Category: Nursing

NURS 6560 Midterm Study Guide – Exam Questions and Answers

NURS 6560 – Mid-Term Review:

Pre and Post-Operative Management:

What is pre-operative process and why is it necessary?

What are the components and testing necessary in the pre-operative process?

What is the pre-operative management of the diabetic patient?

Review common surgical complications and risks

Identify Low risk vs. high risk procedures according the ACS.

Review the NSQIP guidelines for geriatric patients

Identify surgical complication risks as per ACS/NSQIP in chronic diseases

Review ACCF/AHA antiplatelet therapy guidelines

Post-op fevers – early vs. late (more than 24 hours post-op) – Review how to assess and manage post-op fever

Post op wound assessment

Ordering post-operative pain medications

TPN management with electrolytes

Fluid and electrolyte management in the post-op period

Reading/interpreting chemistry panels;

Review the obesity paradox

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HEENT/GI:

Review risk factors for throat cancers

Foreign Body removal risks and workup

Vertigo differentials and diagnosis;

Cholesteatoma

Allergic rhinitis

Ludwig’s angina

Sialadentitis

Common Infections of head and neck

Obstructive Sleep Apnea

Thyroid disease and parathyroid disorders

GERD

Esophagitis

Esophageal achalasia

Pharyngoesophageal (Zenker) diverticulum

Esophageal motility disorders

Barrett’s esophagus

Nutcracker esophagus;

Esophageal carcinoma

Esophageal perforation

Gastroparesis;

Hernias

NURS 6560 Midterm Study Guide – Exam Questions and Answers

CV:

CAD risks, etiology, prevention, treatment, diagnostics, and pathology

Endocarditis

Unstable angina

Valvular disorders – identification of murmurs, treatment and complications

CABG – options and complications; dysrhythmias; pulmonary edema;

Marfan’s syndrome

Thoracic aneurysms – diagnosis, treatment and complications

Heart transplant – indications and treatments

Normal carotid endarterectomy course, management after surgery, and writing post-op notes

NURS 6560 Midterm Study Guide – Exam Questions and Answers

Pulmonary:

VATS

Thoracentesis

Lung biopsies

Tietze syndrome

Empyema;

Pneumothorax;

Mediastinitis

Broncholithiasis

TB test interpretation and limitations;

All types of pneumonia;

Sarcoidosis

Lung cancer post op complications

PE

 

Shock:

Hypovolemic shock

Cardiogenic Shock

Obstructive Shock (especially in PE)

Distributive Shock (neurogenic and septic shock)

Focus on the diagnosis and treatment of different types of Shock

Pulmonary Artery Catheter – normal and abnormal pressures

ACLS standards/guidelines for treating Shock

NURS 6560 Midterm Study Guide – Exam Questions and Answers

NURS 6560 Final Exam Questions and Answers- Advanced Practice Care of Adults in Acute Care Settings II

NURS 6560 Final Exam Review

General Pre and Post Op Care

Hemoglobin in relation to surgery

Predictors of increased morbidity and mortality post-operatively

Risks factors for poor wound healing

Medications the patient should take on the morning of surgery

Positioning in the PACU

 

Head, Neck, Esophagus, and Diaphragm

Sudden sensorineural hearing loss (SSHL) diagnosis and treatment

Otitis Externa – secondary treatment

Non-Hodgkin’s lymphoma- treatment related complications

Achalasia risk factors

Traumatic diaphragmatic hernia repair

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Cardiology

EKG interpretation of different types of MI according to the leads presenting with signs of ischemia

Society of Thoracic Surgeon’s statistics and synopsis regarding patient outcomes after coronary artery bypass grafting and mortality

INR management

Mitral stenosis with catheter-based balloon mitral valvotomy and reduction of the transvalvular pressure gradient

Types of aortic aneurysms and immediate surgery

 

Pulmonary and Shock

Fatty Lipoma

Thymoma and autoimmune disorders

Positive TB skin test and when treatment is needed

Cardiac pressures related to shock and PE

Treatment for neurogenic shock, distributive-septic shock, and cardiogenic shock

NURS 6560 Final Exam Questions and Answers- Advanced Practice Care of Adults in Acute Care Settings II

 

Acute Abdomen, Stomach/Duodenum, Appendix Disorders

Abdominal pain and epigastric pain workup and presentation

Symptoms of colicky pain

Gas stoppage sign

Pancreatitis labs

ureteral colic s/s

Perforated bowel s/s

Rebound tenderness

Diverticulitis s/s

When is a pelvic exam indicated and when can it be deferred?

Gastric resection and how vitamins absorption is affected

Post-op care of abdominal surgery

Gastroparesis

perforated ulcer s/s and resection and hospital complications

vagotomy

gastrinoma s/s

peptic ulcer disease s/s and management

gastrectomy and bezoar formation

Zollinger-Ellison syndrome

Pyloric obstruction s/s

 

Liver/Biliary Track, Pancreas, Spleen

Resection of the liver and regeneration- follow up monitoring

pregnant women and spontaneous hepatic rupture s/s

hepatic hemangiomas

hepatic adenomas s/s

portal hypertension with alcoholic liver disease s/s

acutely bleeding varices treatment

Budd-Chiari syndrome s/s

Von Willebrand’s disease

Paracentesis and subsequent analysis of the fluid

ascites s/s and treatment

chemical mediators of hepatic encephalopathy, protein intake

Extrahepatic obstruction s/s

Cholelithiasis s/s and treatment

Biliary colic s/s

acute pancreatitis s/s and causes

Grey Turner Sign

Ranson Criteria of Severity for pancreatitis

Idiopathic thrombocytopenia purpura s/s

myelodysplastic syndrome s/s and treatment

 

Intestines, Hernias, Abdominal Wall Lesions

Jejunum resection and effects on nutrition

Crohn’s disease complications

Small bowel obstruction s/s and treatment

anemias and abdominal discomfort diagnosis

Campylobacter jejuni s/ s and treatment

Pneumatosis s/s and treatment

Colectomy discharge education

transit time in constipation

bacterial growth in small and large intestine benefits vs. complications of over growth

Complete bowel obstruction s/s

Frame pattern of colon distention on x-ray

Inflammatory polyps

Radiographic work up for lower abdominal complaints

Diverticulitis assessment, s/s, diagnosis, and treatment

colovesical fistula treatment

sigmoid volvulus- s/s and treatment

colitis – s/s and treatment

McBurney’s sign

NURS 6560 Final Exam Questions and Answers- Advanced Practice Care of Adults in Acute Care Settings II

 

Adrenals and Urogynecology

Unique features of adrenal surgery complications

Primary hyperaldosteronism- s/s, diagnosis and treatment

Aldosteronoma- s/s and treatment

Catecholamine-secreting tumor s/s

Pheochromocytoma treatment and complications

Cushing’s syndrome and adrenal tumor- s/s, lab values and results of removal of tumor

Bilateral total adrenalectomy post op treatment

Adrenal tumors with gender symptoms

Vesicoureteral reflux diagnosis

Hypospadias and circumcision

Administration of the American Urological Association (AUA) Symptom Scale-When is it needed?

microscopic hematuria- s/s and treatment

acute pyelonephritis s/s

Bladder distention treatment

Tuberculosis and UTI s/s

Posterior compartment syndrome- s/s and treatment

Menorrhagia diagnosis

Ectopic pregnancy- s/s and treatment

NURS 6560 Final Exam Questions and Answers- Advanced Practice Care of Adults in Acute Care Settings II

Neurology, Orthopedics, Plastic/Reconstructive

Use of plain film x-rays with head injuries

Hypotension and head injury – risk of mortality

Cushing’s triad s/s

Closed head injury s/s and treatment

Acute subdural hematoma on CT scan

Concussion definition s/s and treatment

Brain Trauma Foundation recommendations for intracranial pressure monitoring

Crush injuries – s/s and treatment

Fasciotomy

open fractures – treatment

transverse process fractures – treatment

Flexion-distraction injuries – causes

Pelvic fracture – s/s

Scapular fracture – treatment

Proximal humerus fracture

full thickness grafts – when to use

Treatment of hypertrophic scar

Seborrheic keratosis – treatment

Verrucae lesions – s/s and treatment

Actinic keratosis – s/s and treatment

Time frame for suturing injuries

 

Oncology, Organ Transplant, Medical/Ethical

tumor nomenclature

various methods of tumor biopsy

Proctocolectomy – when is it needed

Partial response to neoadjuvant chemotherapy

Monoclonal antibodies uses and advantages

Acute post-radiation effects with throat cancer

Organ donation – when is a patient not a candidate for organ donation?

Use of Corticosteroids in post-transplant patients

Donation guidelines

Treatment strategies for bradyarrhythmias in post-heart transplant patients

Bone marrow transplant – treatment for prevention of rejection

Kidney transplant – treatment

First line treatment of acute rejection of liver

Ethical principles beneficence, nonmaleficence, veracity

Counseling rape victims

Informed Consent and cognitively impaired patients

End of life considerations

NURS 6560 Final Exam Questions and Answers- Advanced Practice Care of Adults in Acute Care Settings II

NURS 6640 WALDEN – ONLINE MID TERM EXAM QUESTIONS AND ANSWERS

QUESTION 1

The PMHNP understands that anxiety and depression are two disorders in which their symptoms may overlap. When discussing this, you explain that the autonomic nervous system is activated and further helps distinguish anxiety symptoms by making the following points:

A.”You may experience an elevated heart rate, constant worrying, and diarrhea.

“B.”You may experience fear, sweating, and muscle tension.

“C.”You may experience an elevated heart rate, the need to urinate, and fear.

“D.”You may experience sleepiness, decreased blood pressure, and fear.”

 

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1 points  

QUESTION 2

The PMHNP is working with a school-aged child who has been diagnosed with depression. The child has attended several sessions with the PMNHP, but recently presents with avoidant behavior by showing increased distress and being late to sessions. What approach does the PMHNP need to employ with the child to continue making therapeutic progress?

A.Remaining quiet until the child is ready to talk

B.Using communication techniques that are expressive

C.Inviting the child’s parents to speak on behalf of the child

D.All of the above

 

1 points  

QUESTION 3

After informing a prospective patient about limits of confidentiality, the patient consents to the “conditions” of confidentiality and signs an informed consent form. Several weeks later, a lawyer representing the patient’s spouse for a court case, asks the PMHNP for the disclosure of information about the patient. The PMHNP should:

A.Disclose all patient information as requested

B.Refuse to disclose any confidential information

C.Limit disclosure to the extent legally possible

D.Ignore the request based on ethical reasons

 

1 points  

QUESTION 4

In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making it impossible for her to sleep. What recommendations based on principles of sleep hygiene will the PMHNP make?

A.Eat a heavy meal before bedtime to induce sleepiness

B.Maintain a warm bedroom temperature

C.Avoid watching television or reading in bed

D.Try going to sleep at different times throughout the week to avoid monotony

 

1 points  

QUESTION 5

An 11-year-old patient has been exhibiting low self-esteem at school and acting out. According to Maslow’s hierarchy of needs, which of the following questions would best be addressed first by the PMHNP?

A.”Are Joel’s peers including him at recess?

“B.”Does Joel feel safe and secure at school?”

C.”Is Joel getting enough sleep at home?”

D.”How can Joel feel that he is loved?”

NURS 6640 Walden – Online Mid Term Exam Questions and Answers

QUESTION 13

You are seeing a 29-year-old widow whose husband recently died overseas while serving his country in the military. She has been mourning the loss of her husband for several months, and continues to grieve. She refuses to go to group grieving sessions, but reports that she is still able to go to work and her fitness classes sometimes, and even makes attempts to stay social. She says, “Sometimes it’s like he’s not even gone. Other times it feels like it’s been an eternity since I’ve seen him. It’s hard to talk about this type of stuff with my girlfriends, especially since all of their husbands are still alive.” The PMHNP understands that it is appropriate to employ which therapeutic principle?

Encouraging catharsisB.Encouraging abreaction to repressed feelingsC.Identifying conflict-resolution techniquesD.All of the above

NURS 6640 Walden – Online Mid Term Exam Questions and Answers

QUESTION 19

The PMHNP is meeting with a 38-year-old divorced, single mother who has been seeing the PMHNP for anxiety and anger management. During one of the sessions, the patient tells the PMHNP that she is having a problem getting her child support payments from her ex-husband, which is triggering increased anxiety and anger, which she admittedly takes out on her children. How does the PMHNP respond in a way that upholds the supportive psychodynamic psychotherapy approach?

Telling the patient to take a vacation to get away and relaxB.Suggesting that she seek legal helpC.Giving her advice about men and how to get them to pay child supportD.Suggesting that the patient start going to church to help find more solace.

NURS 6640 Walden – Online Mid Term Exam Questions and Answers

QUESTION 60The PMHNP is treating a patient with a substantial fear of feeling closed in (claustrophobia). Thus, the patient will not get into an elevator. The office where he works is on the 10th floor and this requires that he walk up and down the stairs in the morning and evening to get to his office. With permission from the patient, the PMHNP is beginning systematic desensitization to address the patient’s need to use the elevator. What is the PMHNP’s best plan of action?Begin by having the patient stand in front of the elevator and write down his feelingsB.Complete a 30-minute therapy session in an elevatorC.Allow the patient to watch an elevator go up and downD.Allow the patient to see the PMHNP getting into an elevator

QUESTION 63

During a session, the PMHNP asks a patient with a history of sexual abuse to recall the relationship she had as a child with her parents. The patient responds by saying she has a headache and her stomach hurts, and starts talking about her physical ailments. What is the appropriate response by the PMHNP?

Assure the patient that she does not have to discuss these memoriesB.Explain why it is important for the patient to discuss these memories openlyC.Tell the patient that she may not get better if she does not face her fearsD.Let the patient know that plenty of other people have similar painful memories, too

A 35-year-old patient has been seeking treatment for depression for several months. The PMHNP does an assessment to see if processing has led to adaptive change. The patient’s self-references are positive in relation to past events, work is productive, relationships are adaptive, and there is congruence between behavior, thoughts, and affect. Based on this information, the PMHNP decides the patient ____________.

will require more processing strategiesB.would benefit from the stabilization stageC.is ready to move to Stage III, future visioningD.no longer needs to continue with therapy NURS 6640 Walden – Online Mid Term Exam Questions and Answers

Find below the NURS 6550 Midterm Exam Walden – Questions and Answers, questions only, if you need the answers, please
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Question 1

0 out of 1 points

D.E. is a 41-year-old female who had lumbar surgery two days ago to repair a ruptured nucleus pulposus. She has been doing well postoperatively but today is complaining of resting fatigue and some shortness of breath at rest. In ruling out a pulmonary embolus the AGACNP first orders a:

 

Response Feedback:

“B” is the correct answer. The D-dimer is a highly sensitive serology and is the least invasive mechanism by which a pulmonary embolus may be ruled out; a negative D-dimer virtually eliminates pulmonary embolus from the differential diagnosis. “A” is not correct—while it can be used to make the diagnosis it is more invasive and less specific than other options. “D” is not correct—there is no indication that the patient is on warfarin, and in any event it would not be used to rule in or out pulmonary embolus “C” is not accurate when after surgery, as it will be positive after surgery.

Question 2

0 out of 1 points

Mr. Nixon is being treated with unfractionated heparin infusion for acute pulmonary embolus. In order to avoid a potentially fatal complication of heparin infusion, the AGACNP monitors:

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Response Feedback:

“D” is the correct answer. An uncommon but potentially serious consequence of heparin infusion is heparin-induced thrombocytopenia. Some patients make autoantibodies in response to exogenous heparin that activate their own platelets. When this occurs, heparin must be immediately discontinued and thrombin inhibitors started. “A” is not correct—this is not affected by heparin, but is monitored in those on Coumadin. “B” is not correct—this is also unaffected by heparin, but monitored on Coumadin. “C” is not correct—this is monitored to assess therapeutic efficacy, but not for complications.

Question 3

1 out of 1 points

Differentiating vertigo from near-syncope and ataxia is one of the goals of history-taking when a patient presents as “dizzy.” The AGACP knows that vertigo is the problem when the patient reports the primary symptom as:

 

Response Feedback:

“A” is the correct answer. Dizzy is a layperson’s term and can mean many different things to patients and health care providers. When the patient identifies the primary symptom as a sense of spinning this supports vertigo, which is usually an inner ear problem. This versus ataxia which is neurologic or near-syncope which may be cardiac, neurological, or neurocardiogenic. “B” is not correct—this may occur with vertigo, but when it is the primary symptom it is most likely ataxia and neurological causes should be considered. “C” is not correct as coincident nausea is not specific and can occur with any of these complaints. “D” is not correct as it is also not specific; while ataxia cannot occur when supine near-syncope can.

Question 4

1 out of 1 points

Mr. Banks has been admitted for surgical resection of a metastatic tumor, during surgery it is discovered that he has widespread, diffuse metastasis throughout the abdomen. Surgery is no longer an option, and his oncologist says that chemotherapy is unlikely to produce any meaningful benefit. Mr. Banks is concerned that his sons will not support a transfer to comfort care. The AGACNP advises that he:

 

Response Feedback:

“B” is the correct answer. If there is any concern about disagreement among family members, or any concern at all that a patient’s wishes will not be carried out, the best action is to ensure that there is a clearly defined legally executed document. “A” is not correct. Living wills are not legally enforceable documents and when dissention arises among family members they may not be carried out. “C” is not correct – while the patient should arrange for his care as long as he is capable of doing so, if questions arise at such a time that he is not capable of answering his next of kin will need to do so. “D” is not correct — identifying the proxy is not enough without assigning legal rights and responsibilities. While “A,” “C,” and “D” should all be done and will support his care, the only way to ensure that one’s wishes are carried out is to ensure that a legally enforceable direction is in place.

Question 5

1 out of 1 points

Mr. Wilkerson is a 77-year-old male who is being evaluated and treated for his cardiogenic pain. His vital signs are as follows: Temperature of 99.1° F, pulse of 100 bpm, respirations of 22 bpm, and blood pressure of 168/100 mm Hg. A 12-lead ECG reveals deep ST segment depression in leads V
3
-V
6
. The AGACNP recognizes which of the following as a contraindication to rTPA therapy?

 

Response Feedback:

“D” is the correct answer. rTPA is not indicated in patients with ST segment depression; this is not a ST elevation MI. “A” is not correct as age > 80 is a relative contraindication. “B” is not correct as a temperature of 99.1° F is an expected response to myocardial necrosis, and “C” is not correct—the blood pressure is not prohibitive until > 180/110 mm hg.

Question 6

1 out of 1 points

A 71-year-old patient is recovering from a particularly severe exacerbation of chronic obstructive pulmonary disease. He has been in the hospital for almost two weeks and was on mechanical ventilation for 7 days. While discussing his discharge plan he tells you that he is really going to quit smoking this time. He acknowledges that he has been “sneaking” cigarettes in the hospital for two days, but he has established a timeline to decrease the number of cigarettes daily. According to his plan his last cigarette will be the last day of the month. This patient’s behavior is consistent with which stage of the Transtheoretical Model of Change?

 

Response Feedback:

“C” is the correct answer. The Transtheoretical model of change is characterized by 5 stages. “A” is when the patient has no intention to make a change. “B” is when the patient is intending to make a change in the next 6 months. “C” is when the patient is ready to take action or has already taken some action, as this patient has in establishing his plan to quit by the end of the month. “D” is the overt action that attains a criterion sufficient to reduce disease risk—in this patient the action stage would be characterized by actual smoking cessation. The final phase, not presented in the answer choices here, is maintenance.

Question 7

1 out of 1 points

While assessing a patient with a known psychiatric history, the AGACNP knows that the primary difference between a psychotic and neurotic disorders is:

 

Response Feedback:

“B” is the correct answer. Patients with psychotic disorders are characterized by a distinct alteration in their perception of reality which may be manifest by visual or auditory hallucinations or impaired thought processes. Neurotic disorders, while many times very serious, are seen in patients who remain aware and interactive with the reality. “A” is incorrect as neurotic disorders may be characterized by a tendency or actual act of harm, such as the self-mutilating actions classic of a borderline personality, suicide by a depressed patient, or even murder or torture committed by an antisocial personality. While dangerous, none of those disorders include a dis-connect from reality as part of the presentation. “C” is incorrect as antipsychotic medications are used to manage a variety of neurotic disorders such as depression or oppositional defiant disorder. “D” is incorrect as lack of conscience and remorse is typical of antisocial personalities.

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The AGACNP is caring for a patient who is quite ill and has developed, among other things, a large right sided pleural effusion. Thoracentesis is sent for pleural fluid analysis. While evaluating the fluid analysis, the AGACNP knows that a fluid identified as a(n) __________ is the least worrisome type.

Mrs. Miller is transported to the emergency department by paramedics. She is having profound, unremitting chest pain, is diaphoretic and pale. She has jugular venous distention and a widened pulse pressure. Suspecting ascending aortic aneurysm, the AGACNP order which test to confirm the diagnosis?

Certain subgroups of the elderly population are at an increased risk for rapid deterioration and long-term care placement. Which of the following is not considered a high risk factor for long term care placement?

A patient with anterior epistaxis has been treated with 20 minutes of direct pressure to the cartilaginous portion of the nose. Following pressure the patient is instructed to gently blow the nose. Expected findings in the patient who has been successfully treated include all of the following except a:

Kevin is a 14-year-old male who presents for evaluation of a fever of 102.5° F and significant right ear pain. He appears quite ill and says he feels nauseous. Otoscopic evaluation reveals pain to palpation, a very erythematous and bulging tympanic membrane with bullous myringitis. The AGACNP knows that antibiotic therapy must be selected to cover:

P.M. is a 71-year-old gay male patient who presents as an outpatient for evaluation of increasing shortness of breath. The diagnostic evaluation ultimately supports a diagnosis of community acquired pneumonia. The AGACNP appreciates right middle lobe consolidation on chest radiography. Pending sputum cultures, empiric antibiotic therapy must be initiated to cover which organism? NURS 6550 Midterm Exam Walden – Questions and Answers

Which of the following is the greatest risk factor for vascular dementia?

