South NSG 6440 All Week Discussions-latest

2017 November

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Question
Week 1 - Assignment 2 Discussion
You are a family nurse practitioner working in a community health center. The patient you
are about to see is a 3 month old natal female infant for a well-baby check. The child has
just been adopted. The mother stays at home with the baby and the father works outside
the home. They are covered by private health insurance through the father’s work. The
parents own their own home in a suburban area, neither smoke, and they have one
dog.Answer the following questions using course resources (texts) and two other evidence
based sources (current guidelines and/or scholarly articles that are within a 3-5 year time
frame).
What are the components of a well-child check for this 3-month old infant?
Write an educational intervention plan for the parents. What are you going to teach the
parents about their baby?
When completing a physical exam for this baby, what would be of particular focus and why?
Week 2 - Assignment 1 Discussion
SOAP Note
Each week, you are required to enter your patient encounters into eMedley. Your faculty will
be checking to ensure you are seeing the right number and mix of patients for a good
learning experience. You will also need to include a minimum of one complete SOAP note
using the SOAP Note template.
SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-
Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of
patient identification from the SOAP note format. Provide a reference (s) for the differential
diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time
frame and come from a textbook, guideline,or currently published peer reviwed journal
article.
Submission Details:
By Wednesday, October 18, 2017, enter your patient encounters into eMedley and complete
at least one SOAP note in the template provided.
Include the reference number from eMedley in your document.
Submit your SOAP note into the discussion area below by Sunday, October 15, 2017 along
with clinical insights about your case.
Respond to two peers with a substantial response that includes supportive references by
Wednesday, October 18, 2017.
Week 3 - Assignment 1 Discussion
Assignment 1: SOAP Note
Each week, you are required to enter your patient encounters into eMedley. Your faculty will
be checking to ensure you are seeing the right number and mix of patients for a good
learning experience. You will also need to include a minimum of one complete SOAP note
using the SOAP Note template.
SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-
Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of
patient identification from the SOAP note format. Provide a reference (s) for the differential
diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time
frame and come from a textbook, guideline, or currently published peer reviewed journal
article.
Submission Details:
By Wednesday, October 25, 2017, enter your patient encounters into eMedley and complete
at least one SOAP note in the template provided.
Include the reference number from eMedley in your document.
Submit your SOAP note into the discussion area below by Sunday, October 22, 2017 along
with clinical insights about your case.
Respond to two peers with a substantial response that includes supportive references by
Wednesday, October 25, 2017.

Name: Pt. Encounter Number:

Date: Age: Sex:

SUBJECTIVE

CC:

Reason given by the patient for seeking medical care “in quotes”

HPI:

Describe the course of the patient’s illness, including when it began,

character of symptoms, location where the symptoms began,
aggravating or alleviating factors, pertinent positives and negatives,
other related diseases, past illnesses, and surgeries or past
diagnostic testing related to the present illness.

Medications: (List with reason for med )

PMH

Allergies:

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Medication Intolerances:

Chronic Illnesses/Major traumas

Hospitalizations/Surgeries

“Have you ever been told that you have diabetes, HTN, peptic ulcer
disease, asthma, lung disease, heart disease, cancer, TB, thyroid
problems, kidney problems, or psychiatric diagnosis?”

Family History

Does your mother, father, or siblings have any medical or psychiatric

illnesses? Is anyone diagnosed with: lung disease, heart disease,
HTN, cancer, TB, DM, or kidney disease?

Social History

Education level, occupational history, current living

situation/partner/marital status, substance use/abuse, ETOH,
tobacco, and marijuana. Safety status

ROS

General Cardiovascular

Weight change, fatigue, fever, chills, night sweats, and energy level Chest pain, palpitations, PND,
orthopnea, and edema

Skin Respiratory

Delayed healing, rashes, bruising, bleeding or skin discolorations, Cough, wheezing, hemoptysis,
and any changes in lesions or moles dyspnea, pneumonia hx, and TB

Eyes Gastrointestinal

Corrective lenses, blurring, and visual changes of any kind Abdominal pain, N/V/D,
constipation, hepatitis,
hemorrhoids, eating disorders,
ulcers, and black, tarry stools

Ears Genitourinary/Gynecological

Ear pain, hearing loss, ringing in ears, and discharge Urgency, frequency burning,
change in color of urine.

