Category: Nursing

  • Care Coordination Essay

    To prepare for this Care Coordination Essay Discussion:

    • Review this week’s Resources. Select one media piece and one article on the patient-centered medical home or on telehealth.

    • Reflect on the use of a patient-centered medical home model or a telehealth system.

    • Consider two or more of the following: features, benefits, barriers, clinical outcomes, operational efficiencies, and health care costs related to the use of a patient-centered medical home or a telehealth system.

    • Consider the impact of patient-centered medical home models and telehealth systems on care coordination and your role as a nurse. Care Coordination Essay.

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    Post the following:

    • Choose a telehealth system or the patient-centered medical home as described by the media piece you selected.

    • Explain the impact of your choice (telehealth or patient-centered medical home) on patient care coordination.

    • Determine how this model of care can increase patients’ engagement in their care Care Coordination Essay.

    • Explain the potential impact of your choice on the role of the nurse as care is provided across settings and across state lines.

    Resources

    Grady, J. (2014). CE: Telehealth: A case study in disruptive innovation. American Journal of Nursing, 114(4), 38–45.

    https://class.waldenu.edu/bbcswebdav/institution/USW1/201950_03/BS_NURS/NURS_3110/readings/USW1_NURS_3110_Week06_AdlerMilstein_2014.pdf

    Hebda, T., & Czar, P. (2013). Handbook of informatics for nurses and healthcare professionals (5th ed.). Upper Saddle River, NJ: Pearson. Care Coordination Essay.

    • Chapter 24, “Consumer Education and Informatics” (pp. 482–503)

    • Chapter 25, “Telehealth” (pp. 504–529)

     

    Care coordination

    Choose a telehealth system or the patient-centered medical home as described by the media piece you selected.

    Telehealth Kiosks has been selected as the system under focus. It involves the installation of a booth or stall that is staffed and equipped with basic medical and communication equipment. The medical equipment captures basic medical data while the communication equipment provides consultative contact with medical personnel. The system is intended to present patients with a convenient location to access medical services and specialists such as being located on the worksite or mall for convenience. In addition, it eliminates the need for patients to set up telemedicine systems at home (eVisit, 2018) Care Coordination Essay.

    Explain the impact of your choice (telehealth or patient-centered medical home) on patient care coordination.

    The selected telehealth system has an influence on patient care coordination, particularly care utilization. In this case, the system reduces the number of visits that patients make to medical facilities. To be more precise, it
    ensure
    that unplanned visits are addressed by the telehealth system so that only planned visits are made to medical facilities. The result is better care planning and utilization patterns (McKissick et al., 2017). Besides that, the system improves ratings for care providers, communication, and overall health care (Looman et al, 2015). Care Coordination Essay.

    Determine how this model of care can increase patients’ engagement in their care.

    The identified system can improve patients’ engagement from three perspectives. The first perspective is the cognitive domain whereby the system changes how patients think about medical care, understanding that unscheduled visits can be conducted using the system while scheduled visits should be conducted in medical facilities. The second perspective is emotional domain whereby the system gives patients peace of mind by offering them a convenient care option that addresses their routine care needs in a location easily accessible to them in terms of time and cost. Care Coordination Essay The final perspective is behavioral dimension that increases patients’ contact with medical facilities by presenting a system that addresses medical conditions they consider minor and that they could have ignored otherwise (Barello et al., 2015).

    Explain the potential impact of your choice on the role of the nurse as care is provided across settings and across state lines.

    The telehealth system has an influence on the role of nurses as care providers. The system has added to the nurses’ responsibilities by manage and administer the technology associated with telehealth. To be more precise, the system will present a new category of nurses responsibilities focused on the technological needs of medicine. For that matter, it adds functions and departments associated with the technology (Grain & Schaper, 2013) Care Coordination Essay.

    References

    Barello, S., Triberti, S., Libreri, C., Serino, S., Hibbard, J., Riva, G. (2015). eHealth for patient engagement: a systematic review.
    Frontiers in Psychology
    , 6. doi: 10.3389/fpsyg.2015.02013. Retrieved from

    eVisit (2018).
    Telehealth systems
    . Retrieved from https://evisit.com/resources/telehealth-systems/

    Grain, H. & Schaper, L. (2013).
    Health informatics: digital health service delivery – the future is now
    . Amsterdam: IOS Press. Care Coordination Essay.

    Looman, W., Antolick, M., Cady, R., Lunos, S., Garwick, A. & Finkelstein, S. (2015). Effects of a telehealth care coordination intervention on perceptions of health care by caregivers of children with medical complexity: a randomized controlled trial.
    J Pediatr Health Care
    , 29(4), 352-363. doi: 10.1016/j.pedhc.2015.01.007

    MccKissick, H., Cady, R., Looman, W. & Finkelstein, S. (2017). The impact of telehealth and care coordination on the number and type of clinical visits for children with medical complexity.
    J Pediatr Health Care
    , 31(4), 452-458. doi: 10.1016/j.pedhc.2016.11.006 Care Coordination Essay

  • Discussion: Emerging Technologies in Health Care Essay

    To prepare for this Discussion: Emerging Technologies in Health Care Essay

    Review the following from this week’s Resources:

    • Required readings and media

    • Hunter, K. M., McGonigle, D. M., & Hebda, T. L. (2013). TIGER-based measurement of nursing informatics competencies: The development and implementation of an online tool for self-assessment. Journal of Nursing Education and Practice, 3(12), 70.

    Note: You will access this article from the Walden Library databases.

    • Huston, C. (2013). The impact of emerging technology on nursing care: Warp speed ahead. Online Journal of Issues in Nursing, 18(2), 1–11. Discussion: Emerging Technologies in Health Care Essay.

    Note: You will access this article from the Walden Library databases.

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    Then, think about an emerging technology that may impact nursing practice, and consider how this emerging technology may impact quality or safety in practice.

    Post the following:

    • Describe the emerging technology you selected and why you selected it.

    • Categorize the target population for whom this technology was designed.

    • Explain how this technology will impact or improve quality, safety, and cost in your practice.

    Post a 3-paragraph (at least 350 words) response. Be sure to use evidence, in-text citations, and essay-level writing skills, including the use of transitional material and organizational frames. Discussion: Emerging Technologies in Health Care Essay.

    Discussion: Emerging Technologies in Health Care

    The ability to prevent, treat and diagnose diseases in the contemporary society relies on technological advancements. A significant emerging technology in healthcare is Internet of Medical Things. It describes the unification of medical devices and applications to networks and thus consists of medical monitors, smart wearables and devices exclusively employed in medical practice (Yuehong et al, 2016).  This emerging technology was selected following its ability to support monitoring, data collection, analysis and transfer of medical information across the web (Hassanalieragh et al, 2015). Moreover, it allows sharing of data in real time between healthcare products and medical equipment and with authorized handlers of healthcare information making it a center of interest for study. Discussion: Emerging Technologies in Health Care Essay. Discussion: Emerging Technologies in Health Care Essay.

    Internet of Medical Things use targets persons authorized to handle medical information. This includes healthcare providers and patients as well as other information technology personnel. It provides real time patient data thus facilitating fast and accurate diagnosis and retrieval of the patient’s medical history (Hunter, McGonigle & Hebda, 2013). Furthermore, it promotes efficiency in delivering healthcare services to patients through proper diagnoses, treatment and enhancement of fast recovery (Huston, 2013). Consequently, Internet of Medical Things helps in reducing financial burden to patients.

    Internet of Medical Things technologies has seen increased use over the years following their ability to reduce the cost of healthcare, improve safety and quality of healthcare Discussion: Emerging Technologies in Health Care Essay. It facilitates accurate diagnosis and reduces the occurrence of medical errors which affects the safety of patients (Dimitrov, 2016). More so, it improves quality through efficient delivery of care and use of evidence based approaches. It also presents low per patient cost through fast access of impatient care and operational efficiency associated with accurate diagnosis and lack of medical errors whose management is costly.

    References

    Dimitrov, D. V. (2016). Medical internet of things and big data in healthcare. 
    Healthcare informatics research
    , 
    22
    (3), 156-163.

    Hassanalieragh, M., Page, A., Soyata, T., Sharma, G., Aktas, M., Mateos, G., … & Andreescu, S. (2015, June). Health monitoring and management using Internet-of-Things (IoT) sensing with cloud-based processing: Opportunities and challenges. In 
    2015 IEEE International Conference on Services Computing
     (pp. 285-292). IEEE.

    Hunter, K. M., McGonigle, D. M., & Hebda, T. L. (2013). TIGER-based measurement of nursing informatics competencies: The development and implementation of an online tool for self-assessment.
    Journal of Nursing Education and Practice
    , 3(12), 70. Discussion: Emerging Technologies in Health Care Essay.

    Huston, C. (2013). The impact of emerging technology on nursing care:
    Warp speed ahead. Online Journal of Issues in Nursing,
    18(2), 1–11

    Yuehong, Y. I. N., Zeng, Y., Chen, X., & Fan, Y. (2016). The internet of things in healthcare: An overview. 
    Journal of Industrial Information Integration
    , 
    1
    , 3-13. Discussion: Emerging Technologies in Health Care Essay.

  • Health Literacy—Evaluation of Patient Forms / Educational Materials Essay

    For this Assignment: Health Literacy—Evaluation of Patient Forms / Educational Materials Essay

    • Review the Resources for this week.

