Nurse Practitioner working in a community
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NSG 6440 All Week Discussion
NSG 6440 Week 1 Discussion
Discussion Questions
You are a Family Nurse
Practitioner working in a community health center. You are seeing a
14-year-old adolescent patent for an annual visit. The patient’s mother is also
present during the visit and notes that the patient’s grades in school have
been declining. Her son is also hanging out with a group of kids that she has
concerns about. The mother has concerns for what is going on with her son.
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 an annual exam for an adolescent
patient?
- Is the mother required to be present during your exam?
- Describe 1 health promotion idea that you would discuss with your
middle adolescence patient. Why is this idea important?
- What are some screening tools that might be of
importance in this situation? (hint: do you suspect drug or alcohol abuse
here?)
NSG 6440 Week 2 Discussion
This week you learned about common conditions in the adolescent
client. Please review the following case study and answer the following
questions.
A fifteen-year-old female presents to your
clinic complaining of shortness of breath and a nonproductive nocturnal cough.
She states she used to feel this way only with extreme exercise, but lately,
she has felt this way continuously. She denies any other upper respiratory
symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her
past medical history is significant only for seasonal allergies, for which she
takes a nasal steroid spray but is otherwise on no other medications. She has
had no surgeries. Her mother has allergies and eczema, and her father has high
blood pressure. She is the only child. She denies smoking and illegal drug use.
On examination, she is in no acute distress and her vital signs are: T 98.6, BP
120/80, pulse 80, and respirations 20. Her head, eyes, ears, nose, and throat
examinations are essentially normal. Inspection of her anterior and posterior
chest shows no abnormalities. On auscultation of her chest, there is decreased
air movement and high-pitched whistling on expiration in all lobes. Percussion
reveals resonant lungs.
- What is the chief complaint?
- Based on the subjective and objective information provided what are
your 3 top differential diagnosis listing the presumptive final diagnosis
first?
- What treatment plan would you consider utilizing
current evidence based practice guidelines?
NSG 6440 Week 3 Discussion
In week 3 you
learned about other common adolescent health conditions. Review the
following case study and answer the following questions:
An 18 year old white female presents to your
clinic today with a 2 week history of intermittent abdominal pain. She
also is positive for periodic cramping and diarrhea as well as low grade
fever. She also notes reduced appetite. She notes that She admits smoking
½ PPD for the last 2 years. Denies any illegal drug or alcohol use. Does note a
positive history of Crohn’s Disease. Based on the information provided
answer the following questions:
- What are the top 3 differentials you would consider with the
presumptive final diagnosis listed first?
- What focused physical exam findings would be beneficial to know?
- What diagnostic testing needs completed if any to confirm
diagnosis?
- Using evidence based treatment guidelines note a
treatment plan.
Submission Details:
- Post your response to the Discussion Area by the due date assigned.
Respond to atleast two posts by the end of the week.
NSG 6440 Week 4 Discussion
This week’s content addressed common chronic
diseases. Please review the case study below and answer the following
questions:
A sixty-year-old baker presents to your
clinic, complaining of increasing shortness of breath and nonproductive cough
over the last month. She feels like she can’t do as much activity as she used
to do without becoming tired. She even has to sleep upright in her recliner at
night to be able to breathe comfortably. She denies any chest pain, nausea, or
sweating. Her past medical history is significant for high blood pressure and
coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal
bleeding. She is married and is retiring from the local bakery soon. She denies
any tobacco, alcohol, or drug use. Her mother died of a stroke, and her father
died from prostate cancer. She denies any recent upper respiratory illness, and
she has had no other symptoms. On examination, she is in no acute distress. Her
blood pressure is 160/100, and her pulse is 100. She is afebrile, and her
respiratory rate is 16. With auscultation, she has distant air sounds and she
has late inspiratory crackles in both lower lobes. On cardiac examination, the
S1 and S2 are distant and an S3 is heard over the apex.
- What is the chief complaint?
- Based on the subjective and objective information provided what are
your 3 top differential diagnosis listing the presumptive final diagnosis
first?
- What treatment plan would you consider utilizing
current evidence based practice guidelines?
Submission Details:
- Post your response to the Discussion Area by the due date assigned.
Respond to atleast two posts by the end of the week.
NSG 6440 Week 5 Discussion
Discussion Questions
The discussion assignment provides a forum
for discussing relevant topics for this week based on the course competencies
covered.
For this assignment, go to the Discussion Area and post
a response to one question in the Discussion Area by the
due date assigned. You may respond to your classmates’ posts for either
question.
To support your work, use your course and
text readings and also use the South University Online Library. As in all
assignments, cite your sources in your work and provide references for the
citations in APA format.
Start reviewing and responding to the
postings of your classmates as early in the week as possible. Respond to at
least two of your classmates’ initial postings. Participate in the discussion
by asking a question, providing a statement of clarification, providing a point
of view with a rationale, challenging an aspect of the discussion, or
indicating a relationship between two or more lines of reasoning in the
discussion. Cite sources in your responses to other classmates. Complete your
participation for this assignment by the end of the week.
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 a 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.
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.
Reference:
Centers for Disease Control and Prevention. (2013). Youth risk
behavior surveillance
system (YRBSS). Retrieved from http://www.cdc.gov/healthyyouth/data/yrbs/index.htm
system (YRBSS). Retrieved from http://www.cdc.gov/healthyyouth/data/yrbs/index.htm
NSG 6440 Week 6 Discussion
Discussion:
This week’s content discussed common
psychiatric disorders in the Adult and Older Adult client. Often times a
secondary diagnosis is masked due to their psychiatric disorder. Review
the following case study and answer the following questions.
Mr. White is a 72-year-old man, with a
history of hypertension, COPD and moderate dementia, who presents with 4 days
of increased confusion, nighttime restlessness, visual hallucinations, and
urinary incontinence. His physical exam is unremarkable except for tachypnea, a
mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score
from a baseline of 18 to 12 today.
Mr. White’s presentation is most consistent
with an acute delirium (acute change in cognition, perceptual derangement,
waxing and waning consciousness, and inattention).
- What is the most likely diagnosis to frequently cause acute
delirium in patients with dementia?
- What additional testing should you consider if any?
- What are treatment options to consider with this
patient?
Submission Details:
- Post your response to the Discussion Area by the due date assigned.
Respond to atleast two posts by the end of the week.
NSG 6440 Week 7 Assignment 1 Discussion
This week’s content addressed common techniques and testing that can be
prescribed by the Nurse Practitioner. Review ONE of the
following videos and post for the class what you have learned this week:
Watch the following video on suturing
Watch the following video on EKG rhythms
Submission Details:
- Post your response to the Discussion Area by the due date assigned.
Respond to atleast two posts by the end of the week.
NSG 6440 Week 8 Discussion
Complete The Growth and Development APEA
module. Pick one of the following topics that were reviewed: Newborn
assessment, Nutrition, Child, Adolescent, or Immunization. Please choose on
that has not been previously covered by a peer.
- What is an area that you may have forgotten?
- Explain the specific growth and development concept
in detail and describe strategies that you will undertake to assist in
retaining that information?
NSG 6440 Week 9 Discussion
This week’s content addressed professional and legal issues, state
boards of nursing, advanced practice licensure, regulations, scope of practice,
and national certification as an advanced practice nurse. It is your
responsibility to look at your individual board of nursing and remain up to
date with the changes that are carried out in your state. For this week’s
discussion review your states scope of practice and address 3 areas that you
were not aware you can do as a licensed provider in your state.
NSG 6440 Week 10 Discussion
Evidence-Based Clinical Intervention
By the due date assigned, 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.
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