Contraception, sexual activity,

STDs

Female: last pap, breast, mammo,

menstrual complaints, vaginal
discharge, pregnancy hx

Male: prostate, PSA, urinary

complaints

Nose/Mouth/Throat Musculoskeletal

Sinus problems, dysphagia, nose bleeds or discharge, dental Back pain, joint swelling, stiffness
disease, hoarseness, and throat pain or pain, fracture hx, and
osteoporosis

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Breast Neurological

SBE, lumps, bumps, or changes Syncope, seizures, transient

paralysis, weakness, paresthesias,
and black-out spells

Heme/Lymph/Endo Psychiatric

HIV status, bruising, blood transfusion hx, night sweats, swollen Depression, anxiety, sleeping
glands, increase thirst, increase hunger, and cold or heat intolerance difficulties, suicidal
ideation/attempts, and previous
dx

OBJECTIVE

Weight BMI Temp BP

Height Pulse Resp

General Appearance

Healthy-appearing adult female in no acute distress. Alert and

oriented; answers questions appropriately. Slightly somber affect at
first and then brighter later.

Skin

Skin is brown, warm, dry, clean, and intact. No rashes or lesions

noted.

HEENT

Head is normocephalic, atraumatic, and without lesions; hair evenly

distributed. Eyes: PERRLA. EOMs intact. No conjunctival or scleral
injection. Ears: Canals patent. Bilateral TMs pearly gray with positive
light reflex; landmarks easily visualized. Nose: Nasal mucosa pink;
normal turbinates. No septal deviation. Neck: Supple. Full ROM; no
cervical lymphadenopathy; no occipital nodes. No thyromegaly or
nodules. Oral mucosa, pink and moist. Pharynx is nonerythematous
and without exudate. Teeth are in good repair.

Cardiovascular

S1, S2 with regular rate and rhythm. No extra sounds, clicks, rubs,
or murmurs. Capillary refills two seconds. Pulses 3+ throughout. No
edema.

Respiratory

Symmetric chest wall. Respirations regular and easy; lungs clear to

auscultation bilaterally.

Gastrointestinal

Abdomen obese; BS active in all the four quadrants. Abdomen soft,

nontender. No hepatosplenomegaly.

Breast

Breast is free from masses or tenderness, no discharge, no dimpling,

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wrinkling, or discoloration of the skin.

Genitourinary

Bladder is nondistended; no CVA tenderness. External genitalia

reveals coarse pubic hair in normal distribution; skin color is
consistent with general pigmentation. No vulvar lesions noted. Well
estrogenized. A small speculum was inserted; vaginal walls are pink
and well rugated; no lesions noted. Cervix is pink and
nulliparous. Scant clear to cloudy drainage present. On bimanual
exam, cervix is firm. No CMT. Uterus is antevert and positioned
behind a slightly distended bladder; no fullness, masses, or
tenderness. No adnexal masses or tenderness.Ovaries are
nonpalpable.

(Male: Both testes are palpable, no masses or lesions, no hernia,

and no uretheral discharge.)

(Rectal as appropriate: No evidence of hemorrhoids, fissures,

bleeding, or masses—Males: Prostrate is smooth, nontender, and
free from nodules, is of normal size, and sphincter tone is firm).

Musculoskeletal

Full ROM seen in all four extremities as the patient moved about the
exam room.

Neurological

Speech clear. Good tone. Posture erect. Balance stable; gait normal.

Psychiatric

Alert and oriented. Dressed in clean slacks, shirt, and

coat. Maintains eye contact. Speech is soft, though clear and of
normal rate and cadence; answers questions appropriately.

Lab Tests

Urinalysis—pending

Urine culture—pending

Wet prep—pending

Special Tests

Diagnosis

o Include at least three differential diagnosis

o Final diagnosis
 Evidence for final diagnosis should
be documented in your Subjective and
Objective exams.

PLAN including education

o Plan:
 Further testing

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  Medication
 Education
 Nonmedication treatments
 Follow-up