    • Locate a patient-related document that is given to patients in your practice area or an area with which you are familiar. This document could be admission paperwork, health education materials, or other materials that are provided to a patient to inform them about health care decisions.

    • Save this original document either as a file or in a portable document format (PDF) file to be submitted with this Assignment..

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    • Evaluate the document in each of the six areas: message content, text appearance, visuals, layout and design, translation, and understandability. For each area, provide a summary of your assessment according to the criteria given. Health Literacy—Evaluation of Patient Forms / Educational Materials Essay.

    • Include a brief summary (250 to 350 words) of the selected patient materials, how they are used in the facility, why they have been selected, and what improvements were made.

    • Include a minimum of three resources from the professional nursing literature in the assigned course readings and other references in the Walden Library (Include the “Checklist for Easy to Understand Print Materials “as a reference). If relevant, you may use one or two professional web sites in addition to the literature references. Health Literacy—Evaluation of Patient Forms / Educational Materials Essay.

    Resources: http://www.cdc.gov/healthliteracy/pdf/simply_put.pdf

    Eadie, C. (2014). Health literacy: A conceptual review. MEDSURG Nursing, 23(1), 1–13.

    Harris, L., Thomas, V., & Fox, M. (2015). The influence of health care literacy on the use of PHRs among older adults. MEDSURG Nursing, 24(4), 283–285.

    Liebner, L. T. (2015). I can’t read that! Improving perioperative literacy for ambulatory surgical patients. AORN Journal, 101(4), 416–427.

    http://www.nap.edu/read/10883/chapter/1 Health Literacy—Evaluation of Patient Forms / Educational Materials Essay

    Health Literacy-Evaluation of Patient Forms

    Introduction

               
    America has recently faced a great opioid epidemic which was noted by the National Institute of Health as a significant public health issue. Many states have been prompted to take necessary action such as declaring a state of emergency due to the effects related to the opioid crisis (Velis, Borras & Khaja, 2018).  Such decisions came after a historic landmark was released that declared the use of alcohol and drugs as one of the most pressing crisis in the health sector similar to type 2 diabetes mellitus, obesity, hypertension and cancers (Koenig, 2018). Health Literacy—Evaluation of Patient Forms / Educational Materials Essay.

    Document Review

    Early in 2017, regional and local hospitals within New Hampshire started a program whose aim was to reduce the use, abuse, and overdose of opioids especially from prescriptions that were being written in emergency rooms. One of the most effective programs which were implemented were basic guidelines which determined the prescribing of opioid named New Hampshire Safe Opioid Prescribing (Abuse, 2017). These guidelines were well written in a pamphlet and served as a resource for information and continuous education for nurses, healthcare providers, patients and families across New Hampshire as well as every Emergency Department. A policy for nurses to hand over the pamphlet to every patient who had either requested for an opioid, been prescribed or initially identified by the Prescription Drug Monitoring Program as an abuser or misuser of opioids.

    The guidelines contained in the pamphlet clearly explained circumstances under which healthcare providers could and could not administer opioids for pain relief either as a form of a written prescription or for pain relief (Abuse, 2017). The pamphlet was for both males and females aged 18 and older. The details in the pamphlet were in simple English Language, was easy to read and understand. Health Literacy—Evaluation of Patient Forms / Educational Materials Essay.

    Document Summary and Important Improvements

               
    Nurses have a primary role of educating patients and in this case, are expected to provide patients with the pamphlet titled New Hampshire Safe Opioid Prescribing Guidelines to ensure that they understood basic information such as when and when not opioids could be prescribed. Based on the information conveyed, the “Nice to Know” section had information which was not important; the “Did You Know” section had unnecessary details such as statistics on the incidence, prevalence, and mortalities as a result of overdosages from prescribed opioids (Abuse, 2017). Health Literacy—Evaluation of Patient Forms / Educational Materials Essay. The section “Text appearance” was well in the entire pamphlet apart from the variation of font sizes in the entire document. In other instances, it was too small and those who had issues with vision had a lot of difficulties reading.

    The “Visuals” used were clearer and the graphics were very much appropriate on opioid’s prescription guidelines. The pamphlet was provided in two languages: Spanish and English since the document was primarily designed for the Spanish demography. Thus, the “Translation” aspect was well addressed as the document was not only reliable but also accurate.  In the “Understandability” area, the material was simple, understandable and easy to read. The best way to improve the material is to reduce the volume of the information provided and leave only what is essential. There is also some jargon used which hinders the ability to easily understand for some users. This jargon should be done away with. Health Literacy—Evaluation of Patient Forms / Educational Materials Essay.

    Conclusion

               
    The opioid epidemic required a lot of vigilance and collaboration to address.  The invention of the pamphlet on the Greater Richmond Safe Opioid Prescribing Guidelines served as a major educational resource for nurses working in outpatient settings and emergency departments. Despite small issues, the pamphlet uses simple and understandable English language, good visuals and delivers the right message to its audience. Health Literacy—Evaluation of Patient Forms / Educational Materials Essay.

    References

    Abuse, N. I. (2017). Opioid Crisis. Retrieved August 10, 2017, from
    https://www.drugabuse.gov/drugs-abuse/opioids/opioid-crisis

    Bao, Y., Pan, Y., Taylor, A., Radakrishnan, S., Luo, F., Pincus, H. A., & Schackman, B. R. (2016). Prescription drug monitoring programs are associated with sustained reductions in opioid prescribing by physicians. 
    Health Affairs
    , 
    35
    (6), 1045-1051.

    Haffajee, R. L., Jena, A. B., & Weiner, S. G. (2015). Mandatory use of prescription drug monitoring programs. 
    Jama
    , 
    313
    (9), 891-892.

    Koenig K. L. (2018). The Opioid Crisis in America: Too much, too little, too late. 
    The western journal of emergency medicine
    , 
    19
    (3), 557–558. doi:10.5811/westjem.2018.2.38087

    Velis, E., Borras, S., & Khaja, S. (2018). Mental Illness and Opioid Epidemic in the United States. 
    European Scientific Journal, ESJ
    , 
    14
    (10). Health Literacy—Evaluation of Patient Forms / Educational Materials Essay.

  • HIPAA: An Issue of Patient Privacy Essay

    For this HIPAA: An Issue of Patient Privacy Essay Assignment, review the following from this week’s Resources:

    • Resources on the HIPAA Privacy and Security Rules

    • Resources on privacy and security and the use of mobile devices in patient care

    • Privacy and Confidentiality Scenario

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    As you reflect on the Privacy and Confidentiality Scenario (located in this week’s Resources), consider the following points and write a 2-3-pages proposal addressing privacy issues:

    • Identify the issues related to patient privacy and confidentiality in this scenario.

    • Describe strategies your organization (or one with which you are familiar) might use to safeguard patient information from the use of mobile devices.

    • Discuss the use of mobile devices for patient care in your organization (or one with which you are familiar) and any organizational policies related to mobile devices. Specifically, address the use of text messages to communicate patient care information and explain what happens to a message after it is sent.

    • Analyze your personal strategies used to protect patient health information on mobile devices.

    • Do your personal strategies adequately protect information in a patient care setting?

    • Provide examples of alternate or additional methods that could be used to insure patient privacy and confidentiality is maintained.

    Include a minimum of three resources from the professional nursing literature in the assigned course readings and other references in the Walden Library.

    Privacy and Confidentiality Scenario

    This scenario is based on a true story and due to increased ubiquitous use of mobile technology more incidents such as this will occur. Nurses must fully understand privacy and confidentiality issues and apply the information to various settings and situations to best advocate for the patient. Working in a busy cardiac cath lab provides many opportunities for possible breaches of confidentiality or privacy. Jennifer works in a cath lab and has noticed mobile technology is encroaching on patient confidentiality and privacy. A few months back they were very busy and several patients were in the holding area awaiting procedures. HIPAA: An Issue of Patient Privacy Essay. Jennifer’s coworker, Tim, decided to take a picture of the patients in the holding area and posted it on Facebook to show his friends how busy he was. Jennifer felt very uncomfortable about this and told Tim she really did not think that was appropriate due to the patients in the picture. She also noted the schedule board was in the picture which contained patient initials, procedures, and doctor. Tim said it was nothing, as the patients could not really be identified and pretty much told Jennifer she was being, “Miss. Perfect because she was in school.” As time went by Jennifer noticed it was becoming commonplace for techs and nurses to text information back and forth about cases to the physicians on their personal cell phones. Initials were supposed to be used, but sometimes, patient names would be added by mistake. The physicians loved the convenience and encouraged this behavior. It wasn’t long before patient scheduling via Google was the new tool. This meant all the nurses, techs, and physicians could share a common calendar on Google Calendar and view the schedule in real time. Again, patient initials were to be used and at times full names came through. Every time a patient was added to the schedule a popup on the physician’s, tech’s, and nurses’ personal phones would flash the procedure, time, and patient. Jennifer knew all this was not correct as none of the phones or tools had been approved via the Compliance Officer or Information Technology. The most difficult thing was the unit manager was in agreement with the mobile communications and Jennifer felt she had nowhere to go to stop this potential breach of patient information. HIPAA: An Issue of Patient Privacy Essay.

    • Identify the issues related to patient privacy and confidentiality in this scenario.

    • Describe strategies your organization uses to safeguard patient information from the use of mobile devices.

    • Discuss the use of mobile devices for patient care in your organization and any organizational policies related to mobile devices. Specifically address the use of text messages to communicate patient care information and explain what happens to the message after it is sent.

    • Analyze your personal strategies used to protect patient health information on mobile devices.

    • Do these strategies adequately protect information in your patient care setting?

     

    HIPAA – an issue of patient privacy

    Identify the issues related to patient privacy and confidentiality in this scenario.

    There are three issues that can be seen in the scenario. Firstly, there is an issue of confidentiality that focuses on the health professionals’ obligation to hold patient information in confidence, especially when they have access to the information. The social media postings violate the confidentiality expectations. Besides that, communicating using the patients’ names rather than initials also violates confidentiality expectations. Secondly, there is an issue of privacy that concerns the patients’ right to make independent decisions on whether and how their personal information should be shared. None of the patients was consulted when the information was shared on social media. Finally, there is an issue of security that concerns that absence of protection protocols that support medical personnel in holding patient information in confidence. The facility is using Google technology which does not provide adequate protection for the information. HIPAA: An Issue of Patient Privacy Essay.

    Describe strategies your organization (or one with which you are familiar) might use to safeguard patient information from the use of mobile devices.

    There are two strategies for safeguarding patient information from the use of mobile phones. The first strategy is to educate mobile personnel on the need to protect patient information and how the use of mobile phones can violate this need. The second strategy is to mobile devices use policies that punish persons who violate security expectations. Finally, implementing a breach protocol the involves containing and evaluating the scope of the breach, notifying the affected persons, conducting an investigation to identify the nuances of the breach, and remediation (Bromwich, M. & Bromwich, R., 2016) HIPAA: An Issue of Patient Privacy Essay.

    Discuss the use of mobile devices for patient care in your organization (or one with which you are familiar) and any organizational policies related to mobile devices. Specifically, address the use of text messages to communicate patient care information and explain what happens to a message after it is sent.

    Mobile devices have offered medical personnel new ways for carrying out professional communication, ease access to decision support, and accelerated consultations. In fact, it is not uncommon for medical personnel to communicate among themselves and with patients using text messages that communicate diagnosis, test results, care progress, make and confirm appointments, access medical records, and so on. Although mobile devices offer communication conveniences, they present some concerns with regards to breaching privacy expectations, insecure data storage, and legal liability for failing to obtain the patient’s consent. This is particularly true when the possibility of data hacking and access by a third party is considered (McGonigle & Mastrian 2018). HIPAA: An Issue of Patient Privacy Essay.

    Analyze your personal strategies used to protect patient health information on mobile devices.

    I implement four personal strategies to protect patient health information on mobile devices. The first strategy is authentication controls that involve locking my devices when not in use and requiring biometrics and passcodes to access secured information. The second strategy is an automatic and remote lock and wipe policy that comes into play if the device is stolen or a loose it. HIPAA: An Issue of Patient Privacy Essay. The fourth strategy is positional awareness whereby I only access patient information away from prying eyes so that no third party unintentionally sees the information. The final strategy involves installing regularly updated security programs that protect the device from malicious programs such as viruses as well as hackers (Maki & Petterson 2013).

    Do your personal strategies adequately protect information in a patient care setting?

    I do not believe that my personal strategies offer adequate protection of patient information within the care setting. That is because these strategies still has a loophole for breaches. The loophole is that patient information is not typically encrypted. This implies that any person who can intercept the information while being transmitted will be able to view the information. This loophole can be addressed by employing encryption that prevents unauthorized persons from reading the information even if they can access it (Maki & Petterson 2013). HIPAA: An Issue of Patient Privacy Essay.

    Provide examples of alternate or additional methods that could be used to insure patient privacy and confidentiality is maintained.

    Other than the mentioned strategies, there are two additional strategies that can be applied. The first strategy is to implement a mobile device use policies that controls how the device is used if it contains vital information. The strategy focuses on evaluating applications. At the very least, unsecured and unapproved applications should not be used. The second strategy is to regularly update operating systems, applications and other software. The updates plug previous security vulnerabilities. The mobile device users should be informed of these updates while the more sensitive devices should include options for forced security updates (Davis & LaCour, 2016). HIPAA: An Issue of Patient Privacy Essay.

    References

    Bromwich, M. & Bromwich, R. (2016). Privacy risks when using mobile devices in health care.
    CMAJ
    , 188(12), 855-856. doi: 10.1503/cmaj.160026

    Davis, N. & LaCour, M. (2016).
    Foundations of health information management
    . Amsterdam: Elsevier Health Sciences.

    Maki, S. & Petterson, B. (2013).
    Using the electronic health record: in the health care provider practice
    (2
    nd
    ed.). Mason, OH: Cengage Learning. HIPAA: An Issue of Patient Privacy Essay.

    McGonigle, D., & Mastrian, K. G. (2018).
    Nursing informatics and the foundation of knowledge
    (4th ed.). Burlington, MA: Jones and Bartlett Learning. HIPAA: An Issue of Patient Privacy Essay.

  • Meaningful Use: Nurses Hold the Key Essay

    Meaningful Use: Nurses Hold the Key Essay

    Reflect on the key role of nurses in implementing meaningful use. Address how two or more of the following five aims of the meaningful use initiative impact or will impact your practice. Also, explain how the five aims depend on an interprofessional approach to patient-centered care in your setting.

    1. Improve quality, safety, and efficiency, and reduce health disparities

    2. Engage patients and families

    3. Improve care coordination

    4. Improve population and public health

    5. Ensure adequate privacy and security protections for personal health information

    Note: Post a 3-paragraph (at least 250–350 words) response. Be sure to use evidence, in-text citations, and essay-level writing skills, including the use of transitional material and organizational frames. Meaningful Use: Nurses Hold the Key Essay.

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    Jones, et al (2014), notes that meaningful use supports delivery of efficient, safe and quality care as well as minimizes disparities in healthcare. It was developed as a component of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 (Adler-Milstein & Jha, 2017). Nurses play significant roles in the implementation of meaningful use. Several aims of the meaningful use initiative impact the nursing practice. This paper seeks to examine two meaningful use aims and explain how they depend on an interprofessional approach to patient-centered care setting. Meaningful Use: Nurses Hold the Key Essay.

    One of the five aims of meaningful use is to improve quality, safety, and efficiency, and reduce health disparities (Lye et al., 2018). The goal of healthcare system is the provision of quality services to patient to promote recovery. This involves safety which prevent accidents as well as efficiency, which ensures smooth workflow. Additionally, nursing practice seeks to minimize disparities based on gender, social, cultural and economic factors Meaningful Use: Nurses Hold the Key Essay. Another aim is to improve population and public health which is characterized by community empowerment through seminars as well as individual sessions (Lye et al., 2018). These two aims guide the nurses in practice and influence the health outcomes of patients.

    The five aims of meaningful use promote collaboration between the public and clinical healthcare. This involves bringing different specialists together to support clinical knowledge and development of standardized data exchange as well as improve patient-oriented prevention of diseases (Washington et al, 2017). For instance, the occupational safety personnel teams up with the healthcare practitioners to create safe environment for patients. Moreover, mental specialists and public health providers come together to share knowledge regarding the patient, family and community empowerment. Meaningful Use: Nurses Hold the Key Essay Consequently, security and protection demands the collaboration between the information technology specialists with the nurse experts to ensure efficiency, confidentiality and privacy of electronic health records (Thompson et al., 2016).

    References

    Adler-Milstein, J., & Jha, A. K. (2017). HITECH Act drove large gains in hospital electronic health record adoption. 
    Health Affairs
    , 
    36
    (8), 1416-1422.

    Jones, S. S., Rudin, R. S., Perry, T., & Shekelle, P. G. (2014). Health information technology: an updated systematic review with a focus on meaningful use. 
    Annals of internal medicine
    , 
    160
    (1), 48-54. Meaningful Use: Nurses Hold the Key Essay.

    Lye, C. T., Forman, H. P., Daniel, J. G., & Krumholz, H. M. (2018). The 21st Century Cures Act and electronic health records one year later: will patients see the benefits?. 
    Journal of the American Medical Informatics Association
    , 
    25
    (9), 1218-1220.

    Thompson, L. A., Martinko, T., Budd, P., Mercado, R., & Schentrup, A. M. (2016). Meaningful use of a confidential adolescent patient portal. 
    Journal of Adolescent Health
    , 
    58
    (2), 134-140.

    Washington, V., DeSalvo, K., Mostashari, F., & Blumenthal, D. (2017). The HITECH era and the path forward. 
    New England Journal of Medicine
    , 
    377
    (10), 904-906 Meaningful Use: Nurses Hold the Key Essay.

  • NUR 641 Midterm Exam Study Guide

    NUR-641E Mid-Term Exam Study Guide

    Note: Read the questions: the questions
    only have one answer

    unless the question specifically states there is more than one correct answer.

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    Understand what a prodrug is, and activation/inactivation by liver enzymes, and how it differs from active drugs.

    The liver is the principal site of drug metabolism. Although metabolism typically inactivates drugs, some drug metabolites are pharmacologically active—sometimes even more so than the parent compound. An inactive or weakly active substance that has an active metabolite is called a prodrug, especially if designed to deliver the active moiety more effectively.

     

    Know what Bioavailability (BA)

    a term used in pharmacology and nutritional and environmental sciences. In pharmacology, it refers to the degree and rate at which an administered drug is absorbed by the body’s circulatory system, the systemic circulation. Bioavailability is an essential measurement tool since it determines the correct dosage for non-intravenous administration of a drug availability means

    Bioavailability. In pharmacology, bioavailability (BA or F ) is a subcategory of absorption and is the fraction of an administered dose of unchanged drug that reaches the systemic circulation

     

    Bioavailability is affected by chemical instability, solubility and first-pass metabolism

    The first pass effect- is a phenomenon of drug metabolism whereby the concentration of a drug is greatly reduced before it reaches the systemic circulation. It is the fraction of drug lost during the process of absorption which is generally related to the liver and gut wall.

    Bioequivalence does not affect bioavailability

    Bioequivalence is the similarity of two drugs that share the same desired outcome for patients. Pharmaceutical equivalence means two drugs release the active ingredient into the bloodstream at the same amount and same rate. When assessing how well a generic drug works, scientists evaluate its bioequivalence to the name-brand version.

    Understand what the Cytochrome P450 system is in the liver

    Cytochrome P450 enzymes are primarily found in liver cells but are also located in cells throughout the body. … Cytochrome P450 enzymes account for 70 percent to 80 percent of enzymes involved in drug metabolism. Cytochrome P450 enzymes also function to metabolize potentially toxic compounds, including drugs and products of endogenous metabolism such as bilirubin, principally in the liver.

     

    Clopidogrel (Plavix) is a prodrug and must be activated by hepatic CYP2C19 metabolism; individuals who are poor metabolizers may not form the active metabolite and have reduced antiplatelet response.

     

    A drug’s half-life determines how often the drug is administered?

    The elimination 
    half
    –
    life
     of a 
    drug
     is a pharmacokinetic parameter that is defined as the time it takes for the concentration of the 
    drug
     in the plasma or the total amount in the body to be reduced by 50%. In other words, after one 
    half
    –
    life
    , the concentration of the 
    drug
     in the body will be 
    half
     of the starting dose.

    Steady state of a drug is reached in approximately 5 to 6 times the half-life

    Inhalation, oral and parenteral
    drug action and onset of effects?

    Inhalational administration
    can be used. The lungs serve as an effective route of administration of drugs. The pulmonary alveoli represent a large surface and a minimal barrier to diffusion. The lungs also receive the total cardiac output as blood flow. Thus, absorption from the lungs can be very rapid and complete.

    Bioavailability of drugs administered
    orally
    varies greatly.

    Parenteral administration
    refers to any routes of administration that do not involve drug absorption via the GI tract (par = around, enteral = gastrointestinal), including the IV, intramuscular (IM), subcutaneous (SC or SQ), and transdermal routes

    Know the mechanism of action of anticoagulants (e.g., warfarin, apixaban, heparin).

    Warfarin
    competitively inhibits the vitamin K epoxide reductase complex 1 (VKORC1), which is an essential enzyme for activating the vitamin K available in the body. Through this mechanism, warfarin can deplete functional vitamin K reserves and therefore reduce the synthesis of active clotting factors

    Heparin produces rapid anticoagulation by binding with antithrombin III, and inhibits factors IXa, Xa, XIIa, and XIII.

     

    Monitor heparin with a
    PTT
    (low dose SC heparin [5000 units BID] does not require aPTT monitoring).

    Warfarin inhibits vitamin K-dependent blood factors II, VII, IX and X; takes several days for its anticoagulant effect.

    Monitor the International Normalized Ratio
    (INR) when warfarin
    is used.

    Blood Factor IIa inhibitor (direct thrombin inhibitor): dabigatran (Pradaxa).

    An antidote to dabigatran-induced hemorrhage is idarucizumab.

    Blood Factor Xa inhibitors: apixaban (Eliquis), edoxaban (Savaysa), rivaroxaban (Xarelto), fondaparinux (Arixtra).

     

    Know what pulmonary emboli are, where they come from and what these emboli do in the body

    Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the legs or, rarely, other parts of the body (deep vein thrombosis).

    Know the risk factors for cerebrovascular accident (CVA)

    Some stroke risk factors, such as gender, age and family history, can’t be controlled. Lifestyle factors that increase your risk of stroke include high blood pressure, smoking, diabetes, high blood cholesterol levels, heavy drinking, high salt and high fat diet and lack of exercise.

    Know the elements involved in the action potential of myocardial tissue

    Calcium…??

    Know what tuberculosis is and its epidemiology in the world.

    Tuberculosis (TB) is one of the top 10 causes of death worldwide.

    In 2017, 10 million people fell ill with TB, and 1.6 million died from the disease (including 0.3 million among people with HIV).

    In 2017, an estimated 1 million children became ill with TB and 230 000 children died of TB (including children with HIV associated TB).

    TB is a leading killer of HIV-positive people.

    Isoniazid (INH) is famous for causing jaundice when combined with other drugs in a multidrug combination for treating TB.

    Be able to explain the side effects of multidrug therapy/polypharmacy

    3.1 Increased Healthcare Costs. Polypharmacy contributes to health care costs to both the patient and the healthcare system. …

    3.2 Adverse Drug Events. …

    3.3 Drug-Interactions. …

    3.4 Medication Non-adherence. …

    3.5 Functional Status. …

    3.6 Cognitive Impairment. …

    3.7 Falls. …

    3.8 Urinary Incontinence.

    Know the difference between vertical and horizontal transmission of organisms

    In general, transmission of viruses can occur through two pathways: horizontal and vertical transmission. In horizontal transmission, viruses are transmitted among individuals of the same generation, while vertical transmission occurs from mothers to their offspring.

     

    Know how empiric antimicrobial therapy is selected

    Empiric therapy or empirical therapy is medical treatment or therapy based on experience and, more specifically, therapy begun on the basis of a clinical “educated guess” in the absence of complete or perfect information.

    Antibiotic drugs
    that inhibit cell
    wall integrity include penicillins, ampicillin, cephalosporins, and carbapenems

    Antibiotic drugs that inhibit bacterial protein synthesis include the aminoglycoside, tetracyclines, fluoroquinolondes and tetracyclines.

    The 
    antibiotic
     penicillin works by keeping a 
    bacterium
     from building a 
    cell
     wall.
    Bacteria
     and human 
    cells
     also differ in the structure of their 
    cell
     membranes and the machinery they use to build proteins or copy DNA. Some 
    antibiotics
     dissolve the membrane of just 
    bacterial cells
    .

    Endotoxic and exotoxic bacteria

    Exotoxins are toxic substances secreted by bacteria and released outside the cell. Whereas Endotoxins are bacterial toxins consisting of lipids that are located within a cell.

    Invasion period
    is when the immune and inflammatory responses are initiated

    Explain the cause of upper and lower respiratory tract infections, especially pneumonia

    Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.

    List the antibiotics that should and should not be used in children

    SHOULD:

    Penicillins (amoxicillin and penicillin G). …

    Beta-lactamase inhibitors (amoxicillin-clavulanic acid or Augmentin). …

    Cephalosporins (cefdinir, ceftibuten, etc.). …

    Macrolides (azithromycin and erythromycin). …

    Sulfa drugs (trimethoprim-sulfamethoxazole).

    SHOULD NOT:

    fluoroquinolones and tetracyclines.

    Be able to discuss antibodies in newborns.

    During the last 3 months of pregnancy, antibodies from the mother are passed to her unborn baby through the placenta. This type of immunity is called passive immunity because the baby has been given antibodies rather than making them itself. Babies produce their own antibodies every time they are exposed to a virus or germ, but it takes time for this immunity to fully develop.

     

    Know what pathophysiologic factors increase respiratory rate

    Conditions That May Result in Tachypnea. A wide range of medical conditions can result in tachypnea. … The rapid breathing rate is the body’s way of trying to increase oxygen or lower carbon dioxide levels in the blood.

     

    Know how to interpret an arterial blood gas

    Use pH to determine Acidosis or Alkalosis. ph. < 7.35. 7.35-7.45. … Use PaCO2 to determine respiratory effect. PaCO2. < 35. … Assume metabolic cause when respiratory is ruled out. You’ll be right most of the time if you remember this simple table: R O M E   Use HC03 to verify metabolic effect. Normal HCO3- is 22-26. Know the ABGs for metabolic acidosis, metabolic alkalosis, respiratory alkalosis, and respiratory acidosis   Know the causes of respiratory acidosis Be able to explain COPD and stepwise therapy (additions to current COPD medications) in its treatment Be able to explain hypoxemia at altitude (reduced oxygen inspiration) Discuss how pulmonary arterial hypertension is associated with right ventricular hypertrophy and an enlarged pulmonary artery Be able to explain fluid and electrolyte disorders Know the laboratory values of magnesium, calcium, sodium and potassium. Be able to explain how aldosterone affects sodium and water Know the effects of atrial natriuretic factor (ANF) Be able to explain the relationship between edema and oncotic pressure Be able to differentiate corticosteroids by potencies, mechanism of action and pharmacokinetics. Be able to explain how angiotensin and affects the cardiovascular system Know the unique pharmacokinetics of amiodarone Amiodarone can cause thyroid and pulmonary toxicity. Know what drugs are used for angina: beta-adrenergic antagonists (beta-blockers), angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), nitrates, calcium channel blockers (CCBs). Remember that many heart failure patients have more than just heart failure; look for underlying hypertension, angina, etc.   Be able to describe how electrolyte serum levels affect digoxin serum levels Know how hyperkalemia is caused by renal failure and Addison’s Disease. Know how hypercalcemia is treated with calcitonin salmon and Kayexalate (sodium polystyrene sulfate) What is compensatory hyperplasia What are the effects of Nonsteroidal anti-inflammatory drugs (NSAIDs) An NSAID safe for use in CAD patients is naproxen NSAIDs can cause GI bleeding (indicated by darkening of stools and epigastric pain); one recommendation is switch to a COX-2 inhibitor (i.e., celecoxib). Corticosteroids include glucocorticoids (e.g., prednisone, prednisolone, dexamethasone, hydrocortisone, methylprednisolone) and mineralocorticoids (e.g., aldosterone). Patients on corticosteroids should be monitored for changes in skin, muscle wasting, blood pressure, weight gain, blood glucose and vitamin D levels, and any vision changes.

  • NURS 6512: Advanced Health Assessment and Diagnostic Reasoning

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    Walden University

    NURS 6512: Advanced Health Assessment and Diagnostic Reasoning

    Syllabus

    Student Support and Calendar Information

    So you have all key information available to you off-line, it is highly recommended that you print

    the following items for your reference:

    This Syllabus, including the Course Schedule that is linked on this page as a PDF

    Course Calendar

    Student Support

    Photo Credit: Steve Hix/Fuse/Corbis/Getty Images

    Credit Hours

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    5 quarter hours

    Walden University assigns credit hours based on the number and type of assignments that

    enable students to achieve the course learning objectives. In general, each semester credit

    equals about 42 hours of total student work and each quarter credit equals about 28 hours of

    total student work. This time requirement represents an approximate average for undergraduate

    work and the minimum expectations for graduate work. The number and kind of activities

    estimated to fulfill time requirements will vary by degree level and student learning style, and by

    student familiarity with the delivery method and course content.

    Course Description

    The physical and emotional well-being of patients and families can be complex and

    multifaceted. Advanced practice nurses need to have the knowledge and ability to provide safe,

    competent, and comprehensive physical health assessments. Students in this course focus on

    concepts and skills to assess patients across the lifespan. They learn to use diagnostic

    reasoning, advanced communication, and physical assessment skills to identify changes in

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    health patterns. Students also use a systematic approach through which they focus on the

    assessment of patients with acute and chronic health problems. The advanced skills of suturing,

    reading 12 Lead EKGs, and interpreting X-rays will be covered. Students engage in course

    assignments that emphasize risk assessment, diagnostic reasoning, and evidence-based

    assessment across the lifespan.

    Course Prerequisites

    Pre-requisites: NURS 6501: Advanced Pathophysiology

    Pre- or Co-Requisite: NURS 6521: Advanced Pharmacology

    Course Outcomes

    By the conclusion of this course, you should be able to:

    1. Apply sound critical thinking to clinical assessment and decision making

    2. Develop an effective and appropriate approach to patient assessment that takes into

    consideration life circumstance and cultural, ethnic, and developmental variations

    3. Elicit appropriate data from a patient using functional assessment, health history, and

    physical assessment

    4. Interpret patient health history and physical examination data

    5. Apply diagnostic reasoning when assessing patient physiology

    6. Relate assessment findings to underlying pathology or physiologic changes

    7. Establish a differential diagnosis based on the assessment data

    8. Evaluate options for a systematic approach to preventative and palliative care

    9. Analyze evidence-based and ethical considerations in health assessment

    To access the SON Alignment of Learner Outcomes for this course, please select the following

    link:

    NURS 6512 Alignment Chart (PDF)

    Course Materials

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    Please visit the university bookstore via your Walden student portal to ensure you are obtaining

    the correct version of any course texts and/or materials noted in the following section. When you

    receive your materials, make sure that all required items are included.

    Course Texts

    Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and

    clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

    Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide

    to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

    Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A.

    Davis.

    Note: While only the print edition of this book is referenced here, electronic versions also

    may be available and may be acceptable for use in this course.

    Optional Course Text

    LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination

    (10th ed.). New York, NY: McGraw-Hill Medical.

    Note: Students are expected to procure the optional course text themselves.

    Other readings (journal articles, websites, book excerpts, etc.) are assigned throughout the

    course and may be found within each week and within the Course Schedule.

    Course Readings List

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    The Course Readings List contains all of the required Walden Library resources for this course.

    Please select the following link to access the list:

    NURS 6512 Course Readings List

    Media

    Assigned course media elements may be found in one or more weeks of the course and are

    available via a streaming media player or https://evolve.elsevier.com/.

    https://evolve.elsevier.com/

    Note: If the print editions of these books are referenced here, electronic versions also may

    be available and may be acceptable for use in this course. If electronic versions are listed,

    no print versions are available.

    Other readings (journal articles, websites, book excerpts, etc.) are assigned throughout the

    course and may be found within each week.

    Dedicated Support for Course Media

    You may use the following e-mail address and toll-free number for any questions or concerns

    you have about media in the course.

    E-mail: mediasupport@waldenu.edu

    Phone: 1-877-238-2963

    Primary and Secondary Sources

    Review the following information prior to selecting resources for assignments.

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    Primary: A primary source is an original document that is the first account of what happened. A

    research report is primary, and you can tell because it includes materials and methods

    demonstrating how the research was done. Some creative work is also primary, such as poetry,

    novels, and interviews of people who experienced something firsthand. In nursing, which is an

    evidence-based discipline, we strive to use primary research that is published in scholarly, peerreviewed journals.

    Scholarly, peer-reviewed journal: Scholarly journals publish papers by professional authors

    and experts in the field using a peer-review process to review the work and assure quality before

    publishing. The focus of a scholarly journal is to provide accurate information for scholars and

    other researchers. The focus is on content rather than advertising, a direct contrast to popular

    media. Scholarly journals publish both primary and secondary papers, the former usually noted

    as original research and the latter as reviews and commentaries. Letters to the editor may also

    be published but should be recognized as opinion pieces.

    Note: When selecting articles for course assignments, you are advised (unless you are

    referencing seminal information) to focus on work published within the past 5 years.

    Secondary: A secondary source is one step removed from the original source. This work

    interprets and often compiles other work, and it includes review articles, textbooks, fact sheets,

    and commentaries about a topic. It also includes news reports of original research. Secondary

    work is more prone to error and bias than primary work because it is being filtered through an

    additional person or persons. Review papers can be useful to glean information about a topic

    and to find other sources from the reference list, but it is the original, primary research that

    should be relied on most heavily in demonstrating scholarship, depth, and validation of factual

    information.

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    Course Assignments

    1. Participation in weekly Discussions: The exchange of ideas among colleagues engaged in

    scholarly inquiry is a key aspect of learning and is a requisite activity in this course. You are

    expected to participate each week by posting a response to a prompt or question in the

    weekly Discussion area. Discussion topics/questions are provided in the Discussion area in

    each week. In addition, you are expected to respond to your fellow students’ postings. To

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    count as participation, responses need to be thoughtful; that is, they must refer to the week’s

    readings, relevant issues in the news, information obtained from other sources, and/or ideas

    expressed in the postings of other class members. You may ask questions or offer further

    information or links about the subject. Please pay attention to grammar and spelling, as

    consistently poorly written posts will receive grade penalties. In grading the required

    Discussion postings, your Instructor will be using the Formative Evaluative Criteria for

    Discussion Board Assignments located in the Course Information area.

    Note: Unless otherwise noted, initial postings to Discussions are due on or before Day

    3, and response postings are due on or before Day 6. You are required to participate in

    the Discussion on at least 3 different days. It is important to adhere to the weekly time

    frame to allow others ample time to respond to your posting. In addition, you are

    expected to respond to questions directed toward your own initial posting in a timely

    manner.

    2. Assignments: The Assignments provide you with the opportunity to apply the skills and

    knowledge gained through the Learning Resources. See the Assignment area of specific

    weeks for detailed descriptions of the assignments. In grading the required Assignments,

    your Instructor will be using rubrics located in the Course Information area.

    3. Physical Health Assessment Videos: This course requires that you demonstrate proficiency

    in conducting physical health assessments, including a health history and a head-to-toe

    physical examination. You will demonstrate this proficiency by videotaping yourself as you

    perform the assessments. You will need to have access to a video recorder to capture the

    required physical health assessments on video. Additionally, you will need to obtain the

    necessary equipment required to perform these physical health assessments, including a

    stethoscope, an otoscope, an ophthalmoscope, a pocket eye chart, a tape measure, a reflex

    hammer, and Tuning Forks ( Frequency of 500-1000Hz to be used). All of the required

    equipment must be used in order to pass the video and you must pass each video with a

    score >69.5% in order to pass the course. You will also need to have a volunteer to act as

    your “patient” for each physical assessment. Each volunteer must sign the Video Release

    Form located on the Kaltura Media Uploader page located in the course navigation menu.

    The signed form must be faxed to the following toll-free number prior to recording each Video

    Assignment: 888–546–7564. Note: You may use the same volunteer for each video if

    appropriate.

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    Throughout this course, you will create and submit three physical health assessment videos.

