Tag Archive for: nursing

SOAP Note Assignment

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SOAP Note Assignment

Click  here to download and analyze the case study for this week. Create a SOAP note for disease prevention, health promotion, and acute care of the patient in the clinical case. Your care plan should be based on current evidence and nursing standards of care.

Visit the online library and research for current scholarly evidence (no older than 5 years) to support your nursing actions. In addition, consider visiting government sites such as the CDC, WHO, AHRQ, Healthy People 2020. Provide a detailed scientific rationale justifying the inclusion of this evidence in your plan.

Next determine the ICD-10 classification (diagnoses). The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-10-CM) is the official system used in the United States to classify and assign codes to health conditions and related information.

Click here to access the codes.

Download the SOAP template to help you design a holistic patient care plan. Utilize the SOAP guidelines to assist you in creating your SOAP note and building your plan of care. You are expected to develop a comprehensive SOAP note based on the given assessment, diagnosis, and advanced nursing interventions. Reflect on what you have learned about care plans through independent research and peer discussions and incorporate the knowledge that you have gained into your patient’s care plan.  If the information is not in the provided scenario please consider it normal for SOAP note purposes, if it is abnormal please utilize what you know about the disease process and write what you would expect in the subjective and objective areas of your note.

Format

  • Your care plan should be formatted as a Microsoft Word document. Follow the current APA edition style. Your paper should be no longer than 3-4 pages excluding the title and the references and in 12pt font.

Emergency Department

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Mr. Sweet, 38 years old, is brought to the Emergency Department unresponsive. He has a history of Type 1 diabetes and has been sick for the last 3 days. On admission his Blood sugar is 532, Potassium is 7.2 and ABG results include pH 7.08, Bicarb 12, and CO2 28. His VS are HR 116, BP 107/64, RR 36 Deep and rapid, and Temp 101.5. Answer the following questions:

  1. What interventions do expect to be ordered for Mr. Sweet? Why?
  2. What type of acid-base disturbance does he have?
  3. What do you think is Mr. Sweet’s Medical Diagnosis?

ACE Star Model

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Updated 01/2019

Purpose

The purpose of this assignment is:

· To apply a change process using the ACE Star Model of Knowledge Transformation and a systematic review after identifying a clinical topic of concern and related nursing practice issue.

· The information from the ‘Illustration’ part of our lessons in Weeks 1-6 will mentor you through this process. Your change process is to be set up as a pilot project.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO#2)

CO8: Selects evidence for best practices when planning professional nursing care involving systems, processes, and devices for individuals, families, aggregates and communities. (PO#8)

Points

The assignment is worth 225 points.

Due Date

Submit your completed assignment by Sunday end of Week 6 by 11:59 p.m. MT.

Directions

A short tutorial with tips for completing this assignment may be viewed here: Evidence-Based Practice Change Process (Links to an external site.)Links to an external site.

EBP Change Process (form)

1. Download the EBP Change Process form (Links to an external site.)Links to an external site. during Week 1.

2. The use of this specific form is REQUIRED and is due at the end of Week 6.

3. A short tutorial with tips for completing this assignment may be viewed in the short video above.

4. Identify a clinical topic and related nursing practice issue you think needs to be changed.

5. Locate a systematic review on your topic from the Cochrane Database of Systematic Reviews located in the Chamberlain Library. Be sure this involves nursing actions.

6. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.

7. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).

8. Work on a portion of the process each week, as the illustration unfolds.

9. Please reach out to your instructor for feedback or assistance with your PICOT question as needed.

10.Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.

11.Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed. Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!

12.For questions about this assignment, please contact your instructor.

13.Use the grading rubric as a final way to check that all components of the form have been completed. The rubric is the tool your instructor will use to assess your content.

**Academic Integrity Reminder**

College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment. Please see the grading criteria and rubrics on this page.

NOTE: Please use your browser’s File setting to save or print this page.

aging process

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Please read the instruction. ( citation, references, 250 words ) see the picture below for instructions.
The answer has to be in a table.

Describe the characteristics of the aging process. Explain how some of the characteristics may lead to elder abuse (memory issues, vulnerability, etc.). Discuss the types of consideration a nurse must be mindful of while performing a health assessment on a geriatric patient as compared to a middle-aged adult.

strategic plan

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Work with your preceptor to assess the organization for required resources needed for the strategic plan if the change proposal were to be implemented. Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal.

The assignment will be used to develop a written implementation plan.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines

holistic nursing care

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This assignment provides the opportunity for the student to continue development of a MSN EBP scholarly project that started with the identification of a nursing concern and PICOT/PICo question from Week 2. The focus of this assignment is to discuss the research-based literature support for the selected concern, identify an appropriate research design, explain the sampling method, and discuss implementation through the use of a change model.

Course Outcome:

This assignment enables the student to meet the following course outcome:

CO 1. Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. (PO 1)

CO 2. Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare. (PO 2, 5)

CO #4. Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies. (PO 1, 2, 3, 5)

CO #5. Analyze research findings and evidence-based practice to advance holistic nursing care initiatives that promote positive healthcare outcomes. (PO 1, 2, 5)

Due Date Sunday 11:59 PM MT at the end of Week Five

Students are given the opportunity to request an extension on assignments for emergent situations. Supporting documentation must be submitted to the assigned faculty. If the student’s request is not approved, the assignment is graded and a late penalty is applied as follows:

  • Monday = 10% of total possible point reduction
  • Tuesday = 20% of total possible point reduction
  • Wednesday = 30% of total possible point reduction

If the student’s request is approved, the student will be informed of the revised due date. Should the student fail to meet the revised due date, the assignment is graded and a late penalty is applied as follows:

  • Monday = 10% of total possible point reduction
  • Tuesday = 20% of total possible point reduction
  • Wednesday = 30% of total possible point reduction

Total Points Possible: 250 points

Requirements

Description of the Assignment: This continues the development of a MSN EBP scholarly project by requiring the student to identify the additional elements of the process. The required elements are noted to be:

  • Research Literature Support (NOTE: Ten research-based references related to PICOT/PICo question are required)
  • Research Approach and Design
  • Sampling
  • Intervention

Criteria for Content

  1. Research Literature Support: In this section, comprehensive research literature support for the identified nursing concern and PCIOT/PICo question is to be provided. A minimum of ten (10) research-based references are required. The use of a systematic research review article as a reference is NOT allowed. All research studies are to be consistent with the selected concern and PICOT/PICo question. The PICOT/PICOT question is restated before presenting the research literature support. For each research-based reference the following information is to be discussed:
  • -Purpose of the research study
  • -Research approach that was used
  • -Data collection methods used
  • -Results of the research study
  • -One strength of the research study
  • -One limitation of the research study.
  • 2. Research Approach and Design: In this section, the student will identify the research approach that he/she plans on using for the EBP project as being either quantitative or qualitative. In addition, if the selected approach is quantitative, the student needs to identify if the design is experimental, quasi-experimental, or descriptive. If the selected approach is qualitative, the student needs to identify if the design is phenomenological, ethnography, grounded theory, or historical. A description of the selected design is to be provided as well as rationale for its selection. In addition one advantage and one disadvantage to the selected design is to be identified and discussed. Required content includes:
  • -Identification of the research approach that the student plans on using as either quantitative or qualitative
  • -Identification of selected quantitative research design by indicating if the design is experimental, quasi-experimental, or   descriptive
  • -Identification of the selected qualitative design by indicating if the design is phenomenological, ethnography, grounded theory,  or historical
  • -Description of the selected design
  • -Rationale for the selected design
  • -Identification of one advantage of the selected design
  • -Identification of one disadvantage of the selected design
  • -Provide scholarly reference(s) to support information about the selected research approach/design
  • 3. Sampling: In this section, the student will identify the sampling method to be used in order to obtain the necessary participants for the proposed EBP project. Discussion of participants’ rights as research subjects is also included. Required content includes:
  • -Describe the target population
  • -Identify the sampling method as being either probability or nonprobability
  • -Provide a complete description of the sampling procedure including:
    • Sample size
    • Inclusion criteria
    • Exclusion criteria
  • -Identify one advantage to the selected sampling procedure
  • -Identify one disadvantage to the selected sampling procedure
  • -Explain how participants’ rights will be protected including confidentiality, anonymity, protection from harm, and informed consent
  • -Provide scholarly reference(s) to support information about the selected sampling method
  • 4. Proposed Implementation with a change model: In this section, the student will apply the PDSA Change Model as the method to implement the proposed EBP practice solution/change. The required content includes:
  • -Describe the PDSA Change Model
  • -Explain why this change model is best suited for implementation of your evidence-based nursing practice solution/change
  • -Apply each step of the PDSA Change Model to implementing the proposed practice solution/change
  • -Explain how to overcome one barrier to the use of the EBP results from this project
  • -Explain how an environment that supports EBP can be fostered in your future practice setting
  • -Include a scholarly reference(s) for the PDSA Change Model

Preparing the Assignment

Criteria for Format and Special Instructions

  1. The additional sections to the proposal are not to exceed 15 (fifteen) pages. Be sure that all literature review articles are on your reference page. Points will be lost for not meeting these length requirements.
  2. Title page, running head, body of paper, headings, and reference page(s) must follow APA guidelines as found in the 6th edition of the manual.
  3. Required textbook for this course, dictionary and Chamberlain College of Nursing lesson information may NOTbe used as scholarly references for this assignment. For additional assistance regarding scholarly nursing references, please see the Library Guide. Be aware that information from .com, .edu, and library websites may be incorrect and should be avoided. Please contact your faculty member for guidance concerning the acceptability of a website as a scholarly source. References are current – within a 5-year time frame unless a valid rationale is provided and the instructor has approved the use of the older reference.
  4. This assignment is the required submission to Turn It In™ (TII) for NR 505. To prepare for the final submission, students are encouraged to submit their assignments early. A similarity score of 24% or less is required for the final submission. Any other level of similarity index requires the student to revise the assignment before the due date and time. To allow sufficient time for revision, early submission of the assignment to TurnItIn™ is highly encouraged. The final submission will be graded by faculty. If the final TurnItIn™ report indicates that plagiarism has occurred, the Academic Integrity policy will be followed. Similarity scores of 25% or higher result in the implementation of the Academic Integrity Policy located in the Chamberlain College of Nursing Student Handbook.

FNU Physical Assessment in Health Care

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FNU Physical Assessment in Health Care Quiz 5

Question

Question 1

Which nodes are also called Virchow nodes?

a. Internal mammary
b. Anterior axillary
c. Deep cervical
d. Supraclavicular
Question 2

To palpate the inguinal nodes, you should have the patient:

a. bend over a table and cough
b. lie supine, with the knees slightly flexed
c. lie supine, with the legs extended
d. stand with the back extended
Question 3

Which risk factor is least likely to result in someone contracting HIV infection?

a. Prostitution
b. Hemophilia
c. Intravenous drug use
d. Working with AIDS patients
Question 4

Which of the following organs does not have lymphatic vessels?

a. Brain
b. Kidneys
c. Liver
d. Lungs
Question 5

Which disorder is characterized by a single node that is chronically enlarged and nontender in a patient with no other symptoms?

a. Retropharyngeal abscess
b. Streptococcal pharyngitis
c. Mononucleosis
d. Toxoplasmosis
Question 6

Transillumination is performed during an examination of the lymphatic system to:

a. detect lymphatic pulsation
b. distinguish nodes from cysts
c. evaluate nodal contours
d. observe erythematous lesions
Question 7

Serum sickness is usually characterized first by the appearance of:

a. diffuse lymph node enlargement
b. joint pain
c. urticaria
d. fever
Question 8

The most important clue to the diagnosis of immunodeficiency disease in a child is:

a. family history
b. illness in siblings
c. previous hospitalizations
d. serious recurring infections
Question 9

Which of the following conditions will stimulate lymph node enlargement? (Select all that apply.)

a. Graves diseaseb

b. Lymphangiomac

c. Esophageal refluxd

d. Parotid swelling

Question 10

The nurse tells her patient with lymphadenopathy not to rub the swollen lymph node because this would result in:

a. spreading the infection
b. enlarging the node
c. slowing the lymphatic drainage
d. making the node more fibrotic

Question 11

The harder and more discrete a node, the more likely that there is a(n):

a. innocent cause
b. infection
c. malignancy
d. metabolic disease

Question 12

Tender nodes associated with cat scratch disease are usually found in which area?

a. Epitrochlear area
b. Popliteal area
c. Axilla
d. Inguinal area

Question 13

To find the infection site associated with acute lymphangitis, the examiner should look ________ to the inflammation.

a. proximal
b. distal
c. contralateral
d. anterior

Question 14

Which landmark is the dividing line between the anterior and posterior cervical triangles?

a. Clavicle
b. Cervical spine
c. Sternocleidomastoid
d. Sternum

Question 15

Which disorder is a dysfunction of cell-mediated immunity?

a. Acute idiopathic polyneuritis
b. Acquired immunodeficiency syndrome
c. Epstein-Barr virus (EBV) mononucleosis
d. Systemic lupus erythematosus (SLE)

Question 16

When examining lymph nodes near a joint in the arm or leg, which of the following maneuvers is likely to facilitate the examination?

a. Extension of the extremity
b. Circumduction of the extremity
c. Flexion of the extremity
d. Rotation of the extremity

Question 17

The most common causes of acute suppurative lymphadenitis are:

a. HIV and herpes zoster
b. Haemophilus influenzae and adenovirus
c. herpes simplex types 1 and 2
d. streptococcal and staphylococcal organisms

Question 18

What is the most frequent cause of edema of the lower extremities?

a. Deficiency of vitamins and minerals
b. Excessive walking or running
c. Prolonged sitting or standing
d. Use of table salt

Question 19

Which of the following findings indicates that the examiner is assessing a blood vessel rather than a lymph node?

a. A bruit
b. Inflammation
c. Tenderness
d. Redness

Question 20

Which nodes are most often associated with inflammation?

a. Shotty
b. Movable
c. Fixed
d. Tender

Question 21

Which bronchial structure(s) is(are) most susceptible to aspiration of foreign bodies?

a. Left mainstem bronchus
b. Terminal bronchioles
c. Right mainstem bronchus
d. Respiratory bronchioles

Question 22

While auscultating the lung fields, you note that the patient’s voice sound is intensified, the voice has a nasal quality, and e’s sound like a’s. This describes:

a. resonance
b. bronchophony
c. pectoriloquy
d. egophony

Question 23

You are documenting a rash between the eighth and ninth ribs on the lateral border.This intercostal space will be documented in terms of the:

a. rib immediately above it
b. rib immediately below it
c. number of centimeters it is positioned below the clavicle
d. number of inches it is positioned below the clavicle

Question 24

Which chest structure contains all the thoracic viscera except the lungs?

a. Manubrium
b. Mediastinum
c. Sternum
d. Xiphoid

Question 25

Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by:

a. percussing all lung fields
b. auscultating the lung bases
c. determining tactile fremitus
d.estimating diaphragmatic excursion

Question 26

When the umbilical cord is cut:

a. blood flows through the infants lungs more vigorously.
b. lungs fill with air
c. closure of the foramen ovale occurs
d. closure of the ductus arteriosus occurs

Question 27

Which of the following are signs and symptoms of atelectasis?

a. Diminished chest wall movement
b. Tachypnea
c. Bradypnea
d. Trachea deviated ipsilaterally
Question 28

Which type of apnea requires immediate action?

a. Primary apnea
b. Secondary apnea
c. Sleep apnea
d. Periodic apnea of the newborn

Question 29

To distinguish between a respiratory friction rub and cardiac friction rub, ask the patient to:

a. hold the breath
b. lean forward
c. say “99” while you palpate the anterior chest
d. identify the location of the pain

Question 30

When auscultating the apex of the lung, you should listen at a point:

a. even with the second rib
b. 4 cm above the first rib
c. higher on the right side
d. on the convex diaphragm surface

Question 31

Your trauma patient has no auscultated breath sounds in the right lung field. You can hear adequate sounds on the left side. A likely cause of this abnormality could be that the patient:

a. has a closed head injury
b. has fluid in the pleural space
c. is moaning and in severe pain
d. is receiving high-flow oxygen

Question 32

Which condition requires immediate emergency intervention?

a. Patient with pleuritic pain without dyspnea
b. Patient with fever and a productive cough
c. Patient with tachypnea but no chest retractions
d. Patient with absent breath sounds and dull percussion tones

Question 33

Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?

a. Lower chest
b. Along the anterior axillary line
c. Above the clavicles
d. At the nipple line

Question 34

With consolidation in the lung tissue, the breath sounds are louder and easier to hear, whereas healthy lung tissue produces softer sounds. This is because:

a. consolidation echoes in the chest
b. consolidation is a poor conductor of sound
c. air-filled lung sounds are from smaller spaces
d. air-filled lung tissue is an insulator of sound

Question 35

Which term would you use to document a respiratory rate more than 20 breaths/min in an adult?

a. Dyspnea
b. Orthopnea
c. Platypnea
d. Tachypnea

Question 36

Which finding suggests a minor structural variation?

a. Barrel chest
b. Clubbed fingers
c. Pectus carinatum
d. Chest wall retractions

Question 37

Which symptom is the most significant indicator of asthma and should be identified in the health history?

a. Wheezing
b. Paroxysmal dyspnea
c. Coexistent skin conditions
d. Chest pain

Question 38

To distinguish crackles from rhonchi, you should auscultate the lungs:

a. before and after the patient coughs
b. first at the lung base and then at the apex
c. with the patient inhaling and then exhaling
d. with the patient recumbent and then sitting

Question 39

Which of the following is an expected finding in newborns?

a. Mottling of the thorax
b. Sternal retractions
c. Cough
d. Sneezing

Question 40

You would expect to document the presence of a pleural friction rub for a patient being treated for:

a. pneumonia
b. atelectasis
c. pleurisy
d. emphysema

stakeholders/change agents

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Max Points: 60

Details:

Write a paper of 500-750 words (not including the title page and reference page) on your proposed problem description for your EBP project. The paper should address the following:

  1. Describe the background of the problem. Tell the story of the issue and why it deserves attention.
  2. Identify the stakeholders/change agents. Who, or what organizations, are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc.
  3. Use the feedback from the Topic 2 main forum post and refine your PICOT question. Make sure that the question fits with your graduate degree specialization.
  4. State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence-based practice is introduced to identify the expected changes.
  5. 5) Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.
  6. Develop an initial reference list to assure that there is adequate literature to support your evidence-based practice project. Follow the “Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Use “NUR-699 Search Method Example” to assist you.
  7. 7) The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem.
  8. Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence-based project, you must have enough evidence to introduce this as a practice change. If you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted.

Prepare this assignment according to the APA 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 to Turnitin. Please refer to the directions in the Student Success Center.

Upon receiving feedback from the instructor, refine “Section B: Problem Description” for your final submission. This will be a continuous process throughout the course for each section.

 

 

  • Posted: 3 Years Ago
NUR-69

Age Appropriate Health Maintenance Screening and Associated Tools

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Assignment: Age Appropriate Health Maintenance Screening and Associated Tools

This Assignment includes ten different pediatric cases that require further evaluation with a developmental testing tool. Selecting the correct tool is vitally important in getting accurate data that promotes early identification and intervention. A template is available to you as an Excel spreadsheet in Course Documents, and is specifically designed for this Assignment.

After you have selected the standardized developmental testing tool that is appropriate for each of the following cases, address the following:

  • Does the tool measure the domain(s) of concern?
  • Is the tool “age appropriate?”
  • Does the tool address cultural considerations?
  • Who is to administer the test?
  • Is the reliability and validity of the tool acceptable? How did you assess these measurements?
  • How much time is involved in using the tool?
  • Is the language of the tool applicable to the patient and family?

Use template attached.

  • attachment

    MN581_Unit2AssignmentTemplate.xlsx

Health Policy Paper

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Health Policy Paper

Forward the topic of the health policy paper to faculty at the end of Week One(Paper named Diet and physical Activity),

Health policy unfolds daily and drives clinical practice in the US. The student will investigate current policies or legislation underway for a specific health-related issue. The Student will develop a scholarly APA formatted paper supported by evidence. The policy paper rubric:

Introduction to population or problem (incidence, prevalence, epidemiology, cost burden etc)

Description of how the policy is intended for a specific population, program or organization

Specific legislators involved in the policy development and dissemination

Identify the role of the APRN in assisting with the policy or refuting the policy – this requires the evidence to support opinion, ideas and/or concepts.

Discuss how the policy influences clinical practice and is used to promote best outcomes

Examine how the policy can be used by the interprofessional team to ensure coordinated and comprehensive care for the specific population

Conclusion – summarize findings

APA format – use of primary peer-reviewed references as much as possible