses

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area .

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format. NSG 6435.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment .

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam NSG 6435.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Samantha Graves, Gastroenteritis”.

Apply information from the iHuman Case Study to answer the following questions:

Which essential questions will you ask a pediatric patient or his or her caregiver when the presenting complaint is bloody diarrhea? Will these questions vary depending upon the child’s age? Why or why not? What clinical or historical findings will indicate the need for diagnostic studies and why? Which diagnostic studies will you initially order and why?

What would be three differential diagnoses in this case?

How do the common causes of vomiting differ in infants, children, and adolescents? What clinical or historical findings will indicate the need for diagnostic studies and why? Which diagnostic studies will you initially order and why NSG 6435?

NSG 6435 Week 8 Discussion

Discussion: iHuman Case Study – Neurological Disorders and Cognitive Perceptual Problems in Children

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area .

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this NSG 6435 assignment.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam NSG 6435.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Timoth Adams, VE”.

Apply information from the iHuman Case Study to answer the following questions:

What do you believe is your best course of action for this appointment?

What clinical or historical findings will indicate the need for diagnostic studies and why? Which diagnostic studies will you initially order and why?What would be three differentials in this case?

NSG 6435 Week 9 Discussion

Discussion: Infectious Diseases in Children

The discussion assignment provides a forum for discussing relevant topics for this week on the basis of the course competencies covered.

To support your work, use your course and textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to your classmates.Complete your participation for this NSG 6435 assignment.

Using your course and textbook readings and the South University Online Library, perform research on the following:

Assessment, diagnostic testing, and management of infectious conditions in a pediatric patient

Differential diagnoses for presentation of symptoms involving infectious diseases in pediatric patients

After completing your research, consider this scenario:

An eighteen-month-old child, well-known to your practice, presents with a seven-day history of fever ranging from 101 to 104.7 degrees Fahrenheit.On the fourth day of the fever, the emergency department had performed the following tests:

A blood and urine culture

A complete blood count

A comprehensive metabolic panel

The culture reports were found to be negative.

Today, the vitals of the child are the following:

Temperature: 101.5 degrees Fahrenheit

Heart rate: 120 beats/minute

Respiratory rate: 20 breaths/minute

Blood pressure: 90/40

Physical examination of the child indicates the following positive findings:

Injected conjunctiva

Palmar redness

Magenta-colored lips

Red macula

Excoriating rashes in the diaper area

On the basis of the above information, respond to the following:

What will be your differential diagnoses for this patient?

What specific physical exam findings support these differential diagnoses?

Of the differential diagnoses you listed, which would be the most concerning?

What additional diagnostic tests will you recommend? Why?

What would be your focus for caregiver education?

NSG 6435 Week 10 Discussion

Discussion: iHuman Case Study – Adolescent Risk Behaviors

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area NSG 6435.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment by Wednesday, October 4, 2017.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Angela Cotez VE”.

Apply information from the iHuman Case Study to answer the following questions:

Describe the evaluation tool and explain why this tool is essential in the care of the adolescent patient population.

Apply the findings of the scholarly research articles to the use of this evaluation tool and describe its validity and reliability.

Apply this evaluation tool to a patient situation and summarize your opinion of the results.

Describe a plan of care for the patient, depending upon the results NSG 6435.

NSG 6435 All Week Assignments Latest SU

NSG 6435 Week 1 Assignment 3

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W1_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 2 Assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W2_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 3 Assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and submit your Pediatric SOAP note document to the W3 Assignment 3 Dropbox.

Name your SOAP note document SU_NSG6435_W3_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document NSG 6435.

NSG 6435 Week 4 Assignment 4

Assignment 4: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W4_A4_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 5 Assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W5_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 6 Assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template NSG 6435. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

Complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W6_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 7 W7 Assignment 1

Assignment 1: Comprehensive Case Study

General Guidelines for Comprehensive Case Study – Week 7 Assignment 1

Your case study should not be just a SOAP note of a patient encounter—it should be a comprehensive evaluation of an iHuman patient case.

You will complete a Comprehensive SOAP note on the approved Pediatric SOAP Note template based on the findings of the iHuman case – then major research and discussion of the disease process are presented.

This case study should be a summative evaluation supported by a minimum of 5 evidence-based articles.

Evaluation of the case study should be no more than 3-4 substantive paragraphs.A minimum of five evidence-based sources (in addition to your text) should be used for your case study.

Course texts will not count as a scholarly source; if using data from websites you must go back to the literature source for the information-no secondary sources are allowed, ie, Medscape, UptoDate, etc.

This week, complete the iHuman case titled “Tommy Acker, Child Abuse”.Click here for information on how to access and navigate iHuman.

Name your SOAP note document SU_NSG6435_W7_A1_lastname_firstinitial.doc

i-Human

i-Human is an interactive cloud based system that provides comprehensive learning that

integrates clinical experience.The i-Human system helps students develop patient assessment

and diagnostic reasoning skills at various levels of education.Students will receive online

guidance, feedback, and coaching during the learning process.

Student Login Instructions for i-Human

Logging in to i-Human:

Log on at:

http://toolmanagement.next.ecollege.com/tools/thirdparty/blti.ed?launch=LS:iHuman:Patients

Next Steps:

1) If you were unable to attend a Student Orientation Webinar, please watch this introduction

video: https://vimeo.com/185046053/228aea3fc9

2) Additional tutorial videos can be found on the i-Human home screen under the title “Player

Screencast Tutorials” NSG 6435.

3) After attending the webinar or viewing the tutorial you are ready for your first practice

case.

4) The i-Human Student Support Center (link on the home screen under the videos) is a

resource for our most frequently asked questions.The Student Manual is also located here.

5) If you are having any issues that are not answered through the webinars, videos or support

center, you can email: support@i-human.com

NSG 6435 Week 7 Assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley NSG 6435.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W7_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 8 Assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W8_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 9 Assignment 4

Assignment 4: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley NSG 6435.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W9_A4_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 10 Assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W10_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 1 Discussion

Discussion: Pediatric Health-Care Services

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area .

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.

Using your course textbook readings and the South University Online Library, perform research on the following:

Sources of pediatric primary care in the United States

Current status of pediatric health-care services in the United States

Barriers to health care for children in the United States

After completing your research, answer the following questions:

What are the sources of pediatric primary care in the United States? Are these sources sufficient for providing health-care services to the pediatric population? Why or why not?

Are there certain pediatric populations that lack access to health-care services? Why?

What are the barriers to children in accessing health-care services in the United States? Why do these barriers exist?

NSG 6435 Week 2 Discussion

Discussion: iHuman Case Study – Developmental Assessment and Biological Functioning

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area .

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment .

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Buddy (Theodore, Jr.) VE.”

Apply information from the iHuman Case Study to answer the following questions:

Why is developmental assessment essential in the provision of primary care for infants, children, and adolescents, and what are the essential components of this assessment on the basis of a child’s age?

Which tools will you use to assess specific components of development (such as speech, motor skills, social skills, etc.)? Which tools do you think are the most accurate in assessing the developmental components and why?

Which components would you consider in assessing the basic biological functioning and well-being of your pediatric patients? Why are these components important in providing primary health-care services to children?

NSG 6435 Week 3 Discussion

Discussion: MedU Case Study – Developmental Evaluation and Screening

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment .

For this assignment, you will complete a MedU case study based on the course objectives and weekly content.MedU cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the MedU case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The MedU assignments are highly interactive and a dynamic way to enhance your learning.Material from the MedU cases may be present in the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate MedU.

This week, complete the MedU case titled “FmCase 2: Infant well-child (2, 6, and 9 months) – Asia.”

Apply information from the MedU Case Study to answer the following questions:

Discuss the history that you would take on this child in preparation for the well-child visit.Include questions regarding her growth and development that are appropriate for her age.

Describe the developmental tool to be used for Asia, its reliability and validity and how Asia scored developmentally on this tool.Is she developmentally appropriate for her age?

What immunizations will Asia be given at this visit; what is the patient education and follow-up?

NSG 6435 Week 4 Discussion

Discussion: iHuman Case Study – HEENT and Respiratory Infections

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Katherine Harris.”

Apply information from the iHuman Case Study to answer the following questions:

Do you recommend a limited or an involved use of antibiotics in treatment of these diseases and other unconfirmed bacterial illnesses and why? What are the standards regarding the use of antibiotics in pediatric population, and what assessment findings would warrant prescribing an antibiotic for Asthma symptoms?

Using national guidelines and evidence-based literature, develop an Asthma Action Plan for this patient.

