Tag: Clinical-Nursing

PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay

Case Study: Mark

You are the intake clinician at a large acute inpatient psychiatric facility, which includes a sizable detoxification unit. It is an unusually busy day and the lobby is full of patients seeking treatment. Half an hour before lunch, you pick up another clipboard from the 
“pending
” rack and quickly scan the intake information filled in by the prospective patient and receptionist. Mark is a 45-year-old male who has been waiting since 8:15 AM. He is requesting alcohol detox. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay. You notice that Mark has been waiting for over three hours and you are frustrated because you will have to begin yet another interview with an apology for the long wait. You notice that the blood pressure assessed by the receptionist is somewhat elevated you make a mental note to inform the nurse: BP = 149/97, pulse 104, respiration rate 18. You invite Mark into one of the free interview rooms and you notice that he appears much older than his 45 years. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay. He’s dressed casually and is a bit disheveled; his skin looks old/tanned and flushed; in his right hand, he holds an emesis bag. He apologizes and he states that he has been having dry heaves since yesterday evening but he tells you that he is able to keep down some fluids.

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You observe that Mark does not look too good and since he’s been waiting in your lobby for three hours, you think it’s a good idea to assess another set of vitals. The receptionist obliges and reports the new vital signs as BP = 154/103, pulse 114, respiration rate 20, oxygen saturation 98% at room air. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay. You become a little concerned by the increase in blood pressure and pulse and you note that while previously Mark’s shirt was dry, he now has sweat stains on his back and chest; visible sweat beads are also noticeable on his forehead and neck. You noticed that Mark speaks softly now when the door to the interview room is closed to cut down on the noise from the hallway. He asks you if you can turn off the bright ceiling lights and to keep on only the lamp on your desk. You oblige. Mark tells you that he started drinking at the age of 16 simply because it was popular and the fun thing to do on the weekends in high school. His social drinking increased somewhat in his 20s but it became problematic in his early 30s. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay.

Mark works as a plumber, and along with his older brother, he owned his own plumbing business. Somewhat embarrassed, he tells you that for the past 15 years, he has been more drunk than sober. His longest period of sobriety was seven years ago, after a detox and rehab program he managed to stay clean for nine months. Slowly he relapsed into drinking, believing that he is one of the few who can only drink socially. For the past 15 years, he has had several DUIs. Several times, his wife of 20 years threatened divorce; now they have come to a truce of sorts, but he describes a disengage relationship. His brother continues to be very loyal to him, but Mark tells you that this is both a blessing and a curse. On one hand, his brother has “covered” for him when his drinking and the hangovers made him an unreliable worker. On the other hand, he regrets the fact that had his brother been stricter with him he may have sought serious help a long time ago. Mark tried to quit drinking several times on his own. He reports that on one such occasion when he went “cold turkey” after a religious conversion of sorts, he experienced a grand mal seizure and had to be taken to the emergency room. The ER doctor strongly advised him to never stop drinking abruptly or you have another seizure. The past two years, Mark has been averaging a six-pack of beer and a pint of vodka every day. This is enough to lead to intoxication. He starts with the beers in the morning and after work, he switches to the vodka. On the weekends, he can drink up to a gallon of vodka per day. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay. Those binges lead to blackouts because he often cannot remember most of his Sundays. He often goes out with his brother to a local casino where he gambles $500 to $1000 each weekend. His wife stopped nagging him about it when he insisted that he works hard for his earned money and that he always pays the bills first. Mark has decided to stop drinking because during a routine doctor’s visit, his liver enzymes were significantly elevated. His primary care physician warned him seriously about liver cirrhosis. On several occasions during the interview, Mark quickly turns away from you and leans into his emesis bag heaving heavily. He apologizes. You offer him a bottle of water and he takes small sips occasionally. You ask Mark to stand up and to stretch out his arms: you notice visible tremors in both his arms and his shoulders. He reports a headache of 5 out of 10 (subjective units of distress) and he tells you that normally a few Advils help. His last full drink was yesterday morning before going to his doctor’s office and he had only a sip of beer at lunch. You calculate that by now he has been without any alcohol for approximately 24 hours. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay. He reports mild anxiety, but you observe him to fidget during the interview. You complete the CIWA scale (attached) and you observed that with a score of 25 he is in severe alcohol withdrawals. You notify the nurse immediately, urging her to come and have a look at Mark and to call the doctor for admitting orders.

PCN 605 Case Study: Mark

CIWA scale for Mark

Assessment Protocol
a. Vitals, Assessment Now.
  

b. If initial score ³ 8 repeat q1h x 8 hrs, then

if stable q2h x 8 hrs, then if stable q4h.

c. If initial score < 8, assess q4h x 72 hrs.     If score < 8 for 72 hrs, d/c assessment. If score ³ 8 at any time, go to (b) above. d. If indicated, (see indications below) administer prn medications as ordered and record on MAR and below. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay.   Date Today’s date Time 11:30am Pulse 114 RR 20 O 2 sat 98% BP 154/103 Nausea/vomiting   (0 – 7)0 – none; 1 – mild nausea ,no vomiting; 4 – intermittent nausea; 7 – constant nausea , frequent dry heaves & vomiting. 7 Tremors   (0 – 7)0 – no tremor; 1 – not visible but can be felt; 4 – moderate w/ arms extended; 7 – severe, even w/ arms not extended. 4 Anxiety   (0 – 7)0 – none, at ease; 1 – mildly anxious; 4 – moderately anxious or guarded; 7 – equivalent to acute panic state 1 Agitation  (0 – 7)0 – normal activity; 1 – somewhat normal activity; 4 – moderately fidgety/restless; 7 – paces or constantly thrashes about 4 Paroxysmal Sweats  (0 – 7)0 – no sweats;    1 – barely  perceptible sweating,  palms moist; 4 – beads of sweat obvious on forehead;     7 – drenching sweat 4 Orientation   (0 – 4)0 – oriented; 1 – uncertain about date; 2 – disoriented to date by no more than 2 days; 3 – disoriented to date by  > 2 days;

4 – disoriented to place and / or  person

0

Tactile Disturbances
 (0 – 7)0 – none; 1 – very mild itch, P&N, ,numbness; 2-mild itch, P&N, burning,  numbness; 3 – moderate itch,  P&N, burning ,numbness;  4 – moderate  hallucinations; 5 – severe  hallucinations;

6 – extremely severe hallucinations; 7 – continuous hallucinations

0

Auditory Disturbances
 (0 – 7)0 – not present; 1 – very mild harshness/ ability to startle; 2 – mild harshness, ability to startle; 3 – moderate harshness, ability to startle; 4 – moderate hallucinations; 5 severe hallucinations;

6 – extremely severe hallucinations; 7 – continuous.hallucinations

1

Visual Disturbances
 (0 – 7)0 – not present;    1 – very mild sensitivity;      2 – mild sensitivity;   3 – moderate sensitivity;       4 – moderate hallucinations;   5 – severe hallucinations;        6 – extremely severe hallucinations;   7 – continuous hallucinations

1

Headache
  (0 – 7)0 – not present; 1 – very mild; 2 – mild; 3 – moderate; 4 – moderately severe; 5 – severe; 6 – very severe; 7 – extremely severe

3

Total  CIWA-Ar score:

25

PRN Med: (circle one)Diazepam     Lorazepam

Dose given (mg):

Route:

Time
 of PRN medication administration:

Assessment of response (CIWA-Ar score 30-60 minutes after medication administered)

RN Initials. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay.

 

Scale for Scoring:
Total Score =

0 – 9: absent or minimal withdrawal

10 – 19: mild to moderate withdrawal

more than   20: severe withdrawal

Indications for PRN medication
:
a.  Total CIWA-AR score 8 or higher if ordered PRN only (Symptom-triggered method).

b.  Total CIWA-Ar score 15 or higher if on Scheduled medication. (Scheduled + prn method)

Consider transfer to ICU for any of the following
: Total score above 35, q1h assess. x more than 8hrs required,  more than 4 mg/hr lorazepam x 3hr 
or
 20 mg/hr diazepam x 3hr required, or resp. distress. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay.

PCN 605 Case Study: Mark Question Description

To complete this assignment, access the links above regarding alcohol withdrawal treatments and the CIWA. Read the case study of “Mark,” which also includes Mark’s CIWA at the bottom of the case study. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay.

Write a 750-1,000-word essay response to the following questions:

What are the significant diagnostic markers (“red flags”) that indicate acute alcohol withdrawal syndrome for Mark?

What is the most appropriate/safest course of action for Mark? Support your response.

Assess the appropriate DSM diagnoses for Mark.

Include at least three to five scholarly references in your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center.

Refer to the directions in the Student Success Center. PCN 605 Case Study: Mark – acute alcohol withdrawal syndrome essay.

NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers

When percussing, a dull tone is expected to be heard over:

most of the abdomen.

emphysemic lungs.

the liver.

healthy lung tissue.

an empty stomach.

The dorsal surface of the hand is most often used for the assessment of:

crepitus.

thrills.

texture.

vibration.

temperature.

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A patient in the emergency department has a concussion to the head. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Strabismoscope

Red-free filter

Slit lamp

Small aperture

Grid

The use of secondary, tangential lighting is most helpful in the detection of:

variations in skin color.

enlarged tonsils.

foreign objects in the nose or ear.

variations in contour of the body surface.

variations in texture and mobility.

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:

vibratory sensations.

hearing from bone conduction.

hearing range of normal speech.

noise above the threshold level.

peripheral motor nerve damage.

Which patient is at the highest risk for the development of latex allergy?

The new patient who has no chronic illness and has never been hospitalized

The patient who has had multiple procedures or surgeries

The patient who is allergic to eggs

The patient who is allergic to contrast dye

The patient who is a vegetarian

A variant of the percussion hammer is the neurologic hammer, which is equipped with which of the following?

Brush and needle

Tuning fork and cotton swab

Penlight and goniometer

Ruler and bell

Transilluminator

Transillumination functions on the principle that:

infrared radiation is easily detected.

black light causes certain substances to fluoresce.

converging and diverging light brings structures into focus.

tangential light casts shadows that illuminate contours.

air, fluid, and tissue transmit light differentially.

Which statement is true regarding the relationship of physical characteristics and culture?

Physical characteristics should be used to identify members of cultural groups.

There is a difference between distinguishing cultural characteristics and distinguishing physical characteristics.

To be a member of a specific culture, an individual must have certain identifiable physical characteristics.

Gender and race are the two essential physical characteristics used to identify cultural groups. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

All cultural traits can be viewed as static whereas physical traits are dynamic.

A scale used to assess patients weight should be calibrated:

when the patient tells you the weight is not correct.

by a qualified technician at regularly scheduled intervals.

each time it is used.

when necessary, with the patient standing on the scale.

only by the manufacturer.

Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?

Finger percussion

Only indirect percussion techniques are ever used to elicit tenderness.

Fist percussion

Thumb percussion

Palmer percussion

A rubber or plastic ring should be around the bell end-piece of a stethoscope to:

prevent the transmission of static electricity.

avoid cold metal from touching the patient.

prevent the sharp edge of the stethoscope from damaging the patient s skin.

allow firm pressure to be applied without discomfort.

ensure secure contact with the body surface.

In terms of cultural communication differences, Americans are more likely to _____ than are other groups of patients.

emphasize attitudes and feelings

maintain eye contact

come quickly to the point

use silence comfortably

speak more softly than other cultures

For a woman with a small vaginal opening, the examiner should use a _____ speculum.

plastic Graves

Pederson

pediatric

nasal

metal Graves

During percussion, the downward snap of the striking fingers should originate from the:

wrist.

forearm.

shoulder.

interphalangeal joint.

elbow.

You are auscultating a patient s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Anticipate the next sounds.

Isolate each cycle segment.

Listen to all sounds together.

Move the stethoscope clockwise.

Ask the patient to whisper his name.

Expected normal percussion tones include:

dullness over the lungs.

hyperresonance over the lungs.

tympany over an empty stomach.

flatness over an empty stomach.

resonance over the liver.

During auscultation, you can limit your perceptual field best by:

asking patients to describe their symptoms.

listening through the patient s clothing.

closing your eyes.

performing palpation before percussion.

turning out the lights in the examination room.

Standard Precautions apply to all patients:

with bloodborne infections.

with infected, draining wounds.

in intensive care units.

receiving care in hospitals.

believed to have an infectious disease.

Which of the following describes a physical, not a cultural, differentiator?

Ritual

Rite

Race

Norm

Ethos

 

Course

NURS-6512N-28,Advanced Health Assessment.2017 Fall Qtr 08/28-11/19-PT27

Test

Quiz – Week 2

Started

9/9/17 11:22 AM

Submitted

9/9/17 11:53 AM

Due Date

9/11/17 1:59 AM

Status

Completed

Attempt Score

40 out of 40 points

Time Elapsed

30 minutes out of 30 minutes

Instructions

Click
Begin
to begin: Quiz – Week 2. Click
Cancel
to go back.

Results Displayed

Feedback

Question 1

2 out of 2 points

 

When percussing, a dull tone is expected to be heard over:

 

Response Feedback:

Dull tones are expected over more dense areas such as the liver.

Question 2

2 out of 2 points NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers

 

The dorsal surface of the hand is most often used for the assessment of:

 

Response Feedback:

The dorsal surface, or back of the hand, can best feel for warmth.

