Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Week 9: Assessment and Care of Patients With Adrenal and Urogynecologic Conditions
From severe abdominal pain to urinary frequency, urinary incontinence, sexual health issues, and the overproduction of hormones, adrenal and urogynecologic symptoms often cause frustration and embarrassment for patients. These feelings might cause patients to hold back information, making assessment and diagnosis of adrenal and urogynecologic conditions challenging. Because patients may require surgery to minimize the impact of these conditions on their daily lives, it is essential that you establish trust with patients and carefully ask questions to quantify complaints appropriately.
This week, as you examine the pre- and post-operative care of patients with adrenals and urogynecology conditions, you explore strategies for assessment, diagnosis, and treatment.
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Learning Objectives
By the end of this week, students will:
Evaluate medical and surgical patients with adrenal and urogynecologic conditions
Develop differential diagnoses for medical and surgical patients with adrenal and urogynecologic conditions
Develop treatment plans for medical and surgical patients with adrenal and urogynecologic conditions
Photo Credit: Andrew Brookes/Cultura/Getty Images. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Learning Resources
Required Readings
Colyar, M. R. (2015).
Advanced practice nursing procedures
(1st ed.). Philadelphia, PA: F. A. Davis Company.
Chapter 42, “Breast Biopsy (Fine Needle Aspiration)”
Chapter 44, “Colposcopy (Endocervical Curettage and Cervical Biopsy)”
Chapter 45, “Endometrial Biopsy”
Chapter 49, “Bartholin Cyst Abscess (Incision and Drainage)”
Chapter 51, “Cervical Lesions—Cryotherapy”
Chapter 52, “Circumcision and Dorsal Penile Nerve Block”
Chapter 58, “Paracervical Nerve Block”
Chapter 61, “Vasectomy”
Doherty, G. M. (2015).
Current diagnosis and treatment: Surgery
(14th ed.). New York, NY: McGraw Hill.
Chapter 17, “Breast Disorders”
Chapter 33, “Adrenals”
Chapter 38, “Urology”
Chapter 39, “Gynecology”
Weber, E. C., Vilensky, J. A., & Fog, A. M. (2013).
Practical radiology: A symptom-based approach.
Philadelphia, PA: F. A. Davis Company.
Chapter 7, “Breast”
Chapter 9, “Male and Female Urinary Tract and Male Genital Tract”
Chapter 10, “Female Pelvic Imaging”
American Cancer Society. (2014).
American Cancer Society guidelines for the early detection of cancer.
Retrieved from http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Required Media
i-Human Patient Cases. (2014). Retrieved from https://ih2.i-human.com/users/sign_in
Optional Resources
Massad, L. S., Einstein, M. H., Huh, W. K., Katki, H. A., Kinney, W. K., Schiffman, M. … Lawson, H. W. (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors.
Journal of Lower Genital Tract Disease, 17
(5), S1–S27.
Discussion Part I: Assessment and Care of Patients With Adrenal and Urogynecologic Conditions
Many genitourinary (GU) disorders such as kidney disease start developing during adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for adolescent patients, to identify potential signs and symptoms. Although some adolescent GU disorders require long-term treatment and management, other disorders such as urinary tract infections are more common and frequently require only minor interventions. In your role with adolescent patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Case Study 1
Alicia is an 18-year-old female who is brought into urgent care by her mother. She is complaining of dizziness. She recently started to lift weights for softball season. She has been healthy up to this point. Vitals are: temp 101.9°F, HR 120, RR 24, BP 90/54. She has lower extremity edema and decreased skin turgor. She states that her shoulders, thighs, and lower back hurt. She is having trouble moving her arms and legs. She also complains of vague abdominal pain, with nausea and vomiting. Labs came back with CK 10,000, uric acid 40 mg/dl, WBC 14.3, BUN:creatinine ratio 6:1, K 5.8. Urinalysis shows a presence of myoglobin of more than 25. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Case Study 2
Mark is a 15-year-old male with a complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago as a dull ache and gradually has worsened such that he can no longer stand without doubling over. He is afebrile and in marked pain. Physical exam results are negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Case Study 3
Maya is a 16-year-old female who presents to the ER for urinary pain. She is a healthy adolescent with complaints of lower abdominal pain, low back pain, and burning with urination. She had a fever of 102°F at home. Physical examination results are normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood. Leukocytes are moderate and nitrites, moderate. Her blood pressure is normal, and she is at the 60th percentile for height and weight. Vitals are: temp 103.1°F, HR 116, RR 18, BP 100/58. P Ox is 98% (Johns Hopkins Children’s Center, 2010).