Do the etiology, diagnosis, and management of a child who is wheezing vary according to the child’s age? Why or why not? Which objective of the clinical findings will guide your diagnosis? Why? When is a chest x-ray indicated in this case?

NSG 6435 Week 5 Discussion

Discussion: iHuman Case Study – Cardiovascular and Hematologic Disorders in Children

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area.

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Robert Ross.”

Apply information from the iHuman Case Study to answer the following questions:

Robert Ross is a 17 year-old male who presents with acute chest pain, palpitations, fever and malaise.He has had symptoms suggestive of a viral syndrome for the past week, but otherwise has no significant past medical history.

What questions would you ask to gather important diagnostic information?

How would you diagnose and manage this 17 year old male whose symptoms include palpitations, fever and malaise?

Which diagnostic studies would you recommend for this patient.Include the rationale for ALL diagnostics and Labs?

What physical exam findings and diagnostic results would be concerning to you and why? What would be three differentials in this case? Identify additional life threatening diagnoses that must be considered when a patient presents with acute chest pain.

What is the treatment (including rationale) for Robert and education for the family?

NSG 6435 Week 6 Discussion

Discussion: iHuman Case Study – Common Pediatric Illnesses

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area .

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment .

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Samantha Graves, Gastroenteritis”.

Apply information from the iHuman Case Study to answer the following questions:

Which essential questions will you ask a pediatric patient or his or her caregiver when the presenting complaint is bloody diarrhea? Will these questions vary depending upon the child’s age? Why or why not? What clinical or historical findings will indicate the need for diagnostic studies and why? Which diagnostic studies will you initially order and why?

What would be three differential diagnoses in this case?

How do the common causes of vomiting differ in infants, children, and adolescents? What clinical or historical findings will indicate the need for diagnostic studies and why? Which diagnostic studies will you initially order and why?

NSG 6435 Week 8 Discussion

Discussion: iHuman Case Study – Neurological Disorders and Cognitive Perceptual Problems in Children

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area .

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Timoth Adams, VE”.

Apply information from the iHuman Case Study to answer the following questions:

What do you believe is your best course of action for this appointment?

What clinical or historical findings will indicate the need for diagnostic studies and why? Which diagnostic studies will you initially order and why?What would be three differentials in this case?

NSG 6435 Week 9 Discussion

Discussion: Infectious Diseases in Children

The discussion assignment provides a forum for discussing relevant topics for this week on the basis of the course competencies covered.

 

To support your work, use your course and textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to your classmates.Complete your participation for this assignment.

Using your course and textbook readings and the South University Online Library, perform research on the following:

Assessment, diagnostic testing, and management of infectious conditions in a pediatric patient

Differential diagnoses for presentation of symptoms involving infectious diseases in pediatric patients

After completing your research, consider this scenario:

An eighteen-month-old child, well-known to your practice, presents with a seven-day history of fever ranging from 101 to 104.7 degrees Fahrenheit.On the fourth day of the fever, the emergency department had performed the following tests:

A blood and urine culture

A complete blood count

A comprehensive metabolic panel

The culture reports were found to be negative.

Today, the vitals of the child are the following:

Temperature: 101.5 degrees Fahrenheit

Heart rate: 120 beats/minute

Respiratory rate: 20 breaths/minute

Blood pressure: 90/40

Physical examination of the child indicates the following positive findings:

Injected conjunctiva

Palmar redness

Magenta-colored lips

Red macula

Excoriating rashes in the diaper area

On the basis of the above information, respond to the following:

What will be your differential diagnoses for this patient?

What specific physical exam findings support these differential diagnoses?

Of the differential diagnoses you listed, which would be the most concerning?

What additional diagnostic tests will you recommend? Why?

What would be your focus for caregiver education?

NSG 6435 Week 10 Discussion

Discussion: iHuman Case Study – Adolescent Risk Behaviors

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area .

To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment by Wednesday, October 4, 2017.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Here you can view information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Angela Cotez VE”.

Apply information from the iHuman Case Study to answer the following questions:

Describe the evaluation tool and explain why this tool is essential in the care of the adolescent patient population.

Apply the findings of the scholarly research articles to the use of this evaluation tool and describe its validity and reliability.

Apply this evaluation tool to a patient situation and summarize your opinion of the results.

Describe a plan of care for the patient, depending upon the results.

NSG 6435 All Week Assignments Latest SU

NSG 6435 Week 1 
 Assignment 3

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W1_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

 

NSG 6435 Week 2 
 Assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W2_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

 

NSG 6435 Week 3 Assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and submit your Pediatric SOAP note document to the W3 Assignment 3 Dropbox.

Name your SOAP note document SU_NSG6435_W3_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

NSG 6435 Week 4 
 Assignment 4

Assignment 4: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W4_A4_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

 

NSG 6435 Week 5 
 Assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W5_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

 

NSG 6435 Week 6 
 Assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

Complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W6_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

 

NSG 6435 Week 7  
 W7 Assignment 1

Assignment 1: Comprehensive Case Study

General Guidelines for Comprehensive Case Study – Week 7 Assignment 1

Your case study should not be just a SOAP note of a patient encounter—it should be a comprehensive evaluation of an iHuman patient case.

You will complete a Comprehensive SOAP note on the approved Pediatric SOAP Note template based on the findings of the iHuman case – then major research and discussion of the disease process are presented.

This case study should be a summative evaluation supported by a minimum of 5 evidence-based articles.

Evaluation of the case study should be no more than 3-4 substantive paragraphs.A minimum of five evidence-based sources (in addition to your text) should be used for your case study.

Course texts will not count as a scholarly source; if using data from websites you must go back to the literature source for the information-no secondary sources are allowed, ie, Medscape, UptoDate, etc.

This week, complete the iHuman case titled “Tommy Acker, Child Abuse”.Click here for information on how to access and navigate iHuman.

 

Name your SOAP note document SU_NSG6435_W7_A1_lastname_firstinitial.doc

i-Human

i-Human is an interactive cloud based system that provides comprehensive learning that

integrates clinical experience.The i-Human system helps students develop patient assessment

and diagnostic reasoning skills at various levels of education.Students will receive online

guidance, feedback, and coaching during the learning process.

Student Login Instructions for i-Human

Logging in to i-Human:

Log on at:

http://toolmanagement.next.ecollege.com/tools/thirdparty/blti.ed?launch=LS:iHuman:Patients

Next Steps:

1) If you were unable to attend a Student Orientation Webinar, please watch this introduction

video: https://vimeo.com/185046053/228aea3fc9

2) Additional tutorial videos can be found on the i-Human home screen under the title “Player

Screencast Tutorials”

3) After attending the webinar or viewing the tutorial you are ready for your first practice

case.

4) The i-Human Student Support Center (link on the home screen under the videos) is a

resource for our most frequently asked questions.The Student Manual is also located here.

5) If you are having any issues that are not answered through the webinars, videos or support

center, you can email: support@i-human.com

NSG 6435 Week 7 
 Assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W7_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

 

NSG 6435 Week 8 
 Assignment 3

Assignment 3: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W8_A3_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

 

NSG 6435 Week 9 
 Assignment 4

Assignment 4: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template NSG 6435.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W9_A4_LastName_FirstInitial.doc.

Include the reference number from eMedley in your document.

 

NSG 6435 Week 10 
 Assignment 2

Assignment 2: SOAP Note

Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.

Submission Details:

enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Name your SOAP note document SU_NSG6435_W10_A2_LastName_FirstInitial.doc.

Include the reference number from eMedley in your NSG 6435 document.

nsg3039 – Technology’s Impact on Population Health

The discussion assignment provides a forum for discussing

relevant topics for this week on the basis of the course competencies covered.

By the due date assigned, post a response to one of the two

discussion topics below, using information from the lectures, reading

assignments, library resources, and Internet resources. All responses should be

posted to the Discussion Area.

To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

ORDER A PLAGIARISM-FREE PAPER HERE

Tasks:

Advances in technology have fed the explosion of wearable

devices and patient self-monitoring. How can nurses leverage this technology to

promote healthy lifestyles and improved compliance with self-care and

monitoring?

There are vast quantities of consumer data available today.

For example, every time you use your grocery store loyalty card, data about what

you purchased is collected, analyzed, and saved. This data in the hands of

population health professionals can contribute to the creation of healthy

lifestyle programs. However, the same data in the hands of health insurance

plans could lead to higher insurance costs of denial of insurance. Should there

be regulations on how these consumer data are used? nsg3039 – Technology’s Impact on Population Health

Citations should conform to APA guidelines. You may use this

APA Citation Helper as a convenient reference for properly citing resources or

connect to the APA style website through the APA icon below.

