You will take on the role of a clinician who is building a health history for one of the following cases.

CASE STUDY: 

CHIEF OF COMPLAINT “I had a severe headache yesterday with difficulty to speak”

History of Present Illness (HPI) A 64-year-old African American female who reports having a severe pulsatile diffuse headache yesterday with sudden difficulty to talk with last for about two hours. She did not seek medical attention. This morning she woke up with no problems but is here today due her husband advise.

PMH: Atrial Fibrillation, Hypertension. Is allergic to Non-steroidal Anti-inflammatory drugs Aspirin

Drug Hx: Losartan 50 mg, Xarelto 15 mg BID

Subjective: Feels Palpitations, joint pain with yesterday’s episode

Objective Data

VS: B/P 131/80; temperature 98.2°F;  (RR) 18;  (HR) 84, irregular; oxygen saturation (PO2) 96%;

General: well-developed female, no acute distress

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition.

Lungs: CTA AP&L

Card: Irregular heart beat with normal rate

Abd: No tenderness normoactive bowel sounds x 4;

Rectal exam: Non contributory

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

Then answer the following questions:

1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.
6. What teachings will you provide?

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic source

Write a 750- to 1,000-word summary of recommendations to your manager. Complete the following in your summary:

• Identify the potential challenges around collaboration this group might experience.
• Describe collaborative skills you would use to create a more positive atmosphere.
• Explain what would comprise effective communication for this group.

Cite a minimum of one reference to support your assignment.

Format your assignment according to APA guidelines.

 Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared. 

Activity Learning Outcomes 

Through this discussion, the student will demonstrate the ability to: 

1. Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care (CO1) 
2. Apply concepts of person-centered care to nursing practice situations (CO2) 
3. Analyze essential skills needed to lead within the context of complex systems (CO3) 
4. Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings (CO4) 

Discussion Criteria

I.   Application of Course Knowledge: of Course Knowledge: 

The student post contributes unique perspectives or insights gleaned from personal experience or examples from the healthcare field. The student must accurately and fully discuss the topic for the week in addition to providing personal or professional examples. The student must completely answer the entire initial question. 

II.  Engagement in Meaningful Dialogue: I. The student responds to a student peer and course faculty to further dialogue.

a. Peer Response: The student responds substantively to at least one topic-related post by a student peer. A substantive post adds content or insights or asks a question that will add to the learning experience and/or generate discussion.  

• A post of “I agree” with a repeat of the other student’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.
• The peer response must occur on a separate day from the initial posting.
• The peer response must occur before Sunday, 11:59 p.m. MT.
• The peer response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.

Faculty Response: The student responds substantively to at least one question by course faculty. The faculty question may be directed to the student, to another student, or to the entire class.

• A post of “I agree” with a repeat of the faculty’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.
• The faculty response must occur on a separate day from the initial posting.
• Responses to the faculty member must occur by Sunday, 11:59 p.m. MT.
• This response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.

III.  Integration of Evidence: The student post provides support from a minimum of one scholarly in-text citation with a matching reference AND assigned readings OR online lessons, per discussion topic per week.

1. What is a scholarly resource? A scholarly resource is one that comes from a professional, peer-reviewed publication (e.g., journals and government reports such as those from the FDA or CDC).
   • Contains references for sources cited
   • Written by a professional or scholar in the field and indicates credentials of the author(s)
   • Is no more than 5 years old for clinical or research article
2. What is not considered a scholarly resource?
   • Newspaper articles and layperson literature (e.g., Readers Digest, Healthy Life Magazine, Food, and Fitness)
   • Information from Wikipedia or any wiki
   • Textbooks
   • Website homepages
   • The weekly lesson
   • Articles in healthcare and nursing-oriented trade magazines, such as Nursing Made Incredibly Easy and RNMagazine (Source: What is a scholarly article.docx; Created 06/09 CK/CL Revised: 02/17/11, 09/02/11 nlh/clm)
3. Can the lesson for the week be used as a scholarly source?
   • Information from the weekly lesson can be cited in a posting; however, it is not to be the sole source used in the post.
4. Are resources provided from CU acceptable sources (e.g., the readings for the week)?
   • Not as a sole source within the post. The textbook and/or assigned (required) articles for the week can be used, but another outside source must be cited for full credit. Textbooks are not considered scholarly sources for the purpose of discussions.
5. Are websites acceptable as scholarly resources for discussions?
   • Yes, if they are documents or data cited from credible websites. Credible websites usually end in .gov or .edu; however, some .org sites that belong to professional associations (e.g., American Heart Association, National League for Nursing, American Diabetes Association) are also considered credible websites. Websites ending with .com are not to be used as scholarly resources

IV.  Professionalism in Communication: The post presents information in logical, meaningful, and understandable sequence, and is clearly relevant to the discussion topic. Grammar, spelling, and/or punctuation are accurate.

V.  Wednesday Participation Requirement: The student provides a substantive response to the graded discussion question(s) or topic(s), posted by the course faculty (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.

VI.  Total Participation Requirement: The student provides at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.

Resource:

 DeNisco, S.M., & Barker, A. M. (2015). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning. 

 American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). American Psychological Association. 

CASE STUDY 2

A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity.

• Based on the scenarios provided:
  • reflect on the material       presented throughout this course.
  • What necessary information       would need to be obtained about the patient through health assessments       and diagnostic tests?
  • Consider how you would       respond as an advanced practice nurse. Review evidence-based practice       guidelines and ethical considerations applicable to the scenarios you       selected.

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

jordan is a 35-year-old woman who presents with intermittent diarrhea with cramping that is relieved by defecation. The diarrhea is not bloody or accompanied by nausea and vomiting. Review of past medical history includes some childhood “stomach issues”, HTN, and a recent cholecystectomy. She works in the environmental department of a large hotel. . She denies alcohol and cigarette.

Diagnosis: Irritable Bowel Syndrome (IBS): Please address the following questions in APA format: 

I.     Discuss the epidemiology of IBS?

II.   What is your treatment goals for this patient?

III.  Discuss First line and second line drug therapy for IBS. Please include pharmacotherapeutic information.