Category: Nursing

Submission Type

15-minute video

Details

Record yourself performing a head-to-toe assessment, including cranial nerves 1-12, of an adult volunteer subject. Your subject must be at least 18 years old. Exceptions may be made by your instructor on a case-by-case basis.

Video should be no longer than 15 minutes. You must have the subject fill out and sign a . The signed consent by the adult volunteer must be attached along with the recordings. No consent, no grading.

Please create a clinical judgment plan based on the patient in the NPW 2 file I uploaded and using the template I provided as well. Please adhere to the rubric below and include scholarly sources as well as a turn it in plagiarism score below 5% Rubric History of present illness (HPI) and Admitting Diagnosis 8 pts Proficient Explains 1) HPI and 2) admitting pathophysiology in detail with clear and accurate and in-depth understanding of chief complaint. 3) Evidence-based rationales clearly and accurately support the HPI. Pathophysiology of past medical/surgical/social histories 8 pts Proficient Includes 1) all past medical, surgical, and social history detailed with 2) full explanation of pathophysiology for each diagnosis. 3) Thoroughly describes potential complications for each diagnosis and the indications for surgery. 4) Clearly and accurately relates the client’s past history and current signs/symptoms with evidence-based citations. Social Determinants of Health 4 pts Proficient Clearly and accurately 1) describes socioeconomic and psychosocial background in detail 2) with evidence-based citations to support social determinants of health. 3) Identifies at least 3 or more psychosocial concerns with interventions/ recommendations. Eriksons Developmental Stages 4 pts Proficient 1) Identifies and 2) defines correct stage 3) with examples of meeting/not meeting tasks 4) supported by evidenced-based citations. Teaching Assessment & Client Education 4 pts Proficient Clearly and accurately 1) identifies areas of instructional needs, 2) learning preference, and 3) learning barriers. 4) Provides clear and concise client education related to their condition that will aid in health promotion, health maintenance and self-care activities. 5) Client education is supported by evidence-based practice. Interprofessional Consults and Multidisciplinary Plan 4 pts Proficient 1) Lists at least 3 appropriate collaborative issues/concerns. 2) Identifies 3 interdisciplinary consults to support patient well-being. 3) Evidence- based rationales demonstrate clear and accurate understanding of consults and interventions. Discharge Planning 4 pts Proficient Clearly and accurately 1) describes issues/concerns related to discharge planning 2) with evidence-based rationales. Labs 4 pts Proficient Clearly and accurately 1) identifies admission and current pertinent laboratory tests with applicable indications, 2) addresses abnormal values, and 3) recognizes trends related to a clients disease process 4) with evidence-based rationales. Diagnostics/procedures 4 pts Proficient Clearly and accurately 1) describes the clients diagnostic criteria and indications 2) with evidence- based rationales that clearly support the chief complaint and presenting signs/symptoms. Medications 8 pts Proficient Clearly and accurately 1) identifies all components of the medication list, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the clients current health condition, 2) with evidence-based citations. Assessment & Review of Systems 14 pts Proficient 1) Documents thorough Head-to-Toe physical assessment with relevant information to the patient/client as performed by the student. 2) Utilizes an organized format and appropriate terms to describe both normal and abnormal assessment findings. Recognition of cues (Assessment) 4 pts Proficient Identifies all imperative cues taken from the environment, patient assessment/observation, medical record, other resources, time pressures, task complexity, and cultural considerations. Minimum of 15 cues required. Analysis of cues (Analysis) 6 pts Proficient 1) Links and clusters recognized cues to the client’s clinical presentation. Accurately 2) establishes prioritized client needs based off the patients clinical presentation. Clearly and accurately clusters cues to establish probable patient needs, concerns, or problems. Prioritization of hypotheses (Analyze) 4 pts Proficient 1) Establishes 4 priorities of care based on the client’s health problems (i.e., environmental factors, risk assessment, urgency, signs/symptoms, diagnostic tests, lab values). 2) The clinical decision is clear, accurate, and presents correlation from the recognized cues. 3) Identifies the framework used to identify priority order (ABCs, Maslow, safety, acute v chronic, unstable v stable, urgent v non-urgent). Outcome Generation of solutions (Planning) 8 pts Proficient Clearly and accurately 1) establishes one expected outcome to address each hypothesis that can be achieved with nursing assistance to ensure a clients needs are met. Outcomes are specific, measurable, realistically attainable, and appropriately timed. 2) Identifies 4 solutions for each outcome supported by evidence-based practice. Clearly and accurately identifies at least 16 solutions that are independent nursing interventions supported by scientific rationale and evidence-based practice. Take actions (Implementation) 4 pts Proficient 1) Implements appropriate interventions in priority order based on nursing knowledge, priorities of care, and planned outcomes to promote, maintain, or restore a client’s health. 2) Nursing actions are always aimed at the expected outcomes and directed at the stated health deviation based on the nursing assessment and Eriksons stages of development. Evaluate Outcomes (Evaluation) 4 pts Proficient Clearly and accurately 1) identifies criteria for evaluation, effectiveness of interventions, and measurement of goal completion. 2) Evaluation is clearly and accurately linked to the generated solutions and overall plan of care. 3) Modifies, revises, and recommends alternative solutions with evidence-based citations as applicable. General Organization 4 pts Proficient 1) Clear and accurate APA format. 2) Concisely appropriate citations and references. 3) No spelling or grammar errors.

SMART Goal and Clinical Experience Reflection I gain more knowledge in peds im more comfortable with kids more assesment medicationt focus the goal mainly by finishing the class

Remember the SMART Goal Template you completed in Module 1? Now is the time to reflect on your accomplishments this term. For your intial post, write or talk about the obstacles you overcame, and how you feel you did in accomplishing your goal. Include your key takeaways from your clinical experience and include anything you wish you could have learned more about.

Submission Instructions:

• Your initial post can be either a video or text.
• In the spirit of collaboration, feel free to support your colleagues by responding to their posts.
• This discussion forum is graded as Complete/Incomplete.
• Pleas

Initial Post Instructions

In your initial post, address the following:

1. Identify the health problem.
2. Clearly state the primary diagnosis you are focusing on for this discussion.
3. Describe current management.
4. How is your patient currently being managed? Include medications, referrals to specialists, monitoring, and lifestyle/behavioral interventions (e.g., smoking cessation, inhaler technique, diet, activity). Briefly compare this current management to the relevant guideline recommendations.
5. Evaluate opportunities to optimize care.
6. Based on the guideline(s), is there anything you would consider doing differently or in addition? For example:

• Do any medications need to be started, uptitrated, or deprescribed?
• Are additional labs or diagnostics indicated?
• Are comorbidities influencing your plan?
• Is referral to a specialist or another service appropriate?

1. Patient counseling and education.
2. What specific counseling or education would you provide for this patient related to their condition, medications, self-management, and risk reduction?

Expectations for Your Initial Post

• Address all four questions listed above.
• Demonstrate clear, stepwise clinical reasoning.
• Approximate length: around 300 words.
• Reference the guideline(s) or key evidence you are using, as appropriate.

The Patient I Seen: 58-year-old female presented with cough and left axillary pain. She is a smoker with a history of COPD and currently uses Trelegy. Reports shortness of breath with prolonged walking. Phlegm is clear. Also reports headache for the past 23 days, slight runny nose, and ear pressure. She has a pulmonology appointment scheduled for Wednesday. Prescribed Promethazine DM at night, albuterol four times daily, and Mucinex 600 mg BID. Assessment consistent with COPD exacerbation. Return precautions reviewed.

Use this source as your reference: Hollier, A. (2021). Clinical guidelines in primary care (4th ed.). Advanced Practice Education Associates.

Develop, in detail, a situation in which a health care worker might be confronted with ethical problems related to patients and prescription drug use OR patients in a state of poverty.

• Your scenario must be original to you and this assignment. It cannot be from the discussion boards in this class or any other previous forum.
• Articulate (and then assess) the ethical solutions that can found using “care” (care-based ethics) and “rights” ethics to those problems.
• Assessment must ask if the solutions are flawed, practicable, persuasive, etc.
• What health care technology is involved in the situation? What moral guidelines for using that kind of healthcare technology should be used there? Explore such guidelines also using utilitarianism, Kantian deontology, ethical egoism, or social contract ethics.
• Say how social technologies such as blogs, crowdfunding, online encyclopedias can be used in either case. What moral guidelines for using that kind of healthcare technology should be used there? Develop such guidelines also using utilitarianism, Kantian deontology, ethical egoism, or social contract ethics.

You should not be using any text you used in a discussion board or assignment for this class or any previous class.

Cite the textbook and incorporate outside sources, including citations.

Requirements

• Length: 2-3 pages (not including title page or references page)
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 2 scholarly sources)

Assignment Instructions

1. Describe area of interest and focus of the evidence-based practice quality improvement project
2. Describe the Johns Hopkins Nursing Evidence Based Practice Model
3. Describe each component of the model
4. Restate the clinical/practice question developed in NR520 (Note clinical/practice question might need to be revised)
5. Identify how the model will guide, inform, and support the evidence-based practice quality improvement project.
6. Abide by the Chamberlain College of Nursing Academic Integrity Policy.
7. Sources older than five years may not be used without the permission of the class professor.
8. Title page, pagination, subheadings, body of paper, citation of sources, and reference page must follow APA guidelines as found in the most current edition of the manual.
9. Rules of grammar, spelling, word usage, punctuation, sentence and paragraph structure are followed and consistent with formal, scholarly writing as noted in the most current edition of the APA Manual.
10. Please note: If you do not receive a proficient rating in any major content category, you can re-submit your assignment with revisions in those content categories to receive a better grade. You have one additional opportunity to revise after the initial submission in order to make improvements. The initial submission must be a complete paper, rough drafts will not be graded. All revisions must be submitted no later than Sunday of Week 7 at 11:59pm. (You cannot revise your APA for a higher grade in that category)