By the end of the week, comment on at least two of your

peers’ responses. You can ask questions or respond generally to the overall

experience. Be objective, clear, and concise. Always use constructive language,

even in criticism, to work toward the goal of positive progress. All comments

should be posted to the Discussion Area nsg3039 – Technology’s Impact on Population Health.

Tommy Acker’s Comprehensive Case Study

STUDENT NAME:

DATE OF ASSIGNMENT:

Patient Initials: Tommy Acker

Date of Encounter:

 

Sex: Male

Age/DOB/Place of Birth: 26 months old

2/5/2017

SUBJECTIVE

Historian: Mother

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Present Concerns/CC: “Stomach ache” (abdominal pain)

Child Profile: Listless and ill appearing 26-month-old, male with a history of Downs’s syndrome and ASD repair. The mother states that “normally he is a healthy, very active and playful toddler.” She mentions that he is delayed developmentally due to his Downs syndrome. She states that he does not speak much, says basic words and does not pick things up as quickly as other children Tommy Acker’s Comprehensive Case Study. She states that he is clumsy. He is always tripping, falling, or bumping into things as if he does not see that it is there. None of his falls/incidents have resulted in him requiring medical attention. She states that he is normally well-behaved, has a good appetite, drinks an adequate amount of fluids, sleeps well during the night, and does not require much else. He does not go to day care and lives at home with his two siblings and mother. His mother works and their neighbors or mother’s boyfriend babysit the children.

HPI:

Onset: 2 days ago

Location/Radiation: abdominal pain

Duration: constant; worsening over 2 days

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Character: aching

Aggravating factors: being touched

Relieving Factors: none

Timing: constant

Severity: severe

Tommy, a 26-month-old male with Down syndrome, was brought into the ED by his mother who reports he has been “complaining” of abdominal pain x 2 days, had emesis x 1, is lethargic, sweating, breathing rapidly and has diminished urine output. All symptoms started soon after his “falling out of the bed during his nap.” She denies associated head trauma but claims he is not eating or drinking. She denies prior injuries that required medical attention. PMH is notable for post atrial-septal defect repair with transient CHF as an infant. The child appears listless and pale. Exam reveals hypotension, tachycardia, tachypnea, and signs of dehydration. The abdomen is grossly distended with significant epigastric bruising, in a distribution that is atypical for a fall. It is firm to palpation with diffuse tenderness, guarding and rebound tenderness. A reducible 2.0-cm umbilical hernia is present. Tommy Acker’s Comprehensive Case Study.

Medications: None currently.

PMH: Normal pregnancy and no complications noted at birth.

 

Allergies: None

Medication Intolerances:  None

Chronic Illnesses/Major traumas: Atrioventricular septal defect, transient CHF, heart murmur Denies any trauma Tommy Acker’s Comprehensive Case Study

Hospitalizations/Surgeries: Atrioventricular septal defect repair

Immunizations: Immunizations up-to-date; DTaP x 5, Hep-A x2, Hep-B x3, HIB x4, MMR x2, PCV7 x4, IPV x4, VZV x2, FLU x2

 

Family History:

Mother: Anemia, 3 healthy pregnancies

Father: unknown; not involved

5-year-old sibling: Asthma

6-month-old sibling: Healthy

Social History:

Single-Mother but currently dating 6-month-old sibling’s father. Mother graduated from high school and is employed as a cashier at a local retail shop. She states that she does not make a lot of money and is unable to afford daycare. Her neighbor helps her with childcare and if her neighbor is unavailable, her boyfriend will help her. Her boyfriend does not like to babysit because he claims the children become whiny at the same time and he cannot tolerate it. The mother and the boyfriend both smokes, but “try to keep it away from the kids.” T.A. is exposed to second-hand smoke. She denies the use of any illicit drugs, ETOH, and marijuana. Mother feels safe in community and surrounding neighborhood and feels they have adequate transportation and access to care when necessary Tommy Acker’s Comprehensive Case Study.

Review of Systems (ROS)

 

 

General:

Complains of listlessness, fatigue, lethargy, decreased energy. Denies fever and chills, weight change, and night sweats. Tommy Acker’s Comprehensive Case Study.

Cardiovascular:

Known history of ASD with repair. Denies dizziness, chest pain, palpitations, PND, orthopnea, edema, peripheral cyanosis.

Skin:

Complains of cool/clammy skin. Bruising noted on abdomen. Denies rashes, bleeding or any changes in lesions or moles. v

Respiratory:

Breathing rate appears more rapid then baseline. Denies cough, shortness of breath, wheezing, hemoptysis, dyspnea, pneumonia history, TB, or sputum production.

Eyes:

Denies use of corrective lenses, redness, blurring, or visual changes of any kind.

Gastrointestinal:

Complains of abdominal pain, vomiting x1 episode. Denies diarrhea, constipation, hepatitis, bloating, hemorrhoids, eating disorders, ulcers, red or black tarry stools.

Ears:

Denies ear pain, hearing loss, ringing in ears, discharge

Genitourinary/Gynecological:

Patient wears diapers; urine is notably dark, strong smelling, and less frequent. Denies urgency, frequency or burning. No complaints of dysuria or hematuria.

Nose/Mouth/Throat:

Denies throat pain, hoarse voice, and foul-smelling breath. Denies sinus problems, dysphagia, nose bleeds, nasal discharge, or dental disease.

Musculoskeletal:

Denies back pain, joint swelling, stiffness or pain, fracture history, osteoporosis

Breast:

Deferred.

Neurological:

Developmentally delayed related to Downs Syndrome, poor verbal communication. Denies syncope, seizures, transient paralysis, weakness, paresthesia’s, black out spells, gait abnormality or tremors.

Heme/Lymph/Endo:

Complains of bruising but denies blood disorders, night sweats, increase thirst, swollen lymph-nodes, palpable masses, increase hunger, cold or heat intolerance.

Psychiatric:

Complains of fussiness x2 days. Denies depression, anxiety, sleeping difficulties, suicidal ideation/attempts.

 

OBJECTIVE (plot height/weight/head circumference along with noting percentiles)
Attach growth chart