    Week 3: Health History

    In Week 3, you will videotape yourself collecting a “patient’s” health history. This video is due

    by Day 7 of Week 4.

    Week 8: Skin, Hair, and Nails and HEENT Assessment

    By Day 7 of Week 8, you will create and submit a video of yourself conducting a Skin, Hair,

    and Nails and HEENT assessment

    Week 10: Head-To-Toe Physical Assessment

    By Day 7 of Week 10, you will create and submit a video of yourself conducting a head-totoe physical exam.

    Submitting Your Videos

    All videos will be submitted through the weekly assignment submission area using the

    Kaltura Media option available via the mashup tool. Refer to the Kaltura Media Uploader

    page in the course navigation menu for more information about uploading media for

    assignments.

    Note: Although you will only film and submit the health history, partial physical exam, and

    head-to-toe physical exam video assessments in Weeks 4, 8, and 10, respectively, it is highly

    recommended that you view each week’s media and practice performing the related health

    assessment on family members and/or patients. For example, in Week 7, you study the

    abdomen and gastrointestinal system. After watching the media assigned in that week’s

    Learning Resources, it is recommended that you practice conducting an abdominal

    examination.

    1. Exams: The course contains 2 exams that have been designed to assess your

    understanding of the course topics. The Midterm exam is due by Day 7 of week 6 and the

    Final exam is due by Day 7 of week 11.

    2. All assignments must be completed to pass the course. This includes ALL discussion

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    boards, case study assignments, midterm exam, final exam, and the mandatory videos in

    Week 4 (Health History), Week 8 (Skin, Hair, Nails/HEENT), and Week 10 (Head to Toe

    Physical Examination).

    3. If an Incomplete is granted for students registered for clinical courses the following

    quarter, you will only have 5 days to complete and pass your outstanding assignments as

    this course must be passed prior to starting your practicum.

    Grading Criteria and Total Components of a Grade

    Course grades will be based on participation (postings) and completion of assignments listed

    below. All assignments must be completed in order to receive a grade for the course.

    Note: All assignments must be completed to pass the course.

    Grading Scale

    Letter grades will be assigned as follows:

    90%–100% = A

    80%–89% = B

    70%–79% = C

    <70% = F Please see below for the policy on Incomplete (I) grades. Important Note: This course contains weighted grading. Assignments are weighted differently depending on their type. The total points achieved for each assignment will be weighted based on the percentage values noted in the Weighted Total (%) column of the table that follows. Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/201910…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 9 of 17 Assignment Total Points Weighted Total (%) Discussions: Participation in Discussions* (7 @ 100 points each) (Weeks 1, 2, 3, 5, 7, 8, 9) 700 10% Video Assignments: Week 4 (100 points) Week 8 (100 points) Week 10 (100 points) All graded videos must be passed with a score of 69.5% or greater in order to pass the course. 300 20% Case Study Assignments: Week 4 (100 points) Week 6 (100 points) Week 10 (100 points) Week 11 (100 points) 400 20% Exams: Midterm (100 points) – 25% Final (100 points) – 25% 200 50% Total: 1,600 100% * Each Discussion requires that you make one initial posting and at least two response postings to colleagues. See the Formative Evaluative Criteria for Discussion Board Assignments in Course Information area for posting details. Incomplete Grade Policy Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/20191…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 10 of 17 Per University policy, Incomplete grades can be granted only to students who have already met the minimum criteria for active weekly participation in a course (including weekly postings in online courses) and have completed at least 80% of other coursework. Incompletes can be awarded when, because of extenuating circumstances, a student has not met additional course requirements, including but not limited to written assignments, group projects, and research papers, as applicable. All Incomplete grades are awarded at the discretion of the course faculty. (Reproduced from Student Catalog) Students who are eligible for an Incomplete must contact the course faculty to request the grade as soon as possible. Students who do not meet the criteria listed above will not be allowed to earn an Incomplete. If the Incomplete is approved, the Faculty Member will work with the student to outline the due date(s) for remaining work. Under no circumstances will the new due dates extend beyond 50 days from the last day of the term. Faculty will then have 10 days to assess the work and post the permanent grade before the University-allotted Incomplete time limit of 60 days expires. All Incomplete grades not resolved within the time allotted will convert to permanent grades of F. Instructor Feedback Schedule The Instructor will log in to the course during the week to monitor the weekly Discussion area. Feedback will be provided via the comments in the My Grades area, the Discussion area, and/or the Announcements page. You can expect your weekly assignment grades to be posted within 1 week of a due date. Instructor feedback and explanation is provided whenever full credit is not achieved. Depending on the nature of the feedback, Instructor responses may be posted to the Discussion area or included in the My Grades area. The goal of your Instructor is to act as a discussion and learning facilitator rather than a lecturer. The Instructor will not respond to every posting by every individual, so please feel free to ask your Instructor if you would like some personal feedback on a particular assignment posting or any time you have any questions regarding your assignments or your grade.  ORDER A PLAGIARISM-FREE PAPER NOW Course Procedures 1. All class Discussions take place in the weekly Discussion areas. Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/20191…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 11 of 17 2. You are encouraged to post course-related questions to the Contact the Instructor area, as they may be of interest to all; however, if your question is urgent, it is often best to e-mail the Instructor. If your e-mailed question is thought to be of benefit to all, it may be responded to by the Instructor via e-mail to all or posted as an announcement. 3. Instructor feedback on content and writing issues that is thought to be of benefit to the entire class may be posted to the Contact the Instructor area; however, most personal critique will be done privately in My Grades. Be sure to check the My Grades area for comments every week, even if you received full credit. 4. Please feel free to use the Class Café to initiate and participate in conversations not directly related to the course. This is an excellent opportunity to get to know other students better. The Instructor will browse the Class Café occasionally, but generally will not respond to conversations posted there unless students have specific questions for him or her. 5. Check the e-mail account you use for official Walden University business on a regular basis. The expectation is that you are checking this e-mail account daily during the week. If you experience difficulty sending or receiving Walden e-mail, please contact the Student Support Team right away. Contact information for the Student Support Team is located in the Student Support area. 6. Review all materials in the Course Information area, as well as the materials contained under each of the weekly buttons. Please note: There are Optional Readings located within the Learning Resources section of each week in the course. You are encouraged to explore these readings as needed in order to enhance your understanding of the course content. Preferred Methods for Delivering Assignments 1. Be sure that you post to the correct Discussion area each week. Do not e-mail postings to the Instructor. For all initial Discussion postings, make sure that the first sentence of your posting reads Main Question Post. For your responses to others’ response postings, make Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/20191…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 12 of 17 sure that the first sentence of your response reads Response. These actions will ensure easily identifiable subject lines for your postings and responses. 2. Assignments are submitted to the SafeAssign link and named according to the week in which the Assignment is submitted. Directions for naming each Assignment are included in each week’s Assignment area. 3. All e-mail correspondence must contain in the subject line “NURS 6512-XX-NAME” (XX is the section number) followed by a brief description of the subject. This subject line convention ensures that your e-mail will be easily identified and responded to in a timely manner. It is required that the e-mail contain a signature that matches the official name used in the course. Late Assignment Policy Students are expected to submit assignments by the due dates noted in the course. In extenuating circumstances, such as illness, the student must contact the Instructor as soon as possible to discuss the situation. In those circumstances, faculty will determine the appropriate course of action for the student. Depending on the situation, these actions may include recommendations to drop the course (if within the University drop/withdrawal period), acceptance of some or all of the overdue assignments with or without penalties, or failure to accept assignments. Assignments submitted late without prior agreement of the Instructor, outside of an emergency absence, or in violation of agreements for late submission, will receive a grade reduction for the assignment amounting up to 20%. After 5 days, the assignment will not be graded. Students should be aware that late assignments may not receive the same level of written feedback as do assignments submitted on time. Keeping Your Coursework You will have access to the course and your coursework from the course start date until 60 days after the course ends. After this time, you will no longer be able to access the course or related materials. For this reason, we strongly recommend that you retain copies of your Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/20191…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 13 of 17 completed assignments and any documents you wish to keep. The University is not responsible for lost or missing coursework. Course Evaluation At or near the end of the course, you will receive an e-mail inviting you to submit an online evaluation of the course and instruction. All submitted course evaluations are confidential, and only aggregate data and comments will be shared with the Instructor and Program Director. Your feedback is vitally important to Walden University in its efforts to continuously improve programs. Students With Disabilities Students in this course who have a disability that might prevent them from fully demonstrating their abilities should contact the director of disability services at disability@waldenu.edu or at 1- 800-925-3368, ext. 312-1205 and +1-612-925-3368 or https://www.waldenu.edu/contact for international toll-free numbers as soon as possible to initiate disability verification and discuss accommodations that may be necessary to ensure full participation in the successful completion of course requirements. Classroom Participation In accordance with U.S. Department of Education guidance regarding class participation, Walden University requires that all students submit at least one of their required Week 1 assignments (which includes posting to the Discussion Board) within each course(s) during the first 7 calendar days of class. For courses with two-week units, posting to the Discussion Board by Day 7 meets this requirement. The first calendar day of class is the official start date of the course as posted on your myWalden academic page. Assignments submitted prior to the official start date will not count toward your participation. Financial Aid cannot be released without class participation as defined above. Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/20191…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 14 of 17 Students who are taking their first class with Walden and do not submit at least one of their required Week 1 assignments (or at least one Discussion post) by the end of the 7th day will be administratively withdrawn from the university. Students who have already taken and successfully completed at least one or more class(es) with Walden, and who do not participate within the first 7 days, will be dropped from that class. If you have any questions about your assignments, or you are unable to complete your assignments, please contact your Faculty Member. Checklist The weekly course checklist below outlines the assignments due for the course. For full assignment details and directions, refer to each week of the course. All assignments are due by 11:59 p.m. Mountain Time (MT) on the day assigned (which is 1:59 a.m. Eastern Time (ET) the next day). The time stamp in the classroom will reflect Eastern Time (ET), regardless of your time zone. As long as your submission time stamp is no later than 1:59 a.m. Eastern Time (ET), you have submitted on time. To view the Course Calendar: Course Calendar To View a Printable Course Schedule For full assignment details and directions, refer to each week of the course. Click on the NURS 6512 Course Schedule (PDF) link to access the Course Schedule. Document: NURS 6512 Course Schedule (PDF) Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/20191…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 15 of 17 Checklist Module Assignment Title Week 1 Building a Comprehensive Health History Learning Resources Reading Optional Discussion Building a Health History Looking Ahead Physical Health Assessment Videos Week 2 Functional Assessments and Cultural and Diversity Awareness in Health Assessment Learning Resources Reading Optional Discussion Diversity and Health Assessments Week 3 Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children Learning Resources Reading Optional Discussion Assessment Tools and Diagnostic Tests in Adults and Children Assignment Health History Assessment Video Week 4 Assessment of the Skin, Hair, and Nails Learning Resources Reading Media Optional Assignment 1 Differential Diagnosis for Skin Conditions Assignment 2 Health History Assessment Video Assignment 3 (Optional)Practice Assessment: Skin, Hair, and Nails Examination Week 5 Assessment of Head, Neck, Eyes, Ears, Nose, and Throat Learning Resources Reading Media Optional Discussion Assessing the Ears, Nose, and Throat Week 6 Assessment of the Abdomen and Gastrointestinal System Learning Resources Reading Media Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/20191…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 16 of 17 Optional Assignment 1 Assessing the Abdomen and Gastrointestinal System Exam Midterm Exam Assignment 2 (Optional)Practice Assessment: Abdominal Examination Week 7 Assessment of the Heart, Lungs, and Peripheral Vascular System Learning Resources Reading Media Optional Discussion Assessing the Heart, Lungs, and Peripheral Vascular System Assignment (Optional) Practice Assessment: Cardiac and Respiratory Examination Week 8 Assessment of the Musculoskeletal System Learning Resources Reading Media Optional Discussion Assessing Muscoskeletal Pain Assignment 1 Assessing the Skin, Hair, Nails, and HEENT Assignment 2 (Optional) Practice Assessment: Musculoskeletal Examination Week 9 Assessment of Cognition and the Neurologic System Learning Resources Reading Media Optional Discussion Assessing Neurological Symptoms Assignment (Optional) Practice Assessment: Neurological Examination Looking Ahead Head-to-Toe Physical Assessment Video Week 10 Special Examinations—Breast, Genital, Prostate, and Rectal Learning Resources Reading Media Optional Assignment 1 Assessing the Genitalia and Rectum Assignment 2 Head-to-Toe Physical Assessment Video Week 11 The Ethics Behind Assessment Syllabus 11/18/18, 5:00 PM https://class.waldenu.edu/bbcswebdav/institution/USW1/20191…%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN Page 17 of 17 Learning Resources Reading Assignment Ethical Concerns Exam Final Exam Bibliography The bibliography contains the references for all learning materials in the course. For your convenience, a link has been provided to download and save the bibliography. To access the Bibliography: Document: NURS 6512 Bibliography (PDF)

  • online nursing essays, discussions and assignments papers

    Prefix

    Course 

    DNP-836

    Facilitation of Learning in Nursing Education

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    DNP-838

    Nursing Program Development and Educational Leadership

    DNP-840

    Leadership for Advanced Nursing Practice

    NRS-410V

    Pathophysiology and Nursing Management of Clients’ Health

    NRS-433V

    Introduction to Nursing Research

    NRS-451VN

    Nursing Leadership and Management

    NUR-502

    Theoretical Foundations for Nursing Roles And Practice

    NUR-504

    Health Care Research Analysis and Utilization

    NUR-508

    Ethics, Policy, and Finance in the Health Care System

    NUR-513

    Introduction to Advanced Registered Nursing

    NUR-514

    Organizational Leadership and Informatics

    NUR-550

    Translational Research and Population Health Management

    NUR-590

    Evidence-Based Practice Project

    NUR-631

    Advanced Physiology and Pathophysiology

    NUR-634

    Advanced Health Assessment and Diagnostic Reasoning With Skills Lab

    NUR-635

    Advanced Pharmacology

    NUR-637

    ACNP-AG Didactic II

    NUR-637C

    ACNP-AG Practicum II

    NUR-638

    ACNP-AG Didactic III

    NUR-638C

    ACNP-AG Practicum III

    NUR-641E

    Advanced Pathophysiology and Pharmacology for Nurse Educators

    NUR-643E

    Advanced Health Assessment for Nurse Educators

    NUR-645E

    Advanced Health Assessment for Nurse Educators

    NUR-646E

    Nursing Education Seminar I

    NUR-647E

    Nursing Education Seminar I

    NUR-648E

    Nursing Education Seminar II

    NUR-649E

    Nursing Education Seminar II

    NUR-665E

    Nursing Education Practicum

    NUR-667

    Advanced Practice Management of Women’s Health Care Issues in Primary Care

    NUR-667C

    Advanced Practice Management of Women’s Health Care Issues in Primary Care

    NUR-669

    Advanced Practice Management of Geriatric Issues in Primary Care

    NUR-669C

    Advance Practice Management of Geriatric Issues in Primary Care Clinical

    NUR-670

    Leadership Health Care Organizations Practicum

    NUR-682C

    Advanced Practice Clinical Practicum

    NUR-690

    Nursing Informatics Practicum

    NUR-699

    Evidence-Based Practice Project

    PHN-600

    Foundations of Public Health Nursing

    PHN-690

    Public Health Nursing Practicum

    NRS-410V

    Pathophysiology and Nursing Management of Clients’ Health

    NUR-631

    Advanced Physiology and Pathophysiology

    NUR-641E

    Advanced Pathophysiology and Pharmacology for Nurse Educators

    PCN-370

    Psychopath & Adv.Treatment-Spec Pop w/Addiction&Substance Use Disorders

    PCN-445

    Psychopathology, Co-Occurring Disorders, and Dual Diagnoses in Counseling

    PCN-605

    Psychopathology and Counseling

    PCN-671

    Psychopathology and Treatment of Children and Adolescence

    PCN-807

    Psychopathology, Behavioral Assessment, and Interventions

    PSY-570

    Psychopathology

    PSY-622

    Psychopathology of Crime

    HCA-240

    Health Care Accounting and Billing

    HCA-255

    Health Policy and Economic Analysis Care

    HCA-360

    Health Information Technology and Management

    HCA-450

    Quality in Health Care

    HCA-455

    Organizational Behavior and Leadership in Health Care

    HCA-460

    Operations and Risk Management in Health Care

    HCA-465

    Health Care Administration and Management

    HCA-470

    Strategic Planning and Implementation in Health Care

    HCA-515

    Analysis of Contemporary Health Care Delivery Models

    HCA-530

    Health Care Policies and Economics

    HCA-545

    Organizational Structure, Dynamics, and Effectiveness

    HCA-610

    Essential Health Care Business Analysis

    HCA-615

    Human Resource Management and Marketing Communication Strategies

    HCA-620

    Business/Project Plan Evaluation and Development

    HCA-675

    Health Care Innovation

    HCA-699

    Evidence-Based Research Project

    HCA-807

    Structures and Governance in Health Care

    HCA-812

    Health Care Regulation

    HCA-817

    Professional Development and Leadership in Health Care

    HCA-822

    Building a Culture of Community in Health Care

    HCA-827

    Sustainability of Health Care Organizations

    HCI-600

    Foundations of Informatics

    HCI-655

    Electronic Health Records

    HCI-660

    Health Data Analytics

    HCI-665

    Health Information Systems Security

    HCI-670

    User Interface Design for Informatics

    HEB-501

    Elementary Hebrew I

    HIM-515

    Foundations and Concepts of Health Care Informatics

    HIM-615

    Health Care Information Systems and Technology

    HIM-650

    Health Care Data Management

  • NURS 6512 Advanced Health Assessment final examination

    Which portion of the physical examination is best done with the patient standing? spinal

     

    To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested? patellar

     

    To assess a cremasteric reflex, the examiner strokes the: lightly stroking the inner thigh

     

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    Which condition is considered progressive rather than reversible? dementia

     

    When palpating breast tissue, the examiner should use the _pads of the fingers____ at each site.

     

    Palpation of a normal prostate in an older adult is likely to feel: rubbery

     

    The difference in blood pressure readings between the right and the left arms is considered normal up to _5____ mm Hg.