To prepare:
Review and select
1
of the 3 provided case studies. Analyze the patient information.
Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder.
By Day 3
Post
an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Read
a selection of your colleagues’ responses.
By Day 6
Respond
to at least
two
of your colleagues on
2 different days in both of the ways
listed below. Respond to colleagues who selected different case studies from yours. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Describe how culture might affect the diagnosis, management, and follow-up care of patients with the genitourinary disorders your colleagues discussed.
Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.
Discussion Part II: Pharmacology
Read the following articles to enhance your knowledge of commonly prescribed medications:
Daley, B. (2015, February 23).
Peritonitis and abdominal sepsis.
Retrieved from http://emedicine.medscape.com/article/180234-overview
Shahedi, K., Chudasama, Y. N., Dea, S. K., & Cooperman, A. (2015, January 14).
Diverticulitis treatment and management.
Retrieved from http://emedicine.medscape.com/article/173388-treatment
Tobias, J. D., & Leder, M. (2011). Procedural sedation: A review of sedative agents, monitoring, and management of complications.
Saudi Journal of Anasthesia, 5
(4), 395–410. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227310/
All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.
Sedation
Diazepam
Fentanyl
Ketamine
Lorazepam
Midazolam
Propofol
Benzodiazepines
Nonsedation
Chlorpromazine
Peritonitis—what antibiotics are chosen for peritonitis?
Nerve blocks—what drugs are used with nerve blocks?
Diverticulitis—what drugs are used with diverticulitis?
Note:
When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
By Day 3
For this Discussion, address 1 of the following options:
Option 1
Post
a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose.
Option 2
Conduct an evidence-based drug search on the drug you selected and
post
an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?
Option 3
Post
an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication.
Note:
To be considered as one of your required responses, your pharmacology rationale must include a supporting reference.
Note:
For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Submission and Grading Information
Grading Criteria
Week 9 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 9 Discussion
Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Adrenal and Urogynecologic Conditions
While some adrenal and urogynecologic conditions are specific to male or female patients, many are common among both. The presentations of these common conditions, however, can vary greatly depending on sex. Because such variations may lead to challenges in assessment and diagnosis, it is essential for you to have strong examination and diagnostic skills. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with adrenal and urogynecologic conditions.
To prepare:
Review this week’s Learning Resources. With adrenal and urogynecologic conditions in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.
Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
Identify three to five possible conditions to consider in a differential diagnosis for the patient.
Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with adrenal and urogynecologic conditions. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
To complete:
As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the
i-Human Patients Case Player Student Manual
in the Week 2 Learning Resources.
Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Discussion_Rubric
Outstanding Performance
Excellent Performance
Competent Performance
Proficient Performance
Room for Improvement
Main Posting:
Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
44
(44%)
– 44
(44%)
Thoroughly responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
supported by at least 3 current, credible sources
40
(40%)
– 43
(43%)
Responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
75% of post has exceptional depth and breadth
supported by at least 3 credible references
35
(35%)
– 39
(39%)
Responds to most of the discussion question(s)
is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
50% of post has exceptional depth and breadth
supported by at least 3 credible references
31
(31%)
– 34
(34%)
Responds to some of the discussion question(s)
one to two criteria are not addressed or are superficially addressed
is somewhat lacking reflection and critical analysis and synthesis
somewhat represents knowledge gained from the course readings for the module.
post is cited with fewer than 2 credible references
0
(0%)
– 30
(30%)
Does not respond to the discussion question(s)
lacks depth or superficially addresses criteria
lacks reflection and critical analysis and synthesis
does not represent knowledge gained from the course readings for the module.