Weight 22lbs. (<5 th Percentile) BMI: 19.7 (97 th percentile) Temp 97.9 BP 68/40 Height 2’ 4” Pulse 140 Resp 50 OBJECTIVE (Physical Examination) General Appearance and parent-child interaction: Lying still on exam table sucking thumb. Appears to be an ill, listless, and lethargic 26-month-old male with poor eye contact, tachycardia and rapid breathing. He is lying on exam table, his skin is pale, cool, and clammy. He is of an appropriate weight and is afebrile at this time.   Skin: Skin is pale, cool, clammy, and slightly mottled. A thoracotomy scar is consistent with heart surgery. Diffused diaper rash, faint circumferential macular discoloration on bilateral wrist consistent with aging ligature marks. Bruises is various stages of healing noted Tommy Acker’s Comprehensive Case Study. HEENT: Head is normocephalic, atraumatic and without lesions; hair evenly distributed. Eyes: fundi & red reflex present, non-injected conjunctivae, no nystagmus, no green/yellow discharge noted in conjunctiva, negative hordeolum. PERRLA (pupils equal, round, reactive to light and accommodation) 4mm, upward slanting with small skin folds on inner corners. Extraocular Movements intact. Ears: Low set, Canals patent. Bilateral Tympanic Membranes pearly grey with positive light reflex; landmarks easily visualized. Nose: Nasal mucosa pink. No septal deviation. Neck: Supple. Full Range of motion; no cervical lymphadenopathy; no occipital nodes. No thyromegaly or nodules. Oral mucosa pink and moist. Pharynx is not erythematous and without exudate. Dental caries noted. Cardiovascular: Early systolic murmur is present. Capillary refill delayed at 4 seconds. Pulses weak throughout. No edema. Respiratory: tachypnea noted with symmetric chest wall with inspiration and expiration. Respirations non-labored; lungs clear to auscultation bilaterally. Gastrointestinal: Tommy Acker’s Comprehensive Case Study. The abdomen is grossly distended with significant epigastric bruising, in a distribution that is atypical for a fall. It is firm to palpation with diffuse tenderness, guarding and rebound tenderness. A reducible 2.0-cm umbilical hernia is present. Breast: No masses, tenderness, asymmetry, nipple discharge or axillary lymphadenopathy. Genitourinary: Circumcised male, testes undescended and non-tender. No evidence of trauma, urethral discharge or inguinal herniation. Visual inspection of rectum reveals no fissures, bleeding, or masses. Soft, brown stool, guaiac-negative. Musculoskeletal: Full ROM seen in all 4 extremities, spontaneous movements. No trauma or focal deficits. Tommy Acker’s Comprehensive Case Study.   Neurological: Cranial nerves II-XII intact. Alert to verbal stimulation. No nuchal rigidity or meningeal irritation noted (Wald, 2016). Psychiatric: Alert to verbal stimuli. Poor eye contact, lethargy, listless; delayed responses. In-house Lab Tests – CBC: WBC 19000                             Head CT CMP                                                   Skeletal Survey PT/INR                                               CT abd/pelvis with IV contrast Venous blood gas Lipase Serum Amylase Serum Lactic acid Urinalysis Pediatric/Adolescent Assessment Tools (Ages & Stages, etc) with results and rationale For adolescents (HEADSSSVG Assessment) Age Appropriate: Vital signs assessment tool. Faces Pain Scale (1-5) Home: Lives at home with mother and two other siblings. Education: Unable to afford daycare/childcare. Neighbor and boyfriend care for the child while mother works. Eating: Eats a balanced diet with fruits and vegetables, good appetite Tommy Acker’s Comprehensive Case Study. Tommy Acker’s Comprehensive Case Study. Activities: on average: active and energetic, enjoys playing with age-appropriate toys and siblings. Drugs: The mother admits to smoking in the home, denies drug/alcohol use of any kind. Safety: Denies guns or weapons in the home. Sits in a car seat, forward facing when riding in automobiles and wears helmet when riding bicycle.   ASSESSMENT 1.       Traumatic intra-abdominal organ injury (S36.899A): Trauma is the leading cause of morbidity and mortality in the pediatric population. The abdomen is the third most commonly injured anatomic region in children, after the head and the extremities (Christian & Greenbaum, 2015).  Abdominal trauma can be associated with significant morbidity and may have a mortality as high as 8.5% (CDC, 2019). More than 80% of traumatic abdominal injuries in children result from blunt mechanisms; most commonly, they are related to motor vehicle accidents. However, in T.A. his mother’s boyfriend punching him in his abdomen most likely caused his duodenal hematoma. 2.       Systemic Inflammatory Response Syndrome (SIRS [R65.10]): SIRS can be caused by ischemia, inflammation, trauma, infection, or several insults combined. The diagnosis of SIRS depicts a clinical response to a nonspecific insult of either infectious or noninfectious origin. SIRS is defined as 2 or more of the following criteria: Fever of more than 100.4°F or less than 96.8°F, heart rate of more than 140 beats per minute, respiratory rate of more than 30 breaths per minute or arterial carbon dioxide tension (PaCO2) of less than 32 mm Hg, or abnormal white blood cell count, systolic blood pressure ,75mmHG  (Kaplan, 2018). T.A. had a WBC count of 19000, his heart rate was 160, SBP 68, and he was tachypneic at fifty breaths per minute, thus, meeting more than two criteria for SIRS. 3.       Child Abuse: Act of Commission (T74.12XA): According to the Centers for Disease Control (CDC), physical, sexual, neglect, and emotional abuse are the four common types of abuse and neglect (CDC, 2019). Neglect is defined as the failure to meet a child’s basic physical and emotional needs, including food, shelter, clothing, education, and access to medical care (CDC, 2019). Physical abuse is intentionally using physical force that may result in injury, such as, hitting, kicking, burning, or shaking of a child (CDC, 2019). Emotional abuse refers to the behaviors that harm a child’s self-worth or emotional well-being, such as shaming, rejection, or withholding love or affection (CDC, 2019). Abuse can come from several individual, family, societal, and environmental factors Tommy Acker’s Comprehensive Case Study. In the situation with T.A., the mother was neglecting her children to be able to provide basic needs for them, while depriving them of education and exposing them to physical abuse from her boyfriend. Tommy’s injuries also do not match up to the stories his mother is reporting, and she seemed to take some time to bring him in to be evaluated and became defensive when possible questions that may point toward abuse were asked Tommy Acker’s Comprehensive Case Study. 4.       Volvulus (K56.2): Volvulus can vary in presentation from vague, recurrent gastrointestinal discomfort to sudden onset of an acute abdomen with associated shock symptoms (Saxena, 2017). It may present in any age group and is not associated with traumatic injury. More often it occurs as a result of a congenital malrotation of the midgut (Saxena, 2017). PLAN including education Initial resuscitation and stabilization protocol: 1.       Assess airway, circulation and breathing. Provide oxygen for hypoxia. 2.       Place on continuous cardiac monitor, continuous pulse oximetry, and monitor vital signs Tommy Acker’s Comprehensive Case Study. 3.       Place two large-bore intravenous lines to administer isotonic fluid boluses as they are needed. 4.       Complete Primary (airway, breathing, circulation, disability, and exposure) and secondary (head-toe exam) surveys (Kaplan, 2018). T.A. is a child that is critically-ill. He will require further testing such as a CT scan of his abdomen and pelvis with contrast and an emergent surgical consult. He will also be admitted to the intensive care unit for further management. It is important to contact child protective services, police, and social-work personnel as needed Tommy Acker’s Comprehensive Case Study. *ALL references must be Evidence Based (EB) Evaluation of Case Tommy Acker’s case study was an especially depressing situation. Tommy is a non-verbal toddler with Downs Syndrome and a cardiac history. His mother is a single mother with three young children. She is a high school graduate and currently works as a cashier at a retail store. She does not make enough money to send her children to daycare, so she depends on the assistance of her neighbor and her boyfriend for child care. According to the Centers of Disease Control (CDC), children with disabilities are at higher risk for abuse or neglect compared to children without disabilities due to the perceived, extra demands a special-needs child places on a family (CDC, 2019). Signs of abuse include behavioral changes, cuts, bruises, or broken bones in various stages of healing, dirty hair, clothing, or diaper rash (Burns, Dunn, Brady, Starr, Blosser, Garzon, 2017). Tommy’s assessment revealed a diffuse diaper rash, bruises, a firm, distended abdomen, and his mother reported his behavior had changed within the last two days after falling from his bed during a nap. He is found to be critically ill requiring an emergent surgical consult, from bleeding or injury caused by blunt force trauma to his abdomen (iHuman, 2017). Tommy’s father is not involved in his life and his mother is frequently absent due to working to support her children. He is exposed to second hand smoke, he has dental caries, and his scans show various broken ribs in different stages of healing Tommy Acker’s Comprehensive Case Study. His mother waited two days to bring him in for an evaluation, thus, delaying him care and allowing his condition to deteriorate (Christian & Greenbaum, 2015). Therefore, child abuse and neglect belong in Tommy’s diagnosis list. According to the Centers for Disease Control (CDC), physical, sexual, neglect, and emotional abuse are the four common types of abuse and neglect (CDC, 2019). Neglect is defined as the failure to meet a child’s basic physical and emotional needs, including food, shelter, clothing, education, and access to medical care (CDC, 2019). Physical abuse is intentionally using physical force that may result in injury, such as, hitting, kicking, burning, or shaking of a child (CDC, 2019). Emotional abuse refers to the behaviors that harm a child’s self-worth or emotional well-being, such as shaming, rejection, or withholding love or affection (CDC, 2019). Abuse can come from several individual, family, societal, and environmental factors. In the situation with T.A., the mother was neglecting her children to be able to provide basic needs for them, while depriving them of education and exposing them to physical abuse from her boyfriend Tommy Acker’s Comprehensive Case Study. Trauma is the leading cause of mortality in the pediatric population. The abdomen is the third most commonly injured anatomic region in children, after the head and the extremities (Christian & Greenbaum, 2015).  This is because a child’s anatomy is different of that of an adult. Children’s major organs are larger in size so more surface area is exposed in a child versus an adult (Saxena, 2017). Abdominal trauma can be associated with significant morbidity and may have a mortality as high as 8.5% (CDC, 2019) Tommy Acker’s Comprehensive Case Study. More than 80% of traumatic abdominal injuries in children result from blunt mechanisms; most commonly, they are related to motor vehicle accidents. However, in Tommy’s situation, his mother’s boyfriend punching him in his abdomen most likely caused his duodenal hematoma. Tommy also is diagnosed with Systemic Inflammatory Response Syndrome (SIRS). SIRS can be caused by ischemia, inflammation, trauma, infection, or several insults combined (Kaplan, 2018). The diagnosis of SIRS depicts a clinical response to a nonspecific insult of either an infectious or a noninfectious origin. Tommy’s mental status, clammy skin, and deteriorating condition direct the provider to consider this as a diagnosis. SIRS is defined as 2 or more of the following criteria: Fever of more than 100.4°F or less than 96.8°F, heart rate of more than 140 beats per minute, respiratory rate of more than 30 breaths per minute or arterial carbon dioxide tension (PaCO2) of less than 32 mm Hg, or abnormal white blood cell count, systolic blood pressure ,75mmHG  (Kaplan, 2018). Tommy had a WBC count of 19000, his heart rate was 160, SBP was 68, and he was tachypneic at fifty breaths per minute, thus, meeting more than two criteria for SIRS. This indicates the need to stabilize this child by inserting two large bore intravenous lines so isotonic fluid boluses may be administered if necessary (Kaplan, 2018) Tommy Acker’s Comprehensive Case Study. A differential diagnosis to consider is a volvulus, because it is a must-not miss-diagnosis, and Tommy’s symptoms and age align with this as a possibility. Volvulus can vary in presentation from vague, recurrent gastrointestinal discomfort to sudden onset of an acute abdomen with associated shock symptoms (Saxena, 2017). It may present in any age group and is not associated with traumatic injury. More often it occurs as a result of a congenital malrotation of the midgut (Saxena, 2017). Tommy Acker’s Comprehensive Case Study. Tommy is predisposed to abuse, and neglect based on his age as well as, the fact that he has a disability. Schilling and Christian (2014) mention that a multidisciplinary approach including social workers, nurses, psychologists, communities, police, and pediatricians can help to prevent abuse. First, a report of abuse must be made, and it must be investigated following the state and facility’s appropriate steps (Schilling & Christian, 2014) Tommy Acker’s Comprehensive Case Study. Hagan, Shaw, and Duncan (2017) state that aggressive therapy and early interventions can help reduce trauma when a child experiences neglect and abuse at a young age. Tommy was stabilized, emergent surgery was consulted, and he will be admitted to the intensive care unit for continuous monitoring of his hemodynamic status, provided oxygen, and an aggressive fluid replacement protocol will be initiated all in an effort to save his life (iHuman, 2017) Tommy Acker’s Comprehensive Case Study. References Burns, C., Dunn, A., Brady, M., Starr, N., Blosser, C., & Garzon, D. (2017). Pediatric Primary Care (6th ed.). St. Louis: Elsevier. Centers for Disease Control. (2019). Child maltreatment: facts at a glance. Retrieved from https://www.cdc.gov/violenceprevention/childabuseandneglect/fastfact.html CDC. (2000). The National Center for Health Statistics in collaboration with the national center for chronic disease prevention and health promotion http://www.cdc.gov/growthcharts Christian C, Greenbaum VJ. (2015). Child abuse: Epidemiology, mechanisms, and types of abusive head trauma in infants and children. UpToDate. Retrieved from https://www.uptodate.com/contents/child-abuse-epidemiology-mechanisms-and-types-of-abusive-head-trauma-in-infants-and-children Davis, C., & Rajasegaran, K. (2018). Headss up! An evaluation of an adolescent simulated patient program to teach headss assessment to medical students in a diverse se asian context. Journal of Adolescent Health, 62(2), S107. Hagan, J. F., Shaw, J. S., & Duncan, P. M. (2017). Bright Futures Guidelines for health supervision of infants, children, and adolescents (4th ed.). Elk Grove Village, IL: American Academy of Pediatrics. IHuman (2017). Tommy Acker V3 PC (basic DDX) review mode. Retrieved from: https://app.i- human.com Kaplan, L. J. (2018). Systemic Inflammatory Response Syndrome. Retrieved from https://emedicine.medscape.com/article/168943-overview Saxena, A. (2017). Pediatric Abdominal Trauma. Medscape. Retrieved from https://emedicine.medscape.com/article/1984811-overview Tommy Acker’s Comprehensive Case Study Tommy Acker’s Comprehensive Case Study Schilling S, Christian C. (2014). Child physical abuse and neglect. Child and Adolescent Psychiatric Clinics of North America. 2014; 23(2):309-319. Tommy Acker’s Comprehensive Case Study Children with disabilities may be at higher risk for abuse or neglect than children without disabilities. Signs of abuse are sudden changes in behavior or unusual behavior, cuts, and bruises or broken bones (not due to a medical condition). Possible signs of neglect are dirty hair or skin, constant hunger or thirst without a known cause, and diaper rash not caused by a medical condition (Burns, Dunn, Brady, Starr, Blosser, Garzon, 2017).Tommy had a diffuse diaper rash, and his behavior had changed according to his mother Tommy Acker’s Comprehensive Case Study. Data collected by the Department of Health and Human Services (2012), reported that 13.3 percent of abused children had some disability. In a review of the literature, it was estimated at approximately 1 in 4 or 26.7 percent of disabled children will be a victim of violence. Of those, 20.4 percent will be victims of physical violence and 13.7 percent victims of sexual violence (Child Maltreatment, 2012). It is alarming at how disabled children are abused more, but it is believed that this is due to the extra demands a disabled child places on the family Tommy Acker’s Comprehensive Case Study. Recognizing the clinical presentation of a child with abusive injuries is crucial. It is evident that the patient is extremely ill; however, the mother waited 2 days to bring him in for medical attention. He has ligature marks to both wrists as well as a large bruise to his abdomen Tommy Acker’s Comprehensive Case Study. Upon evaluation of his skeletal survey, the patient has had multiple rib fractures that his mother never mentioned. Abdominal trauma is the second most common cause of death in children who have been abused. The diagnosis and management of these injuries require careful consideration (Yu, Ngo, and Goldstein, 2016). By T.A. having developmental delays, chronic illnesses, and having special needs, these all predispose him to abuse. One of the primary diagnoses in this particular case is abuse. The chest and abdominal x-ray showed evidence of multiple fractures in different stages of healing which definitively supports this diagnosis. There is an inconsistency between the reported cause of the abdominal injury “fell out of the bed” and the proven presentation of the trauma. In addition, the delay in seeking health attention and the ligature marks on patient wrists are clear evidences of abuse. Another final diagnosis must be blunt abdominal trauma due to child abuse. According to the CT scan of the abdomen, Tommy has a large central area of edema inclusive of a collection of blood, marked bowel distension, findings consistent with a duodenal hematoma. Tommy Acker’s Comprehensive Case Study He will be admitted to the ICU, and a call will be placed to Child Protective Services to report the abuse. He will need IV fluids for his shock, a surgical consult and continuous monitoring. I also consider Systemic Inflammatory Response Syndrome (SIRS) as a primary diagnose due to the signs of fluid volume deficit and hypoperfusion such as hypotension; tachycardia; increased respiratory rate; dark and strong-smelling urine; decreased urinary output; lethargy; decreased energy; cool, clammy, and pale skin are present in this patient along with abnormal WBC count (Kaplan, 2018). The differential diagnosis of incarcerated hernia should not be missed since a 2.0 cm umbilical hernia is found on PE, but this is reducible. This condition causes a severe acute abdominal pain, generalized abdominal distension, overlying skin changes and signs of shock. The most important thing is to rule out a vascular involvement of a hernia. In the cases of strangulation, the skin appears hard and painful, may appear ecchymosis, phlegmon or even fistulation in advanced stages Tommy Acker’s Comprehensive Case Study. The hernia strangulation is usually accompanied by an important systemic manifestation, with vomiting, in part by the vagal component and partly by the occlusion, abdominal pain that usually accompanies of distension, an important affectation of the general state being able to arrive at the shock. Early diagnosis is very important since incarcerated hernias can be life threatening if left untreated. (Millet et al., 2014). Hirschsprung disease should also be considered as a differential diagnosis because he did vomit, and this happens in children with Down syndrome but with the absence of chronic vomiting, constipation and abdominal obstruction it was ruled out (Burn et al. 2017) Tommy Acker’s Comprehensive Case Study. Volvulus is a condition that should also be considered as a differential diagnosis since it causes an acute bowel obstruction which is presented with abdominal pain, but this cramping in character, not constant like TA’s pain, also it is associated with vomiting, signs of dehydration, abdominal distension with tympanic sounds at percussion. The acute form present as an acute abdomen associated with abdominal distension, nausea and vomiting, absence of stools and expulsion of gases via anal. In the digestive tract, a volvulus refers to a structure that rolls abnormally over its meso and its symptoms result from the occlusion of the intestinal lumen (obstruction in closed loop) and blood supply (ischemia-gangrene)(Millet, Orliac, Alili, Guillon, & Taourel, 2014). The approach to the battered child syndrome is complex. The development of protective laws for children and multidisciplinary teams with pediatricians, psychologists, nurses, and social workers among others, is necessary to fight against this social scourge. The first step is the mandatory report. Tommy Acker’s Comprehensive Case Study. This case illustrates the need to maintain a high degree of suspicion regarding an unconvincing explanation of the family, which does not correspond to the severity of the trauma or the presence of associated lesions at different stages of evolution Fractures of the skull, long bones, ribs, and retinal hemorrhages in the examination of the fundus are frequently associated with child maltreatment; however, its absence does not exclude the diagnosis, as happened in our case. Tommy Acker’s Comprehensive Case Study As with the multiple trauma of other etiologies, therapeutic aggressiveness, and early intervention, if any, contribute to reducing morbidity and mortality (Child Maltreatment, 2012). The aggressive management of our critically ill patient, with admission to ICU, continuous cardiac monitoring, oxygen supplementation, aggressive hydration with IV fluids, was undoubtedly a determining factor in his survival. References Bowling, K., Hart, N., Cox, P., & Srinivas, G. (2017). Management of paediatric hernia.  BMJ : British Medical Journal (Online), 359 doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1136/bmj.j4484 Burns, C., Dunn, A., Brady, M., Starr, N., Blosser, C., & Garzon, D. (2017). Pediatric Primary Care (6th ed.). St. Louis: Elsevier. Tommy Acker’s Comprehensive Case Study. Chen, Y. Y, Su, W. W., Soon, M. S., & Yen, H. H. (2016). Gastrointestinal: Intramural hematoma of the duodenum.  J Gastroenterol Hepatol , 21(6),1071 Child Maltreatment 2012, (U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau), Table 3–9, accessed July 28, 2018, http://www.acf. hhs.gov/programs/cb/resource/child-maltreatment-2012. Kaplan, L. J. (2018). Systemic Inflammatory Response Syndrome. Retrieved from https://emedicine.medscape.com/article/168943-overview Tommy Acker’s Comprehensive Case Study Millet, I., Orliac, C., Alili, C., Guillon, F., & Taourel, P. (2014). Computed tomography findings of acute gastric volvulus.  European Radiology, 24 (12), 3115-22. doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1007/s00330-014-3319-2 Yu, D., Ngo, T., Goldstein, M. (2016). Child abuse-a review of inflicted intraoral, esophageal, and abdominal visceral injuries. Clinical Pediatric Emergency Medicine. Volume 17, issue 4. PP. 284-295. Tommy Acker’s Comprehensive Case Study Tommy Acker’s Comprehensive Case Study.