Week 4 - Assignment 1 Discussion

Assignment 1: Grand Rounds
As a major project in this course, you will deliver a Grand Rounds presentation.
The health care topic for this presentation will be decided by your course faculty based on
the results of the APEA Pre-Predictor Exam in Week 1. Your presentation will consist of a
patient scenario that you experienced in your clinical setting. The format of your
presentation can be Microsoft PowerPoint. APA format is also expected, and references
should be cited. Include references at the bottom of the slides and a final reference list on
the last slide.
Your goal is to:
Provide a case study to go with the diagnosis.
Utilize research articles or other materials to support your findings.
Identify any practice barriers, issues, or problems (including cultural diversity and
healthcare literacy).
Discuss best practices for optimal outcomes.
In addition to submitting your presentation, you will also be expected to lead a discussion
throughout the week.You will want to keep the presentation interesting, professional, and
focused to the topic.
When the week is over, you will update, revise, and complete your presentation on the
basis of student comments and instructor feedback.
In Week 1, the instructor will divide the class into groups and assign you a week in which
you will be expected to present your case. Some of you will present in Week 4, some will
present in Week 7, and the remainder will present in Week 9.
Those who are not presenting in a given week are responsible for participating in at least
two presentations.
For additional details, please see the Grand Rounds assignment page in the week in which
you are assigned to present.
Submission Details:
Name your document SU_NSG6440_W4_A1_LastName_FirstInitial.doc.
Week 5 -Assignment 1 Discussion
Assignment 1: Discussion
As a family nurse practitioner, you are working in a rural health clinic. You are evaluating a
16-year-old adolescent patient who comes in complaining of having difficulty concentrating
in school. On exam, you also note that the patient is very thin and frail in appearance and is
asking you for diet pills.

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What are some initial areas for concern? What screening tools can help lead you closer to
your diagnosis?
Describe 1 health promotion strategy you can discuss with the patient.
Be sure to address the following in your plan of care: pharmacological and non-
pharmacological (OTC) interventions, labs, follow-up, teaching, and referral/s.
Your work should integrate course resources (text/s) as well as a minimum of two (2) other
evidence-based guidelines and/or articles published within 3–5 years.
Submission Details:
Name your document SU_NSG6440_W5_A1_LastName_FirstInitial.doc.
Submit by Saturday, November 4, 2017.
Week 6 -Assignment 1 Discussion
Assignment 1: SOAP Note
Each week, you are required to enter your patient encounters into eMedley. Your faculty will
be checking to ensure you are seeing the right number and mix of patients for a good
learning experience. You will also need to include a minimum of one complete SOAP note
using the SOAP Note template.
SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-
Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of
patient identification from the SOAP note format. Provide a reference (s) for the differential
diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time
frame and come from a textbook, guideline, or currently published peer reviewed journal
article.
Submission Details:
By Wednesday, November 15, 2017, enter your patient encounters into eMedley and
complete at least one SOAP note in the template provided.
Include the reference number from eMedley in your document.
Submit your SOAP note into the discussion area below by Sunday, November 12, 2017
along with clinical insights about your case.
Respond to two peers with a substantial response that includes supportive references by
Wednesday, November 15, 2017.
Week 7 -Assignment 1 Discussion
Assignment 1: Grand Rounds
As a major project in this course, you will deliver a Grand Rounds presentation.
The health care topic for this presentation will be decided by your course faculty based on
the results of the APEA Pre-Predictor Exam in Week 1. Your presentation will consist of a
patient scenario that you experienced in your clinical setting. The format of your
presentation can be Microsoft PowerPoint. APA format is also expected, and references
should be cited. Include references at the bottom of the slides and a final reference list on
the last slide.
Your goal is to:

Copyright © 2015 Pearson Canada Inc. vii

Provide a case study to go with the diagnosis.
Utilize research articles or other materials to support your findings.
Identify any practice barriers, issues, or problems (including cultural diversity and
healthcare literacy).
Discuss best practices for optimal outcomes.
In addition to submitting your presentation, you will also be expected to lead a discussion
throughout the week.You will want to keep the presentation interesting, professional, and
focused to the topic.
When the week is over, you will update, revise, and complete your presentation on the
basis of student comments and instructor feedback.
In Week 1, the instructor will divide the class into groups and assign you a week in which
you will be expected to present your case. Some of you will present in Week 4, some will
present in Week 7, and the remainder will present in Week 9.
Those who are not presenting in a given week are responsible for participating in at least
two presentations.
For additional details, please see the Grand Rounds assignment page in the week in which
you are assigned to present.
Submission Details:
Name your document SU_NSG6440_W7_A1_LastName_FirstInitial.doc.
Submit by Saturday, November 18, 2017.
Week 8 - Assignment 1 Discussion
Assignment 1: SOAP Note
Each week, you are required to enter your patient encounters into eMedley. Your faculty will
be checking to ensure you are seeing the right number and mix of patients for a good
learning experience. You will also need to include a minimum of one complete SOAP note
using the SOAP Note template.
SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-
Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of
patient identification from the SOAP note format. Provide a reference (s) for the differential
diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time
frame and come from a textbook, guideline, or currently published peer reviewed journal
article.
Submission Details:
By Wednesday, November 29, 2017, enter your patient encounters into eMedley and
complete at least one SOAP note in the template provided.
Include the reference number from eMedley in your document.
Submit your SOAP note into the discussion area below by Sunday, November 26, 2017
along with clinical insights about your case.
Respond to two peers with a substantial response that includes supportive references by
Wednesday, November 29, 2017.

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Week 9 -Assignment 1 Discussion
Assignment 1: Grand Rounds
This week continues the Grand Rounds presentations as assigned by the instructor.
Those who are not presenting this week are responsible for participating in at least two
presentations.
Keep in mind the following guidelines while taking part in this assignment:
For those who are presenting, post your presentation to this Discussion Area by Saturday,
December 2, 2017.Begin facilitating the discussion and continue to lead it throughout the
week.
For those who are participants this week, begin participating on Saturday, December 2,
2017, and continue until the end of the week.
For the presenters:
The Grand Rounds presentation should consist of a patient scenario that you experienced in
your clinical setting or a diagnosis that has been covered within the course material prior to
this week. This may be presented in Microsoft PowerPoint or Microsoft Word format
Your goal is to:
Provide a case study to go with the diagnosis.
Utilize research articles or other materials to support your findings.
Identify any practice barriers, issues, or problems (including cultural diversity and
healthcare literacy).
Discuss best practices for optimal outcomes.
In addition to submitting your presentation, you will also need to lead a discussion. Here are
some guidelines:
To prepare for your presentation, rehearse the key points and findings of your research and
think about points you can make to initiate the discussion and keep it going.
Develop questions you can ask to initiate the discussion and keep it going.
As you approach the end of the discussion period, ask participants to:
Summarize the discussion.
Draw conclusions from the collective group discussion.
Keep the presentation interesting, professional, and focused to the topic. APA format is
expected and references should be cited. If you are presenting on Microsoft PowerPoint,
include references at the bottom of the slide(s) and a final reference list on the last slide.
When the week is over, update/revise/complete your presentation based on students'
comments and instructor's feedback.
For the participants:
Those who are not assigned to present this week should review at least two presentations
and participate in the discussion. Here are some guidelines for participation:
Prepare for the discussion by reading the presenter's submission.

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Keep your participation at the level of critical thinking—analyzing, synthesizing, and
evaluation. Make connections between what you are learning in this course and what you
already know.
Make comparisons, note contrasts, and challenge points of view. Interact with both
presenters and other students.
Add to the experience what you might have read about the topic or experienced personally.
Be prepared to substantiate your points of view.
At the end of the week, be prepared to summarize or draw conclusions from the
presentation experience.
Week 10 - Assignment 1 Discussion
Assignment 1: Evidence-Based Clinical Intervention
By Friday, December 8, 2017, submit your Evidence-Based Clinical Intervention to the
Discussion Area.
Your Evidence-Based Clinical Intervention should be submitted in a Microsoft Word
document following APA style and should include the following:
The medical problem/diagnosis/disease.
Typical presenting signs and symptoms including:
Onset, Characteristics, Location, Radiation, Timing, Setting, Aggravating factors, Alleviating
factors, Associated symptoms, Course since onset, Usual age group affected
Concomitant disease states associated with the diagnosis
The pathophysiology of the problem.
Three differential diagnoses and the usual presenting signs and symptoms in priority
sequence with rationales.
Reference to at least two current journal articles that show evidence-based practice as how
to best treat this disorder related to the primary differential.
The expected outcomes of the intervention.
Algorithms if available.
A typical clinical note in SOAP format.
Respond to at least two of your classmates' Evidence-Based Clinical Interventions using the
lessons and vocabulary found in the reading. Support your answers with examples and
research. Your responses should clarify your understanding of the topic. They should be
your own, original, and free from plagiarism. Follow the APA format for writing style,
spelling and grammar, and citation of sources.
Week 10 -Assignment 2 Discussion
Assignment 2: Reflection
By Saturday, December 9, 2017, reflect on the course and what you have learned over the
last ten weeks. Write up a brief summary of how you meet each course objective. Include
examples from both the course and practicum experiences.

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Post your response to the Discussion Area by Saturday, December 9, 2017. Include
references to support your work. Respond to at least two of your peers providing substantial
feedback supported with references.

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