J.R. is a 55-year-old male who presents for a commercial driver’s license physical examination with a blood pressure of 170/102 mm Hg. He has no medical history and is without complaint. Which of the following findings constitutes hypertensive urgency? NURS 6550 Midterm Exam Walden – Questions and Answers

Because of the commonly recognized adverse effects of atypical antipsychotics, annual laboratory assessment for patients taking these medications should include a:

K.R. presents for an evaluation of eye discomfort. He works in a fabricating shop for a custom automobile restoration company and while working he felt like something flew into his eye. He was wearing eye protection at the time but still has the sensation that something is there. Physical examination is significant for some tearing and he reports a persistent sense of something in his eye. Which of the following is not indicated in the diagnostic evaluation? NURS 6550 Midterm Exam Walden – Questions and Answers

D.E. is a 41-year-old female who had lumbar surgery two days ago to repair a ruptured nucleus pulposus. She has been doing well postoperatively but today is complaining of resting fatigue and some shortness of breath at rest. In ruling out a pulmonary embolus the AGACNP first orders a:

Mr. Nixon is being treated with unfractionated heparin infusion for acute pulmonary embolus. In order to avoid a potentially fatal complication of heparin infusion, the AGACNP monitors:

Differentiating vertigo from near-syncope and ataxia is one of the goals of history-taking when a patient presents as “dizzy.” The AGACP knows that vertigo is the problem when the patient reports the primary symptom as:

Mr. Banks has been admitted for surgical resection of a metastatic tumor, during surgery it is discovered that he has widespread, diffuse metastasis throughout the abdomen. Surgery is no longer an option, and his oncologist says that chemotherapy is unlikely to produce any meaningful benefit. Mr. Banks is concerned that his sons will not support a transfer to comfort care. The AGACNP advises that he:

Mr. Wilkerson is a 77-year-old male who is being evaluated and treated for his cardiogenic pain. His vital signs are as follows: Temperature of 99.1° F, pulse of 100 bpm, respirations of 22 bpm, and blood pressure of 168/100 mm Hg. A 12-lead ECG reveals deep ST segment depression in leads V
3
-V
6
. The AGACNP recognizes which of the following as a contraindication to rTPA therapy? NURS 6550 Midterm Exam Walden – Questions and Answers

A 71-year-old patient is recovering from a particularly severe exacerbation of chronic obstructive pulmonary disease. He has been in the hospital for almost two weeks and was on mechanical ventilation for 7 days. While discussing his discharge plan he tells you that he is really going to quit smoking this time. He acknowledges that he has been “sneaking” cigarettes in the hospital for two days, but he has established a timeline to decrease the number of cigarettes daily. According to his plan his last cigarette will be the last day of the month. This patient’s behavior is consistent with which stage of the Transtheoretical Model of Change?

While assessing a patient with a known psychiatric history, the AGACNP knows that the primary difference between a psychotic and neurotic disorders is: NURS 6550 Midterm Exam Walden – Questions and Answers

L.T. is an 85-year-old male who is admitted for evaluation of profound diarrhea that has produced significant dehydration. He also complains of being very tired lately, and feeling like he is going to vomit all of the time. His vital signs are significant for a pulse of 41 b.p.m. and a blood pressure of 90/60 mm Hg. A gastrointestinal evaluation including stool for blood, white blood cells, and ova and parasites is negative. He insists that he has not started any new medications or made any diet changes; the only thing new is that he got new eye drops for his glaucoma. The AGACNP correctly assumes that his new eye drops are:

Janice is a 19-year-old female who presents to the emergency department via ambulance. She is pale, diaphoretic, agitated, and convinced she is having a stroke. Her vital signs include a temperature of 98.9° F, pulse of 114 beats per minute, respirations of 32 breaths per minute, and a blood pressure of 110/74 mm Hg. Diagnostic evaluation is negative and Janice is diagnosed with an acute panic attack. The initial treatment of choice is:

Lorraine is a 41-year-old female who presents for an asthma follow-up visit. She says she feels very well, has almost no daytime symptoms, and is using her inhaled corticosteroid medication daily as prescribed. Her PEFR is 85% of her personal best. The best approach to this patient is to:

Mr. Owen is a 37-year-old patient who has been admitted for surgical resection of a malignant tumor in his lung. His physical recovery has been uneventful and he is being prepared for discharge. While discussing his ongoing cancer therapy with Mr. Owen, the AGACNP determines that he has experienced persistent, excessive anxiety and worry almost every day for more than one year. What other aspect of Mr. Owen’s psychosocial history would be required to made a diagnosis of generalized anxiety disorder?

Kevin T. is a 49-year-old male who is being discharged after hospitalization for an acute inferior wall myocardial infarction. This is his first hospitalization and his first chronic medical diagnosis. Aside from his elevated cardiac isoenzymes and troponins, his laboratory profile was essentially within normal limits. The only apparent cardiac risk factor is an LDL cholesterol of 200 mg/dL. Initiating an HMG-CoA reductase inhibitor is an example of which level of prevention for Kevin?

You are evaluating a patient who has been admitted to the emergency room after being arrested for starting a fight in a local sports’ bar. The patient is now being cooperative, but reports that he has been in treatment for PTSD for months. He has been prescribed fluoxetine but has not noticed any improvement in symptoms, and now has been arrested for violence. The AGACNP knows that the next step in medication management is likely to include:

Mrs. Salter is an 81-year-old lady who presents for evaluation of near-syncopal episodes. Her 12-lead ECG, complete blood count, and comprehensive metabolic panel are all essentially normal. A urinalysis shows some trace protein but is otherwise normal. A 24-hour rhythm monitor demonstrates rare premature ventricular contractions. Mrs. Salter has been in good health and had her first episode at her aerobics class. She only gets lightheaded when she exerts herself. Her heart auscultates for a grade III/VI systolic crescendo-decrescendo murmur at the second intercostal space, right sternal border. The AGACP considers that the likely cause of the syncope is:

Who among the following patients is at greatest risk for a pulmonary embolus?

Mrs. Birdsong is an 85-year-old female who has been admitted for surgical repair of a hip fracture. She is in remarkably good spirits and is quite talkative. She readily answers all of the questions on her intake assessment, and readily acknowledges information provided during her room orientation. Later while talking with the patient’s son the AGACNP learns that the patient has had significant cognitive impairment for a few years. She has virtually no short term memory, but compensates by confabulating. Her son says she is generally very happy as long as there is no change in her day to day routine. This history is most consistent with which form of dementia?

Mrs. Radovich is an 80-year-old female with a variety of chronic medical conditions which are reasonably well controlled. She generally enjoys a good quality of life and is active with her family. Today her only concern is that she is having problems with her vision. She notices that while trying to look at pictures of her great grandchildren she can’t seem to focus on their faces. She also reports increased trouble reading—she cannot seem to see the words that she is looking at, and her reading glasses do not help. Further evaluation of Mrs. Radovich should include assessment with:

R.J. is a 55-year-old female who presents with acute onset left sided facial pain and an inability to move the left side of her face. She cannot smile, raise her eyebrow or even close her left eye, The immediate approach to this patient should include:

A 78-year-old male present for a physical examination. He has no discomfort or complaints other than a general decrease in vision, but it helps when he puts things under a bright light to read. He admits that while driving at night the streetlights appear to be a bit distorted and his night vision is pretty poor. Given the likely diagnosis, the AGACNP expects which of the following physical findings?

Jason is a 46-year-old male who is being managed for sepsis. He has HIV/AIDS and has had a prolonged hospitalization characterized by a variety of complications. He was extubated 3 days ago but continues gastric decompression with a nasogastric tube(NGT), total parenteral nutrition and antibiotic therapy via a central venous catheter, and urinary drainage via a Foley catheter. He continues to demonstrate consistent low grade fevers but all points of insertion of his tubes are normal to inspection, a chest radiograph demonstrates improvement of his pneumonia, and his urinalysis shows no bacteria, leukocytes, or nitrites. The AGACNP should next order: NURS 6550 Midterm Exam Walden – Questions and Answers

The interpretation of a chest radiography should follow a systematic approach to ensure that all vital structures are evaluated and important clinical findings are not missed. The last thing to be assessed when looking at chest radiography should be the _____________:

The Short Confusion Assessment Method (Short-CAM) is a widely used four item tool that assesses delirium in the hospitalized patient. It includes observation of all of the following except: NURS 6550 Midterm Exam Walden – Questions and Answers

Ms. Yang has been hospitalized for 5 days for the management of a gastrointestinal bleeding. She appears to have stabilized hemodynamically, but today she had a temperature of 101.9° F and chest radiography demonstrates a diagnosis of pneumonia. The AGACNP knows that the diagnostic evaluation for hospital acquired pneumonia for all patients must include:

Most psychosocial theories of aging center around the core concept that successful aging requires acceptance of a series of changes or losses that predictably occur later in the life span. The theory that specifically addresses coming to terms with the inevitability of death is known as:

All of the following conditions are risk factors for pulmonary embolus except:

A patient is diagnosed with acute descending aortic aneurysm and hypertension should be immediately started on which medication pending surgical evaluation?

Jason is a 27-year-old with a long history of intermittently controlled asthma. He is currently prescribed Advair daily with albuterol as needed for symptoms. Today he presents to the emergency department with cough and wheezing and difficulty catching his breath. His FEV
1
is 51% at the time of presentation. He is given alternating albuterol and ipratropium nebulizer treatments along with oral prednisone. After one hour his FEV
1
 has increased 65%. The appropriate disposition for Jason at this point is:

A patient in the intensive care unit suddenly becomes tachypneic and dyspneic. The physical examination reveals pale, cool, clammy skin and an arterial blood gas demonstrates hypocapnea and hypoxia. Pulmonary artery pressure demonstrates a pattern consistent with obstructive shock. The AGACNP knows that which of the following causes of this presentation is most likely? NURS 6550 Midterm Exam Walden – Questions and Answers

Mr. Bowers is an 81-year-old male who is being terminally extubated at the request of his family due to the presence of a large subdural hematoma with a shift; the patient is not initiating respirations on his own and the prognosis is very poor. After he is extubated he begins to initiate his own respirations and 24 hours later has not expired yet. The decision is made to leave him in the hospital on a general medical floor rather than transfer to another facility for hospice. Which of the following is the best indicator that the patient’s death is imminent?

A patient is newly admitted to your service for open reduction and internal fixation of the left hip. She seems very down, and as you talk with her you realize that her mood is not just related to her hip fracture. Which of the following symptoms would not be consistent with major depressive disorder?

“C” is the correct answer. Alzheimer’s dementia is statistically the most common form of dementia and is characterized by a long trajectory that progresses to include confabulation. Additionally, patients with this form of dementia are very reliant upon routine and may be distressed when it is disrupted. “A” is not correct; Lewy body dementia characteristically progresses much more quickly and produces an angry demeanor. “B” is incorrect because vascular dementia typically produces a more depressive affect and is not characterized by confabulation; additionally, patients with vascular dementia often have a medical history consistent with vascular risk factors. “D” is not correct as there is no apparent history of Parkinson’s disease.

What is the primary purpose of using eye ointments or lubricants to patients under general anesthesia, on paralytics, or in long-term comatose states? NURS 6550 Midterm Exam Walden – Questions and Answers

When reading a 12-lead electrocardiogram, the AGACNP knows that all 12 leads are required to provide:

A 49-year-old male presents for evaluation of chest tightness. It has happened before, but he just ignored it and it went away. Today he just could not ignore it anymore. He has always enjoyed good health and says he has never been told that he has any chronic medical conditions like high blood pressure or diabetes. A 12-lead ECG demonstrates changes consistent with inferior wall ischemia. Both his symptoms and inferior wall changes improve with the administration of sublingual nitroglycerin. Consistent with ACS protocol, this patient’s assessment is consistent with:

Mr. Rosen is a 49-year-old male who is being managed for an acute myocardial infarction. He develops significant shortness of breath at rest and coarse rales 2/3 up bilaterally. The AGACNP suspects acute pulmonary edema due to papillary muscle rupture and acute mitral valve regurgitation. Which physical finding would support this finding?

A patient with minor head trauma presents for evaluation. Which of the following findings should be followed up with a CT scan to rule out orbital fracture? NURS 6550 Midterm Exam Walden – Questions and Answers

Mrs. Forbes is a 69-year-old lady being discharged from the hospital after complications following a cosmetic surgical procedure. She is basically in good health. She has a history of hypothyroidism for which she takes levothyroxine daily, and mild osteoarthritis which is controlled with only prn nonsteroidal use. Her blood pressure is 148/90 mm Hg. The AGACNP knows that in accordance with the most current guidelines published in JNC 8 the appropriate action is to:

When assessing driver safety in the older adult, the AGACNP considers that:

The nursing staff calls to tell you that your 81-year-old male patient is having an acute change in mental status. He is a basically healthy man who was admitted three days ago for inpatient antibiotic management of community acquired pneumonia. His daughter is at the bedside and she is very distraught because she has never seen him like this. She is asking for medication to make him stop acting disoriented. Upon examination the patient is lying in bed, appears calm and happy, but does not recognize his daughter as anyone he knows. He is talking as if he is at home and has company. The AGACNP instructs the daughter that: NURS 6550 Midterm Exam Walden – Questions and Answers

While discharging a patient following her myocardial infarction, you offer some patient education about medically supervised cardiac rehabilitation. The patient expresses fear of rehab because she was on her treadmill when she had her infarction and now she is afraid of making it happen again. She doesn’t understand how the rehab can force her to exercise her heart but not make her have another cardiac event. The AGACNP explains that the patient will be monitored and that her goal heart rate will be:

During physical examination of a 51-year-old African-American female you appreciate a decrease in her peripheral vision. The rest of her eye examination is within normal limits and she is symptom free. This presentation is consistent with:

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Mr. Moffett is a 66-year-old male with a long history of lower extremity edema. All other causes of lower extremity edema have been ruled out and his overall symptom presentation and history are strongly supportive of chronic venous insufficiency. Today he presents with increased itching of both lower legs. Physical exam reveals 2-3+ pitting edema and trophic hyperpigmentation. The AGACNP know that treatment should include:

L.R. is an 84-year-old female patient being treated for pneumonia. Her condition is deteriorating despite aggressive broad spectrum antipseudomonal cephalosporin antibiotic therapy. Induced sputum culture reveals heavy growth of 
Legionella pneumophilia
. The AGACNP knows that antibiotic therapy must be adjusted to include coverage with:

The AGACNP is treating a patient with a corneal abrasion. The patient has a clear recollection of the mechanism of injury—she was scratched in the eye earlier today with her 18-month-old daughter’s fingernail. Which of the following is contraindicated in the management of this patient’s abrasion?

M.T. is a 41-year-old male patient in the intensive care unit. He was admitted to the hospital in septic shock and has been aggressively managed with broad spectrum antibiotics. He has become progressively hypoxemic and the last arterial blood gas revealed a paO
2
of 58 mm Hg. Chest radiography reveals a “white out” pattern bilaterally. The patient is intubated and ventilated. The AGACNP knows that appropriate management must include:

Teenagers and adults with acute otitis media can often be treated with “watchful waiting” given the high incidence of spontaneous resolution and low risk of poor outcomes. Which of the following is an absolute indication to begin antibiotic therapy at the time of diagnosis?

Mr. Bowers is on mechanical ventilation for respiratory support through an episode of septic pneumonia. Due the extensive lobar consolidation it was very difficult to keep Mr. Bowers oxygenated and he required very high FIO
2
s and PEEP. The AGACNP knows that the primary concern with FIO
2
s > 60% is

Acute respiratory distress syndrome (ARDS) occurs when an overwhelming systemic insult results in which maladaptive physiologic response?

NURS 6550 Midterm Exam Walden – Questions and Answers

Acute respiratory distress syndrome is characterized by which abnormality of ventilation and perfusion?

George Schulz is a 69-year-old male who presents for evaluation of acute foot pain. It is so painful that he cannot walk on it without assistance. At first he denies any significant medical history, but then reveals that he has been diagnosed with dyslipidemia and hypertension but stopped taking his medications because he couldn’t afford it. Pulses are not palpable but are audible by Doppler. The extremity is pale and shiny with decreased hair growth, suspecting peripheral arterial disease, the AGACNP expects which additional finding?

G.T. is a 40-year-old male who is under your case for long term management of secondary osteoarthritis. Today he asks if he can take a medication for anxiety. Further assessment reveals that he is in a relationship that has been very stressful; his girlfriend wants very much to get married and start a family, and he does not. He admits that he no longer feels they are compatible and acknowledges that he needs to end this relationship. He is sure that this is the source of his anxiety. The best approach would be to:

During the physical examination of a 31-year-old female, the AGACNP appreciates a bifurcate uvula. The most appropriate action would be to:

During routine immigration screening a 29-year-old male patient from Mexico has a positive purified protein derivative (PPD) test at 17 mm induration. He reports no known history of tuberculosis (TB) infection or exposure, or vaccination with the BCG vaccine. Chest x-ray is negative for any evidence of TB exposure. The AGACNP knows that the appropriate next step is to:

Clinical diagnostic criteria for acute respiratory distress syndrome (ARDS) include all of the following except:

While managing a patient in acute pulmonary edema, the AGACNP monitors the pulmonary capillary wedge pressure. When this pressure falls below 12 mm Hg it suggests that:

All of the following are important elements of the immediate management of penetrating eye injury except:

While evaluating a patient with diastolic failure due to a long history of uncontrolled hemochromatosis, the AGACNP appreciates an extra heart sound just before the S
1
heart sound. This sound is most likely a(n):

Secondary hypertension occurs in approximately 10% of all patients with hypertension, and requires management of the underlying problem in order to eliminate the cause. Which of the following is not a secondary cause of hypertension?

L.M, is a 26-year-old male who presents to the emergency department complaining of acute onset vertigo this morning. He describes a strong sense of the room spinning and can barely walk without feeling nauseous. The vertigo is reproducible when his neck is rotated suddenly left or right. The AGACNP knows that which of the following is not indicated? NURS 6550 Midterm Exam Walden – Questions and Answers

A 36-year-old female presents complaining of left leg swelling. She describes the onset as acute over the last day or two, and says it feels “tight and throbbing.” She denies any significant medical history and says the only medication she takes is oral contraception, which she has taken since she was 15 years old. The AGACNP first orders:

The primary neurotransmitter implicated in post-traumatic stress disorder (PTSD) is:

Mr. Avila is an 82-year-old male being counseled about the risks and benefits of his upcoming abdominal surgery. While considering risk factors for atelectasis, pneumonia and other pulmonary complications, the AGACNP advises that the greatest risk comes from:

The female AGACNP is practicing with a cardiology group and sees patients one day a week in the outpatient office. A 49-year-old female presents for follow-up after her admission for infective endocarditis. She is recovering well, and says that she is going to be more proactive about her health. She admits to not having had any of her regular health screenings for years, and asks if she can have her Pap performed at this office. The AGACNP:

The AGACNP is seeing a patient who was transferred from the correctional facility for evaluation. He has a profound purulent discharge from his right eye. The conjunctive is erythematous and there is mild photosensitivity. The inmate denies any real eye pain, just says that it is extremely uncomfortable. Treatment for this patient is likely to include:

Ms. Ewing is a 78-year-old female who lives in a long term care facility because her dementia has progressed to the point at which her family cannot provide the necessary safety measures at home. In addition to her absent short term memory she has developed some affective changes and most recently is demonstrating sexual disinhibition. While considering management options, the AGACNP knows that all of the following are medications are options for the management of disinhibition except:

A patient recently had a nasal packing inserted for management of refractory epistaxis. One week later he presents with fatigue, a headache “inside of his nose” and a feeling generally unwell. The AGACNP considers:

A 55-year-old female patient presents with a fever of 103.4° F. She was treated approximately 10 days ago at urgent care for a sinus infection, but two days ago the right side of her fact started to hurt, and today she has significant swelling of the right orbit and eyelid. The eyelid is very edematous and there is purulent drainage noted. The priority of care for this patient begins with:

Which of the following is the best indicator that pulmonary rehabilitation has been successful in a patient with chronic obstructive pulmonary disease? NURS 6550 Midterm Exam Walden – Questions and Answers

Mrs. Marriott is being discharged to home after being managed for an exacerbation of congestive heart failure. She is currently feeling well but her ejection fraction after optimal diuresis and fluid management is 29%. The AGACNP knows that her discharge medications must include:

Which of the following is an accurate statement with respect to the assessment of delirium in the geriatric patient?

Mrs. Warner is a 57-year-old female who presents with unplanned weight loss. Chest radiography reveals diffuse hyperlucency of the left lung and in the lower half of the right lung. The AGACNP knows that the differential diagnosis for hyperlucency include all of the following except:

When evaluating a patient with epistaxis, which of the following signs or symptoms is suggestive of a more serious etiology and posterior packing?

R.M. is a 15-year-old male who presents to the emergency department with his mother. Mom says he has been complaining that his throat hurts so badly he cannot even swallow saliva. According to Mom R.M. is not the type to complain, but he is in so much pain with his throat he is almost crying. He has no significant medical history and takes no daily medications. He has no allergies of which his mother is aware. Upon physical examination he is febrile with a temperature of 102.4° F and he is a bit tachycardic, but other vital signs or normal. Inspection of the throat is basically unremarkable—the AGACNP does not appreciate any abscesses, edema, or exudate; there may be some slight erythema. The AGACNP becomes suspicious that the patient:

Mr. Stossel is a 66-year-old male patient who was admitted for management of acute anterior wall myocardial infarction. Over a period of hours he has developed acute shortness of breath, coarse rales to auscultation, and Kerley B lines on chest radiography. Arterial blood gas reveals a pH of 7.34, pCO
2
of 30 mm Hg, and paO
2
 of 59 mm Hg. The AGACNP anticipates which of the following findings on physical examination?

According to the revised criteria in DSM-V, the primary difference between panic attacks and panic disorder is that: NURS 6550 Midterm Exam Walden – Questions and Answers

Mr. Wilson is a 71-year-old male who has been treated with prn short acting anticholinergics for his COPD. Last week he developed an exacerbation that required a 4 day hospitalization for support and stabilization. He was discharged on a five day course of prednisone and now presents for follow-up. The AGACNP knows that his outpatient medication regimen should be adjusted to include:

What is the primary difference in patient management between high risk non-ST elevation myocardial infarction (MI) and the low risk non-ST elevation MI patient?

J.T. is a 26-year-old female patient being evaluated for eye discharge. She says that for the last few days she has developed this sticky, string-like discharge in both eyes. She denies any pain or visual changes, but does admit to a sense of “something in my eyes” and that her eyes itch a lot. Physical examination reveals injected conjunctiva, rope-like discharge bilaterally; pupil response is equal and brisk in both eyes. Which factor in the patient’s history would be supportive of the most likely diagnosis? NURS 6550 Midterm Exam Walden – Questions and Answers

The pathophysiology of endogenous depression is best described as

The diagnostic study most supportive of a diagnosis of pericarditis is:

A 31-year-old male presents to urgent care because he has something in his eye. He was changing the oil under his car and says that something dropped into his eye. He is not having any pain, in fact he waited a day before coming in because he thought it would work itself out. Physical exam reveals a black 1 mm foreign body visible on the corneal surface. The most appropriate intervention is to:

A patient with pericarditis is most appropriately treated with:

Which of the following is not a risk factor for thoracic aneurysm?

