Case Studies 1–3

Respiratory disorders such as pneumonia and asthma are among the leading causes of hospitalization in pediatric patients (U.S. Department of Health and Human Services, 2011). With such severe implications associated with many respiratory disorders, advanced practice nurses must be able to quickly identify symptoms, diagnose patients, and recommend appropriate treatment. For this Discussion, consider potential diagnoses and treatments for the patients in the following three case studies.

Case Study 1:

A 14-month-old female presents with a 4-day history of nasal congestion and congested cough. This morning, the mother noted that her daughter was breathing quickly and “it sounds like she has rice cereal popping in her throat.” Oral intake is decreased. Physical examination reveals the following: respiratory rate is 58, lung sounds are diminished in the bases, she has pronounced intercostal and subcostal retractions, expiratory wheezes are heard in all lung fields, and her tympanic membranes are normal. There is moderate, thick, clear rhinorrhea and postnasal drip. Her capillary refill is less than 3 seconds, and she is alert and smiling. Her RSV rapid antigen test is positive.

Case Study 2:

Brian is a 14-year-old known asthmatic with a 2-day history of worsening cough and shortness of breath. He reports using a short-acting beta agonist every 3 hours over the previous 24 hours. He has a long-acting inhaled corticosteroid, but the prescription ran out, and he forgot to get it refilled. He says he came today because he woke up at 2 a.m. coughing and couldn’t stop, thus preventing him from going back to sleep. Over-the-counter cough suppressants don’t help. He denies cigarette smoking, but his clothing smells like smoke. His respiratory rate is 18 and he has prolonged expiration and expiratory wheezes in all lung fields. There are no signs of dyspnea. All other exam findings are normal.

Case Study 3:

A father presents his 9-year-old with a 3-day history of cough. Dad states that his son is coughing up yellow mucus. The boy is afebrile and is sleeping through the night, but the father’s sleep is disturbed listening to his son coughing. Dad says he thinks his son has bronchitis and is requesting treatment. Physical examination reveals the following: respiratory rate is 18, lungs are clear to auscultation, patient is able to take deep breaths without coughing, there is no cervical adenopathy, nasal turbinates are slightly enlarged, and there is moderate clear rhinorrhea.

Case Studies 4–6

Assessing, diagnosing, and treating pediatric patients for many cardiovascular and genetic disorders can be challenging. As an advanced practice nurse who facilitates care for patients presenting with these types of disorders, you must be familiar with current evidence-based clinical guidelines. Because of the clinical implications, you have to know when to treat patients with these disorders and when to refer them for specialized care. In this Discussion, you examine the following case studies and consider appropriate treatment and management plans.

Case Study 4:

Miguel is a 15-year-old male who presents for a sports physical. He is a healthy adolescent with no complaints. He plays basketball. He is 6 feet 5 inches tall and weighs 198 pounds. You note long arms and long thin fingers. He has joint laxity in his wrists, shoulders, and elbows.

Case Study 5:

Trina is a 9-year-old female who weighs 110 pounds. Vital signs are as follows: BP 122/79, P 98, R 20. Her mother reports she is a picky eater and refuses to eat fruits and vegetables. Her physical activity includes soccer practice for 1 hour a week with one game each weekend from September through November. Family history is negative for myocardial infarction, but both parents take medication for dyslipidemia.

Case Study 6:

You see a 2-month-old for a well-child visit. She is breastfed and nurses every 2 to 3 hours during the day, but her mother reports she is not nursing as vigorously as before. She sleeps one 4-hour block at night. Birth weight was 7 pounds 5 ounces. Weight gain over the last 2 weeks reveals gain of 5 ounces per week. Physical examination reveals the following: HEENT exam is benign, lung sounds are clear, a new III/VI systolic ejection murmur is noted along the left lower sternal border, cap refill is brisk, skin is pink and moist, and abdominal exam is benign.

To prepare:

• Review “Respiratory Disorders,” “Cardiovascular Disorders,” and “Genetic Disorders” in the Burns et al. text.
• Review and select one of the six provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the respiratory disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the respiratory, cardiovascular, and/or genetic disorder.

Assignment: Academic Success and Professional Development Plan Part 2: Academic Resources and Strategies New construction projects begin with a design phase, where architects blueprint the vision complete with design details. They work in collaboration with builders who use the designs to prepare the appropriate strategies, tools, and materials to bring the vision to reality. You are both architect and builder of your success. You have started to blueprint your vision in your Academic Success and Professional Development Plan. You have identified others with whom you will collaborate. Now you can begin to prepare the appropriate strategies, tools, and materials How will you approach your studies? What types of resources are available to you, and how will you access and utilize them? Taking the opportunity to prepare these strategies, tools, and materials will help ensure you can “break ground” without incident and successfully move to the phase where you begin building your vision. To Prepare: Consider your goals for academic accomplishments while a student of the MSN program. Reflect on the strategies presented in the Resources for this week. The Assignment: Clearly identify and accurately describe in detail at least three academic resources or strategies that can be applied to the MSN program. Clearly identify and accurately describe in detail at least three professional resources that can be applied to success in the nursing practice in general or in a specialty. Clearly and thoroughly explain in detail how you intend to use these resources, and how they might benefit you academically and professionally. Note: Add your work for this Assignment to the original document you began in the Week 1 Assignment, which was built off the Academic Success and Professional Development Plan Template. By Day 7 Submit your completed Assignment. Remember to include an introduction paragraph which contains a clear and comprehensive purpose statement which delineates all required criteria, and end the assignment Part with a conclusion paragraph. Rubric Detail Select Grid View or List View to change the rubric’s layout. Name: NURS_6002_Week_2_Assignment_Rubric Grid View List View Excellent Good Fair Poor Continue developing your Academic Success and Professional Development Plan by appending the original document you began in Week 1 to develop the second component: academic resources and strategies. To do this: · Identify and describe at least three academic resources or strategies that can be applied to the MSN program. 23 (23%) – 25 (25%) The response clearly identifies and accurately describes in detail at least three academic resources or strategies that can be applied to the MSN program. 20 (20%) – 22 (22%) The response partially identifies and partially describes at least three academic resources or strategies that can be applied to the MSN program. 18 (18%) – 19 (19%) The response vaguely identifies and vaguely describes at least two academic resources or strategies that can be applied to the MSN program. 0 (0%) – 17 (17%) The response only vaguely and inaccurately identifies one academic resource or strategy or the three academic resources or strategies that can be applied to the MSN program are vague and inaccurate, or is missing. · Identify and describe at least three professional resources that can be applied to success in the nursing practice in general or your specialty in particular. 23 (23%) – 25 (25%) The response clearly identifies and accurately describes in detail at least three professional resources that can be applied to success in nursing practice in general or in a specialty. 20 (20%) – 22 (22%) The response partially identifies and partially describes at least three professional resources that can be applied to success in nursing practice in general or in a specialty. 18 (18%) – 19 (19%) The response vaguely identifies and vaguely describes at least two professional resources that can be applied to success in nursing practice in general or in a specialty. 0 (0%) – 17 (17%) The response only vaguely and inaccurately identifies and vaguely describes one professional resource or the three professional resources that can be applied to success in nursing practice in general or in a specialty are vague and inaccurate, or is missing. · Explain how you intend to use these resources, and how they might benefit you academically and professionally. 32 (32%) – 35 (35%) Response clearly and thoroughly explains in detail the intended use of these resources, including a detailed explanation of how they might be beneficial academically and professionally. 28 (28%) – 31 (31%) Response explains the intended use of these resources, including an explanation of how they might be beneficial academically and professionally. 25 (25%) – 27 (27%) Explanation of the intended use of these resources, including an explanation of how they might be beneficial academically and professionally is vague or inaccurate. 0 (0%) – 24 (24%) Explanation of the intended use of these resources, including an explanation of how they might be beneficial academically and professionally is vague and inaccurate, or is missing. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive. 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) APA format errors. 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6002_Week_2_Assignment_Rubric Learning Resources Required Readings ANA Enterprise. (n.d.). Resources to succeed. Retrieved October 12, 2018, from https://www.nursingworld.org/resources/ Kaufffman, H. (2015). A review of predictive factors of student success in and satisfaction with online learning. Research in Learning Technology, 23, 1–13. Online Colleges. (2011, July 14). 10 traits of a successful online learner. Retrieved October 12, 2018, from https://www.onlinecollege.org/2011/07/14/10-traits-of-a-successful-online-learner/ Walden University. (2018). Field Experience: School of Nursing. Retrieved from https://academicguides.waldenu.edu/fieldexperience/son/home Walden University. (2019). Master of Science in Nursing (MSN). Retrieved from https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing Walden University Writing Center. (n.d.). Scholarly voice: Active and passive voice. Retrieved October 12, 2018, from https://academicguides.waldenu.edu/writingcenter/scholarlyvoice/activepassive Walden University. (n.d.). Subject Research: Nursing. Retrieved November 9, 2018, from https://academicguides.waldenu.edu/library/subject/nursing Walden University Writing Center. (n.d.). Walden templates: Overview. Retrieved from https://academicguides.waldenu.edu/writingcenter/templates NOTE: Download and review the School of Nursing template by navigating to ‘Program-Specific Templates’, ‘School of Nursing’, and selecting ‘School of Nursing Writing Template With Instructions’. Walden University Writing Center. (n.d.). Writing a paper: Revising. Retrieved from https://academicguides.waldenu.edu/writingcenter/writingprocess/revising Document: 10 Tips for Being a Successful Online Learner (PDF) Document: Academic Success and Professional Development Plan Template (Word document) Required Media Laureate Education, Inc. (Executive Producer). (2018). Tips for effective online composition and communication [Video file]. Baltimore, MD: Author. PLS TELL THE WRITER TO USE MY TEMPLATE FROM WEEK1 IS A CONTINUATION, THANKS. See less

Communication is used to inform, to persuade and to analyze. In this assignment, you will persuade the reader of your point of view by supporting a thesis with objective facts and credible evidence.

In the week 2 forum, you selected your topic for this paper. You will take a stance on this issue and support your stance with credible evidence in your body paragraphs.

For this assignment, you have traditional and creative options. Choose what will challenge your writing and what would be appropriate for your topic and field:

• Traditional 5 paragraph essay with 1 paragraph introduction, 3 body paragraphs, and 1 paragraph conclusion.
• Op-ed newspaper article.
• Blog post.
• Letter/proposal to stakeholders.
• Press release.
• Letter to the editor.
• Presidential address.
• Election speech (written only).
• Application for a position related to the topic.
• Defense attorney’s opening statement.
• Case brief.
• Advocacy statement.
• Call to action paper.

Guidelines:

In order to persuade the audience to accept the position you are advocating in this paper, you will use different kinds of appeals:

• ethos (which involves the credibility of the speaker, writer, or authority being cited);
• logos (which involves facts, statistics, and logic); and
• pathos (which involves emotions).

A good persuasive argument uses credible sources, objective evidence, and emotional “hooks” to make use of logos, ethos, and pathos respectively.

Be sure your thesis statement is very clear.  It should be a single complete sentence, including both a subject and a predicate, that combine to make claim. Example: “The USA should be more competitive in establishing a presence on Mars.”

Your introduction paragraph should include a “hook” to grab the reader’s attention.  The thesis statement is typically seen in the first paragraph. Your body paragraphs will support the thesis. You should use credible sources and cite them according to the style of your discipline. Your conclusion should reiterate the strongest points from your paper and give the audience something to consider, moving forward.

Requirements:

• PURPOSE:   To persuade
• AUDIENCE:   The applicable audience for the type of document you’ve chosen to write.
• LENGTH:   500 – 750 words (Times New Roman font)
• SOURCES:   A minimum of 3 with at least 1 from the library, and at least 1 from a professional journal or organization
• FORMAT:   The citation style that is appropriate for your discipline
• DUE:   SUNDAY 11:55 pm EST of Week 5
• SUBMIT:   In ASSIGNMENTS submit your essay by uploading your Word file

Use only third person (he/she/they) for a more professional tone. Avoid first person (I, my, us, we) and second person (you and your) in your essay.

The main purpose of the Professional Portfolio is to provide a package of materials, which can be used by you, the prospective family nurse practitioner (FNP), when seeking an employment position.  Its contents include descriptions of your abilities, accomplishments, and goals, as well as providing information regarding the FNP’s scope of practice in California and roles.  The contents of your Professional Portfolio should include the following documents. Use tabs to separate each section and placed each document in a sheet protector plastic with opening on top and ring holes on the side.

Section II:  About Family Nurse Practitioners

Provide supporting data from research study in promoting your profession to employer

Documents from professional organizations, such as American Nurses Association or the American Academy of Nurse Practitioners.

You may obtain information from the American Academy of Nurse Practitioners (AANP) in the form of position statement and: http://www.aanp.org/Publications/AANP+Position+Statements/Position+Statements+and+Papers.asp

American Nurses Credentialing Center: http://www.nursecredentialing.org/Certification/APRNCorner

Reference articles (include at least 5 articles illustrating the roles and quality of care provided by nurse practitioners)

Final Reflection:  Express an understanding of your personal learning experiences, what you have learned from the program and still need to do to enhance personal and professional career advancement.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

Temperature: 37.1 degrees C
BP 123/78 HR 93 RR 22 Pox 99%
Denies pain
Height: 69.5 inches; Weight 87 kg
Laboratory Results

WBC: 19.2 (1,000/uL)
Lymphocytes 6700 (cells/uL)
CT Head shows no changes since previous scan
Urinalysis positive for moderate amount of leukocytes and cloudy
Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L
Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

Describe the clinical manifestations present in Mr. M.
Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
Discuss what interventions can be put into place to support Mr. M. and his family.
Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment t