When the practitioner is preparing to advertise the program being offered, the local newspaper asks the practitioner to identify three of the main objectives of the sports physicals for an article. How would the practitioner respond?

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REPLY TO CASE STUDY (3) REFERENCES NEEDED WITH ANSWERS.

Sports Physicals

In the sports medicine field, the sports physical exam is known as a preparticipation physical examination (PPE). The exam helps determine whether it is safe for you to participate in a certain sport. Most states actually require that kids and teens have a sports physical before they can start a new sport or begin a new competitive season. But even if a sports physical is not required, doctors still highly recommend getting one.

Case Study

The administration of the local critical access hospital has asked the practitioner to organize a community service program to conduct sports physicals for local junior high and high school athletes at no cost to the student. The practitioner has the use of the usual physician office space or the facility’s large meeting space and will recruit physicians, nurse practitioners, nursing staff, and medical technicians to conduct the sports physicals. Based on a survey of nearby school districts, the administration expects to serve 100 to 150 student athletes over the 2 days the physicals will be offered.

Case Questions

Which format would most effectively serve the needs of the students in this program? Include consideration of the space chosen for conducting the program.

Which space would be most appropriate to use for the program and why?

What are the drawbacks to the assembly-line format?

Which physical examination focus points could the nursing staff and medical technicians be assigned to complete?

When the practitioner is preparing to advertise the program being offered, the local newspaper asks the practitioner to identify three of the main objectives of the sports physicals for an article. How would the practitioner respond?

 

How will the sample be selected? What type of sampling method is used? Is it appropriate to the design? Does the sample reflect the population as identified in the problem or purpose statement?

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Nursing Research Identified Problems Stroke Patients and the Lack of Access to the Community Resources.

Begin your discussion by sharing your problem statement and research question. Next, discuss your sampling plan. In addition, discuss your research design. Consider the following as you craft your response.

Sampling
How will the sample be selected?
What type of sampling method is used? Is it appropriate to the design?
Does the sample reflect the population as identified in the problem or purpose statement?
Is the sample size appropriate? Why or why not?
To what population may the findings be generalized? What are the limitations in generalizability?

Research design
What type of design will be used?
Does the design seem to flow from the proposed research problem, theoretical framework, literature review, and hypothesis?

What was the patient’s subjective complaint? What details did the patient provide regarding their history of present illness and personal and medical history? Include a list of prescription and over-the-counter drugs the patient is currently taking. Compare this list to the American Geriatrics Society Beers Criteria®, and consider alternative drugs if appropriate.

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ASSESSING, DIAGNOSING, AND TREATING DEMENTIA, DELIRIUM, AND DEPRESSION

In so many countries, to be old is shameful; to be mentally ill as well as old is doubly shameful. In so many countries, people with elderly relatives who are also mentally ill are ashamed and try to hide what they see as a disgrace on the family.

—Dr. Nori Graham, Psychiatrist and Honorary Vice President of Alzheimer’s Disease International

In this quote, Dr. Graham is expressing her observations and experiences in her work with numerous international organizations. Many patients and their families experience feelings of anxiety and shame upon receiving a diagnosis of dementia, delirium, or depression. Among caregivers, 36% report having tried to hide the dementia diagnosis of their family member (Alzheimer’s Disease International, 2019). As an advanced practice nurse providing care to patients presenting with dementia, delirium, and depression, it is critically important to consider the impact of these disorders on patients, caregivers, and their families. A thorough understanding of the health implications of these disorders, as well as each patient’s personal concerns, will aid you in making effective treatment and management decisions.

This week, you explore geriatric patient presentations of dementia, delirium, and depression. You also examine assessment, diagnosis, and treatment for these disorders and complete a SOAP (subjective, objective, assessment, and plan) note.
With the prevalence of dementia, delirium, and depression in the growing geriatric population, you will likely care for elderly patients with these disorders. While many symptoms of dementia, delirium, and depression are similar, it is important that you are able to identify those that are different and properly diagnose patients. A diagnosis of one of these disorders is often difficult for patients and their families. In your role as an advanced practice nurse, you must help patients and their families manage the disorder by facilitating necessary treatments, assessments, and follow-up care.

To prepare:

Review the case study provided by your Instructor. Reflect on the way the patient presented in the case, including whether the patient might be presenting with dementia, delirium, or depression.
Reflect on the patient’s symptoms and aspects of disorders that may be present. What distinct symptoms or factors would lead you to a diagnosis of dementia, delirium, or depression?
Consider how you might assess, perform diagnostic tests, and recommend medications to treat patients presenting with the symptoms in the case.
Access the Focused SOAP Note Template in this week’s Resources.

The Assignment:

Complete the Focused SOAP Note Template provided for the patient in the case study. Be sure to address the following:

Subjective: What was the patient’s subjective complaint? What details did the patient provide regarding their history of present illness and personal and medical history? Include a list of prescription and over-the-counter drugs the patient is currently taking. Compare this list to the American Geriatrics Society Beers Criteria®, and consider alternative drugs if appropriate. Provide a review of systems.

Objective: What observations did you note from the physical assessment? What were the lab, imaging, or functional assessments results? How would you interpret and address the results of the Mini-Mental State Examination (MMSE)?

Assessment: Provide a minimum of three differential diagnoses. List them from top priority to least priority. Compare the diagnostic criteria for each, and explain what rules each differential in or out. Explain you critical thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.

Plan: Provide a detailed treatment plan for the patient that addresses each diagnosis, as applicable. Include documentation of diagnostic studies that will be obtained, referrals to other healthcare providers, therapeutic interventions, education, disposition of the patient, caregiver support, and any planned follow-up visits. Provide a discussion of health promotion and disease prevention for the patient, taking into consideration patient factors, past medical history (PMH), and other risk factors. Finally, include a reflection statement on the case that describes insights or lessons learned.

Provide at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines, which relate to this case to support your diagnostics and differentials diagnoses. Be sure they are current (no more than 5 years old) and support the treatment plan in following current standards of care. Follow APA 7th edition formatting.
Reminder Links to an external site.: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

To prepare:

Review the case study you chose. Reflect on the way the patient presented in the case, including whether the patient might be presenting with dementia, delirium, or depression.
Reflect on the patient’s symptoms and aspects of disorders that may be present. What distinct symptoms or factors would lead you to a diagnosis of dementia, delirium, or depression?
Consider how you might assess, perform diagnostic tests, and recommend medications to treat patients presenting with the symptoms in the case.

REMEMBER SOAP NOTES ARE VIRTUAL NOTE YOU WILL NOT HAVE ALL THE INFORMATION PROVIDED FOR YOU – YOU FILL IN THE BLANKS FROM PREVIOUS PATIENTS YOU HAVE SEEN, OR WHAT YOU THINK WOULD BE APPROPRIATE. DO NOT WRITE “ INFORMATION NOT PROVIDED” – YOU WILL NEED TO REDO THE NOTE.

Access the Focused SOAP Note Template in this week’s Resources
Remember to use the soap note resources, geriatric assessments forms, and other resources in doc sharing. Review the format of the soap note, the MMSE, heart murmurs, neuro/ musculoskeletal exam, CV exam etc. This is expected of you as an NP.

Case Study:
Ms. Peters is a 70-year-old female who is alert but easily distracted, at times, during today’s clinical interview. Her eye contact is fair. Speech is clear and coherent but tangential at times. She makes no unusual motor movements and demonstrates no tics. She denies any visual or auditory hallucinations. She denies any suicidal thoughts or ideations. She is alert but disoriented to place and time. She denies any falls, denies any pain. Her son does say she has had some “stumbling” and balance issues but no reported falls.
All other Review of System and Physical Exam findings are negative other than stated.
Vital Signs: 98.1 120/64 HR-72 20 Weight: BMI: (formulate these from your past experiences). Note whether the BMI falls within normal, overweight, obese, etc. There is an easy app to use you can google to plug in the Wt and Ht and it will calculate the BMI for you.

*BMI is required

PMH: Hypertension, Diabetes, Osteoporosis, Chronic Allergic Rhinitis
Allergies: Atorvastatin, rash
Medications:
• Multivitamin daily
• Losartan 50mg daily
• HCTZ 50mg daily
• Fish Oil 1 tablet daily
• Glyburide 5mg daily
• Metformin 500mg BID
• Donepezil 10mg daily
• Alendronate 70mg orally once a week

Social History: As stated in Case Study
ROS: As stated in Case study
Diagnostics/Assessments done:
1. CXR—no cardiopulmonary findings. WNL
2. CT head—diffuse Cerebral Atrophy
3. MMSE—Ms. Peters scored 18 out of 30 with primary deficits in orientation, registration, attention and calculation, and recall at a previous visit. At today’s visit, there is no change. The score suggests moderate dementia.
4. Hemoglobin A1C 2%
5. Basic Metabolic Panel as shown below

TEST RESULT REFERENCE RANGE
GLUCOSE 90 65–99
SODIUM 130 135–146
POTASSIUM 3.4 3.5–5.3
CHLORIDE 104 98–110
CARBON DIOXIDE 29 19–30
CALCIUM 9.0 8.6–10.3
BUN 20 7–25
CREATININE 1.00 0.70–1.25

GLOMERULAR FILTRATION RATE (eGFR) 77 >or=60 mL/min/1.73m2

Upon reviewing her labs – what is your diagnosis for Ms. Peters? Look carefully at the labs, her PMH, and current symptoms. What is your treatment plan? Remember that she is already being treated for dementia. Part of making a correct diagnosis is being a detective – do not miss the simple diagnosis, nor the common symptoms. Your primary diagnosis should be one of the differential diagnoses. Include a rationale of why you ruled in – or ruled out the ddx and chose the primary diagnosis. (The standard is at least 3 ddx, with one of these being your primary dx).

Note: Be sure to review the Mini-Mental State Exam (MMSE) and how to interpret results. Use the MMSE, in the attached document, to determine the patient’s MMSE score in the video. Make sure you document the patient’s score in your SOAP note document: Mental State Assessment Tests.

Reference:
Alzheimer’s Disease International. (2019). World Alzheimer report 2019: Attitudes to dementia. Author. https://www.alz.co.uk/research/world-report-2019

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Psychosocial disorders. In Advanced practice nursing in the care of older adults (2nd ed., pp. 428–469). F. A. Davis.
Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Appendix B: Laboratory values in the older adult. In Advanced practice nursing in the care of older adults (2nd ed., pp. 505–506). F. A. Davis.

Note: See the labs that are relevant to this week’s topics.

Laske, R. A., & Stephens, B. A. (2018). Confusion states: Sorting out delirium, dementia, and depression. Nursing Made Incredibly Easy! Links to an external site., 16(6), 13–16. https://doi.org/10.1097/01.NME.0000546254.38666.1f
NIH National Institute on Aging. (2017). Basics of Alzheimer’s disease and dementia: What is Alzheimer’s disease? Links to an external site.[Multimedia file]. https://www.nia.nih.gov/health/what-alzheimers-disease

Demonstrate your ability to provide age-appropriate anticipatory guidance while recognizing the need to refer patients that are outside of the scope of practice of the family nurse practitioner.

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SOAP Note Write Up for VR Patient Anna Jones

Demonstrate your ability to provide age-appropriate anticipatory guidance while recognizing the need to refer patients that are outside of the scope of practice of the family nurse practitioner. This will be demonstrated by completing a SOAP note based on a patient Anna Jones seen in Unit 6 in the VR platform.

Write-ups

The SOAP note serves several purposes:

It is an important reference document that provides concise information about a patient’s history and exam findings at the time of patient visit.

It outlines a plan for addressing the issues which prompted the office visit. This information should be presented in a logical fashion that prominently features all of the data that’s immediately relevant to the patient’s condition.

It is a means of communicating information to all providers who are involved in the care of a particular patient.

It allows the NP student an opportunity to demonstrate their ability to accumulate historical and examination-based information, make use of their medical knowledge, and derive a logical plan of care.

Knowing what to include and what to leave out will be largely dependent on experience and your understanding of illness and pathophysiology. If, for example, you were unaware that chest pain is commonly associated with coronary artery disease, you would be unlikely to mention other coronary risk-factors when writing the history. As you gain experience, your write-ups will become increasingly focused. You can accelerate the process by actively seeking feedback about all the SOAP notes that you create, as well as by reading those written by more experienced practitioners.

The core aspects of the SOAP note are described in detail below.

For ease of learning, a SOAP Note Template has been provided. For this assignment, proper citation and referencing is required because this is an academic paper.

S: Subjective information. Everything the patient tells you. This includes several areas including the chief complaint (CC), the history of present illness (HPI), medical history, surgical history, family history, social history, medications, allergies, and other information gathered from the patient. A commonly used mnemonic to explore the core elements of the history of present illness (HPI) is OLD CARTS, which includes: Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Treatments, and Severity.

O: Objective is what you see, hear, feel or smell. Your physical exam including vital signs.

A: Assessment/ Your differentials

P: Plan of care including health promotion and disease prevention for the patient related to their age and gender.

If there are any questions, please contact your instructor.

DUE: to the Journal Dropbox by end of the unit week, end of day (EOD) Tuesday.

To view the Grading Rubric for this assignment, please visit the Grading Rubrics section of Course Resources.

 

Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected. Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.

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Portfolio Assignment: Global Healthcare Comparison Matrix and Narrative Statement

If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?
You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.

Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.

In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.

To Prepare:
• Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
• Select at least one additional country to compare to the U.S. for this Assignment.
• Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
• Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix
Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:
• Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
• Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
• Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
• Explain how the health policy you selected might impact the role of the nurse in each country.
• Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

 

Part 2: A Plan for Social Change
Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.
In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.
• Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented.

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 National healthcare issue/stressor

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

 

Explain the pathophysiologic processes of select health conditions. Predict clinical manifestations and complications of select disease processes. Correlate lifestyle, environmental, and other influence with changes in levels of wellness.

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Pathophysiological Processes Project

Course Outcomes: This assignment enables the student to meet the following course outcomes.

  1. Explain the pathophysiologic processes of select health conditions.
  2. Predict clinical manifestations and complications of select disease processes.
  3. Correlate lifestyle, environmental, and other influence with changes in levels of wellness.

Requirements:

NOTE: Students should NOT provide any medical/nursing advice or education to interviewees. This assignment is for educational purposes only. Refer interviewee questions to their physician.

  1. Each student is to choose a chronic medical disorder that they would like to learn more about from a list provided.
  2. It is the responsibility of the student to research the topic using current literature, become familiar with the pathophysiology, causes, risk factors, common clinical manifestations and common complications for the disorder.
  3. Once the student has become familiar with the disorder, it is their responsibility to locate an individual to interview . You may find the individual with approved disorder first but should not perform the interview until you have completed research on the topic.

 

Review and critique the techniques and methods of a mental health professional as the practitioner completes a comprehensive, integrated psychiatric assessment of an adolescent. Identify rating scales and treatment options that are specifically appropriate for children/adolescents.

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DISCUSSION BOARD WEEK 1 WALDEN U PMHNP NURS 6665

Many assessment principles are the same for children and adults; however, unlike with adults/older adults, where consent for participation in the assessment comes from the actual client, with children it is the parents or guardians who must make the decision for treatment. Issues of confidentiality, privacy, and consent must be addressed. When working with children, it is not only important to be able to connect with the pediatric patient, but also to be able to collaborate effectively with the caregivers, other family members, teachers, and school counselors/psychologists, all of whom will be able to provide important context and details to aid in your assessment and treatment plans.

Some children/adolescents may be more difficult to assess than adults, as they can be less psychologically minded. That is, they have less insights into themselves and their motivations than adults (although this is not universally true). The PMHNP must also take into consideration the child’s culture and environmental context. Additionally, with children/adolescents, there are lower rates of neurocognitive disorders superimposed on other clinical conditions, such as depression or anxiety, which create additional diagnostic challenges.

In this Discussion, you review and critique the techniques and methods of a mental health professional as the practitioner completes a comprehensive, integrated psychiatric assessment of an adolescent. You also identify rating scales and treatment options that are specifically appropriate for children/adolescents.

The study noted that researchers did not plan to generate findings that would be generalizable. What does this mean? To find out about the limitations of the research and the generalizability of the outcomes, where should the nurse search in the article?

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Nursing grand rounds (NGR)

The staff development nurse is creating a series of nursing grand rounds (NGR) and reviewing an article on this topic . The goal is to make the NGR as accessible as possible because the leadership team wants maximal participation. This facility is one of four inner-city hospitals that make up a health system.

The study reviewed notes that “most nurses prefer online recordings for NGR.” When the nurse implements the NGR via online recordings, a great number of nurses do not access the online recordings. How might this be explained because it is different than what the research reported?

The study noted that researchers did not plan to generate findings that would be generalizable. What does this mean?

To find out about the limitations of the research and the generalizability of the outcomes, where should the nurse search in the article?

 

Ask five lay persons the exact same question in the exact same manner. Summarize your findings and report to the class.

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What is the purpose of nursing?

Ask five nurses the following question. Ask the question without explanation or expansion. Tell them you are doing a class project and need the following question answered. There are no right or wrong answers. “What is the purpose of nursing?” Ask five lay persons the exact same question in the exact same manner. Summarize your findings and report to the class. When you complete this project, you will have just completed your first qualitative research project. Albeit an abbreviated one, but nonetheless, a qualitative study.