The “MONA” acronym provides guidance for immediate interventions in the patient with:

Mr. Sloane is a 36-year-old male patient who presents for treatment of eye pain. He has no significant medical history and does not take any daily or over-the-counter medications. His only recent history is nighttime allergies for which he takes occasional diphenhydramine with good relief. He has had some throbbing in his eye for the last few days on and off but just ignored it; today he says it is flat out painful and he had to come to the emergency department. The eye is throbbing and painful, and he reports generalized decreased vision. The pupil is dilated to 5 mm and non-reactive to light. The eye conjunctiva is reddened. The next step in the diagnostic evaluation should be:

The AGACNP counsels a patient with recurrent epistaxis that the most common cause of nose bleeding is

The geriatric depression scale (GDS) is a commonly used tool to diagnose depression in the elderly population. It comes in a variety of forms for maximal utility. When administering the geriatric depression scale to patients, the AGACNP recognizes that it is extremely important to:

Ventilator-acquired pneumonia (VAP) is a significant problem impacting morbidity, mortality and the cost of inpatient health care. Data-supported mechanisms to reduce the risk for VAP include all of the following except:

Absolute contraindications to thrombolytic therapy in the patient having an acute myocardial infarction include all of the following except:

Which of the following is not a true statement with respect to risk for or occurrence of elder abuse? NURS 6550 Midterm Exam Walden – Questions and Answers

PSY/310 Week 3 Learning Team Assignment Behaviorism Paper

Write a 700- to 1,050-word paper on the main developments and contributions to behaviorism. Include Pavlov and Watson significant contributions to behaviorism.

Format your paper consistent with APA guidelines.

Click the Assignment Files tab to submit your assignment.

PSY/310 Week 3 Learning Team Assignment Behaviorism Paper

Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Week 9: Assessment and Care of Patients With Adrenal and Urogynecologic Conditions

From severe abdominal pain to urinary frequency, urinary incontinence, sexual health issues, and the overproduction of hormones, adrenal and urogynecologic symptoms often cause frustration and embarrassment for patients. These feelings might cause patients to hold back information, making assessment and diagnosis of adrenal and urogynecologic conditions challenging. Because patients may require surgery to minimize the impact of these conditions on their daily lives, it is essential that you establish trust with patients and carefully ask questions to quantify complaints appropriately.

This week, as you examine the pre- and post-operative care of patients with adrenals and urogynecology conditions, you explore strategies for assessment, diagnosis, and treatment.

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Learning Objectives

By the end of this week, students will:

Evaluate medical and surgical patients with adrenal and urogynecologic conditions

Develop differential diagnoses for medical and surgical patients with adrenal and urogynecologic conditions

Develop treatment plans for medical and surgical patients with adrenal and urogynecologic conditions

Photo Credit: Andrew Brookes/Cultura/Getty Images. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

 Learning Resources

Required Readings

Colyar, M. R. (2015).
Advanced practice nursing procedures
(1st ed.). Philadelphia, PA: F. A. Davis Company.

Chapter 42, “Breast Biopsy (Fine Needle Aspiration)”

Chapter 44, “Colposcopy (Endocervical Curettage and Cervical Biopsy)”

Chapter 45, “Endometrial Biopsy”

Chapter 49, “Bartholin Cyst Abscess (Incision and Drainage)”

Chapter 51, “Cervical Lesions—Cryotherapy”

Chapter 52, “Circumcision and Dorsal Penile Nerve Block”

Chapter 58, “Paracervical Nerve Block”

Chapter 61, “Vasectomy”

Doherty, G. M. (2015).
Current diagnosis and treatment: Surgery
(14th ed.). New York, NY: McGraw Hill.

Chapter 17, “Breast Disorders”

Chapter 33, “Adrenals”

Chapter 38, “Urology”

Chapter 39, “Gynecology”

Weber, E. C., Vilensky, J. A., & Fog, A. M. (2013).
Practical radiology: A symptom-based approach.
Philadelphia, PA: F. A. Davis Company.

 

Chapter 7, “Breast”

Chapter 9, “Male and Female Urinary Tract and Male Genital Tract”

Chapter 10, “Female Pelvic Imaging”

American Cancer Society. (2014).
American Cancer Society guidelines for the early detection of cancer.
Retrieved from http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Required Media

i-Human Patient Cases. (2014). Retrieved from https://ih2.i-human.com/users/sign_in

Optional Resources

Massad, L. S., Einstein, M. H., Huh, W. K., Katki, H. A., Kinney, W. K., Schiffman, M. … Lawson, H. W. (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors.
Journal of Lower Genital Tract Disease, 17
(5), S1–S27.

Discussion Part I: Assessment and Care of Patients With Adrenal and Urogynecologic Conditions

Many genitourinary (GU) disorders such as kidney disease start developing during adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for adolescent patients, to identify potential signs and symptoms. Although some adolescent GU disorders require long-term treatment and management, other disorders such as urinary tract infections are more common and frequently require only minor interventions. In your role with adolescent patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Case Study 1

Alicia is an 18-year-old female who is brought into urgent care by her mother. She is complaining of dizziness. She recently started to lift weights for softball season. She has been healthy up to this point. Vitals are: temp 101.9°F, HR 120, RR 24, BP 90/54. She has lower extremity edema and decreased skin turgor. She states that her shoulders, thighs, and lower back hurt. She is having trouble moving her arms and legs. She also complains of vague abdominal pain, with nausea and vomiting. Labs came back with CK 10,000, uric acid 40 mg/dl, WBC 14.3, BUN:creatinine ratio 6:1, K 5.8. Urinalysis shows a presence of myoglobin of more than 25. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Case Study 2

Mark is a 15-year-old male with a complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago as a dull ache and gradually has worsened such that he can no longer stand without doubling over. He is afebrile and in marked pain. Physical exam results are negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Case Study 3

Maya is a 16-year-old female who presents to the ER for urinary pain. She is a healthy adolescent with complaints of lower abdominal pain, low back pain, and burning with urination. She had a fever of 102°F at home. Physical examination results are normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood. Leukocytes are moderate and nitrites, moderate. Her blood pressure is normal, and she is at the 60th percentile for height and weight. Vitals are: temp 103.1°F, HR 116, RR 18, BP 100/58. P Ox is 98% (Johns Hopkins Children’s Center, 2010).

To prepare:

Review and select 
1
 of the 3 provided case studies. Analyze the patient information.

Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.

Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder.

By Day 3

Post
 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Read
 a selection of your colleagues’ responses.

By Day 6

Respond
 to at least 
two
 of your colleagues on 
2 different days in both of the ways
 listed below. Respond to colleagues who selected different case studies from yours. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Describe how culture might affect the diagnosis, management, and follow-up care of patients with the genitourinary disorders your colleagues discussed.

Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.​

Discussion Part II: Pharmacology

Read the following articles to enhance your knowledge of commonly prescribed medications:

Daley, B. (2015, February 23).
Peritonitis and abdominal sepsis.
Retrieved from http://emedicine.medscape.com/article/180234-overview

Shahedi, K., Chudasama, Y. N., Dea, S. K., & Cooperman, A. (2015, January 14).
Diverticulitis treatment and management.
Retrieved from http://emedicine.medscape.com/article/173388-treatment

Tobias, J. D., & Leder, M. (2011). Procedural sedation: A review of sedative agents, monitoring, and management of complications.
Saudi Journal of Anasthesia, 5
(4), 395–410. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227310/

All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.

Sedation

Diazepam

Fentanyl

Ketamine

Lorazepam

Midazolam

Propofol

Benzodiazepines

Nonsedation

Chlorpromazine

Peritonitis—what antibiotics are chosen for peritonitis?

Nerve blocks—what drugs are used with nerve blocks?

Diverticulitis—what drugs are used with diverticulitis?

Note:
 When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

By Day 3

For this Discussion, address 1 of the following options:

Option 1

Post
 a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose.

Option 2

Conduct an evidence-based drug search on the drug you selected and 
post
 an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?

Option 3

Post
 an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication.

Note:
 To be considered as one of your required responses, your pharmacology rationale must include a supporting reference.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Submission and Grading Information

Grading Criteria

Week 9 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 9 Discussion

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Adrenal and Urogynecologic Conditions

While some adrenal and urogynecologic conditions are specific to male or female patients, many are common among both. The presentations of these common conditions, however, can vary greatly depending on sex. Because such variations may lead to challenges in assessment and diagnosis, it is essential for you to have strong examination and diagnostic skills. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with adrenal and urogynecologic conditions.

To prepare:

Review this week’s Learning Resources. With adrenal and urogynecologic conditions in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.

Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions to consider in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with adrenal and urogynecologic conditions. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the 
i-Human Patients Case Player Student Manual
 in the Week 2 Learning Resources.

Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Discussion_Rubric

Outstanding Performance

Excellent Performance

Competent Performance

Proficient Performance

Room for Improvement

Main Posting:

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

44 
(44%)
 – 44 
(44%)

Thoroughly responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

supported by at least 3 current, credible sources

40 
(40%)
 – 43 
(43%)

Responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

75% of post has exceptional depth and breadth

supported by at least 3 credible references

35 
(35%)
 – 39 
(39%)

Responds to most of the discussion question(s)

is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of post has exceptional depth and breadth

supported by at least 3 credible references

31 
(31%)
 – 34 
(34%)

Responds to some of the discussion question(s)

one to two criteria are not addressed or are superficially addressed

is somewhat lacking reflection and critical analysis and synthesis

somewhat represents knowledge gained from the course readings for the module.

post is cited with fewer than 2 credible references

0 
(0%)
 – 30 
(30%)

Does not respond to the discussion question(s)

lacks depth or superficially addresses criteria

lacks reflection and critical analysis and synthesis

does not represent knowledge gained from the course readings for the module.

contains only 1 or no credible references

Main Posting:

Writing

6 
(6%)
 – 6 
(6%)

Written clearly and concisely

Contains no grammatical or spelling errors

Fully adheres to current APA manual writing rules and style

5.5 
(5.5%)
 – 5.5 
(5.5%)

Written clearly and concisely

May contain one or no grammatical or spelling error

Adheres to current APA manual writing rules and style

5 
(5%)
 – 5 
(5%)

Written concisely

May contain one to two grammatical or spelling error

Adheres to current APA manual writing rules and style

4.5 
(4.5%)
 – 4.5 
(4.5%)

Written somewhat concisely

May contain more than two spelling or grammatical errors

Contains some APA formatting errors

0 
(0%)
 – 4 
(4%)

Not written clearly or concisely

Contains more than two spelling or grammatical errors

Does not adhere to current APA manual writing rules and style

Main Posting:

Timely and full participation

10 
(10%)
 – 10 
(10%)

Meets requirements for timely and full participation

posts main discussion by due date

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

Does not meet requirement for full participation

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 
(9%)
 – 9 
(9%)

Response exhibits critical thinking and application to practice settings

responds to questions posed by faculty

the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

8.5 
(8.5%)
 – 8.5 
(8.5%)

Response exhibits critical thinking and application to practice settings

7.5 
(7.5%)
 – 8 
(8%)

Response has some depth and may exhibit critical thinking or application to practice setting

6.5 
(6.5%)
 – 7 
(7%)

Response is on topic, may have some depth

0 
(0%)
 – 6 
(6%)

Response may not be on topic, lacks depth

First Response:

Writing

6 
(6%)
 – 6 
(6%)

Communication is professional and respectful to colleagues

Response to faculty questions are fully answered if posed

Provides clear, concise opinions and ideas that are supported by two or more credible sources

Response is effectively written in Standard Edited English

5.5 
(5.5%)
 – 5.5 
(5.5%)

Communication is professional and respectful to colleagues

Response to faculty questions are answered if posed

Provides clear, concise opinions and ideas that are supported by two or more credible sources

Response is effectively written in Standard Edited English

5 
(5%)
 – 5 
(5%)

Communication is mostly professional and respectful to colleagues

Response to faculty questions are mostly answered if posed

Provides opinions and ideas that are supported by few credible sources

Response is written in Standard Edited English

4.5 
(4.5%)
 – 4.5 
(4.5%)

Responses posted in the discussion may lack effective professional communication

Response to faculty questions are somewhat answered if posed

Few or no credible sources are cited

0 
(0%)
 – 4 
(4%)

Responses posted in the discussion lack effective

Response to faculty questions are missing

No credible sources are cited

First Response:

Timely and full participation

5 
(5%)
 – 5 
(5%)

Meets requirements for timely and full participation

posts by due date

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

Does not meet requirement for full participation. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Second Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 
(9%)
 – 9 
(9%)

Response exhibits critical thinking and application to practice settings * responds to questions posed by faculty

the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

8.5 
(8.5%)
 – 8.5 
(8.5%)

Response exhibits critical thinking and application to practice settings

7.5 
(7.5%)
 – 8 
(8%)

Response has some depth and may exhibit critical thinking or application to practice setting

6.5 
(6.5%)
 – 7 
(7%)

Response is on topic, may have some depth. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

0 
(0%)
 – 6 
(6%)

Response may not be on topic, lacks depth

Second Response:

Writing

6 
(6%)
 – 6 
(6%)

Communication is professional and respectful to colleagues

Response to faculty questions are fully answered if posed

Provides clear, concise opinions and ideas that are supported by two or more credible sources

Response is effectively written in Standard Edited English

5.5 
(5.5%)
 – 5.5 
(5.5%)

Communication is professional and respectful to colleagues

Response to faculty questions are answered if posed

Provides clear, concise opinions and ideas that are supported by two or more credible sources

Response is effectively written in Standard Edited English

5 
(5%)
 – 5 
(5%)

Communication is mostly professional and respectful to colleagues

Response to faculty questions are mostly answered if posed

Provides opinions and ideas that are supported by few credible sources

Response is written in Standard Edited English

4.5 
(4.5%)
 – 4.5 
(4.5%)

Responses posted in the discussion may lack effective professional communication

Response to faculty questions are somewhat answered if posed

Few or no credible sources are cited

0 
(0%)
 – 4 
(4%)

Responses posted in the discussion lack effective

Response to faculty questions are missing

No credible sources are cited

Second Response:

Timely and full participation

5 
(5%)
 – 5 
(5%)

Meets requirements for timely and full participation

Posts by due date

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

NA

0 
(0%)
 – 0 
(0%)

Does not meet requirement for full participation

Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Application_Rubric ( iHuman)

 

Novice

Emerging

Proficient

HPI Statement

0 
(0%)
 – 5 
(5%)

Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills

6 
(6%)
 – 10 
(10%)

Well written HPI statement but may be missing 1-2 key components from the history

11 
(11%)
 – 15 
(15%)

Clearly written HPI statement with comprehensive information gathering from case questions.

Objective testing and physical exam

0 
(0%)
 – 5 
(5%)

Poorly written physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis. Includes 3 or more inappropriate exams or tests.

6 
(6%)
 – 10 
(10%)

Well written physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis. May include 1-2 unnecessary exams or tests.

11 
(11%)
 – 15 
(15%)

Clearly written physical examination covering all critical components of a focus exam. Tests that are ordered are appropriate for patient and cost effective.

Assessment

0 
(0%)
 – 10 
(10%)

Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components. Priority list may be out of order. Primary diagnosis may be wrong.

11 
(11%)
 – 19 
(19%)

Well written differential diagnoses. May be missing 1-2 critical components. Correct primary diagnosis identified.

20 
(20%)
 – 25 
(25%)

Clearly written differential diagnoses. Primary diagnosis identified.

Plan for patient

0 
(0%)
 – 15 
(15%)

Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.

16 
(16%)
 – 25 
(25%)

Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.

26 
(26%)
 – 30 
(30%)

Clearly written plan covering all critical components for patient’s final diagnosis.

Clinical Questions

0 
(0%)
 – 10 
(10%)

Correctly answered 0-69% of the clinical question

11 
(11%)
 – 13 
(13%)

Correctly answered 70-89% of the clinical question

14 
(14%)
 – 15 
(15%)

Correctly answered 90-100% of the clinical questions

Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Intestines, Hernias, and Abdominal Wall Lesions

Week 8: Assessment and Care of Patients With Conditions of the Intestines, Hernias, and Abdominal Wall Lesions

After experiencing issues with bowel movements, Terri Gillmore went to the hospital where she was diagnosed with a perforated appendix. Her condition, worsened over time and pain medications did not alleviate her symptoms. Additional diagnostic testing revealed that the actual cause of Terri’s symptoms was Crohn’s disease, which was so severe that providers recommended surgery (University of Maryland Medical Center, 2013). As Terri’s case demonstrates, abdominal conditions can be challenging to diagnose, causing distress and pain for patients. Thus it is essential for you not only to know which diagnostic tests to order and when to order them, but also to be aware of when it is appropriate to consult with specialists and other professionals on your multidisciplinary team.

This week, as you study the pre- and post-operative care of patients with conditions related to intestines, hernias, and abdominal wall lesions, you examine strategies for assessment, diagnosis, and treatment.

ORDER A PLAGIARISM-FREE PAPER NOW

Learning Objectives

By the end of this week, students will:

Evaluate medical and surgical patients with conditions of the intestines, hernias, and abdominal wall lesions

Develop differential diagnoses for medical and surgical patients with conditions of the intestines, hernias, and abdominal wall lesions

Develop treatment plans for medical and surgical patients with conditions of the intestines, hernias, and abdominal wall lesions

 

Learning Resources

Required Readings

Colyar, M. R. (2015).
Advanced practice nursing procedures
(1st ed.). Philadelphia, PA: F. A. Davis Company.

 

Chapter 110, “Anoscopy”

Chapter 112, “Flexible Sigmoidoscopy”

Chapter 121, “Pilonidal Cyst/Abscess I & D”

Chapter 124, “Thrombosed Hemorrhoid Removal”

Doherty, G. M. (2015).
Current diagnosis and treatment: Surgery
(14th ed.). New York, NY: McGraw Hill.

Chapter 29, “Small Bowel”

Chapter 30, “Large Intestine”

Chapter 31, “Anorectum”

Chapter 32, “Hernias & Other Lesions of the Abdominal Wall”

Fisher, D., Malpas, P., Dominitz, J., Cash, B., Evans, J., & Decker, G. (2011). Complications of colonoscopy.
Gastrointestinal Endoscopy, 74
(4), 745–752. Retrieved from http://www.asge.org/assets/0/71542/71544/56321364-c4d8-4742-8158-55b6bef2a568.pdf

Neugut, A. I., & Lebwohl, B. (2013). Colonoscopy and colorectal cancer mortality: Both sides of the story.
Therapeutic Advances in Gastroenterology, 6
(3), 189–191. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625020/

Required Media

i-Human Patient Cases. (2014). Retrieved from https://ih2.i-human.com/users/sign_in

Singh, I. (2013).
NEJM thoracentesis
+ [Video file]. Retrieved from https://www.youtube.com/watch?v=RLNzv170_7Q&list=PLCq48yXbRGqnzYyV2J5aP0kGLU429VMUw

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Intestines, Hernias, and Abdominal Wall Lesions

Conditions associated with the intestines, hernias, and abdominal wall lesions typically are the result of work environment factors, genetics, or infection. Patients who present with these conditions need extensive diagnostic tests and often require referral to a specialist. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with health conditions related to the intestines, hernias, and abdominal wall lesions.

To prepare:

Review this week’s Learning Resources. With the intestines, hernias, and abdominal wall lesions in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.

Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions to consider in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with conditions of the intestines, hernias, and abdominal wall lesions.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the 
i-Human Patients Case Player Student Manual
 in the Week 2 Learning Resources.

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Intestines, Hernias, and Abdominal Wall Lesions

Application_Rubric

Novice

Emerging

Proficient

HPI Statement

0 
(0%)
 – 5 
(5%)

Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills

6 
(6%)
 – 10 
(10%)

Well written HPI statement but may be missing 1-2 key components from the history

11 
(11%)
 – 15 
(15%)

Clearly written HPI statement with comprehensive information gathering from case questions.

Objective testing and physical exam

0 
(0%)
 – 5 
(5%)

Poorly written physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis. Includes 3 or more inappropriate exams or tests.

6 
(6%)
 – 10 
(10%)

Well written physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis. May include 1-2 unnecessary exams or tests.

11 
(11%)
 – 15 
(15%)

Clearly written physical examination covering all critical components of a focus exam. Tests that are ordered are appropriate for patient and cost effective.

Assessment

0 
(0%)
 – 10 
(10%)

Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components. Priority list may be out of order. Primary diagnosis may be wrong.

11 
(11%)
 – 19 
(19%)

Well written differential diagnoses. May be missing 1-2 critical components. Correct primary diagnosis identified.

20 
(20%)
 – 25 
(25%)

Clearly written differential diagnoses. Primary diagnosis identified.

Plan for patient

0 
(0%)
 – 15 
(15%)

Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.

16 
(16%)
 – 25 
(25%)

Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.

26 
(26%)
 – 30 
(30%)

Clearly written plan covering all critical components for patient’s final diagnosis.

Clinical Questions

0 
(0%)
 – 10 
(10%)

Correctly answered 0-69% of the clinical question

11 
(11%)
 – 13 
(13%)

Correctly answered 70-89% of the clinical question

14 
(14%)
 – 15 
(15%)

Correctly answered 90-100% of the clinical questions

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Intestines, Hernias, and Abdominal Wall Lesions

Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

Week 7: Assessment and Care of Patients With Conditions of the Liver/Biliary Tract, Pancreas, and Spleen

Conditions related to the liver/biliary tract, pancreas, and spleen frequently are chronic in nature and difficult to diagnose. Although many of these conditions are manageable once diagnosed, they often have a tremendous impact on quality of life for patients. With chronic conditions such as these accounting for 81% of hospital admissions (Partnership to Fight Chronic Disease, n.d.), it is essential that you have a strong foundation in the various presentations and symptoms.

ORDER A PLAGIARISM-FREE PAPER NOW

This week, as you examine the pre- and post-operative care of patients with conditions related to the liver/biliary tract, pancreas, and spleen, you explore strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

Evaluate medical and surgical patients with conditions of the liver/biliary track, pancreas, and spleen

Develop differential diagnoses for medical and surgical patients with conditions of the liver/biliary track, pancreas, and spleen. Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

Develop treatment plans for medical and surgical patients with conditions of the liver/biliary track, pancreas, and spleen

Photo Credit: ericsphotography/E+/Getty Images

 Learning Resources

Required Readings

Doherty, G. M. (2015).
Current diagnosis and treatment: Surgery
(14th ed.). New York, NY: McGraw Hill.

Chapter 24, “Liver & Portal Venous System”

Chapter 25, “Biliary Tract”

Chapter 26, “Pancreas”

Chapter 27, “Spleen”

Weber, E. C., Vilensky, J. A., & Fog, A. M. (2013).
Practical radiology: A symptom-based approach.
Philadelphia, PA: F. A. Davis Company. Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

Chapter 8, “Abdomen” (Review)

Gay, S. B., Shaffer, H. A., Vu, Q. D. M., Harker, C. O., Kuzminski, C. D., Christensen, J. D., … Kori, G. A. (2013).
Introduction to gastrointestinal radiology.
Retrieved from https://www.med-ed.virginia.edu/courses/rad/gi/

Required Media

Geertsma, T. S. A. (n.d.).
Abdomen and retroperitoneum.
Retrieved from http://www.ultrasoundcases.info/Case-List.aspx?cat=158

i-Human Patient Cases. (2014). Retrieved from https://ih2.i-human.com/users/sign_in

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen

The liver/biliary tract, pancreas, and spleen often are associated with chronic conditions, which may result in long-term symptoms for patients. Whereas some of these symptoms may be connected easily to a particular condition, many symptoms are associated with multiple conditions, making an immediate diagnosis challenging. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with health conditions related to the liver/biliary tract, pancreas, and spleen. Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

To prepare:

Review this week’s Learning Resources. With the liver/biliary track, pancreas, and spleen in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.

Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient. Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions to consider in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis. Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with conditions of the liver/biliary tract, pancreas, and spleen.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the 
i-Human Patients Case Player Student Manual
 in the Week 2 Learning Resources.

By Day 7

This Assignment is due.

Grading Information

Week 7 i-Human Rubric

Practicum Reminder: Week 7 Time Log

Time Logs

You are required to keep a log of the time you spend related to your practicum experience 
and enter every patient you see each day.
 You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

Week in Review

This week
 you evaluated medical and surgical patients with conditions related to the liver/biliary tract, pancreas, and spleen and developed differential diagnoses and treatment plans for these conditions. Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

Next week
 you will study the pre-and post-operative care of patients with conditions of the intestines, hernias, and abdominal wall lesions and explore strategies for assessment, diagnosis, and treatment.

Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers. Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

Application_Rubric

 

Novice

Emerging

Proficient

HPI Statement

0 
(0%)
 – 5 
(5%)

Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills

6 
(6%)
 – 10 
(10%)

Well written HPI statement but may be missing 1-2 key components from the history

11 
(11%)
 – 15 
(15%)

Clearly written HPI statement with comprehensive information gathering from case questions.

Objective testing and physical exam

0 
(0%)
 – 5 
(5%)

Poorly written physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis. Includes 3 or more inappropriate exams or tests.

6 
(6%)
 – 10 
(10%)

Well written physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis. May include 1-2 unnecessary exams or tests.

11 
(11%)
 – 15 
(15%)

Clearly written physical examination covering all critical components of a focus exam. Tests that are ordered are appropriate for patient and cost effective.

Assessment

0 
(0%)
 – 10 
(10%)

Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components. Priority list may be out of order. Primary diagnosis may be wrong.

11 
(11%)
 – 19 
(19%)

Well written differential diagnoses. May be missing 1-2 critical components. Correct primary diagnosis identified.

20 
(20%)
 – 25 
(25%)

Clearly written differential diagnoses. Primary diagnosis identified.

Plan for patient

0 
(0%)
 – 15 
(15%)

Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.

16 
(16%)
 – 25 
(25%)

Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.

26 
(26%)
 – 30 
(30%)

Clearly written plan covering all critical components for patient’s final diagnosis.

Clinical Questions

0 
(0%)
 – 10 
(10%)

Correctly answered 0-69% of the clinical question

11 
(11%)
 – 13 
(13%)

Correctly answered 70-89% of the clinical question

14 
(14%)
 – 15 
(15%)

Correctly answered 90-100% of the clinical queries

Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Liver/Biliary Tract, Pancreas, and Spleen Essay Assignment Papers

NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

Week 2: Pre- and Post-Operative Care

“A wide range of illnesses and injuries may require treatment that includes some type of surgical intervention. Surgery may be planned or unplanned, major or minor, invasive or noninvasive, and may involve any body part or system”

—Pamela Lynn (2008).

As this quotation suggests, advanced practice nurses must be able to provide pre- and post-operative care to patients with various illnesses and injuries. Consider a 17-year-old patient who is injured in a car accident. The patient has severe burns on her legs, and several toes on her right foot require amputation. Her injuries are affecting multiple body systems. As an advanced practice nurse, how might you stabilize and prepare this patient for surgery? What areas of care will be your focus as the patient recovers from surgery?

This week, you examine and discuss limitations and challenges of clinical practice. Then, as you explore the role of the advanced practice nurse in perioperative settings, you examine strategies for assessing, diagnosing, and treating patients in pre- and post-operative care.

Learning Objectives

By the end of this week, students will:

Analyze limitations and challenges of clinical practice

Evaluate pre- and post-operative care patients

Develop differential diagnoses for pre- and post-operative care patients

Develop treatment plans for pre- and post-operative care patients

Photo Credit: PhotoAlto/Odilon Dimier/PhotoAlto Agency RF Collections/Getty Images

Learning Resources

ORDER A PLAGIARISM-FREE PAPER NOW

Required Readings

Colyar, M. R. (2015).
Advanced practice nursing procedures
(1st ed.). Philadelphia, PA: F. A. Davis Company.

Chapter 1, “Punch Biopsy”

Chapter 2, “Skin Biopsy”

Chapter 4, “Abscesses—Incision and Drainage Drainage (Furuncle, Felon, Paronychia, Pilonidal Cyst, Perianal Cyst)”

Chapter 7, “Burns—Debridement”

Chapter 8, “Digital Nerve Block”

Chapter 12, “Sebaceous Cyst Removal”

Chapter 17, “Soft Tissue Aspiration”

Chapter 21, “Subungual Hematoma Excision”

Chapter 22, “Suture Insertion”

Chapter 23, “Suture Selection”

Chapter 24, “Suture Removal”

Chapter 26, “Topical Hemostatic Agent Application”

Chapter 27, “Ulcer Debridement”

Doherty, G. M. (2015).
Current diagnosis and treatment: Surgery
(14th ed.). New York, NY: McGraw Hill. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

Chapter 6, “Wound Healing”

Chapter 8, “Inflammation, Infection, & Antimicrobial Therapy in Surgery”

Chapter 9, “Fluid & Electrolyte Management & Acid-Base Disorders”

Chapter 10, “Surgical Metabolism & Nutrition”

Chapter 13, “Management of the Injured Patient”

Chapter 14, “Burns & Other Thermal Injuries”

Document: i-Human Patients, Inc. (2014).
i-Human patients case player student manual.

Throughout this course, you will be required to complete case study assignments within i-Human Patients. This manual provides guidance on accessing and using these simulation. It is highly recommended that you explore the various training resources offered in this manual in preparation for the upcoming Assignments.Throughout this course, you will be required to complete case study assignments within i-Human Patients. This manual provides guidance on accessing and using these simulation. It is highly recommended that you explore the various training resources offered in this manual in preparation for the upcoming Assignments.

Required Media

Note:
 You should have received an e-mail with your i-Human Patients login and password information. If you have not received this information, please contact your Instructor.

i-Human Patient Cases. (2014). Retrieved from https://ih2.i-human.com/users/sign_in

Vo, H. (2012).
Placement of central venous catheter—NEJM
[Video file]. Retrieved from https://www.youtube.com/watch?v=HE5QhsPRaPU

 

Optional Resources

University of Michigan Trauma Burn Center. (2015).
Fluid resuscitation.
Retrieved from http://www.traumaburn.org/referring/fluid.shtml

U.S. Department of Health & Human Services. (2014).
Burn triage and treatment: Thermal injuries.
Retrieved from http://www.remm.nlm.gov/burns.htm

 

Discussion Part I: Limitations and Challenges

From providing ongoing assessments to monitoring for complications and facilitating recovery, advanced practice nurses who care for patients in perioperative environments experience a unique set of limitations and challenges. Reflecting on your experiences in this complex and critical environment will help you develop your professional competency and prepare you for your future role as an advanced practice nurse. In this week’s Discussion, you consider limitations and challenges of clinical practice in perioperative care settings. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

To prepare:

Reflect on this week’s clinical experiences.

Consider one limitation or challenge you encountered.

Think about how you overcame this limitation or challenge and how this might affect your future practice in pre- and post-operative care settings.

By Day 3

Post
 a description of at least one limitation or challenge you encountered during your clinical experience this week. Explain how you overcame this limitation or challenge and how this might affect your future practice.

Note:
 If you refer to a patient in your Discussions or Assignments, be sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

Read
 a selection of your colleagues’ responses.

By Day 6

Respond
 to 
two colleagues
 by sharing additional insights or alternative perspectives.

Discussion Part II: Pharmacology

Note:
 To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

To prepare:

Read the following articles to enhance your knowledge of commonly prescribed medications:

Ando, S., Yasugi, D., Matsumoto, T., Kanata, S., & Kasai, K. (2014). Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia.
Psychiatry Clinical Neuroscience, 68
(9), 721.

Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia by Ando, S., et al in Psychiatry Clinical Neuroscience, 68(9). Copyright 2014 by John Wiley & Sons, Inc. Reprinted by permission of John Wiley & Sons, Inc., via the Copyright Clearance Center.

 

Dassanayake, T. L., Jones, A. L., Michie, P. T., Carter, G. L., McElduff, P., Stokes, B. J., & Whyte, I. M. (2012). Risk of road traffic accidents in patients discharged following treatment for psychotropic drug overdose: A self-controlled case series study in Australia.
CNS Drugs 26
(3), 269–276.

Note:
Retrieved from the Walden Library databases.

Kulick, D., & Deen, D. (2011). Specialized nutrition support.
American Family Physician, 83
(2), 173–183. Retrieved from http://www.aafp.org/afp/2011/0115/p173.html

Martini, D. I., Nacca, N., Haswell, D., Cobb, T., & Hodgman, M. (2015). Serotonin syndrome following metaxalone overdose and therapeutic use of a selective serotonin reuptake inhibitor.
Clinical Toxicology 53
(3), 185–187.

Serotonin syndrome following metaxalone overdose and therapeutic use of a selective serotonin reuptake inhibitor by Martini, D., in Clinical Toxicology, 53(3). Copyright 2015 by Informa Healthcare. Reprinted by permission of Informa Healthcare via the Copyright Clearance Center.

 

Robinson, A., & Wermeling, D. P. (2014). Intranasal naloxone administration for treatment of opioid overdose.
American Journal of Health-System Pharmacy, 71
(24), 2129–2135.

Note:
Retrieved from the Walden Library databases.

Thomas, D. R. (2013). Total parenteral nutrition (TPN). In
The Merck Manual Professional Edition.
Retrieved from http://www.merckmanuals.com/professional/nutritional_disorders/nutritional_support/total_parenteral_

 

All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.

KPhos, bicarb, calcium, magnesium

Iron, folic acid, B12

Diamox

Macrolides

Muinolones/mluoroquinolone

Cephalosporins, 4th and 5th generation

Aminoglycosides

Carbapenems

Lipopeptide

Tigecycline

Note:
 When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group.

By Day 3

For this Discussion, address 1 of the following options:

Option 1

Post
 a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose.

Option 2

Conduct an evidence-based drug search on the drug you selected and 
post
 an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?

Option 3

Post
 an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Discuss a patient to whom you would prescribe this medication.

Note:
 To be considered as one of your required responses, your pharmacology rationale must include a supporting reference.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

Week 2 Discussion Rubric

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients

The perioperative period is critical for surgical patients. Whether patients require fluid and electrolyte management, pain management, or treatment for infections or surgical complications, advanced practice nurses must be able to provide safe and effective care. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat patients who require pre- and post-operative care.

To prepare:

Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients in pre- and post-operative care.

Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions to consider in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for each patient that includes health promotion and patient education strategies for pre- and post-operative care patients.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. As you interact with this week’s i-Human patients, complete the assigned case studies. For guidance on using i-Human, refer to the 
i-Human Patients Case Player Student Manual
 in the Week 2 Learning Resources.

By Day 7

This Assignment is due.

Grading Information

Week 2 i-Human Rubric

Week in Review

This week
 you analyzed the unique set of limitations and challenges when providing safe and effective care in perioperative environments for pre-and-post operative patients. You also developed differential diagnoses and treatment plans for these patients. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers.

Next week
 you will explore the assessment and care of pre- and post-operative patients with conditions specifically related to the head, neck, esophagus, and diaphragm, and examine strategies for assessment, diagnosis, and treatment.

NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

Discussion_Rubric

 

Outstanding Performance

Excellent Performance

Competent Performance

Proficient Performance

Room for Improvement

Main Posting:

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

44 (44%) – 44 (44%)

Thoroughly responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

supported by at least 3 current, credible sources

40 (40%) – 43 (43%)

Responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

75% of post has exceptional depth and breadth

supported by at least 3 credible references

35 (35%) – 39 (39%)

Responds to most of the discussion question(s)

is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of post has exceptional depth and breadth

supported by at least 3 credible references

31 (31%) – 34 (34%)

Responds to some of the discussion question(s)

one to two criteria are not addressed or are superficially addressed

is somewhat lacking reflection and critical analysis and synthesis

somewhat represents knowledge gained from the course readings for the module.

post is cited with fewer than 2 credible references

0 (0%) – 30 (30%)

Does not respond to the discussion question(s)

lacks depth or superficially addresses criteria

lacks reflection and critical analysis and synthesis

does not represent knowledge gained from the course readings for the module.

contains only 1 or no credible references

Main Posting:

Writing

6 (6%) – 6 (6%)

Written clearly and concisely

Contains no grammatical or spelling errors

Fully adheres to current APA manual writing rules and style

5.5 (5.5%) – 5.5 (5.5%)

Written clearly and concisely

May contain one or no grammatical or spelling error

Adheres to current APA manual writing rules and style

5 (5%) – 5 (5%)

Written concisely

May contain one to two grammatical or spelling error

Adheres to current APA manual writing rules and style

4.5 (4.5%) – 4.5 (4.5%)

Written somewhat concisely

May contain more than two spelling or grammatical errors

Contains some APA formatting errors

0 (0%) – 4 (4%)

Not written clearly or concisely

Contains more than two spelling or grammatical errors

Does not adhere to current APA manual writing rules and style

Main Posting:

Timely and full participation

10 (10%) – 10 (10%)

Meets requirements for timely and full participation

posts main discussion by due date

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

Does not meet requirement for full participation

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings

responds to questions posed by faculty

the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

8.5 (8.5%) – 8.5 (8.5%)

Response exhibits critical thinking and application to practice settings. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

7.5 (7.5%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting

6.5 (6.5%) – 7 (7%)

Response is on topic, may have some depth

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth

First Response: 

Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues

Response to faculty questions are fully answered if posed

Provides clear, concise opinions and ideas that are supported by two or more credible sources

Response is effectively written in Standard Edited English

5.5 (5.5%) – 5.5 (5.5%)

Communication is professional and respectful to colleagues

Response to faculty questions are answered if posed

Provides clear, concise opinions and ideas that are supported by two or more credible sources

Response is effectively written in Standard Edited English

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues

Response to faculty questions are mostly answered if posed

Provides opinions and ideas that are supported by few credible sources

Response is written in Standard Edited English

4.5 (4.5%) – 4.5 (4.5%)

Responses posted in the discussion may lack effective professional communication

Response to faculty questions are somewhat answered if posed

Few or no credible sources are cited

0 (0%) – 4 (4%)

Responses posted in the discussion lack effective

Response to faculty questions are missing

No credible sources are cited

First Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely and full participation

posts by due date

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

Does not meet requirement for full participation

Second Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings * responds to questions posed by faculty

the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

8.5 (8.5%) – 8.5 (8.5%)

Response exhibits critical thinking and application to practice settings

7.5 (7.5%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting

6.5 (6.5%) – 7 (7%)

Response is on topic, may have some depth

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth

Second Response:

Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues

Response to faculty questions are fully answered if posed

Provides clear, concise opinions and ideas that are supported by two or more credible sources

Response is effectively written in Standard Edited English

5.5 (5.5%) – 5.5 (5.5%)

Communication is professional and respectful to colleagues

Response to faculty questions are answered if posed

Provides clear, concise opinions and ideas that are supported by two or more credible sources

Response is effectively written in Standard Edited English

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues

Response to faculty questions are mostly answered if posed

Provides opinions and ideas that are supported by few credible sources

Response is written in Standard Edited English

4.5 (4.5%) – 4.5 (4.5%)

Responses posted in the discussion may lack effective professional communication

Response to faculty questions are somewhat answered if posed

Few or no credible sources are cited

0 (0%) – 4 (4%)

Responses posted in the discussion lack effective

Response to faculty questions are missing

No credible sources are cited

Second Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely and full participation

Posts by due date

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

Does not meet requirement for full participation

Total Points: 100

NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

Application_Rubric (iHuman)

 

Novice

Emerging

Proficient

HPI Statement

0 (0%) – 5 (5%)

Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills

6 (6%) – 10 (10%)

Well written HPI statement but may be missing 1-2 key components from the history

11 (11%) – 15 (15%)

Clearly written HPI statement with comprehensive information gathering from case questions.

Objective testing and physical exam

0 (0%) – 5 (5%)

Poorly written physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis. Includes 3 or more inappropriate exams or tests.

6 (6%) – 10 (10%)

Well written physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis. May include 1-2 unnecessary exams or tests.

11 (11%) – 15 (15%)

Clearly written physical examination covering all critical components of a focus exam. Tests that are ordered are appropriate for patient and cost effective.

Assessment

0 (0%) – 10 (10%)

Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components. Priority list may be out of order. Primary diagnosis may be wrong.

11 (11%) – 19 (19%)

Well written differential diagnoses. May be missing 1-2 critical components. Correct primary diagnosis identified.

20 (20%) – 25 (25%)

Clearly written differential diagnoses. Primary diagnosis identified.

Plan for patient

0 (0%) – 15 (15%)

Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis. NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

16 (16%) – 25 (25%)

Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.

26 (26%) – 30 (30%)

Clearly written plan covering all critical components for patient’s final diagnosis.

Clinical Questions

0 (0%) – 10 (10%)

Correctly answered 0-69% of the clinical question

11 (11%) – 13 (13%)

Correctly answered 70-89% of the clinical question

14 (14%) – 15 (15%)

Correctly answered 90-100% of the clinical questions

Total Points: 100

NURS 6560 – Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients Essay Assignment Papers

Assessment and Care of Patients With Conditions of the Head, Neck, Esophagus, and Diaphragm

Health conditions involving the head, neck, esophagus, and diaphragm can disrupt patients’ daily lives, making surgical interventions necessary. Consider Janice Savage-Martin, who frequently experienced impaired breathing, congestion, and headaches. These symptoms and the pain associated with them put a strain on her normal routine and ability to work. After being diagnosed with turbinates and a deviated septum, providers recommended surgery to shrink the blood vessels in the turbinates. Like many surgical patients, however, Janice was concerned that her recovery would be painful and might lead to further health complications (Methodist Health System, 2015). As an advanced practice nurse who cares for surgical patients like Janice, you will play significant role in educating patients, easing concerns, and providing evidence-based care. Assessment and Care of Patients With Conditions of the Head, Neck, Esophagus, and Diaphragm

ORDER A PLAGIARISM-FREE PAPER NOW

This week, as you explore the pre- and post-operative care of patients with conditions related to the head, neck, esophagus, and diaphragm, you examine strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

Evaluate medical and surgical patients with conditions related to the head, neck, esophagus, and diaphragm

Develop differential diagnoses for medical and surgical patients with conditions related to the head, neck, esophagus, and diaphragm

Develop treatment plans for medical and surgical patients with conditions related to the head, neck, esophagus, and diaphragm

Photo Credit: Mario Gh/EyeEm/EyeEm/Getty Images

Learning Resources

Required Readings

Colyar, M. R. (2015).
Advanced practice nursing procedures
(1st ed.). Philadelphia, PA: F. A. Davis Company.

 

Chapter 69, “Occipital Nerve Block”

Chapter 72, “Corneal Abrasion and Foreign Body Removal—Eye”

Chapter 73, “Eye Drop Insertion”

Chapter 74, “Eye Irrigation”

Chapter 75, “Eye Trauma Stabilization”

Chapter 78, “Auricular Hematoma Evacuation”

Chapter 81, “Epistaxis Control”

Chapter 82, “Laryngoscopy”

Chapter 83, “Nasal Lavage”

Chapter 84, “Removal of Foreign Body—Ear and Nose”

Chapter 85, “Frenotomy for Ankyloglossia”

Chapter 86, “Lip Laceration Repair”

Chapter 87, “Tongue Laceration Repair”

Doherty, G. M. (2015).
Current diagnosis and treatment: Surgery
(14th ed.). New York, NY: McGraw Hill.

 

Chapter 15, “Otolaryngology—Head & Neck Surgery”

Chapter 16, “Thyroid and Parathyroid”

Chapter 20, “Esophagus & Diaphragm”

Chapter 37, “The Eye & Ocular Adenxa”

Weber, E. C., Vilensky, J. A., & Fog, A. M. (2013).
Practical radiology: A symptom-based approach.
Philadelphia, PA: F. A. Davis Company.

 

Chapter 5, “EENT Imaging”

Javan, R., Machin, J. E., McGinnis, R. S., Moinuddin, M., & Sarti, M. (2013).
Thyroid ultrasound top 10 pathology.
Retrieved from http://www.med-ed.virginia.edu/courses/rad/Thyroid_Ultrasound/index.html, Assessment and Care of Patients With Conditions of the Head, Neck, Esophagus, and Diaphragm

Wipperman, J. L., & Dorsch, J. N. (2013). Evaluation and management of corneal abrasions.
American Family Physician, 87
(2), 114–120. Retrieved from http://www.aafp.org/afp/2013/0115/p114.html

Required Media

i-Human Patient Cases. (2014). Retrieved from https://ih2.i-human.com/users/sign_in

Seger, D. (2010).
EGD (upper endoscopy)
[Video file]. Retrieved from https://www.youtube.com/watch?v=ZvudWuvMjtA

Assignment 1: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Head, Neck, Esophagus, and Diaphragm

There are many common health conditions associated with the head, neck, esophagus, and diaphragm. Although these conditions and their related symptoms usually are managed easily, a delay in treatment can result in sensory debility such as hearing loss or sight loss. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with health conditions related to the head, neck, esophagus, and diaphragm.

To prepare:

Review this week’s Learning Resources. With the head, neck, esophagus, and diaphragm in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.

Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions to consider in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with conditions related to the head, neck, esophagus, and diaphragm.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the 
i-Human Patients Case Player Student Manual
 in the Week 2 Learning Resources.

By Day 7

This Assignment is due.

Grading Information

Week 3 i-Human Rubric

Assignment 2: Fitzgerald Health Education Associates (FHEA) AGPCNP 150 University Exit Comprehensive Exam

The Fitzgerald Health Education Associates (FHEA) AGACNP 150 University Exit Comprehensive Exam is a learning activity used to guide your preparation for your national certification exams. The results of the exam will help you understand how well prepared you are for your national certification exams and the areas in which you need to further prepare.

In Weeks 1 or 2 of this course, you should have received an email from
 Fitzgerald Health Education Associates (FHEA) explaining how to access the Fitzgerald Health Education Associates (FHEA) AGACNP 150 University Exit Comprehensive Exam. Please follow the directions FHEA provided and complete the exam. Assessment and Care of Patients With Conditions of the Head, Neck, Esophagus, and Diaphragm

This exam is graded on a S/U basis. You must complete the exam by Day 7 of Week 3 to receive the grade of ‘S’.

By Day 7

Complete
 the Fitzgerald Health Education Associates (FHEA) AGACNP 150 University Exit Comprehensive Exam.

Week in Review

This week
 you evaluated medical and surgical patients with head, neck, esophagus and diaphragm conditions/injuries with the realization that delays in treatment could result in hearing or sight loss, and developed differential diagnoses and treatment plans for these conditions.

Next week
 you will study the pre- and post-operative care of patients with cardiovascular conditions and examine strategies for assessment, diagnosis, and treatment.

Assessment and Care of Patients With Conditions of the Head, Neck, Esophagus, and Diaphragm