Question 3

2 out of 2 points

 

A patient in the emergency department has a concussion to the head. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers

 

Response Feedback:

The red-free filter permits recognition of hemorrhages. The grid estimates the size of lesions; the slit lamp examines the anterior eye and assesses the elevation of lesions; and the small aperture is used with small pupils. The strabismoscope is used for detecting strabismus.

Question 4

2 out of 2 points

 

The use of secondary, tangential lighting is most helpful in the detection of:

 

Response Feedback:

Tangential lighting is used to cast shadows in order to best observe contours and variations in body surfaces. All of the other choices are best observed with direct lighting that does not cast shadows.

Question 5

2 out of 2 points

 

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:

 

Response Feedback:

Normal speech has a range of 300 to 3000 Hz; therefore, the 500- to 1000-Hz fork is most often used because it can estimate hearing loss in the range of normal speech. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 6

2 out of 2 points

 

Which patient is at the highest risk for the development of latex allergy?

 

Response Feedback:

The patient who has had multiple procedures or surgeries has a higher exposure rate to rubber gloves and to equipment and supplies that contain latex and therefore is at a higher risk for developing an allergic response.

Question 7

2 out of 2 points

 

A variant of the percussion hammer is the neurologic hammer, which is equipped with which of the following?

 

Response Feedback:

The neurologic hammer unscrews at the handle to reveal a soft brush and the knob on the head unscrews, to which is attached a sharp needle.

Question 8

2 out of 2 points

 

Transillumination functions on the principle that:

 

Response Feedback:

Transillumination functions to differentiate between various media in a cavity. It can distinguish between air, fluid, and tissue. It consists of a strong light in the visible spectrum with a narrow beam. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 9

2 out of 2 points

 

Which statement is true regarding the relationship of physical characteristics and culture?

 

Response Feedback:

Physical characteristics do not symbolize cultural groups; there is a difference between the two, and they are considered separately. Cultures are dynamic in their evolution.

Question 10

2 out of 2 points

 

A scale used to assess patients weight should be calibrated:

 

Response Feedback:

Obtaining weight begins with a manual calibration of the scale before the patient stands on the scale. Electronic scales are automatically calibrated before each reading.

Question 11

2 out of 2 points

 

Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?

 

Response Feedback:

The fist percussion is a direct percussion technique used to elicit tenderness over organs such as the liver, gallbladder, or kidneys.

Question 12

2 out of 2 points

 

A rubber or plastic ring should be around the bell end-piece of a stethoscope to:

 

Response Feedback:

The ring around the bell portion of the stethoscope functions to secure contact with body surfaces when placed lightly on the skin. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 13

2 out of 2 points

 

In terms of cultural communication differences, Americans are more likely to _____ than are other groups of patients.

 

Response Feedback:

In the United States, individuals are very direct in conversation and come to the point quickly. They also tend to talk more loudly and to worry less about being overheard.

Question 14

2 out of 2 points

 

For a woman with a small vaginal opening, the examiner should use a _____ speculum.

 

Response Feedback:

The Pederson speculum has blades that are as long as those of the Graves speculum but are both narrower and flatter and therefore more comfortable for women with small vaginal openings. Pediatric or nasal speculums would be too small for adult use. Plastic speculums are similar in uses to the metal counterparts. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 15

2 out of 2 points

 

During percussion, the downward snap of the striking fingers should originate from the:

 

Response Feedback:

The dominant hand s middle finger strikes the stationary finger with a wrist motion and is lifted quickly off the striking surface.

Question 16

2 out of 2 points

 

You are auscultating a patient s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?

 

Response Feedback:

If you are hearing everything at once, it is more difficult to distinguish different sounds. Try isolating each segment and listen to that segment intently, then move on to another segment. For example, listen only to breath sounds, then only to inspiratory breath sounds, then only expiratory breath sounds. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 17

2 out of 2 points

 

Expected normal percussion tones include:

 

Response Feedback:

A normal lung produces resonance percussion tones while an empty stomach is expected to produce tympany. Dull percussion tones are heard over the liver.

Question 18

2 out of 2 points

 

During auscultation, you can limit your perceptual field best by:

 

Response Feedback:

By closing your eyes, your sense of hearing becomes more acute and it increases your ability to isolate sounds.

Question 19

2 out of 2 points

 

Standard Precautions apply to all patients:

 

Response Feedback:

Although all of the statements are true, the best answer is 4. Standard Precautions were developed with the intent of application in the care of all hospitalized patients; however, the standard has merit to be applied to all cases of patient care regardless of the environment in which care is delivered. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 20

2 out of 2 points

 

Which of the following describes a physical, not a cultural, differentiator?

 

Response Feedback:

Race is a physical, not a cultural, differentiator.

Saturday, September 9, 2017 11:53:16 AM EDT

 

Guidelines for Standard Precautions indicate that mask and eye protection or a face mask should be worn while performing

trachea care and suctioning.

 

Standard Precautions apply to all patients

receiving care in hospitals.

 

According to the guidelines for Standard Precautions

the caregiver’s hands should be washed after touching any body fluids and contaminated items regardless of whether gloves are worn.

 

One recommendation to prevent latex allergy is to

wash hands with mild soap after removing gloves and then dry the hands thoroughly.

 

Which patient position is useful for auscultating heart tones?

Left lateral recumbent

 

Which technique is used during the history taking and the physical examination process?

Inspection

 

Which examination technique should be used first?

Inspection

 

The use of secondary, tangential lighting is most helpful in the detection of

variations in contour of the body surface. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

 

A nonambulatory 80-year-old male patient tells the female nurse that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate?

Drape the patient and observe the rectal area.

 

You are conducting a head to toe examination as part of a patient’s preventive health assessment. The room has adequate lighting, and you have access to both sides of the examining table. What position should you assume while conducting this examination?

To the right side of the patient

 

Which part of the examiner’s hand is best for palpating vibration?

Ulnar surface and base of the fingers

 

The dorsal surface of the hand is most often used for the assessment of

temperature.

 

When conducting the abdominal examination, after you inspect, you proceed next to

auscultation.

 

Expected normal percussion tones include

tympany over an empty stomach.

 

When percussing, a dull tone is expected to be heard over

the liver.

 

During percussion, the downward snap of the striking fingers should originate from the

wrist. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

 

Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?

Fist percussion

 

During auscultation, you can limit your perceptual field best by

closing your eyes.

 

You are auscultating a patient’s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?

Isolate each cycle segment.

 

When examining the abdomen, which technique should be used first?

Inspection

 

Auscultation should be carried out last except when examining

the abdomen.

 

Which of the following statements is true regarding tympanic membrane temperature?

It is an accurate measurement of body temperature because the tympanic membrane shares its blood supply with the hypothalamus. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

 

A scale used to assess a patient’s weight should be calibrated

each time it is used.

 

The height-measuring attachment of the standing platform scale should be pulled out

before the patient steps on the scale.

 

An infant should be placed in which position to have his or her height or length measured?

Supine on a measuring board

 

The stethoscope’s diaphragm is most useful in the assessment of _____ sounds.

high-pitched

 

A rubber or plastic ring should be around the bell endpiece of a stethoscope to

ensure secure contact with the body surface.

 

Which technique should be used to stabilize the stethoscope during auscultation?

The endpiece should be held between the second and third fingers.

 

A patient in the emergency department has a concussion to the head. You suspect that the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?

Red-free filter

 

The Tumbling “E” vision acuity chart would most likely be used for _____ patients.

preschool

 

The pneumatic attachment for the otoscope is used to evaluate

tympanic membrane movement.

 

The patient tells you that his ears are “stopped up.” An objective assessment of this complaint is achieved by using a(n)

tympanometer. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

 

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure

hearing range of normal speech

 

To perform a deep tendon reflex measurement, you should

briskly tap the tendon with the rubber end of the hammer.

 

A variant of the percussion hammer is a neurologic hammer, which is equipped with which of the following?

Brush and needle

 

When monitoring serial measurements, such as head circumference or abdominal girth, which procedure is best to ensure that the tape measure is placed in the same position each time?

Mark the borders of the tape at several intervals on the skin with a pen.

 

Transillumination functions on the principle that

air, fluid, and tissue transmit light differentially.

 

When performing transillumination of a body cavity, the use of which of the following could be harmful to the patient?

Halogen bulb

 

For a woman with a small vaginal opening, the examiner should use a _____ speculum.

Pederson

 

You are performing a vaginal examination on a patient with a history of spina bifida. As you insert the metal speculum, the patient suddenly feels nauseated and is sweating, and her skin turns blotchy. What is your most immediate reaction to this situation? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Remove the speculum.

 

Mr. Walder is a 56-year-old man who has been complaining of chest palpitations. Which position is useful for auscultating heart sounds?

Left lateral recumbent

 

Which technique is used during both the history taking and the physical examination process?

Inspection

 

Ms. Jones is a 31-year-old female patient who presents for a routine physical examination. Which examination technique will be used first?

Inspection

 

The use of secondary, tangential lighting is most helpful in the detection

variations in contour of the body surface.

 

You are caring for a nonambulatory 80-year-old male patient and he tells you, a female nurse, that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate?

Drape the patient and observe the rectal area.

 

Mrs. Smalls is a 42-year-old woman who has presented to the office for a head to toe examination as part of her preventive health care assessment. The room has adequate lighting, and you have access to both sides of the examining table. What position should you assume while conducting this examination? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Either side of the patient

 

You are planning to palpate the abdomen of your patient. Which part of the examiner’s hand is best for palpating vibration?

Ulnar surface

 

Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You have completed the inspection of the abdomen. What is your next step in the assessment process?

Auscultation

 

The degree of percussion tone is determined by the density of the medium through which the sound waves travel. Which statement is true regarding the relationship between density of the medium and percussion tone?

 

The less dense the medium, the louder is the percussion tone.

Expected normal percussion tones include:

tympany over an empty stomach.

 

During percussion, a dull tone is expected to be heard over:

the liver.

 

When using mediate or indirect percussion, which technique is appropriate?

Place the palmar surface of the nondominant hand on the body surface, with the fingers slightly spread apart.

 

During percussion, the downward snap of the striking fingers should originate from the:

wrist.

 

During auscultation, you can limit your perceptual field best by:

closing your eyes.

 

You are auscultating a patient’s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. Which technique can you use to facilitate your assessment?

Isolate each cycle segment.

 

Auscultation should be carried out last, except when examining the:

abdomen.

 

Tympanic thermometers measure body temperature when a probe is placed:

in the auditory canal.

 

The height-measuring attachment of the standing platform scale should be pulled up:

before the patient steps on the scale.

 

Which of the following occurs when firm pressure is used to apply the stethoscope’s bell endpiece to the skin?

It functionally converts to a diaphragm endpiece.

 

Weak pulses, fetal heart activity, and vessel patency are all best assessed with which type of stethoscope?   Ultrasonic

 

You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise and then counterclockwise to compensate for: NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

myopia.

 

A patient in the emergency department has a concussion. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?

Red-free filter

 

Which type of speculum should be used to examine a patient’s tympanic membrane?

The largest speculum that will fit comfortably in the ear

 

The pneumatic attachment for the otoscope is used to evaluate:

tympanic membrane movement.

 

Mr. Walters, a 32-year-old patient, tells you that his ears are “stopped up.” An objective assessment of this complaint is achieved by using the:

tympanometer.

 

To perform a deep tendon reflex measurement, you should:

briskly tap the tendon with the rubber end of the hammer.

 

When monitoring serial measures, such as head circumference or abdominal girth, which procedure is best to ensure that the tape measure is placed in the same position each time?

Mark the borders of the tape at several intervals on the skin with a pen.

 

The Pederson speculum has blades that:

are narrower and flatter.

 

Which of the following are causes of hyperreflexia? (Select all that apply.)

Cold stirrups

Insertion of a speculum

Pressure during bimanual exam

 

The Snellen E vision acuity chart would most likely be used for __________.

preschool children

 

The stethoscope’s diaphragm is most useful for the assessment of __________ sounds.

high-pitched

 

For a woman with a small vaginal opening, the examiner should use a __________ speculum.

Pederson NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers

Paranoid Personality Disorder(PPD) Essay Assignment case study

Case Study from Chapter 13 (Personality Disorders) in DSM-5 in Action: PCN 605

CASE OF LEON: Paranoid Personality Disorder(PPD)

Choose and read any one case study from Chapter 13 (Personality Disorders) in DSM-5 in Action.

Research the specific personality disorder from your chosen case study. Paranoid Personality Disorder(PPD) Essay Assignment case study.

Create a 10-15-slide PowerPoint presentation about your selected case study.CASE OF LEON: Paranoid Personality Disorder(PPD)

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Include the following in your presentation:

A brief description of the selected case study

Explanation and rationale for the Personality Disorder Diagnosis using the latest version of the DSM as a reference.

Information on the course of treatment for the disorder.

Identification of which cluster (A, B, or C) this personality disorder belongs to and an explanation of your rationale.

Information on the prognosis and prevalence of the disorder.

A minimum of five scholarly references including your textbook and the latest version of the DSM. Be sure to only use current and scholarly references for this assignment. Paranoid Personality Disorder(PPD) Essay Assignment case study.

Detailed speaker notes that represent what you would say if giving the presentation in person.

While APA format is not required for the body of this assignment on Case Study from Chapter 13 (Personality Disorders) in DSM-5 in Action: PCN 605, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.CASE OF LEON: Paranoid Personality Disorder(PPD) Essay Assignment case study. Paranoid Personality Disorder(PPD)

Case Study from Chapter 13 (Personality Disorders) in DSM-5 in Action: PCN 605

CASE EXAMPLE-CASE OF LEON Paranoid Personality Disorder(PPD)[301.0(F60.0)]

Leon has gotten up late this morning and suspects that someone who was meaning him harm interfered with his alarm clock so that he would be late for work (CriterionA1). He thinks it is Morgan at work, who he believes wants to make him look bad before his boss so that he will be fired (A6). When he arrives an hour late at work, he is greeted by the receptionist, Mary, who says, “Good morning, Leon” (A4). She was trying to be friendly, but Leon thinks she is trying to get him in trouble with the boss by making a scene, so the boss will know he is late. Morgan, who believes she is a good friend of Leon, greets him. He ignores Morgan and goes to his work station. He is thinking of how disloyal Morgan has been (A2). Paranoid Personality Disorder(PPD) Essay Assignment case study. Leon notices his boss, Jacob, and Morgan were whispering about something. Paranoid Personality Disorder(PPD) Essay Assignment case study. He believes they are discussing his tardiness this morning and plotting to write him up (A1andA2). He cannot contain himself any longer and confronts his boss about his conversation with Morgan. The boss tells him they were planning a surprise for a coworker who was celebrating her 50
th
 birthday. Leon does not believe his boss. Paranoid Personality Disorder(PPD) Essay Assignment case study. This incident adds to his grudge against Morgan, whom he cannot forgive for meddling with his alarm clock(A5). Interviewing this case, Leon meets five of the diagnostic criteria (A1, A2, A4, A5, and A6) for a diagnosis of PPD. People with PPD commonly blame others for their own failures. Cultural considerations in diagnosing this disorder may have to do with immigrant groups who do not understand the dominant culture, may experience language barriers, or may not understand rules and regulations of the new country. Several ethnic groups may also display behaviors that might be incorrectly misinterpreted as paranoia (APA,2013). Persons with PPD can be very difficult to treat in psychotherapy because of the chronic suspiciousness and perception of attacks on their character(Dobbert,2007). Paranoid Personality Disorder(PPD) Essay Assignment case study.

Diversity and Health Assessments essay discussion papers – nurs 6512 week 2

Question

Discussion 2: Diversity and Health Assessments

In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012). Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

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Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Case 1

Subjective Data

CC: “I came for my annual physical exam, but do not want to be a burden to my daughter.”

History of Present Illness (HPI): At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs.

PMH: hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency and chronic prostatitis

PSH: S/P cholecystectomy

Drug Hx:

Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and cipro 100mg daily.

Review of Systems (ROS)

General: + weight loss of 25 lbs over the past year; no recent fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT): no changes in vision or hearing, no difficulty chewing or swallowing.

Neck: no pain or injury Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Respiratory:

CV:

GI:

GU: no urinary hesitancy or change in urine stream

Integument: multiple bruises on his upper arms and back.

MS/Neuro: + falls x 2 within the last 6 months; no syncopal episodes or dizziness

Psych:

Objective Data

PE: B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, ornasopharynx clear, edentulous. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

Ext: no cyanosis, clubbing or edema

Integument: multiple bruises in different stages of healing – on his upper arms and back.

Neuro: No obvious deformities, CN grossly intact II-XII

Case 2

Subjective Data

CC: “I am here for my annual physical exam and have been having vaginal discharge.”

History of Present Illness (HPI): 32-year-old pregnant lesbian – her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank.

Drug Hx:

Current Medications: prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion

Family Hx: She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

Review of Systems (ROS) Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

General: no fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT):

Neck: no pain or injury

Respiratory:

CV:

GI:

GU:

Integument: multiple piercings, and tattoos. Old scars related to “cutting”.

Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements

Objective Data

PE: B/P 128/76; Pulse 83; RR 16; Temp 99.0; Ht 5,6; wt 128; BMI 20.98

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, ornasopharynx clear, good dentition. Piercing in her right nostril and lower lip. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

GU: external genitalia intact, no lesions or masses. White copious discharge with an amine odor; no cervical motion tenderness; adenxa intact.

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

Case 3

Subjective Data

CC: “Annual physical exam”

History of Present Illness (HPI): 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle.

Drug Hx:

Current medication – denied

Allergies: no allergies to food or medications.

Family history: is very positive for diabetes, hypertension, and alcoholism. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Review of Systems (ROS)

General: no recent weight gains of losses, fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT):

Neck:

Respiratory:

CV: no chest discomfort or palpitations

GI:

GU:

Integument: history of eczema – not active

MS/Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Psych:

Objective Data

PE: B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6

General: 23 year old male appears well developed and well nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress.

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, ornasopharynx clear, poor dentition – multiple carries.

Lungs: CTA AP&L

Cor: S1S2, +II/VI holosystolic murmur; without rub or gallop

Abd: benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

To prepare:

· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

· Select one of the three case studies. Reflect on the provided patient information. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Post a 1 page paper APA format

1. explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

2. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. 3. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Readings

· Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

o Chapter 2, “Cultural Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

o Chapter 3, “Examination Techniques and Equipment” (pp. 30-49)

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.

· Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

o Chapter 1, “Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis”

This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

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

o Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

o Appendices A–E (pp. 225–236)

· Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine,156(2), 162–163. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Retrieved from the Walden Library databases.

This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.

· Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.Annals of Internal Medicine, 156(2), 147–150. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Retrieved from the Walden Library databases.

This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.

· Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant & Minority Health, 11(6), 460–467.

Retrieved from the Walden Library databases. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions.

· Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? LabMedicine, 40, 105–113.

Retrieved from http://labmed.ascpjournals.org/content/40/2/105.full

This article analyzes the laboratory testing cycle and its impact on diagnostic decision making. This article also examines important diagnostic performance characteristics of laboratory tests, methods of calculating performance, and tools used to assess the diagnostic accuracy of a laboratory test Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Optional Resources

· LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o Chapter 3, “The Physical Screening Examination”

o Chapter 17, “Principles of Diagnostic Testing”

o Chapter 18, “Common Laboratory Tests”

Answer Diversity and Health Assessments essay discussion papers – nurs 6512 week 2. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Bipolar and Depressive Disorders Comparison Chart PCN 605 Essay

Bipolar and Depressive Disorders Comparison Chart Assignment Details

Complete the bipolar and depressive disorder chart. You are not required to submit this assignment to Turnitin.

Bipolar and Depressive Disorders 
Comparison Chart PCN 605

Directions: 
Although bipolar and depressive disorders share several key similarities, some aspects are radically different among these disorders. The completion of this chart gives you an opportunity to thoroughly compare and contrast these specific disorders. Complete the table below by following the example provided for Cyclothymic Disorder. Include examples and at least two scholarly references as reference notes below the chart. Bipolar and Depressive Disorders Comparison Chart PCN 605 Essay.

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Note: “D/O” is an acronym for disorder

Disorder & Features

Depressive Episode?

Manic Episode?

Hypomanic Episode?

Duration of Clinically-Significant Symptoms

Duration of Symptom-Free Intervals

Distinguish From 
(
Differential Diagnosis):

Comorbidity 
(
Often Seen With):

Cyclothymic Disorder

No, but episodes only that do not meet full criteria

No

No, but episodes only that do not meet full criteria

2+ yr. in Adults1+ yr. in Adolescents

No longer than 2 months

Psychotic D/OBipolar D/O

Borderline PD

Substance-Induced D/O

Substance-Related D/OSleep D/O

ADHD

MDD
Major Depressive Disorder

 

 

Dysthymia 
Persistent Depressive Disorder

DMDD
Disruptive Mood Dysregulation Disorder

Bipolar I Disorder
 

Bipolar II Disorder
 

Topic 5 Vignettes

Robin

Robin is a 29-year-old Caucasian female who was referred to counseling from an emergency room doctor. Per the doctor, Robin was extremely distraught when she came into the ER as evidenced by her bizarre behavior and frantic attempts to receive medical help. She informed the ER doctor that she needed to undergo surgery to remove an implant that was in her abdomen. Robin further stated that her television had spoken to her and told her that the implant had been put into her body by aliens during abduction. The doctor assessed Robin for drugs and alcohol and found no evidence of intoxication or withdrawal. Bipolar and Depressive Disorders Comparison Chart PCN 605 Essay. Robin commented to the doctor that “nothing like this has ever happened before” and that she felt “fine until 2 weeks ago,” when she started receiving messages from the television.

Becky

Becky is a 43-year-old Caucasian female who attends counseling regularly. Recently, the focus of counseling has been focused on Becky’s relationship with her boss; she has informed her counselor that her boss is madly in love with her even though he is married with several children. Bipolar and Depressive Disorders Comparison Chart PCN 605 Essay. Becky is trying to determine what course of action to take in convincing her boss to leave his family so that they can start one of their own. Becky tells her counselor that her boss has never discussed these matters with her outright, but she knows how he feels by the way he looks at her. Additionally, Becky states that she is able to infer his love messages out of work emails that he sends to her regularly. She has been working at her current job for approximately 2 years and believes that her boss has been in love with her for about 6 months.

Brett

Brett is a 19-year-old Caucasian male who is brought to counseling by his parents, Margaret and Henry. Margaret and Henry are extremely concerned about their son and are looking for answers regarding his unusual behaviors. Brett is a college sophomore attending a local university; to save money, he lives at his parent’s house and commutes to school. During his freshman year, Brett appeared to be doing well, but over the summer he began to act very strangely. His parents report that Brett started to spend a lot of time in his rooms with the shades drawn. Bipolar and Depressive Disorders Comparison Chart PCN 605 Essay. He refused to bathe for days at a time and stopped eating regularly. Additionally, Margo and Henry heard Brett having conversations in his room when they knew that no one else was with him. One morning, Margo observed Brett sitting at the breakfast with a “blank” expression on his face while trying to pour milk into his shoes. In all, Henry believed that these odd behaviors have been occurring for about 9 months. Margo and Henry are devout Pentecostal believers and report that they have raised Brett to attend church and to believe in God. They are worried because before the onset of Brett’s symptoms, he reported a disturbing incident. He took a World Religions class in which a student performed a “show-and-tell” Ouija board ritual for a class project in which he described Occult religions. Brett was very upset by the event. They sought help from the pastors in their church with little relief. They were referred to you by a friend. They state that mental illness does not run in their family. Bipolar and Depressive Disorders Comparison Chart PCN 605 Essay.

nurs 6501 – week 10 quiz.

NURS-6501N-4/NURS-6501C-4-Advanced Pathophysiology2018 Summer Qtr 05/29-08/19-PT27
 

Quizzes

Review Test Submission: Quiz – Week 10

NURS-6501N-4/NURS-6501C-4-Advanced Pathophysiology2018 Summer Qtr 05/29-08/19-PT27

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Review Test Submission: Quiz – Week 10

 

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NURS-6501N-4/NURS-6501C-4-Advanced Pathophysiology2018 Summer Qtr 05/29-08/19-PT27

Test

Quiz – Week 10

Started

Due Date

Status

Completed

Attempt Score

38 out of 40 points

Time Elapsed

27 minutes out of 45 minutes

Instructions

Please answer each question below and click 
Submit
 when you have completed the Quiz.

Results Displayed

Submitted Answers, Correct Answers, Feedback

Question 1

0 out of 0 points

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? nurs 6501 – week 10 quiz.

Selected Answer:

 

Yes

Correct Answer:

 

Yes

Question 2

1 out of 1 points

A 15-year-old male was diagnosed with pharyngitis. Eight days later he developed acute glomerulonephritis. While reviewing the culture results, which of the following is the most likely cause of this disease?

Selected Answer:

d.

Group A ß-hemolytic streptococcus

Correct Answer:

d.

Group A ß-hemolytic streptococcus

Question 3

1 out of 1 points

A 27-year-old male has a severe kidney obstruction leading to removal of the affected kidney. Which of the following would the nurse expect to occur? nurs 6501 – week 10 quiz.

Question 4

1 out of 1 points

A 25-year-old female is diagnosed with urinary tract obstruction. While planning care, the nurse realizes that the patient is expected to have hydronephrosis and a decreased glomerular filtration rate caused by:

Selected Answer:

Correct Answer:

Question 5

1 out of 1 points

A 42-year-old female is diagnosed with chronic renal failure, and the nurse is discussing dietary treatment. Which information indicates the nurse understands dietary regimen? Treatment includes restricting:

Selected Answer:

Correct Answer:

nurs 6501 – week 10 quiz

Question 6

1 out of 1 points

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is:

Selected Answer:

c.

Acute glomerulonephritis

Correct Answer:

c.

Acute glomerulonephritis

nurs 6501 – week 10 quiz

Question 7

0 out of 1 points

A 5-year-old male was diagnosed with glomerulonephritis. History reveals that he had an infection 3 weeks before the onset of this condition. The infection was most likely located in the:

Selected Answer:

t

Correct Answer:

Question 8

1 out of 1 points

A 3-year-old female presents with recurrent urinary tract infections (UTIs), fever, poor growth and development, and feeding problems. Tests reveal a retrograde flow of urine from the urinary bladder into the ureters. When giving report to the oncoming shift, the nurse will call this condition: nurs 6501 – week 10 quiz

Selected Answer:

.

 

Correct Answer:

Question 9

1 out of 1 points

While turning a patient with chronic renal failure, which principle should the nurse recall? Bone fractures are a risk factor in chronic renal failure because:

Selected Answer:

c.

The kidneys fail to activate vitamin D.

Correct Answer:

c.

The kidneys fail to activate vitamin D.

Question 10

1 out of 1 points

The urologist is teaching about the nephrons that determine the concentration of the urine. The urologist is discussing the _____ nephrons.

Selected Answer:

Correct Answer:

Question 11

1 out of 1 points

A 6-year-old male is experiencing urine reflux from the urinary bladder into a grossly dilated ureter and calyces. He was diagnosed with vesicoureteral reflux. This condition would be graded:

Selected Answer:

Correct Answer:

Question 12

0 out of 1 points

When a newborn is admitted with urinary tract infections (UTIs), which type of infection will the nurse look for in the newborn? nurs 6501 – week 10 quiz.

Selected Answer:

a.

Blood-borne infections

Correct Answer:

b.

Infections caused by bacteria from the gastrointestinal (GI) tract

Question 13

1 out of 1 points

If a nurse wants to obtain the best estimate of renal function, which test should the nurse monitor?

Selected Answer:

a.

Glomerular filtration rate (GFR)

Correct Answer:

a.

Glomerular filtration rate (GFR)

Question 14

1 out of 1 points

A 42-year-old male is involved in a motor vehicle accident during which he loses a lot of blood. The nurse realizes he is in acute renal failure caused by: nurs 6501 – week 10 quiz.

Selected Answer:

c.

Inadequate renal blood flow

Correct Answer:

c.

Inadequate renal blood flow

Question 15

1 out of 1 points

A 35-year-old female was severely burned and is hospitalized. She is now suffering from acute tubular necrosis (ATN). Which of the following is the most likely diagnosis the nurse will observe on the chart?

Selected Answer:

l

Correct Answer:

Question 16

1 out of 1 points

When describing the male urinary anatomy, which information should the nurse include? The portion of the male urethra that is closest to the bladder is the _____ portion.

Selected Answer:

c

Correct Answer:

Question 17

1 out of 1 points

When a nurse is preparing to teach about urine, which information should the nurse include? Just before entering the ureter, urine passes through the: nurs 6501 – week 10 quiz.

Selected Answer:

Correct Answer:

Question 18

1 out of 1 points

A 24-year-old female is diagnosed with renal calculus that is causing obstruction. Which of the following symptoms would she most likely experience?

Selected Answer:

b.

Hematuria

Correct Answer:

b.

Hematuria

Question 19

1 out of 1 points

A 7-year-old male presents to his primary care provider for incontinence. His mother indicates that he has never been continent. Which of the following is the most likely diagnosis the nurse will observe on the chart?

Selected Answer:

c.

Primary enuresis

Correct Answer:

c.

Primary enuresis

Question 20

1 out of 1 points

A 75-year-old male reports to his primary care provider loss of urine with cough, sneezing, or laughing. Which of the following is the most likely diagnosis the nurse will observe on the chart? nurs 6501 – week 10 quiz.

Selected Answer:

b.

Stress incontinence

Correct Answer:

b.

Stress incontinence

Question 21

1 out of 1 points

A 15-year-old female presents with flank pain, irritability, malaise, and fever. Tests reveal glomerulonephritis. When the parents ask what could have caused this, how should the nurse respond?

Selected Answer:

a.

Poststreptococcal infection

Correct Answer:

a.

Poststreptococcal infection

Question 22

0 out of 1 points

A urologist is discussing the phagocytic cells that lie between the layers of the renal corpuscle. What is the urologist describing?

Selected Answer:

b.

Macula densa cells

Correct Answer:

c.

Mesangial cells

Question 23

1 out of 1 points

A nurse observes on the chart that a patient is admitted with Wilms tumors. A nurse knows the tumors are found in the:

Selected Answer:

a.

Kidneys

Correct Answer:

a.

Kidneys

Question 24

1 out of 1 points

When the nurse is discussing the sodium-sensing cells of the glomerulus, what term should the nurse use?

Selected Answer:

b.

Macula densa

Correct Answer:

b.

Macula densa

Question 25

1 out of 1 points

While planning care for a patient who has acute pyelonephritis. A nurse recalls the most common condition associated with the development of acute pyelonephritis is: nurs 6501 – week 10 quiz.

Selected Answer:

c

Correct Answer:

Question 26

1 out of 1 points

A 55-year-old male presents reporting urinary retention. Tests reveal that he has a lower urinary tract obstruction. Which of the following is of most concern to the nurse?

Selected Answer:

b.

Formation of renal calculi

Correct Answer:

b.

Formation of renal calculi

Question 27

1 out of 1 points

Which of the following clusters of symptoms would make a clinician suspect a child has developed glomerulonephritis?

Selected Answer:

d.

Gross hematuria, flank pain, and hypertension

Correct Answer:

d.

Gross hematuria, flank pain, and hypertension

Question 28

1 out of 1 points

A nurse is preparing to teach about the loop of Henle. Which information should be included? The descending segment of the loop of Henle primarily allows for: nurs 6501 – week 10 quiz.

Selected Answer:

Question 29

1 out of 1 points

When the nurse discusses the glomerulus and Bowman capsule together, it is referred to as the renal:

Selected Answer:

Correct Answer:

Question 30

1 out of 1 points

A 19-year-old female was involved in a motor vehicle accident during which she sustained a closed head injury. She is now experiencing detrusor sphincter dyssynergia. Which of the following is the most beneficial medication treatment?

Selected Answer:

Correct Answer:

Question 31

1 out of 1 points

A 2-year-old male is diagnosed with Wilms tumor. Which of the following clinical conditions is often associated with this disease?

Selected Answer:

Correct Answer:

Question 32

1 out of 1 points

A nurse is reviewing urinalysis results and notices glucose is present in the urine. A nurse realizes glucose will be excreted in the urine when:

Selected Answer:

b.

The carrier molecules have reached their maximum

Correct Answer:

b.

The carrier molecules have reached their maximum

Question 33

1 out of 1 points

When a child is admitted with acute renal failure, a clinician realizes the most common cause of acute renal failure is:

Selected Answer:

d.

Hemolytic uremic syndrome (HUS)

Correct Answer:

d.

Hemolytic uremic syndrome (HUS)

Question 34

1 out of 1 points

A 45-year-old female presents with hypertension, anorexia, nausea and vomiting, and anemia. She is diagnosed with chronic renal failure. When the patient asks what caused this anemia, how should the nurse respond? Your anemia is caused by:

Selected Answer:

b.

Inadequate production of erythropoietin

Correct Answer:

b.

Inadequate production of erythropoietin

Question 35

1 out of 1 points

A 4-year-old male is diagnosed with nephrotic syndrome. Which of the following assessment findings accompanies this condition? nurs 6501 – week 10 quiz.

Selected Answer:

Correct Answer:

Question 36

1 out of 1 points

When a nurse is checking the urinalysis, plasma proteins should be absent from the urine because:

Selected Answer:

d.

The negative charge of the glomerular filtration membrane repels the plasma proteins.

Correct Answer:

d.

The negative charge of the glomerular filtration membrane repels the plasma proteins.

Question 37

1 out of 1 points

A urologist is discussing a structure that supplies blood to the medulla. What is the urologist describing?

Selected Answer:

Correct Answer:

Question 38

1 out of 1 points

A 25-year-old female presents with burning urination. nurs 6501 – week 10 quiz. She was diagnosed with a urinary tract infection. When the nurse checks the culture results, which of the following organisms is most likely infecting her urinary tract?

Selected Answer:

i

Correct Answer:

Question 39

0 out of 1 points

Anemia accompanies chronic renal failure because of:

Selected Answer:

b.

Renal insensitivity to vitamin D

Correct Answer:

c.

Inadequate production of erythropoietin

Question 40

1 out of 1 points

A 56-year-old male presents with flank pain and polyuria. Tests reveal that he has an enlarged prostate. Which of the following types of renal failure should the nurse monitor for as it is the most likely to occur?

Selected Answer:

Correct Answer:

Question 41

1 out of 1 points

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is:

Selected Answer:

c.

Acute glomerulonephritis

Correct Answer:

c.

Acute glomerulonephritis

nurs 6501 – week 10 quiz

DSM-IV codes online.

DSM-IV code table

Code table for conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 6th printing.

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DSM-IV code table

Code

Title (NOS= Not Otherwise Specified)

2900

Dementia of the Alzheimers type with late onset Uncomplicated

29010

Dementia of the Alzheimers type with early onset Uncomplicated, Dementia due to Pick’s Disease or Creutzfeld-Jacob Disease

29011

Dementia of the Alzheimers type with early onset With delirium

29012

Dementia of the Alzheimers type with early onset With Delusions

29013

Dementia of the Alzheimers type with early onset With Depressed Mood

29020

Dementia of the Alzheimers type with late onset With Delusions

29021

Dementia of the Alzheimers type with late onset With Depressed Mood

2903

Dementia of the Alzheimers type with late onset With Delirium

29040

Vascular Dementia Uncomplicated

29041

Vascular Dementia With Delirium – DSM-IV codes online

29042

Vascular Dementia With Delusions

29043

Vascular Dementia With Depressed Mood

2910

Alcohol Intoxication Delirium or Alcohol Withdrawal Delirium

2911

Alcohol-Induced Persisting Amnestic Disorder

2912

Alcohol-Induced Persisting Dementia DSM-IV codes online

2913

Alcohol-Induced Psychotic Disorder With Hallucinations

2915

Alcohol-Induced Psychotic Disorder With Delusions

29181

Alcohol Withdrawal

29189

Alcohol-Induced Anxiety, Mood or Sleep Disorder or Sexual Dysfunction

2919

Alcohol-Related Disorder NOS

2920

Substance Withdrawal, Sedative, Hypnotic or Anxiolytic Withdrawal

29211

Substance-Induced Psychotic Disorder, With Delusions

29212

Substance-Induced Psychotic Disorder, With Hallucinations

29281

Substance Intoxication Delirium

29282

Substance-Induced Persisting Dementia

29283

Substance-Induced Persisting Amnestic Disorder

29284

Substance-Induced Mood Disorder

29289

Substance-Induced Intoxication, Sleep, Anxiety, Sexual or Perception Disorder

2929

Substance-Related Disorder NOS

2930

Delirium (Due to General Medical Condition)

29381

Psychotic Disorder (Due to General Medical Condition) With Delusions

29382

Psychotic Disorder (Due to General Medical Condition) With Hallucinations

29383

Mood Disorder (Due to General Medical Condition)

29384

Anxiety Disorder (Due to General Medical Condition)

29389

Catatonic Disorder (Due to General Medical Condition)

2939

Mental Disorder NOS (Due to General Medical Condition)

2940

Amnestic Disorder (Due to General Medical Condition) DSM-IV codes online

2941

Dementia Due to HIV Infection or General Medical Condition

2948

Dementia NOS or Amnestic Disorder NOS

2949

Cognitive Disorder NOS

29510

Schizophrenia Disorganised Type

29520

Schizophrenia Catatonic Type

29530

Schizophrenia Paranoid Type

29540

Schizophreniform Disorder

29560

Schizophrenia Residual Type DSM-IV codes online

29570

Schizoaffective Disorder

29590

Schizophrenia Undifferentiated Type

29600

Bipolar I Disorder, Single Manic Episode Unspecified

29601

Bipolar I Disorder, Single Manic Episode Mild

29602

Bipolar I Disorder, Single Manic Episode Moderate

29603

Bipolar I Disorder, Single Manic Episode Severe without psychotic features

29604

Bipolar I Disorder, Single Manic Episode Severe with psychotic features

29605

Bipolar I Disorder, Single Manic Episode In partial remission

29606

Bipolar I Disorder, Single Manic Episode In full remission

29620

Major Depressive Disorder, Single Episode Unspecified

29621

Major Depressive Disorder, Single Episode Mild

29622

Major Depressive Disorder, Single Episode Moderate

29623

Major Depressive Disorder, Single Episode Severe without psychotic features

29624

Major Depressive Disorder, Single Episode Severe with psychotic features

29625

Major Depressive Disorder, Single Episode In partial remission

29626

Major Depressive Disorder, Single Episode In full remission

29630

Major Depressive Disorder, Recurrent Unspecified

29631

Major Depressive Disorder, Recurrent Mild

29632

Major Depressive Disorder, Recurrent Moderate

29633

Major Depressive Disorder, Recurrent Severe Without Psychotic Features

29634

Major Depressive Disorde, Recurrent Severe With Psychotic Features

29635

Major Depressive Disorder, Recurrent In Partial Remission

29636

Major Depressive Disorder, Recurrent In Full Remission

29640

Bipolar I Disorder, Most Recent Episode Manic, Hypomanic, Unspecified

29641

Bipolar I Disorder, Most Recent Episode Manic Mild

29642

Bipolar I Disorder, Most Recent Episode Manic Moderate DSM-IV codes online

29643

Bipolar I Disorder, Most Recent Episode Manic Severe Without Psychotic Features

29644

Bipolar I Disorder, Most Recent Episode Manic Severe With Psychotic Features

29645

Bipolar I Disorder, Most Recent Episode Manic In Partial Remission

29646

Bipolar I Disorder, Most Recent Episode Manic In Full Remission

29650

Bipolar I Disorder, Most Recent Episode Depressed Unspecified

29651

Bipolar I Disorder, Most Recent Episode Depressed Mild

29652

Bipolar I Disorder, Most Recent Episode Depressed Moderate

29653

Bipolar I Disorder, Most Recent Episode Depressed Severe without psychotic features

29654

Bipolar I Disorder, Most Recent Episode Depressed Severe with psychotic features

29655

Bipolar I Disorder, Most Recent Episode Depressed In partial remission

29656

Bipolar I Disorder, Most Recent Episode Depressed In full remission

29660

Bipolar I Disorder, Most Recent Episode Mixed Unspecified

29661

Bipolar I Disorder, Most Recent Episode Mixed Mild

29662

Bipolar I Disorder, Most Recent Episode Mixed Moderate

29663

Bipolar I Disorder, Most Recent Episode Mixed Severe without psychotic features

29664

Bipolar I Disorder, Most Recent Episode Mixed Severe with psychotic features

29665

Bipolar I Disorder, Most Recent Episode Mixed In partial remission

29666

Bipolar I Disorder, Most Recent Episode Mixed In full remission

2967

Bipolar I Disorder, Most Recent Episode Unspecified

29680

Bipolar Disorder NOS

29689

Bipolar II Disorder

29690

Mood Disorder NOS

2971

Delusional Disorder

2973

Shared Psychotic Disorder

2988

Brief Psychotic Disorder

2989

Psychotic Disorder NOS

29900

Autistic Disorder

29910

Childhood Disintegrative Disorder

29980

Rett’s Disorder, Asperger’s Disorder, Pervasive Developmental Disorder NOS

30000

Anxiety Disorder NOS

30001

Panic Disorder Without Agoraphobia

30002

Generalised Anxiety Disorder

30011

Conversion Disorder

30012

Dissociative Amnesia

30013

Dissociative Fugue

30014

Dissociative Identity Disorder

30015

Dissociative Disorder NOS

30016

Factitious Disorder with Predominantly Psychological Signs and Symptoms

30019

Factitious Disorder NOS, With Predominantly Physical Signs and Symptoms, With Combined Psychological and Physical Signs and Symptoms. DSM-IV codes online.

30021

Panic Disorder With Agoraphobia

30022

Agoraphobia Without History of Panic Disorder

30023

Social Phobia DSM-IV codes online

30029

Specific Phobia

3003

Obsessive-Compulsive Disorder

3004

Dysthymic Disorder

3006

Depersonalisation Disorder

3007

Hypochondriasis or Body Dysmorphic Disorder

30081

Somatisation Disorder

30082

Somatoform Disorder NOS, Undifferentiated Somatoform Disorder

3009

Unspecified Mental Disorder (nonpsychotic)

3010

Paranoid Personality Disorder

30113

Cyclothymic Disorder

30120

Schizoid Personality Disorder

30122

Schizotypal Personality Disorder

3014

Obsessive-Compulsive Personality Disorder

30150

Histrionic Personality Disorder

3016

Dependent Personality Disorder

3017

Antisocial Personality Disorder

30181

Narcissistic Personality Disorder

30182

Avoidant Personality Disorder

30183

Borderline Personality Disorder

3019

Personality Disorder NOS

3022

Pedophilia

3023

Transvestic Fetishism

3024

Exhibitionism

3026

Gender Identity Disorder in Children or Gender Identity Disorder NOS DSM-IV codes online

30270

Sexual Dysfunction NOS

30271

Hypoactive Sexual Desire Disorder

30272

Female Sexual Arousal Disorder or Male Erectile Disorder

30273

Female Orgasmic Disorder

30274

Male Orgasmic Disorder

30275

Premature Ejaculation

30276

Dyspareunia (Not Due to a General Medical Condition)

30279

Sexual Aversion Disorder

30281

Fetishism

30282

Voyeurism

30283

Sexual Masochism

30284

Sexual Sadism

30285

Gender Identity Disorder in Adolescents or Adults

30289

Frotteurism

3029

Paraphilia NOS or Sexual Disorder NOS

30300

Alcohol Intoxication

30390

Alcohol Dependence

30400

Opioid Dependence

30410

Sedative, Hypnotic, or Anxiolytic Dependence

30420

Cocaine Dependence

30430

Cannabis Dependence

30440

Amphetamine Dependence

30450

Hallucinogen Dependence

30460

Inhalant or Phencyclidine Dependence

30480

Polysubstance Dependence

30490

Other (or Unknown) Substance Dependence

30500

Alcohol Abuse

30510

Nicotine Dependence

30520

Cannabis Abuse

30530

Hallucinogen Abuse

30540

Sedative, Hypnotic, or Anxiolytic Abuse

30550

Opioid Abuse

30560

Cocaine Abuse

30570

Amphetamine Abuse

30590

Caffeine Intoxication, Inhalant Abuse, Other (or Unknown) Substance Abuse, Phencyclidine Abuse

30651

Vaginismus (Not Due to a General Medical Condition)

3070

Stuttering

3071

Anorexia Nervosa

30720

Tic Disorder NOS

30721

Transient Tic Disorder

30722

Chronic Motor or Vocal Tic Disorder

30723

Tourette’s Disorder

3073

Stereotypic Movement Disorder

30742

Insomnia Related to Axis 1 or Axis 11 Disorder, Primary Insomnia

30744

Hypersomnia Related to Axis 1 or Axis 11 Disorder, Primary Hypersomnia DSM-IV codes online

30745

Circadian Rhythm Sleep Disorder

30746

Sleep Terror Disorder or Sleepwalking Disorder

30747

Dyssomnia NOS or Nightmare Disorder or Parasomnia NOS

30750

Eating Disorder NOS

30751

Bulimia Nervosa

30752

Pica

30753

Rumination Disorder

30759

Feeding Disorder of Infancy or Early Childhood

3076

Enuresis (Not Due to a General Medical Condition)

3077

Encopresis Without Constipation and Overflow Incontinence

30780

Pain Disorder Associated With Psychological Factors

30789

Pain Disorder Associated With Psychological Factors and a General Medical Condition

3079

Communication Disorder NOS

3083

Acute Stress Disorder

3090

Adjustment Disorder With Depressed Mood

30921

Separation Anxiety Disorder

30924

Adjustment Disorder With Anxiety

30928

Adjustment Disorder With Mixed Anxiety and Depressed Mood

3093

Adjustment Disorder With Disturbance of Conduct

3094

Adjustment Disorder With Mixed Disturbance of Emotions and Conduct

30981

Posttraumatic Stress Disorder

3099

Adjustment Disorder Unspecified

3101

Personality Change (Due to a General Medical Condition)

311

Depressive Disorder NOS

31230

Impulse-Control Disorder NOS

31231

Pathological Gambling

31232

Kleptomania

31233

Pyromania

31234

Intermittent Explosive Disorder

31239

Trichotillomania

31281

Conduct Disorder, Childhood-Onset Type

31282

Conduct Disorder, Adolescent-Onset type

31289

Conduct Disorder, Unspecified Onset

3129

Disruptive Behavior Disorder NOS

31323

Selective Mutism

31381

Oppositional Defiant Disorder

31382

Identity Problem

31389

Reactive Attachment Disorder of Infancy or Early Childhood

3139

Disorder of Infancy, Childhood, or Adolescence NOS

31400

Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type

31401

Attention-Deficit/Hyperactivity Disorder Combined Type or Predominantly Hyperactive-Impulse Type

3149

Attention-Deficit/Hyperactivity Disorder NOS

31500

Reading Disorder

3151

Mathematics Disorder

3152

Disorder of Written Expression

31531

Expressive Language Disorder

31532

Mixed Receptive-Expressive Language Disorder

31539

Phonological Disorder

3154

Developmental Coordination Disorder

3159

Learning Disorder NOS

316

Psychological Factors Affecting a Medical Condition

317

Mild Mental Retardation

3180

Moderate Mental Retardation

3181

Severe Mental Retardation

3182

Profound Mental Retardation

319

Mental Retardation, Severity Unspecified

3321

Neuroleptic-Induced Parkinsonism

3331

Medication-Induced Postural Tremor

3337

Neuroleptic-Induced Acute Dystonia

33382

Neuroleptic-Induced Tardive Dyskinesia

33390

Medication-Induced Movement Disorder NOS

33392

Neuroleptic Malignant Syndrome

33399

Neuroleptic-Induced Acute Akathisia

347

Narcolepsy

60784

Male Erectile Disorder (Due to a General Medical Condition)

60889

Other Male Sexual Dysfunction (Due to a General Medical Condition)

6250

Female Dyspareunia (Due to a General Medical Condition)

6258

Other Female Sexual Dysfunction (Due to a General Medical Condition)

78009

Delirium NOS

78052

Sleep Disorder (Due to a General Medical Condition) Insomnia Type

78054

Sleep Disorder (Due to a General Medical Condition), Hypersomnia Type

78059

Breathing-Related Sleep Disorder or Sleep Disorder (Due to a General Medical Condition), Parasomnia or Mixed Type DSM-IV codes online

7809

Age-Related Cognitive Decline

7876

Encopresis, With Constipation and Overflow Incontinence

7999

Diagnosis or Condition Deferred on Axis I or Diagnosis Deferred on Axis II

9952

Adverse Effects of Medication NOS

99552

Neglect of Child (if focus of attention is on victim)

99553

Sexual abuse of child (if focus of attention is on victim)

99554

Physical abuse of child (if focus of attention is on victim)

99581

Physical abuse of adult (if focus of attention is on victim)

99583

Sexual abuse of adult (if focus of attention is on victim)

V1581

Noncompliance With Treatment

V6110

Partner Relational Problem

V6112

Physical or Sexual Abuse of Adult (if by partner)

V6120

Parent-Child Relational Problem

V6121

Sexual or Physical Abuse or Neglect of Child

V618

Sibling Relational Problem

V619

Relational Problem Related to a Mental Disorder of General Medical Condition

V622

Occupational Problem

V623

Academic Problem

V624

Acculturation Problem

V6281

Relational Problem NOS

V6282

Bereavement

V6283

Physical or Sexual Abuse of Adult (if by person other than partner)

V6289

Phase of Life Problem, Religious or Spiritual Problem or Borderline Intellectual Functioning

V652

Malingering

V7101

Adult Antisocial Behavior

V7102

Child or Adolescent Antisocial Behavior

V7109

No Diagnosis or Condition on Axis I or Axis II

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DSM-IV-TR: numerical listing of codes and diagnoses

To maintain compatibility with ICD-9-CM, some DSM-IV-TR diagnoses share the same code numbers.

NOS
 = 
Not Otherwise Specified

Code

Diagnosis

290.40

Vascular Dementia
, Uncomplicated

290.41

Vascular Dementia
, With 
Delirium

290.42

Vascular Dementia
, With 
Delusions

290.43

Vascular Dementia
, With 
Depressed
 Mood

291.0

Alcohol
 
Intoxication Delirium

291.0

Alcohol
 
Withdrawal Delirium

291.1

Alcohol
-Induced 
Persisting Amnestic Disorder

291.2

Alcohol
-Induced 
Persisting Dementia

291.3

Alcohol
-Induced 
Induced Psychotic Disorder
, With
Hallucinations

291.5

Alcohol
-Induced 
Psychotic Disorder
, With 
Delusions

291.81

Alcohol Withdrawal
 (new code as of 10/01/96)

291.82

Alcohol
-Induced 
Sleep Disorder
 (new code as of 10.01.2005)

291.89

Alcohol
-Induced 
Anxiety Disorder
 (new code as of 10/01/96)

291.89

Alcohol
-Induced 
Mood Disorder
 (new code as of 10/01/96)

291.89

Alcohol
-Induced 
Sexual Dysfunction
  (new code as of 10/01/96)

291.89

Alcohol
-Induced 
Sleep Disorder
 (10.01.1996-10.01.2005)

291.9

Alcohol
-Related Disorder 
NOS

292.0

Amphetamine Withdrawal

292.0

Cocaine Withdrawal

292.0

Nicotine Withdrawal

292.0

Opioid Withdrawal

292.0

Other (or Unknown) Substance Withdrawal

292.0

Sedative, Hypnotic, or Anxiolytic Withdrawal

292.11

Amphetamine
-Induced 
Psychotic Disorder
, With 
Delusions

292.11

Cannabis
-Induced 
Psychotic Disorder
, With 
Delusions

292.11

Cocaine
-Induced 
Psychotic Disorder
, With 
Delusions

292.11

Hallucinogen
-Induced 
Psychotic Disorder
, With 
Delusions

292.11

Inhalant
-Induced 
Psychotic Disorder
, With 
Delusions

292.11

Opioid
-Induced 
Psychotic Disorder
, With 
Delusions

292.11

Other (or Unknown) 
Substance Induced Psychotic Disorder
, With 
Delusions

292.11

Phencyclidine
-Induced 
Psychotic Disorder
, With 
Delusions

292.11

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Induced 
Psychotic Disorder
, With 
Delusions

292.12

Amphetamine
-Induced 
Psychotic Disorder
, With
Hallucinations

292.12

Cannabis
-Induced 
Psychotic Disorder
, With 
Hallucinations

292.12

Cocaine
-Induced 
Psychotic Disorder
, With 
Hallucinations

292.12

Hallucinogen
-Induced 
Psychotic Disorder
, With
Hallucinations

292.12

Inhalant
-Induced 
Psychotic Disorder
, With 
Hallucinations

292.12

Opioid
-Induced 
Psychotic Disorder
, With 
Hallucinations

292.12

Other (or Unknown) 
Substance-Induced Psychotic Disorder
, With 
Hallucinations

292.12

Phencyclidine
–
Induced Psychotic Disorder
, With
Hallucinations

292.12

Sedative
, 
Hypnotic
, or 
Anxiolytic
–
Induced Psychotic Disorder
, With 
Hallucinations

292.81

Amphetamine
 
Intoxication Delirium

292.81

Cannabis
 
Intoxication Delirium

292.81

Cocaine
 
Intoxication Delirium

292.81

Hallucinogen
 
Intoxication Delirium

292.81

Inhalant
 
Intoxication Delirium

292.81

Opioid
 
Intoxication Delirium

292.81

Other (or Unknown) 
Intoxication Delirium

292.81

Phencyclidine
 
Intoxication Delirium

292.81

Sedative
, 
Hypnotic
, or 
Anxiolytic
 
Intoxication Delirium

292.81

Sedative
, 
Hypnotic
, or 
Anxiolytic
 
Withdrawal Delirium

292.82

Inhalant
-Induced 
Persisting Dementia

292.82

Other (or Unknown) 
Substance-Induced Persisting Dementia

292.82

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Induced 
Persisting Dementia

292.83

Other (or Unknown) 
Substance-Induced Persisting Amnestic Disorder

292.83

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Induced 
Persisting Amnestic Disorder

292.84

Amphetamine
-Induced 
Mood Disorder

292.84

Cocaine
-Induced 
Mood Disorder

292.84

Hallucinogen
-Induced 
Mood Disorder

292.84

Inhalant
-Induced 
Mood Disorder

292.84

Opioid
-Induced 
Mood Disorder

292.84

Other (or Unknown) 
Substance-Induced Mood Disorder

292.84

Phencyclidine
-Induced 
Mood Disorder

292.84

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Induced 
Mood Disorder

292.85

Amphetamine
-Induced 
Sleep Disorder
 (new code as of 10.01.2005) DSM-IV codes online.

292.85

Caffeine
-Induced 
Sleep Disorder
 (new code as of 10.01.2005)

292.85

Cocaine
-Induced 
Sleep Disorder
 (new code as of 10.01.2005)

292.85

Opioid
-Induced 
Sleep Disorder
 (new code as of 10.01.2005)

292.85

Other (or Unknown) 
Substance-Induced Sleep Disorder
(new code as of 10.01.2005)

292.85

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Induced 
Sleep Disorder
(new code as of 10.01.2005)

292.89

Amphetamine
-Induced 
Anxiety Disorder

292.89

Amphetamine
-Induced 
Sexual Dysfunction

292.89

Amphetamine
-Induced 
Sleep Disorder
 (before 10.01.2005)

292.89

Amphetamine Intoxication

292.89

Caffeine
-Induced 
Anxiety Disorder

292.89

Caffeine
-Induced 
Sleep Disorder
 (before 10.01.2005)

292.89

Cannabis
-Induced 
Anxiety Disorder

292.89

Cannabis Intoxication

292.89

Cocaine
-Induced 
Anxiety Disorder

292.89

Cocaine
-Induced 
Sexual Dysfunction

292.89

Cocaine
-Induced 
Sleep Disorder
 (before 10.01.2005)

292.89

Cocaine Intoxication

292.89

Hallucinogen
-Induced 
Anxiety Disorder

292.89

Hallucinogen Intoxication

292.89

Hallucinogen Persisting Perception Disorder

292.89

Inhalant
-Induced 
Anxiety Disorder

292.89

Inhalant Intoxication

292.89

Opioid
-Induced 
Sexual Dysfunctiona> 

292.89

Opioid
-Induced 
Sleep Disorder
 (before 10.01.2005)

292.89

Opioid Intoxication 

292.89

Other (or Unknown) 
Substance-Induced Anxiety Disorder

292.89

Other (or Unknown) 
Substance-Induced Sexual Dysfunction

292.89

Other (or Unknown) 
Substance-Induced Sleep Disorder
(before 10.01.2005) DSM-IV codes online

292.89

Other (or Unknown) 
Substance Intoxication

292.89

Phencyclidine
-Induced 
Anxiety Disorder

292.89

Phencyclidine Intoxication

292.89

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Induced 
Anxiety Disorder

292.89

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Induced 
Sexual Dysfunction

292.89

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Induced 
Sleep Disorder
 (before 10.01.2005)

292.89

Sedative, Hypnotic, or Anxiolytic Intoxication

292.9

Amphetamine
-Related 
Disorder
 
NOS

292.9

Caffeine
-Related 
Disorder
 
NOS

292.9

Cannabis
-Related 
Disorder
 
NOS

292.9

Cocaine
-Related 
Disorder
 
NOS

292.9

Hallucinogen
-Related 
Disorder
 
NOS

292.9

Inhalant
-Related 
Disorder
 
NOS

292.9

Nicotine
-Related 
Disorder
 
NOS

292.9

Opioid
-Related 
Disorder
 
NOS

292.9

Other (or Unknown) 
Substance-Related Disorder
 
NOS

292.9

Phencyclidine
-Related 
Disorder
 
NOS

292.9

Sedative
, 
Hypnotic
, or 
Anxiolytic
-Related 
Disorder
 
NOS

293.0

Delirium Due to…[Indicate the General Medical Condition]

293.81

Psychotic Disorder Due to…[Indicate the General Medical Condition]
, With 
Delusions

293.82

Psychotic Disorder Due to…[Indicate the General Medical Condition]
 , With 
Hallucinations

293.83

Mood Disorder Due to…[Indicate the General Medical Condition]

293.84

Anxiety Disorder Due to… (new code as of 10/01/96) [Indicate the General Medical Condition] 

293.89

Catatonic Disorder Due to…[Indicate the General Medical Condition]

293.9

Mental Disorder 
NOS
 Due to…[Indicate the General Medical Condition]

294.0

Amnestic Disorder Due to
…[Indicate the General Medical Condition], Without Behavioral Disturbance

294.10

Dementia
 Due to…[Indicate the General Medical Condition], Without Behavioral Disturbance

294.10

Dementia of the Alzheimer’s Type
, With Early Onset, Without Behavioral Disturbance DSM-IV codes online

294.10

Dementia of the Alzheimer’s Type
, With Late Onset, Without Behavioral Distrubance

294.11

Dementia
 Due to…[Indicate the General Medical Condition], With Behavioral Disturbance

294.11

Dementia of the Alzheimer’s Type
, With Early Onset, With Behavioral Disturbance

294.11

Dementia of the Alzheimer’s Type
, With Late Onset, With Behavioral Disturbance

294.1x

Dementia Due to Creutzfeldt-Jakob Disease

294.1x

Dementia Due to Head Trauma

294.1x

Dementia Due to HIV Disease

294.1x

Dementia Due to Huntington’s Disease

294.1x

Dementia Due to Parkinson’s Disease

294.1x

Dementia Due to Pick’s Disease

294.1x

Dementia Due to…[Indicate the General Medical Condition not listed above]
 (also code the general medical condition on Axis III)

294.8

Amnestic Disorder
 
NOS

294.8

Dementia
 
NOS

294.9

Cognitive Disorder 
NOS

294.9

Cognitive Disorder (new code as of 10/01/96) DSM-IV codes online

295.10

Schizophrenia, Disorganized Type

295.20

Schizophrenia, Catatonic Type

295.30

Schizophrenia, Paranoid Type

295.40

Schizophreniform Disorder

295.60

Schizophrenia, Residual Type

295.70

Schizoaffective Disorder

295.90

Schizophrenia, Undifferentiated Type

296.00

Bipolar I Disorder, Single Manic Episode
, Unspecified

296.01

Bipolar I Disorder, Single Manic Episode
, Mild

296.02

Bipolar I Disorder, Single Manic Episode
, Moderate

296.03

Bipolar I Disorder, Single Manic Episode
, Severe Without Psychotic Features

296.04

Bipolar I Disorder, Single Manic Episode
, Severe With Psychotic Features

296.05

Bipolar I Disorder, Single Manic Episode
, In Partial Remission

296.06

Bipolar I Disorder, Single Manic Episode
, In Full Remission

296.20

Major Depressive Disorder, Single Episode
, Unspecified

296.21

Major Depressive Disorder, Single Episode
, Mild

296.22

Major Depressive Disorder, Single Episode
, Moderate

296.23

Major Depressive Disorder, Single Episode
, Severe Without Psychotic Features

296.24

Major Depressive Disorder, Single Episode
, Severe With Psychotic Features

296.25

Major Depressive Disorder, Single Episode
, In Partial Remission

296.26

Major Depressive Disorder, Single Episode
, In Full Remission

296.30

Major Depressive Disorder, Recurrent
, Unspecified

296.31

Major Depressive Disorder, Recurrent
, Mild

296.32

Major Depressive Disorder, Recurrent
, Moderate

296.33

Major Depressive Disorder, Recurrent
, Severe Without Psychotic Features

296.34

Major Depressive Disorder, Recurrent
, Severe With Psychotic Features

296.35

Major Depressive Disorder, Recurrent
, In Partial Remission

296.36

Major Depressive Disorder, Recurrent
, In Full Remission

296.40

Bipolar I Disorder, Most Recent Episode Hypomanic

296.40

Bipolar I Disorder, Most Recent Episode Manic
, Unspecified

296.41

Bipolar I Disorder, Most Recent Episode Manic
, Mild

296.42

Bipolar I Disorder, Most Recent Episode Manic
, Moderate

296.43

Bipolar I Disorder, Most Recent Episode Manic
, Severe Without Psychotic Features DSM-IV codes online

296.44

Bipolar I Disorder, Most Recent Episode Manic
, Severe With Psychotic Features

296.45

Bipolar I Disorder, Most Recent Episode Manic
, In Partial Remission

296.46

Bipolar I Disorder, Most Recent Episode Manic
, In Full Remission

296.50

Bipolar I Disorder, Most Recent Episode Depressed
, Unspecified

296.51

Bipolar I Disorder, Most Recent Episode Depressed
, Mild

296.52

Bipolar I Disorder, Most Recent Episode Depressed
, Moderate

296.53

Bipolar I Disorder, Most Recent Episode Depressed
, Severe Without Psychotic Features

296.54

Bipolar I Disorder, Most Recent Episode Depressed
, Severe With Psychotic Features

296.55

Bipolar I Disorder, Most Recent Episode Depressed
, In Partial Remission DSM-IV codes online

296.56

Bipolar I Disorder, Most Recent Episode Depressed
, In Full Remission

296.60

Bipolar I Disorder, Most Recent Episode Mixed
, Unspecified

296.61

Bipolar I Disorder, Most Recent Episode Mixed
, Mild

296.62

Bipolar I Disorder, Most Recent Episode Mixed
, Moderate

296.63

Bipolar I Disorder, Most Recent Episode Mixed
, Severe Without Psychotic Features

296.64

Bipolar I Disorder, Most Recent Episode Mixed
, Severe With Psychotic Features

296.65

Bipolar I Disorder, Most Recent Episode Mixed
, In Partial Remission

296.66

Bipolar I Disorder, Most Recent Episode Mixed
, In Full Remission

296.7

Bipolar I Disorder, Most Recent Episode Unspecified

296.80

Bipolar Disorder
 
NOS

296.89

Bipolar II Disorder

296.90

Mood Disorder 
NOS

297.1

Delusional Disorder

297.3

Shared Psychotic Disorder

298.8

Brief Psychotic Disorder

298.9

Psychotic Disorder 
NOS

299.00

Autistic Disorder

299.10

Childhood Disintegrative Disorder

299.80

Asperger’s Disorder 

299.80

Pervasive Developmental Disorder
 
NOS

299.80

Rett’s Disorder

300.00

Anxiety Disorder
 
NOS

300.01

Panic Disorder Without Agoraphobia

300.02

Generalized Anxiety Disorder 

300.11

Conversion Disorder

300.12

Dissociative Amnesia

300.13

Dissociative Fugue

300.14

Dissociative Identity Disorder

300.15

Dissociative Disorder
 
NOS

300.16

Factitious Disorder
 With Predominantly Psychological 
Signs
and 
Symptoms

300.19

Factitious Disorder
 
NOS

300.19

Factitious Disorder
 With Combined Psychological and Physical 
Signs
 and 
Symptoms

300.19

Factitious Disorder
 With Predominantly Physical 
Signs
 and 
Symptoms

300.21

Panic Disorder With Agoraphobia

300.22

Agoraphobia Without History of Panic Disorder

300.23

Social Phobia

300.29

Specific Phobia

300.3

Obsessive-Compulsive Disorder

300.4

Dysthymic Disorder

300.6

Depersonalization Disorder

300.7

Body Dysmorphic Disorder

300.7

Hypochondriasis

300.81

Somatization Disorder

300.82

Somatoform Disorder
 
NOS
 (new code as of 10/01/96) DSM-IV codes online

300.82

Undifferentiated 
Somatoform Disorder
 (new code as of 10/01/96)

300.9

Unspecified Mental Disorder (nonpsychotic)

301.0

Paranoid Personality Disorder

301.13

Cyclothymic Disorder

301.20

Schizoid Personality Disorder

301.22

Schizotypal Personality Disorder

301.4

Obsessive-Compulsive Personality Disorder

301.50

Histrionic Personality Disorder

301.6

Dependent Personality Disorder

301.7

Antisocial Personality Disorder

301.81

Narcissistic Personality Disorder

301.82

Avoidant Personality Disorder

301.83

Borderline Personality Disorder

301.9

Personality Disorder 
NOS

302.2

Pedophilia

302.3

Transvestic Fetishism

302.4

Exhibitionism

302.6

Gender Identity Disorder
 in Children

302.6

Gender Identity Disorder
 
NOS

302.70

Sexual Dysfunction
 
NOS

302.71

Hypoactive Sexual Desire Disorder

302.72

Female Sexual Arousal Disorder

302.72

Male Erectile Disorder

302.73

Female Orgasmic Disorder

302.74

Male Orgasmic Disorder

302.75

Premature Ejaculation

302.76

Dyspareunia
 (Not Due to a General Medical Condition)

302.79

Sexual Aversion Disorder

302.81

Fetishism

302.82

Voyeurism

302.83

Sexual Masochism

302.84

Sexual Sadism

302.85

Gender Identity Disorder
 in Adolescents or Adults DSM-IV codes online

302.89

Frotteurism

302.9

Paraphilia
 
NOS

302.9

Sexual Disorder 
NOS

303.00

Alcohol Intoxication

303.90

Alcohol
 
Dependence

304.00

Opioid
 
Dependence

304.10

Sedative
, 
Hypnotic
, or 
Anxiolytic
 
Dependence

304.20

Cocaine
 
Dependence

304.30

Cannabis
 
Dependence

304.40

Amphetamine
 
Dependence

304.50

Hallucinogen
 
Dependence

304.60

Inhalant
 
Dependence

304.60

Phencyclidine
 
Dependence
 (new code as of 10/01/96)

304.80

Polysubstance 
Dependence

304.90

Other (or Unknown) 
Substance Dependence

305.00

Alcohol
 
Abuse

305.10

Nicotine
 
Dependence

305.20

Cannabis
 
Abuse

305.30

Hallucinogen
 
Abuse

305.40

Sedative
, 
Hypnotic
, or 
Anxiolytic
 
Abuse

305.50

Opioid
 
Abuse

305.60

Cocaine
 
Abuse

305.70

Amphetamine
 
Abuse

305.90

Caffeine Intoxication

305.90

Inhalant
 
Abuse

305.90

Other (or Unknown) 
Substance Abuse

305.90

Phencyclidine
 
Abuse

306.51

Vaginismus
 (Not Due to a General Medical Condition)

307.0

Stuttering

307.1

Anorexia Nervosa

307.20

Tic Disorder
 
NOS

307.21

Transient Tic Disorder

307.22

Chronic Motor or Vocal Tic Disorder

307.23

Tourette’s Disorder

307.3

Stereotypic Movement Disorder

307.42

Insomnia Related to…
[Indicate the 
Axis I
 or 
Axis II
Disorder] (before 10.01.2005)

307.42

Primary Insomnia

307.44

Hypersomnia Related to…
[Indicate the 
Axis I
 or 
Axis II
Disorder]  (before 10.01.2005)

307.44

Primary Hypersomnia

307.45

Circadian Rhythm Sleep Disorder
 (before 10.01.2005)

307.46

Sleep Terror Disorder

307.46

Sleepwalking Disorder

307.47

Dyssomnia
 
NOS

307.47

Nightmare Disorder

307.47

Parasomnia
 
NOS

307.50

Eating Disorder
 
NOS

307.51

Bulimia Nervosa

307.52

Pica

307.53

Rumination Disorder 

307.59

Feeding Disorder of Infancy or Early Childhood

307.6

Enuresis
 (Not Due to a General Medical Condition)

307.7

Encopresis
, Without Constipation and Overflow Incontinence

307.80

Pain Disorder
 Associated With Psychological Factors

307.89

Pain Disorder
 Associated With Both Psychological Factors and a General Medical Condition

307.9

Communication Disorder
 
NOS

308.3

Acute Stress Disorder

309.0

Adjustment Disorder
 With 
Depressed Mood

309.21

Separation Anxiety Disorder

309.24

Adjustment Disorder
 With 
Anxiety

309.28

Adjustment Disorder
 With Mixed 
Anxiety
 and 
Depressed Mood

309.3

Adjustment Disorder
 With Disturbance of Conduct

309.4

Adjustment Disorder
 With Mixed Disturbance of Emotions and Conduct DSM-IV codes online

309.81

Posttraumatic Stress Disorder 

309.9

Adjustment Disorder
 Unspecified

310.1

Personality Change Due to
…[Indicate the General Medical Condition]

311

Depressive Disorder
 
NOS

312.30

Impulse-Control Disorder
 
NOS

312.31

Pathological Gambling

312.32

Kleptomania

312.33

Pyromania

312.34

Intermittent Explosive Disorder

312.39

Trichotillomania

312.81

Conduct Disorder
 Childhood-Onset Type (new code as of 10/01/96)

312.82

Conduct Disorder
 Adolescent-Onset Type (new code as of 10/01/96)

312.89

Conduct Disorder
 Unspecified Onset (new code as of 10/01/96)

312.9

Disruptive Behavior Disorder 
NOS

313.23

Selective Mutism

313.81

Oppositional Defiant Disorder

313.82

Identity Problem

313.89

Reactive Attachment Disorder
 of Infancy or Early Childhood

313.9

Disorder of Infancy, Childhood, or Adolescence 
NOS

314.00

Attention-Deficit/Hyperactivity Disorder
, Predominantly Inattentive Type

314.01

Attention-Deficit/Hyperactivity Disorder
, Combined Type

314.01

Attention-Deficit/Hyperactivity Disorder
, Predominantly Hyperactive-Impulsive Type

314.9

Attention-Deficit/Hyperactivity Disorder
 
NOS

315.00

Reading Disorder

315.1

Mathematics Disorder

315.2

Disorder of Written Expression

315.31

Expressive Language Disorder

315.32

Mixed Receptive-Expressive Language Disorder
 (new code as of 10/01/96)

315.39

Phonological Disorder

315.4

Developmental Coordination Disorder

315.9

Learning Disorder
 
NOS

316…

[Specified Psychological Factor] Affecting…[Indicate the General Medical Condition]

317

Mild 
Mental Retardation

318.0

Moderate 
Mental Retardation

318.1

Severe 
Mental Retardation

318.2

Profound 
Mental Retardation

319

Mental Retardation
, Severity Unspecified

327.01

Sleep Disorder
 Due to…[Indicate the General Medical Condition], 
Insomnia
 Type  (new code as of 10.01.2005)

327.02

Insomnia Related to…
[Indicate the 
Axis I
 or 
Axis II
Disorder] (new code as of 10.01.2005)

327.14

Sleep Disorder
 Due to…[Indicate the General Medical Condition], 
Hypersomnia
 Type (new code as of 10.01.2005)

327.15

Hypersomnia Related to…
[Indicate the 
Axis I
 or 
Axis II
Disorder] (new code as of 10.01.2005)

327.30

Circadian Rhythm Sleep Disorder
  (unspecified type) new code as of 10.01.2005 DSM-IV codes online

327.31

Circadian Rhythm Sleep Disorder
 (delayed sleep phase type) new code as of 10.01.2005

327.35

Circadian Rhythm Sleep Disorder
 (jet lag type) new code as of 10.01.2005

327.36

Circadian Rhythm Sleep Disorder
 (shift work type) new code as of 10.01.2005

327.44

Sleep Disorder
 Due to…[Indicate the General Medical Condition], Parasomnia Type (new code as of 10.01.2005)

327.8

Sleep Disorder
 Due to…[Indicate the General Medical Condition], Mixed Type (new code as of 10.01.2005)

332.1

Neuroleptic-Induced Parkinsonism

333.1

Medication-Induced Postural Tremor

333.7

Neuroleptic-Induced Acute Dystonia

333.82

Neuroleptic-Induced Tardive Dyskinesia

333.90

Medication-Induced Movement Disorder
 NOS

333.92

Neuroleptic Malignant Syndrome

333.99

Neuroleptic-Induced Acute Akathisia

347.00

Narcolepsy

607.84

Male Erectile Disorder
 
Due to…[Indicate the General Medical Condition
]

608.89

Male 
Dyspareunia
 
Due to…[Indicate the General Medical Condition

608.89

Male 
Hypoactive Sexual Desire Disorder
 
Due to…[Indicate the General Medical Condition

608.89

Other Male 
Sexual Dysfunction
 
Due to…[Indicate the General Medical Condition

625.0

Female 
Dyspareunia
 
Due to…[Indicate the General Medical Condition

625.8

Female 
Hypoactive Sexual Desire Disorder
 
Due to…[Indicate the General Medical Condition

625.8

Other Female 
Sexual Dysfunction
 
Due to…[Indicate the General Medical Condition

780.09

Delirium
 NOS

780.52

Sleep Disorder
 Due to…[Indicate the General Medical Condition], 
Insomnia
 Type (before 10.01.2005)

780.54

Sleep Disorder
 Due to…[Indicate the General Medical Condition], 
Hypersomnia
 Type (before 10.01.2005)

780.57

Breathing-Related Sleep Disorder
 (new code as of 10.01.2005)

780.59

Breathing-Related Sleep Disorder
 (before 10.01.2005)

780.59

Sleep Disorder
 Due to…[Indicate the General Medical Condition], Mixed Type

780.59

Sleep Disorder
 Due to…[Indicate the General Medical Condition], 
Parasomnia
 Type (before 10.01.2005)

780.9

Age-Related Cognitive Decline

787.6

Encopresis
, With Constipation and Overflow Incontinence

799.9

Diagnosis Deferred on 
Axis II

799.9

Diagnosis or Condition Deferred on 
Axis I

995.2

Adverse Effects of Medication 
NOS

995.52

Neglect of Child (if focus of attention is on victim) (new code as of 10/01/96)

995.53

Physical Abuse of Child
 (if focus of attention is on victim) (new code as of 10/01/96)

995.54

Physical Abuse of Child
 (if focus of attention is on victim) (new code as of 10/01/96)

995.81

Physical Abuse of Adult
 (if focus of attention is on victim)

995.83

Sexual Abuse of Adult (if focus of attention is on victim) (new code as of 10/01/96)

V15.81

Noncompliance With Treatment

V61.10

Partner Relational Problem (new code as of 10/01/96)

V61.12

Physical Abuse of Adult
 (if by partner) (new code as of 10/01/96)

V61.12

Sexual Abuse of Adult (if by partner) (new code as of 10/01/96) DSM-IV codes online

V61.20

Parent-Child Relational Problem

V61.21

Neglect of Child

V61.21

Physical Abuse of Child

V61.21

Sexual Abuse of Child

V61.8

Sibling Relational Problem

V61.9

Relational Problem
 Related to a Mental Disorder or General Medical Condition

V62.2

Occupational Problem

V62.3

Academic Problem

V62.4

Acculturation Problem

V62.81

Relational Problem 
NOS

V62.82

Bereavement 

V62.83

Physical Abuse of Adult
 (if by person other than partner) (new code as of 10/01/96)

V62.83

Sexual Abuse of Adult (if by person other than partner) (new code as of 10/01/96)

V62.89

Borderline Intellectual Functioning

V62.89

Phase of Life Problem

V62.89

Religious or Spiritual Problem

V65.2

Malingering

V71.01

Adult Antisocial Behavior

V71.02

Child or Adolescent Antisocial Behavior

V71.09

No Diagnosis on 
Axis II

V71.09

No Diagnosis or Condition on DSM-IV codes online 
Axis I

NURS 6501 Week 10 Quiz Answers (Walden)

A 30-year-old female with newly diagnosed PCOS is being counseled by her OB-GYN. The physician indicates that this condition often results in:

When a staff member asks the nurse what the thick middle layer of the uterine wall is called, what is the nurse’s best response? The:

During a routine pelvic exam, a 34-year-old female is found to have an ovarian cyst containing skin, hair, cartilage, and bone. This cyst is classified as a _____ cyst.

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A 21-year-old female is infected with human papillomavirus (HPV) following unprotected sexual intercourse with a male she recently met. She is now at higher risk of developing which of the following cancers?

A 35-year-old female presents with infertility and gradual blindness. She reports that she has otherwise been healthy. History reveals that she was promiscuous and had unprotected sexual intercourse several times when she was younger. She now has neurological involvement. Which of the following sexually transmitted infection (STI) does she most likely have? NURS 6501 Week 10 Quiz Answers.

While speaking to a group of older males, which information should the nurse share? The following is a normal characteristic of aging and the male reproductive system:

Copy of The nurse would anticipate the treatment for pelvic organ prolapse to be:

A 68-year-old male presents complaining of difficulty having sexual intercourse. He reports that his penis curves during erection. This condition is referred to as:

Symptoms of prostatitis are similar to symptoms of:

A 35-year-old female is diagnosed with endometriosis. Suppressing which of the following would be the most appropriate medical treatment for this disease? NURS 6501 Week 10 Quiz Answers.

What term should the nurse use when discussing male sex hormones collectively?

A student asks the instructor which of the following hormones stimulates follicular maturation. How should the instructor respond?

A patient asks the nurse what is the most sensitive area of the penis. What is the nurse’s best answer? The area of the penis with the most nerve endings is the:

A 20-year-old female presents with pelvic and back pain severe enough to miss work. She reports that the pain occurs with the onset of menses. Physical examination fails to find pelvic pathology. The most likely cause of her condition is:

When the nurse describes the duct that carries the ovum from the ovary to the uterus, what is the nurse discussing? The:

When a patient who is trying to get pregnant asks where the usual site of fertilization is, how should the nurse respond? The:

A middle-aged male speaks to his physician about benign BPH. He reveals that his father was recently diagnosed with this condition, and he wants to know if he could have it. The physician tells him that a common complaint from men with mild to moderate BPH is:

A middle-aged male speaks to his physician about benign BPH. He reveals that his father was recently diagnosed with this condition, and he wants to know if he could have it. The physician tells him that a common complaint from men with mild to moderate BPH is:

When discussing the difference between male and female sex hormones, which information should the nurse include? The major difference between male and female sex hormone production is that:

_____ is inflammation of the glans penis.

A 40-year-old male is concerned about the possibility of developing prostate cancer. He reports that his father died of prostate cancer, and he wants to take all preventive measures. He is told to consume a diet low in:

Which of the following signs is usually the first clinical manifestation of breast cancer?

In the majority of cases delayed puberty is due to:

The nurse would anticipate the treatment for pelvic organ prolapse to be:

A nursing student asks the nurse where the glands of Montgomery are located. How should the nurse reply? The glands of Montgomery are located in the:

A syndrome often associated with cystocele is:

Changes in the cervical mucus can be used to identify the periods in which a female is most fertile. How should the nurse describe cervical mucus during ovulation?

A nurse is discussing female anatomy. Which body structure contains the openings to the vagina and urinary meatus?

Progesterone is often referred to as “the hormone of pregnancy,” and the patient asks what this phrase means. How should the nurse respond? Progesterone is the hormone of pregnancy because it:

A 19-year-old female presents with genital warts. Which of the following would cause this condition?

Cryptorchidism can be defined as:

Which information indicates the nurse has a good understanding of the menstrual cycle? When estrogen and progesterone levels drop, the endometrium enters the _____ phase. NURS 6501 Week 10 Quiz Answers.

A 21-year-old male presents with inflammation of the testes. He has a high fever and edema and redness of the testes. Which organism is the most likely the cause of his symptoms?

A nurse is teaching the staff about female hormones. Which hormone promotes the formation of channels in the mucus of the cervical os to facilitate sperm movement into the uterus?

When a teenager asks what makes the breast grow, what is the nurse’s best response? The hormone that promotes breast development during puberty is:

When a staff member asks which structure secretes glucose-rich fluid into the semen, how should the nurse respond?

The most commonly occurring cancer of the female reproductive tract is _____ cancer. NURS 6501 Week 10 Quiz Answers.

When a staff member asks the nurse what is the most potent of the following estrogens, what is the nurse’s best response? It is:

An important risk factor in the development of benign prostatic hypertrophy (BPH) is:

A 40-year-old female presents with cramping and excessive vaginal bleeding. Ultrasound reveals benign uterine tumors in the smooth muscle cells of the myometrium. These tumors are commonly called: NURS 6501 Week 10 Quiz Answers.

NR439 Week 1- Role of Research and the Importance of the Searchable Clinical Question

This week’s graded discussion topic relates to the following Course Outcome (CO).

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CO5 Recognize the role of research findings in evidence-based practice. (POs 7 and 8)

The practice of nursing is deeply rooted in nursing knowledge, and nursing knowledge is generated and disseminated through reading, using, and creating nursing research. Professional nurses rely on research findings to inform their practice decisions; they use critical thinking to apply research directly to specific patient care situations. The research process allows nurses to ask and answer questions systematically that will ensure that decisions are based on sound science and rigorous inquiry. Nursing research helps nurses in a variety of settings answer questions about patient care, education, and administration.

As you contemplate your role in the research process, read the following article.

Kumar, S. (2015). Type 1 diabetes mellitus-common cases. Indian Journal of Endocrinology & Metabolism, 19, S76–S77. doi:10.4103/2230-8210.155409. 
https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=102354944&site=eds-live
 (Links to an external site.)Links to an external site.

 

Choose one case study, and formulate one searchable, clinical question in the PICO(T) format. There are several potential questions that could be asked.

 

Identify whether the focus of your question is assessment, etiology, treatment, or prognosis.

 

Remember to integrate references. NR439 Week 1- Role of Research and the Importance of the Searchable Clinical Question.

Opens System Theory: Evaluation of the Emergency Department Sample essay – NURS 6053 Interprofessional Organization and Systems Leadership

Opens System Theory: Evaluation of the Emergency Department

NURS 6053 Interprofessional Organization and Systems Leadership

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Open Systems Theory: Evaluation of the Emergency Department

The purpose of this assignment is to describe open systems theory related to a large emergency department (ED) located within Community Medical Center (CMC). It further describes the input, throughput, output, cycles of events, and negative feedback of the ED. A problem of dissatisfied patients within the ED is discussed and using the system theory model it is determined where the problem exits. A desired outcome is formulated and goals are identified to facilitate the outcome. Policy and procedures are identified, and relevant professional standards are discussed. The mission, vision, and values of the organization are discussed related to the problem resolution to improve culture and climate. Opens System Theory: Evaluation of the Emergency Department Sample essay – NURS 6053 Interprofessional Organization and Systems Leadership.

Systems Theory

Systems theory is used to identify problems and understand how things work. More specifically it can be used to identify the structures of a healthcare system and its boundaries, recognize the goals of a systems and its response to internal and external forces. A systems ability to adapt is important when responding to feedback and implementing new procedures. It is important to be a leader that management has a clear idea and understands the system to effectively accomplish the organizational goals (Hayajneh, 2007). The system theory uses concepts such as, inputs, throughput, output, cycles of events, and negative feedback to explore issues. Some of these issues include examining the interactions between patients and healthcare providers, stress and burnout of staff, financing of healthcare, leadership and change in organizations, health communication technologies, and interdisciplinary healthcare teams (Ruhl & Harter, 2013). Opens System Theory: Evaluation of the Emergency Department Sample essay – NURS 6053 Interprofessional Organization and Systems Leadership.
 

Input of the Emergency Department

A large healthcare organization known as Robert Wood Johnson Barnabas Health has a smaller hospital called CMC. Within CMC is a large ED that sees many patients a day and has a large volume of elderly in the area. The large elderly population in the surrounding area proposes challenges for the ED to manage large volumes of patients. Inputs are resources that are able to make an output for the systems. For example physicians and nurses (Hayajneh, 2007). In the ED at CMC inputs are gathered from staff, recipients of care, resources from sister hospitals, and materials. Nurses effort, physicians time, vital sign machines, intravenous (IV) start kits and the many other materials in the hospital that make it possible for the ED to provide care. A computer system was also purchased for charting. Evidenced based practice (EBP) guides policy development to assist physicians and nurses in providing the best care possible.

Throughput and Output of the Emergency Department

In systems theory throughput is what converts materials into services (Hayajneh, 2007). In the ED at CMC nurses are trained to take vital signs, start IV therapy, perform physical assessments of patients, and learn critical thinking skills to act in emergency situations. New nurses go through extensive training period to learn how to perform the many procedures that need to be performed and identify heart rhythms correctly. This is provided in a classroom by the education department and then they have one-on-one training in the ED by an experienced nurse. Nurses are also trained on how to use the computer system and chart appropriately. In open systems theory output relates to services provided. Strong inputs and throughputs must be available to provide good quality care of services (Meyer & O’Brien-Pallas, 2010). Opens System Theory: Evaluation of the Emergency Department Sample essay – NURS 6053 Interprofessional Organization and Systems Leadership. In the ED outputs are providing care to patients, providing procedures, diagnosing, discharging, and the use of the computer software to effectively chart.

Cycle of Events and Negative feedback

Cycles of events is needed to renew the system to repeat the series of events (Meyer & O’Brien-Pallas, 2010). In the ED the hospital receives information through accreditation. Receiving accreditation is not easy and all parts of the hospital must work together to achieve it. The ED is important in the cardiac and stroke accreditations as we have time limits to complete procedures that must be maintained for accreditation. If accreditation is not received certain cardiac and stroke procedures cannot be completed when a patient is in need. Negative feedback is information received about operational functioning (Meyer & O’Brien-Pallas, 2010). Opens System Theory: Evaluation of the Emergency Department Sample essay – NURS 6053 Interprofessional Organization and Systems Leadership. In open system theory feedback is information of data gathered used to evaluate the system to make it more effective (Hayajneh, 2007). The reviews of patient satisfaction of CMC can be considered a feedback.  In the ED negative feedback is received from patient satisfaction scores and patients accounts from surveys provided by the hospital. Negative feedback is also received from statistics maintained by the hospital such as the mortality rate, hospital acquired infection rate, medication errors rate, and adverse reactions. Opens System Theory: Evaluation of the Emergency Department Sample essay – NURS 6053 Interprofessional Organization and Systems Leadership.

The Problem

CMC uses business websites such as Yelp to monitor customer reviews. The Yelp website showed CMC to be rated as one star and had multiple accounts of dissatisfied patients and most complaints were about the lack of compassion and rudeness of staff. This included nurses, physicians, and registrars. CMC responds to these reviews on Yelp asking the dissatisfied customer to contact the patient satisfaction department to discuss the feelings patients had of inadequate care. Many times when inadequate reviews are received it comes from the ED. They are then displayed in the ED for staff to see where problems exist and where improvements could be made. The problem of dissatisfied patients starts in the throughput phase. The input is having the staff and equipment available to provide the quality of care. The throughput is where the ball is dropped. Nurses are trained on everything about how to take care of the patient but they are not taught empathy or compassion. They are not taught on how to handle situations and what to say when a person is severely ill by the education staff at CMC. It is also a very stressful environment and the nurse patient ratio is high. Burnout occurs easily and a nurse’s attitude towards patients occurs quickly changes within a year of working. Compassion fatigue is a term used to describe the emotional and physical exhaustion from witnessing physical and emotional suffering (Hamilton, Tran, & Jamieson, 2016). It needs to be addressed at the throughput stage to make progress when the output is completed. Opens System Theory: Evaluation of the Emergency Department Sample essay – NURS 6053 Interprofessional Organization and Systems Leadership.

Desired Outcome and Goals

A long term desired outcome would be to change the communities perception of staff in the ED. A short term desired outcome would be to increase patient satisfaction scores by 20%. A goal would be to make nurses resilient to the lack of compassion. This could be achieved by providing new nurses and existing nurses with educational classes on compassion. Another goal would be to correct compassion fatigue in providers of care. To avoid compassion fatigue nurses should have support by their manager, have someone to talk to, and peer provided support. All these factors have been shown to reduce stress and improve compassion (Hamilton, Tran, & Jamieson, 2016).

Policy and Procedures

Policy and procedures that could be initiated would be every 6 months all healthcare providers must attend a compassion class provided by management. Another policy would ensure all new nurses are provided with education on how to be resilient to compassion fatigue and taught how to handle stressful situation. A policy will also be initiated to provide all healthcare providers with support by having a meeting with management. Nursing management will be required to meet with all employees once a year to discuss areas that may cause extra stress and resolutions will be developed based on employee input. A professional standard of practice in nursing is that nurses effectively communicate through all aspects healthcare. This includes developing a positive nurse-patient relationship and communicating effectively with patients (American Nurses Association, 2010). By not being compassionate nurses are not holdinh up to the highest standards of nursing practice.

Resolution Improving Culture and Climate

The mission of CMC is to promote the well-being of patients through the best nursing care and by providing the newest best practice guidelines and technology. The vision is to empower everyone for optimum health and create a relationship that centers on both patient and families. The values are referred to as CARING: compassion, accountability, respect, innovation, nursing excellence, and genuine (RWJ Barnabas Health, n.d.). Values guide the way a company navigates (Collins, & Porras, 1996). The ED at CMC was not upholding the values of the organization. By making changes the values can be achieved by being caring and providing compassion to patients. Organization culture is the unique environment of a corporation that is based on shared attitudes, values, beliefs and rules (Business Dictionary.com, 2013b). Organizational climate is the workplace environment that influences actions and job performance (Business Dictionary.com, 2013a). For both organizational climate and culture to be changed it starts with management. The current attitude is not based on compassion but based on your in the ED and we are here to save your life. Management shares the same attitude and there is no focus on compassion for the patients. Management needs to change the shared attitudes of the staff in the ED at CMC to change job performance towards patients. Management sets the stage for how employees will act and the overall culture of the department. If management follows the values and portrays it to staff they will follow suit and the culture and climate can be changed (Marquis & Huston, 2015). Opens System Theory: Evaluation of the Emergency Department Sample essay – NURS 6053 Interprofessional Organization and Systems Leadership.

Conclusion

Through the use of open systems theory it can be seen through negative feedback there is a problem in the ED at CMC with patient satisfaction. By manipulating throughput in the open system theory this can be changed through education and incentives to staff. It will then achieve the values of the organization and change the organizational culture and climate. It starts with management setting the tone. With this plan the overall perceptions of the ED at CMC should change and increase patient satisfaction, in turn, achieving the desired outcome.

 
 
 

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