NSG 6435 : Family Health III Pediatrics

Week 1

discussion

Pediatric Health-Care Services

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned. NSG 6435 : Family Health III Pediatrics

To support your work, use your course textbook readings and the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

ORDER A PLAGIARISM-FREE PAPER HERE

Start reviewing and responding to the postings of your

classmates as early in the week as possible. Respond to at least two of your

classmates’ initial postings. Participate in the discussion by asking a

question, providing a statement of clarification, providing a point of view

with a rationale, challenging an aspect of the discussion, or indicating a

relationship between two or more lines of reasoning in the discussion. Cite

sources in your responses to other classmates. Complete your participation for

this assignment by the end of the week.

Using your course textbook readings and the South University

Online Library, perform research on the following:

Sources of pediatric primary care in the United States

Current status of pediatric health-care services in the

United States NSG 6435 : Family Health III Pediatrics

Barriers to health care for children in the United States

After completing your research, answer the following

questions:

What are the

sources of pediatric primary care in the United States? Are these sources

sufficient for providing health-care services to the pediatric population? Why

or why not?

Are there certain

pediatric populations that lack access to health-care services? Why? NSG 6435 : Family Health III Pediatrics.

What are the

barriers to children in accessing health-care services in the United States?

Why do these barriers exist?

Week 2

discussion

iHuman Case Study – Developmental Assessment and Biological

Functioning

This discussion assignment provides a forum for discussing

relevant topics for this week based on the course competencies covered. For

this assignment, make sure you post your initial response to the Discussion

Area by the due date assigned.

To support your work, use your course textbook readings and

the South University Online Library. As in all assignments, cite your sources

in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates

as early in the week as possible. Respond to at least two of your classmates’

initial postings. Participate in the discussion by asking a question, providing

a statement of clarification, providing a point of view with a rationale,

challenging an aspect of the discussion, or indicating a relationship between

two or more lines of reasoning in the discussion. Cite sources in your

responses to other classmates. Complete your participation for this assignment

by the end of the week. NSG 6435 : Family Health III Pediatrics.

For this assignment, you will complete an iHuman case study

based on the course objectives and weekly content. iHuman cases emphasize core

learning objectives for an evidence-based primary care curriculum. Throughout

your nurse practitioner program, you will use the iHuman case studies to

promote the development of clinical reasoning through the use of ongoing

assessments and diagnostic skills and to develop patient care plans that are

grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic

way to enhance your learning. Material from the iHuman cases may be present in

the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate

iHuman.

This week, complete the iHuman case titled “Buddy (Theodore,

Jr.) VE.”

Apply information from the iHuman Case Study to answer the

following questions:

Why is developmental assessment essential in the provision

of primary care for infants, children, and adolescents, and what are the

essential components of this assessment on the basis of a child’s age?

Which tools will you use to assess specific components of

development (such as speech, motor skills, social skills, etc.)? Which tools do

you think are the most accurate in assessing the developmental components and

why?

Which components would you consider in assessing the basic

biological functioning and well-being of your pediatric patients? Why are these

components important in providing primary health-care services to children? NSG 6435 : Family Health III Pediatrics.

Week 3

discussion

Aquifer Case Study – Developmental Evaluation and Screening

This discussion assignment provides a forum for discussing

relevant topics for this week based on the course competencies covered. For

this assignment, make sure you post your initial response to the Discussion

Area by the due date assigned.

To support your work, use your course textbook readings and

the South University Online Library. As in all assignments, cite your sources

in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your

classmates as early in the week as possible. Respond to at least two of your

classmates’ initial postings. Participate in the discussion by asking a

question, providing a statement of clarification, providing a point of view

with a rationale, challenging an aspect of the discussion, or indicating a

relationship between two or more lines of reasoning in the discussion. Cite

sources in your responses to other classmates. Complete your participation for

this assignment by the end of the week.

For this NSG 6435 : Family Health III Pediatrics assignment, you will complete a Aquifer case study based on the course objectives and weekly content. Aquifer cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the Aquifer case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The Aquifer assignments are highly interactive and a dynamic way to enhance your  earning. Material from the Aquifer cases may be present in the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate

Aquifer.

This week, complete the Aquifer case titled “CLIPP Case 2:

Infant well-child (2, 6, and 9 months) – Asia.”

Apply information from the Aquifer Case Study to answer the

following questions:

Discuss the history that you would take on this child in

preparation for the well-child visit. Include questions regarding her growth

and development that are appropriate for her age.

Describe the developmental tool to be used for Asia, its

reliability and validity and how Asia scored developmentally on this tool. Is

she developmentally appropriate for her age?

What immunizations will Asia be given at this visit; what is

the patient education and follow-up?

Week 4

discussion

iHuman Case Study – HEENT and Respiratory Infections

This discussion assignment provides a forum for discussing

relevant topics for this week based on the course competencies covered. For

this assignment, make sure you post your initial response to the Discussion

Area by the due date assigned.

To support your work, use your course textbook readings and

the South University Online Library. As in all assignments, cite your sources

in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your

classmates as early in the week as possible. Respond to at least two of your

classmates’ initial postings. Participate in the discussion by asking a

question, providing a statement of clarification, providing a point of view

with a rationale, challenging an aspect of the discussion, or indicating a

relationship between two or more lines of reasoning in the discussion. Cite

sources in your responses to other classmates. Complete your participation for

this assignment by the end ot the week.

For this assignment, you will complete an iHuman case study

based on the course objectives and weekly content. iHuman cases emphasize core

learning objectives for an evidence-based primary care curriculum. Throughout

your nurse practitioner program, you will use the iHuman case studies to

promote the development of clinical reasoning through the use of ongoing

assessments and diagnostic skills and to develop patient care plans that are

grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic

way to enhance your learning. Material from the iHuman cases may be present in

the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate

iHuman.

This week, complete the iHuman case titled “Katherine

Harris V3.1 PC.”

Apply information from the iHuman Case Study to answer the

following questions:

Do you recommend a limited or an involved use of antibiotics

in treatment of these diseases and other unconfirmed bacterial illnesses and

why? What are the standards regarding the use of antibiotics in pediatric

population, and what assessment findings would warrant prescribing an

antibiotic for Asthma symptoms?

Using national guidelines and evidence-based literature,

develop an Asthma Action Plan for this patient.

Do the etiology, diagnosis, and management of a child who is

wheezing vary according to the child’s age? Why or why not? Which objective of

the clinical findings will guide your diagnosis? Why? When is a chest x-ray

indicated in this case?

Week 5

discussion

iHuman Case Study – Cardiovascular and Hematologic Disorders

in Children

This discussion assignment provides a forum for discussing

relevant topics for this week based on the course competencies covered. For

this assignment, make sure you post your initial response to the Discussion

Area by the due date assigned.

To support your work, use your course textbook readings and

the South University Online Library. As in all assignments, cite your sources

in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your

classmates as early in the week as possible. Respond to at least two of your

classmates’ initial postings. Participate in the discussion by asking a question,

providing a statement of clarification, providing a point of view with a

rationale, challenging an aspect of the discussion, or indicating a

relationship between two or more lines of reasoning in the discussion. Cite

sources in your responses to other classmates. Complete your participation for

this assignment by the end of the week.

For this assignment, you will complete an iHuman case study

based on the course objectives and weekly content. iHuman cases emphasize core

learning objectives for an evidence-based primary care curriculum. Throughout

your nurse practitioner program, you will use the iHuman case studies to

promote the development of clinical reasoning through the use of ongoing

assessments and diagnostic skills and to develop patient care plans that are

grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic

way to enhance your learning. Material from the iHuman cases may be present in

the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate

iHuman.

This week, complete the iHuman case titled “Mia Zavarro V4.”

Apply information from the iHuman Case Study to answer the

following questions:

How would you evaluate and manage a pediatric patient who

has a painful swelling of the hands and feet, fatigue, or fussiness? Which

diagnostic studies would you recommend for this patient and why?

What physical exam findings and diagnostic results would be

concerning to you and why? What would be three differentials in this case?

In SCD, the spleen doesn’t work properly or doesn’t work at

all. This problem makes people with SCD more likely to get severe infections.

What is the treatment for Miah and education for the family?

Week 6

discussion

iHuman Case Study – Common Pediatric Illnesses

This discussion assignment provides a forum for discussing

relevant topics for this week based on the course competencies covered. For

this assignment, make sure you post your initial response to the Discussion

Area by the due date assigned.

To support your work, use your course textbook readings and

the South University Online Library. As in all assignments, cite your sources

in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your

classmates as early in the week as possible. Respond to at least two of your

classmates’ initial postings. Participate in the discussion by asking a

question, providing a statement of clarification, providing a point of view

with a rationale, challenging an aspect of the discussion, or indicating a

relationship between two or more lines of reasoning in the discussion. Cite

sources in your responses to other classmates. Complete your participation for

this assignment by the end of the week.

For this assignment, you will complete an iHuman case study

based on the course objectives and weekly content. iHuman cases emphasize core

learning objectives for an evidence-based primary care curriculum. Throughout

your nurse practitioner program, you will use the iHuman case studies to

promote the development of clinical reasoning through the use of ongoing

assessments and diagnostic skills and to develop patient care plans that are

grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic

way to enhance your learning. Material from the iHuman cases may be present in

the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate

iHuman.

This week, complete the iHuman case titled “Samantha

Graves V3 PC”

Apply information from the iHuman Case Study to answer the

following questions:

Which essential questions will you ask a pediatric patient or

his or her caregiver when the presenting complaint is bloody diarrhea? Will

these questions vary depending upon the child’s age? Why or why not? What

clinical or historical findings will indicate the need for diagnostic studies

and why? Which diagnostic studies will you initially order and why?

What would be three differential diagnoses in this case?

How do the common causes of vomiting differ in infants,

children, and adolescents? What clinical or historical findings will indicate

the need for diagnostic studies and why? Which diagnostic studies will you

initially order and why?

Week 7

discussion

Comprehensive Case Study

General Guidelines for Comprehensive Case Study – Week 7

Project

Your case study should not be just a SOAP note of a patient

encounter—it should be a comprehensive evaluation of an iHuman patient case.

You will complete a Comprehensive SOAP note on the approved

Pediatric SOAP Note template based on the findings of the iHuman case – then

major research and discussion of the disease process are presented.

This case study should be a summative evaluation supported

by a minimum of 5 evidence-based articles.

Evaluation of the case study should be no more than 3-4

substantive paragraphs. A minimum of five evidence-based sources (in addition

to your text) should be used for your case study.

Course texts will not count as a scholarly source; if using

data from websites you must go back to the literature source for the

information-no secondary sources are allowed, ie, Medscape, UptoDate, etc.

This week, complete the iHuman case titled “Tommy Acker

V3”.

Please submit your Comprehensive SOAP Note and Growth Chart

in the Submissions Area by the due date assigned.

Name your SOAP note document

SU_NSG6435_W7_A1_lastname_firstinitial.doc

Week 8

discussion

iHuman Case Study – Neurological Disorders and Cognitive

Perceptual Problems in Children

This discussion assignment provides a forum for discussing

relevant topics for this week based on the course competencies covered. For

this assignment, make sure you post your initial response to the Discussion

Area by the due date assigned.

To support your work, use your course textbook readings and

the South University Online Library. As in all assignments, cite your sources

in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your

classmates as early in the week as possible. Respond to at least two of your

classmates’ initial postings. Participate in the discussion by asking a

question, providing a statement of clarification, providing a point of view

with a rationale, challenging an aspect of the discussion, or indicating a

relationship between two or more lines of reasoning in the discussion. Cite

sources in your responses to other classmates. Complete your participation for

this assignment by the end of the week.

For this assignment, you will complete an iHuman case study

based on the course objectives and weekly content. iHuman cases emphasize core

learning objectives for an evidence-based primary care curriculum. Throughout

your nurse practitioner program, you will use the iHuman case studies to

promote the development of clinical reasoning through the use of ongoing

assessments and diagnostic skills and to develop patient care plans that are

grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic

way to enhance your learning. Material from the iHuman cases may be present in

the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate

iHuman.

This week, complete the iHuman case titled “Timothy Adams V3

PC”.

Apply information from the iHuman Case Study to answer the

following questions:

What do you believe is your best course of action for this

appointment?

What clinical or historical findings will indicate the need

for diagnostic studies and why? Which diagnostic studies will you initially

order and why?

What would be three differentials in this case?

Week 9

discussion

Infectious Diseases in Children

The discussion assignment provides a forum for discussing

relevant topics for this week on the basis of the course competencies covered.

For this assignment, make sure you post your initial

response to the Discussion Area by the due date assigned.

To support your work, use your course and textbook readings

and the South University Online Library. As in all assignments, cite your

sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your

classmates as early in the week as possible. Respond to at least two of your

classmates’ initial postings. Participate in the discussion by asking a

question, providing a statement of clarification, providing a point of view

with a rationale, challenging an aspect of the discussion, or indicating a

relationship between two or more lines of reasoning in the discussion. Cite

sources in your responses to your classmates. Complete your participation for

this assignment by the end of the week.

Using your course and textbook readings and the South

University Online Library, perform research on the following:

Assessment, diagnostic testing, and management of infectious

conditions in a pediatric patient

Differential diagnoses for presentation of symptoms

involving infectious diseases in pediatric patients

After completing your research, consider this scenario:

An eighteen-month-old child, well-known to your practice,

presents with a seven-day history of fever ranging from 101 to 104.7 degrees

Fahrenheit. On the fourth day of the fever, the emergency department had

performed the following tests:

A blood and urine culture

A complete blood count

A comprehensive metabolic panel

The culture reports were found to be negative.

Today, the vitals of the child are the following:

Temperature: 101.5 degrees Fahrenheit

Heart rate: 120 beats/minute

Respiratory rate: 20 breaths/minute

Blood pressure: 90/40

Physical examination of the child indicates the following

positive findings:

Injected conjunctiva

Palmar redness

Magenta-colored lips

Red macula

Excoriating rashes in the diaper area

On the basis of the above information, respond to the

following:

What will be your differential diagnoses for this patient?

What specific physical exam findings support these

differential diagnoses?

Of the differential diagnoses you listed, which would be the

most concerning?

What additional diagnostic tests will you recommend? Why?

What would be your focus for caregiver education?

Week 10

discussion

iHuman Case Study – Adolescent Risk Behaviors

This discussion assignment provides a forum for discussing

relevant topics for this week based on the course competencies covered. For

this assignment, make sure you post your initial response to the Discussion

Area by the due date assigned.

To support your work, use your course textbook readings and

the South University Online Library. As in all assignments, cite your sources

in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your

classmates as early in the week as possible. Respond to at least two of your

classmates’ initial postings. Participate in the discussion by asking a

question, providing a statement of clarification, providing a point of view

with a rationale, challenging an aspect of the discussion, or indicating a

relationship between two or more lines of reasoning in the discussion. Cite

sources in your responses to other classmates. Complete your participation for

this assignment by the end of the week.

For this assignment, you will complete an iHuman case study

based on the course objectives and weekly content. iHuman cases emphasize core

learning objectives for an evidence-based primary care curriculum. Throughout

your nurse practitioner program, you will use the iHuman case studies to

promote the development of clinical reasoning through the use of ongoing

assessments and diagnostic skills and to develop patient care plans that are

grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic

way to enhance your learning. Material from the iHuman cases may be present in

the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate

iHuman.

This week, complete the iHuman case titled “Angela

Cotez V3.1 PC”.

Apply information from the iHuman Case Study to answer the

following questions:

Describe the evaluation tool and explain why this tool is

essential in the care of the adolescent patient population.

Apply the findings of the scholarly research articles to the

use of this evaluation tool and describe its validity and reliability.

Apply this evaluation tool to a patient situation and

summarize your opinion of the results.

Describe a plan of care for the patient, depending upon the

results.

Psychodynamic Psychotherapy and Comprehensive Client Family Assessment

Learning Resources

Week 3 Psychodynamic Psychotherapy Resources Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

Standard 2 “Diagnosis” (pages 46-47)

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 5, “Supportive and Psychodynamic Psychotherapy” (pp. 225–238 and pp. 245–258)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Note: You will access this text from the Walden Library databases.

Young, J. M., & Solomon, M. J. (2009). How to critically appraise an article. Nature Clinical Practice. Gastroenterology & Hepatology, 6(2), 82–91.

ORDER A PLAGIARISM-FREE PAPER HERE

Learning Objectives

Students will:

Evaluate the application of current literature to clinical practice

Assignment 2: Practicum – Assessing Clients

PART 1

Learning Objectives

Students will:

Assess clients presenting for psychotherapy

Develop genograms for clients presenting for psychotherapy

To prepare:

Select a client whom you have observed or counseled at your practicum site.

Review pages 137–142 of the Wheeler text and the 
Hernandez Family Genogram
video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected. Psychodynamic Psychotherapy and Comprehensive Client Family Assessment.

The Assignment

Part 1: Comprehensive Client Family Assessment

With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations):

Demographic information

Presenting problem

History or present illness

Past psychiatric history

Medical history

Substance use history

Developmental history

Family psychiatric history

Psychosocial history

History of abuse/trauma

Review of systems

Physical assessment

Mental status exam

Differential diagnosis

Case formulation

Treatment plan

Assignment 2: Practicum – Assessing Clients

 

Part 2: Family Genogram

Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents). Psychodynamic Psychotherapy and Comprehensive Client Family Assessment.

Rubric Detail

Select 
Grid View
 or 
List View
 to change the rubric’s layout.

Name: 
NURS_6640_Week3_Assignment2_Rubric

Grid View

List View

 

Satisfactory

Unsatisfactory

Quality of Work Submitted: The extent of which work meets the assignned criteria and work reflects graduate level critical and analytic thinking.

26 (26%) – 30 (30%)

Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.

0 (0%) – 25 (25%)

Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.

Quality of Work Submitted: The purpose of the paper is clear. Psychodynamic Psychotherapy and Comprehensive Client Family Assessment.

4 (4%) – 5 (5%)

Purpose of the assignment is stated, yet is brief and not descriptive.

0 (0%) – 3 (3%)

No purpose statement was provided.

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Understand and interpret the assignment’s key concepts.

8 (8%) – 10 (10%)

Demonstrates a clear understanding of key concepts.

0 (0%) – 7 (7%)

Shows a lack of understanding of key concepts, deviates from topics.

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Apply and integrate material in course rsources (i.e. video, required readings, and textook) and credible outside resources.

16 (16%) – 20 (20%)

Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.

0 (0%) – 15 (15%)

Includes and integrates specific information from 0 to 1 resource to support major points and point of view.

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.

16 (16%) – 20 (20%)

Summarizes information gleaned from sources to support major points, but does not synthesize.

0 (0%) – 15 (15%)

Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.

Written Expression and Formatting

Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.

4 (4%) – 5 (5%)

Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.

0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time. “Written Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation” 3 (3%) – 5 (5%) Contains a few (1-2) grammar, spelling, and punctuation errors. 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. “Written Expression and Formatting The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.” 3 (3%) – 5 (5%) Contains a few (1-2) APA format errors. 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name:  NURS_6640_Week3_Assignment2_Rubric   Patient’a Name:  G. M. , DOB 3/27/1959 Primary Insurance:  CareFirst BlueCross BlueShield MD Region, TER83480955 Presenting Problem Glenice is an employed married 60 yr. old African American female who has been married for 17 years to her husband who is 48 yrs old. She has 3 sons and one was murdered. Glenice is referred by her employer’s EAP doctor for stress related concerns. Current Mental Status General Appearance: Appropriate Dress: Appropriate Motor Activity: Unremarkable Insight: Good Judgment: Good Affect: Appropriate Mood: Euthymic Orientation: X3: Oriented to Person, Place, and Time Memory: Intact Attention/Concentration: Good Thought Content: Appropriate Perception: Unremarkable Flow of Thought: Unremarkable Interview Behavior: Appropriate Speech: Normal Safety Issues Patient has intent to act:not specified Patient has plan to act:not specified Patient has means to act:not specified Background Information Identification:Glenice is a Christian and attends church. History of Present Problem:Glenice reports feeling like she needs help w/trying to figure out why she is always being taken advantage of. As a result she has been feeling angry and wonders is she a piece of crap. She cries about 5 days a week for various compiled reasons. The stress also drains her to the point of feeling tired and wants to sleep. Glenice feels like she does not have anyone. She also over thinks a lot about her health issues and her husband’s drama. He cheated on her and she still struggles w/his issues of infidelity and being unable to get past the pain. In addition, he snorts heroin and she is currently responsible for all the household’s finances. Glenice also asked her husband to leave in March 2019 and is now able to get at least 6 hrs of continuous sleep. Prior to him leaving she was getting about 4 hrs of sleep. Glenice also reports being a stress eater and gains weight during the winter months. Past Psychiatric History:Glenice was last seen by a therapist about 3 months ago for marital issues and stress related concerns. Trauma History:Glenice was raped around the age of 7. In addition, she grew up in a household w/an alcoholic mother and was exposed to different instances of potentially being molested. Family Psychiatric History:Alcoholism runs on mother side and father injected heroin. Medical Conditions & History:-Thyroid problems affecting esophagus. -Neck disc problems -Back surgery in 2015 -Total knee replacement on 1 knee in 2016 -Diagnosed w/stage one breast cancer on 2/2018 and had a lumpnectomy in May and June 2018. -Diagnosed w/tendinitis in right foot -Stomach ulcer Current Medications:-Lisinipril – high blood pressure -Linzess -Gabapentin (nerve pain) -Oxycodone 10mg as needed for pain Substance Use:-Alcohol- age of 1st use reports as 12 and last use reports as 6/6/19. Typically drinks about a half red cup of Coconut Rum Cream about 1-2 days a week. -Marijuana- experimental as a child. -Cocaine and Crack- age of 1st use reports as mid 20s and last use reports as 2012. Family History:Raised by her mother in New York who was an alcoholic and father was not present due to drug use. Both parents are deceased. Her father passed away from a heroin overdose. Glenice has 3 siblings and one is deceased. In addition, Glenice has 2 sons who are 39 and 43. Her youngest son was murdered on November 9, 2002. Social History:Glenice reports her oldest son does not talk to her and her middle son is no longer speaking to her. She has not spoken to her oldest son since some time 2018 because she does not agree w/how he treats women. In addition, she has a great relationship w/her brothers. Developmental History:Glenice has issues w/spelling. Educational / Occupational History:Highest grade completed in high-school is the 10th and received GED around 1984. Currently employed by the DC metro system for the past year and 3 months. Prior to she was working w/the City Wide Transportation for a yr. Glenice also worked for Kennedy Krieger for 7 yrs. as a patient care tech. Psychodynamic Psychotherapy and Comprehensive Client Family Assessment. Legal History:Arrested in 1999 for a drug related offense and was incarcerated for 1 yr. Strengths / Liabilities:S- determined N- genuine love A- good at encouraging people P- None Other Information:-Family hx of high blood pressure that contributed to the deaths of her mother and brother. -Glenice moved to Maryland in 1997. Diagnosis F41.1 Generalized Anxiety Disorder F43.21 Adjustment Disorder, With depressed mood Psychodynamic Psychotherapy and Comprehensive Client Family Assessment