     

    Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her: menstrual cycles

     

    Cranial nerve XII may be assessed in an infant by: sucking and swallowing

     

    While collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding:

     

    An idiopathic spasm of arterioles in the digits is termed: Raynauds

     

    A 23-year-old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is to: pregnancy

     

    Assessing orientation to person, place, and time helps determine:

     

    The rectal past medical history of all patients should include inquiry about:

     

    To hear diastolic heart sounds, you should ask patients to:

     

    Loss of immediate and recent memory with retention of remote memory suggests: dementia

     

    Your patient’s chief complaint is repeated pencil-like stools. Further examination should include:

     

    Kawasaki disease is suspected when assessments of a child reveal:

     

    The examiner percusses for diaphragmatic excursion along the:

     

    If pitting edema is unilateral, you would suspect occlusion of a:

     

    Which medical condition would exclude a person from sports participation? fever

     

    The Mini-Mental State Examination:

     

    An ophthalmoscopic eye examination involves: Lens

     

    The Denver II is a tool used to determine:

     

    A common finding in markedly obese and pregnant women is: Lordosis

     

    When conducting a geriatric assessment, basic activities of daily living (ADLs) include: Bathing

     

    The finger-to-nose test allows assessment of: coordination

     

    Inspection of the scrotum should reveal: left lower than the right

     

    Part of the screening orthopedic component of the examination includes evaluating the person while he or she is:

     

    In the most effective percussion technique of the posterior lung fields, the patient cooperates by: crossing arms in front

     

    Normal changes of the aging brain include:

     

    Ulnar deviation and boutonniere deformities are characteristic of: Rheumatoid arthritis

     

    A cervical polyp usually appears as a:

     

    Bimanual examination of the uterus includes:

     

    If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation?

     

    Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the: p wave

     

    Inquiry about nocturnal muscle spasms would be most significant when taking the musculoskeletal history of:

     

    The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the: QRS

     

    As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B.’s pattern as:

     

    The reliability of health-related findings and observations is the responsibility of the: patient and examiner

     

    The physical assessment technique most frequently used to assess joint symmetry is: inspection

     

    The presence of cervical motion tenderness may indicate:

     

    The goals of preparticipation sports evaluation include:

     

    A patient in the deepest coma would be scored a __3___ on the Glasgow Coma Scale.

     

    The adnexa of the uterus are composed of the:

     

    Montgomery tubercles are most prominent in the breasts of:

     

    Palpation of epitrochlear nodes is part of the: upper extremities

     

    During chest assessment, you note the patient’s voice quality while auscultating the lung fields. The voice sound is intensified, there is a nasal quality to the voice, and the e’s sound like a s. This sound is indicative of: bronchial obstruction

     

    When palpating joints, crepitus may occur when: irregular bony surfaces rub together

     

    Examination of the patient in the lithotomy, or knee-chest, position includes: anal sphincter

     

    The best way to ease the apprehension of a 3-year-old child before a physical examination is to: let him hold the stethoscope during the exam

     

    Recent unilateral inversion of a previously everted nipple suggests: cancer

     

    A grade IV mitral regurgitation murmur would:

     

    Breath sounds normally heard over the trachea are called: bronchial

     

    Nerves that arise from the brain rather than the spinal cord are called: cranial

     

    The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: plan follow ups

     

    You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of: schizophrenia

     

    A 12-year-old boy relates that his left scrotum has a soft swollen mass. The scrotum is not painful upon palpation. The left inguinal canal is without masses. The mass does transilluminate with a penlight. This collection of symptoms is consistent with: hydrocele

     

    Postural hypotension is defined as a ___15 mm hg decrease__ when the patient stands, compared with sitting or supine readings.

     

    While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should: document in the record

     

    You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: ask about previous infections

     

    An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection? Cytology smear

     

    When you attempt to move a 10-month-old child from his mother’s lap to the examination table, he screams loudly. Your best action is to: let them sit on the mothers lap

     

    It is especially important to test for ankle clonus if: deep tendon reflexes are hyperactive

     

    Which one of the following is a proper technique for use of a speculum during a vaginal examination?

     

    Diabetic peripheral neuropathy will likely produce: decreased pain sensation

     

    One of the most important aspects to consider in the orthopedic screening examination is: symmetry

     

    The Mini-Mental State Examination should be administered for the patient who: get lost in their own neighborhood

     

    When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally observes the:

     

    During a routine prenatal visit, Ms. T. was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T. that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings: normal pregnancy

     

    An apical PMI palpated beyond the left fifth intercostal space may indicate: left ventricular hypertrophy

     

    Which one of the following techniques is used to detect a torn meniscus? McMurray

     

    When assessing superficial pain, touch, vibration, and position perceptions, you are testing: sensory

     

    Which of the following statements is true regarding the examination of peripheral arteries? Do not use your thumb

     

    Tarry black stool should make you suspect: upper gastrointestinal bleed

     

    A pulsation that is diminished to the point of being barely palpable would be graded as: 1

     

    Temporalis and masseter muscles are evaluated by: clenching teeth

     

    The foramen ovale should close: minutes after birth

     

    A parent is advised to restrict contact or collision sports participation for their child. An example of a sport in which this child could participate is: riflery

     

    When is the mental status portion of the neurologic system examination performed? constantly

     

    Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify: uremia

     

    You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. What additional diagnostic testing would be required for her? Cervical radiographs

     

    For purposes of examination and communication of physical findings, the breast is divided into: 4 quadrants and a tail

     

    A red, hot swollen joint in a 40-year-old man should lead you to suspect: gout

     

    You are examining Mr. S., a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of arterial occlusion? Lack of hair growth

     

    You are initially evaluating the equilibrium of Ms. Q. You ask her to stand with her feet together and arms at her sides. She loses her balance. Ms. Q. has a positive: Rombergs

     

    Anterior cruciate ligament integrity is assessed via the _____ test. Lachmans

     

    Throughout the history and physical examination, the clinician should:

     

    Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by: auscultating lung bases

     

    When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test, you would also perform a test for the _____ sign.

     

    You are assessing Mr. Z.’s fluid volume status as a result of heart failure. If your finger depresses a patient’s edematous ankle to a depth of 6 mm, you should record this pitting as: 4+

    A finding that is indicative of osteoarthritis is: Herberdens

     

    To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine with: arm up over head and pillow behind one shoulder

     

    You are conducting an examination of Mr. Curtis’s heart and blood vessels and auscultate a grade III murmur. The intensity of this murmur is: moderately loud

     

    At your first meeting with a patient, it is usually best to say: Tell me about yourself

     

    Functional assessment is most important during the examination of a(n): older adult

    Nancy Walker is a 16-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Nancy, apart from occasional colds, Nancy is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Nancy’s current problem? Cocaine

    A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of “heart trouble.” The most important follow-up question you should pose is which of the following? How old was your father at the time of his death

    Which cranial nerves are usually evaluated during the examination of the eyes?

     

    While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s wort. You make a short note to check for results of the: MMSE

  • Problem Focus Exams: Head, Eyes, Ears, Nose, and Throat (HEENT)

    NUR 643 Topic 2: Problem Focus Exams: Head, Eyes, Ears, Nose, and Throat (HEENT)

    Topic 2: Problem Focus Exams: Head, Eyes, Ears, Nose, and Throat (HEENT)

    Read the “Procedures for Advanced Health Assessment Check-Offs” and submit your response below in this forum within the allotted timeframe for completion: Procedures for Advanced Health Assessment Check-Offs Acknowledgement I, (INSERT NAME), verify that I have read, understand, and will comply with the requirements set forth in the “Procedures for Advanced Health Assessment Check-Offs” document.

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    Objectives:

    Review the appropriate anatomy and physiology related to the HEENT systems: head, eyes, nose, ears, and throat.

    Explore basic physical examination techniques for conducting a HEENT examination for the applicable regions.

    Compile focused subjective and objective health history for the specified HEENT regions while communicating effectively with the patient.

    Prepare a competent SBAR (situation, background, assessment, and recommendations) documentation note.

    SBAR Template

    Choose an experience from your nursing practice. Using the “SBAR” template, explain the situation in detail, followed with background information. Then explain your immediate assessment and recommendations you have for the provider.

    Include the following in the “SBAR” template:

    Be sure to include three or four evidence‐based references, not older than 5 years.

    When giving your recommendation discuss how you would educate the client using evidence‐based research and guidelines. How would you deliver your recommendation in various learning environments?

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Health Assessment Topic Reflection 2

    Complete a 250‐word reflection of what you have learned during this topic. Include the following in your reflection:

    Think about an experience you’ve encountered when viewing or completing the particular assessment.

    Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.

    Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing (the particular) assessment.
                

    Describe how the Christian worldview and compassion for all plays a role in this type of assessment.

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Course Code Class Code Assignment Title Total Points

    NUR-643E NUR-643E-O500 Health Assessment Topic Reflection 2 10.0

    Criteria Percentage 1: Unsatisfactory (0.00%) 2: Less Than Satisfactory (80.00%) 3: Satisfactory (88.00%) 4: Good (92.00%) 5: Excellent (100.00%) Comments Points Earned

    Content 85.0%

    Topic 2 DQ 1

    As an instructor, you are working with a nursing student in the second year of a 4-year nursing program. The student does not perform an ear exam correctly. How would you explain the appropriate technique to examine the ears?

    Topic 2 DQ 2

    You are working the triage desk of the ED. A client presents with sudden loss of vision of the right eye after a head collision during a volleyball game. What would your assessment include? What could be initial problems and would they warrant emergent intervention?