contains only 1 or no credible references
Main Posting:
Writing
6
(6%)
– 6
(6%)
Written clearly and concisely
Contains no grammatical or spelling errors
Fully adheres to current APA manual writing rules and style
5.5
(5.5%)
– 5.5
(5.5%)
Written clearly and concisely
May contain one or no grammatical or spelling error
Adheres to current APA manual writing rules and style
5
(5%)
– 5
(5%)
Written concisely
May contain one to two grammatical or spelling error
Adheres to current APA manual writing rules and style
4.5
(4.5%)
– 4.5
(4.5%)
Written somewhat concisely
May contain more than two spelling or grammatical errors
Contains some APA formatting errors
0
(0%)
– 4
(4%)
Not written clearly or concisely
Contains more than two spelling or grammatical errors
Does not adhere to current APA manual writing rules and style
Main Posting:
Timely and full participation
10
(10%)
– 10
(10%)
Meets requirements for timely and full participation
posts main discussion by due date
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
Does not meet requirement for full participation
First Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9
(9%)
– 9
(9%)
Response exhibits critical thinking and application to practice settings
responds to questions posed by faculty
the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives
8.5
(8.5%)
– 8.5
(8.5%)
Response exhibits critical thinking and application to practice settings
7.5
(7.5%)
– 8
(8%)
Response has some depth and may exhibit critical thinking or application to practice setting
6.5
(6.5%)
– 7
(7%)
Response is on topic, may have some depth
0
(0%)
– 6
(6%)
Response may not be on topic, lacks depth
First Response:
Writing
6
(6%)
– 6
(6%)
Communication is professional and respectful to colleagues
Response to faculty questions are fully answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English
5.5
(5.5%)
– 5.5
(5.5%)
Communication is professional and respectful to colleagues
Response to faculty questions are answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English
5
(5%)
– 5
(5%)
Communication is mostly professional and respectful to colleagues
Response to faculty questions are mostly answered if posed
Provides opinions and ideas that are supported by few credible sources
Response is written in Standard Edited English
4.5
(4.5%)
– 4.5
(4.5%)
Responses posted in the discussion may lack effective professional communication
Response to faculty questions are somewhat answered if posed
Few or no credible sources are cited
0
(0%)
– 4
(4%)
Responses posted in the discussion lack effective
Response to faculty questions are missing
No credible sources are cited
First Response:
Timely and full participation
5
(5%)
– 5
(5%)
Meets requirements for timely and full participation
posts by due date
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
Does not meet requirement for full participation. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9
(9%)
– 9
(9%)
Response exhibits critical thinking and application to practice settings * responds to questions posed by faculty
the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives
8.5
(8.5%)
– 8.5
(8.5%)
Response exhibits critical thinking and application to practice settings
7.5
(7.5%)
– 8
(8%)
Response has some depth and may exhibit critical thinking or application to practice setting
6.5
(6.5%)
– 7
(7%)
Response is on topic, may have some depth. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
0
(0%)
– 6
(6%)
Response may not be on topic, lacks depth
Second Response:
Writing
6
(6%)
– 6
(6%)
Communication is professional and respectful to colleagues
Response to faculty questions are fully answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English
5.5
(5.5%)
– 5.5
(5.5%)
Communication is professional and respectful to colleagues
Response to faculty questions are answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English
5
(5%)
– 5
(5%)
Communication is mostly professional and respectful to colleagues
Response to faculty questions are mostly answered if posed
Provides opinions and ideas that are supported by few credible sources
Response is written in Standard Edited English
4.5
(4.5%)
– 4.5
(4.5%)
Responses posted in the discussion may lack effective professional communication
Response to faculty questions are somewhat answered if posed
Few or no credible sources are cited
0
(0%)
– 4
(4%)
Responses posted in the discussion lack effective
Response to faculty questions are missing
No credible sources are cited
Second Response:
Timely and full participation
5
(5%)
– 5
(5%)
Meets requirements for timely and full participation
Posts by due date
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
NA
0
(0%)
– 0
(0%)
Does not meet requirement for full participation
Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Application_Rubric ( iHuman)
Novice
Emerging
Proficient
HPI Statement
0
(0%)
– 5
(5%)
Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills
6
(6%)
– 10
(10%)
Well written HPI statement but may be missing 1-2 key components from the history
11
(11%)
– 15
(15%)
Clearly written HPI statement with comprehensive information gathering from case questions.
Objective testing and physical exam
0
(0%)
– 5
(5%)
Poorly written physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis. Includes 3 or more inappropriate exams or tests.
6
(6%)
– 10
(10%)
Well written physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis. May include 1-2 unnecessary exams or tests.
11
(11%)
– 15
(15%)
Clearly written physical examination covering all critical components of a focus exam. Tests that are ordered are appropriate for patient and cost effective.
Assessment
0
(0%)
– 10
(10%)
Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components. Priority list may be out of order. Primary diagnosis may be wrong.
11
(11%)
– 19
(19%)
Well written differential diagnoses. May be missing 1-2 critical components. Correct primary diagnosis identified.
20
(20%)
– 25
(25%)
Clearly written differential diagnoses. Primary diagnosis identified.
Plan for patient
0
(0%)
– 15
(15%)
Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.
16
(16%)
– 25
(25%)
Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.
26
(26%)
– 30
(30%)
Clearly written plan covering all critical components for patient’s final diagnosis.
Clinical Questions
0
(0%)
– 10
(10%)
Correctly answered 0-69% of the clinical question
11
(11%)
– 13
(13%)
Correctly answered 70-89% of the clinical question
14
(14%)
– 15
(15%)
Correctly answered 90-100% of the clinical questions
Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers