Category: Nursing

  • Nursing Assignment Help USA

    Nursing Assignment Help

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  • NURS-6051N Transforming Nursing & HC

    BY DAY 3 OF WEEK 1

    Post
     a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? NURS-6051N Module 1: Week 1: Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

     

    Electronic health record (EHR) systems are now widely used, making it easy to retrieve patient records digitally and extract helpful clinical data. As a result, several ancillary applications, including translational research, quality control, and health management, have become available. These supplementary uses are all intended to raise patient care. Data quality has a major impact on how well patients are treated and how well healthcare is provided overall. Therefore, having erroneous, lacking, and inconsistent data and documentation may lead to mistakes and unfavorable outcomes that may compromise patient safety, restrict the exchange of health information, and impede clinical research(
    Alzu’bi et al.,2021)
    . The most efficient treatment plan can be created by gathering information on the patient’s health in addition to determining whether they fit the admittance standards. Making a new and more successful treatment plan for a patient requires considering previous treatment plans and their effectiveness. When establishing a treatment strategy that results in positive patient and healthcare outcomes, data from earlier treatment methods and their level of success must be considered.
     

    Patients experiencing adverse reactions to several types of pharmaceuticals and the measures taken to ensure that the patient does not receive the same medicine while undergoing treatment are common occurrences in practice that profit from the collection and application of data. In my experience as a psychiatric nurse, I have worked with patients who had adverse responses to mental drugs, which not only complicated care processes but also created a fresh crisis and caused the patient tremendous distress. Because of this, it is essential for medical providers to know whether a patient has had unfavorable side effects from a prescription provided during a prior hospitalization. To effectively treat the patient in the scenario I just described, knowledge of previous hospital stays and treatments, bad drug reactions, notes from medical specialists about the patient’s condition, and a clear understanding of the diagnosis would all be essential (Nagle et al., 2017). Evidence-based techniques may need to be applied, the patient may need to be involved in the assessment process, and earlier evaluations may need to be identified using electronic health records. This information could enhance evidence-based practice by broadening the body of knowledge on the subject and providing an in-depth understanding of the patient’s condition and effective treatments without using drugs with unfavorable side effects. Psychiatric patients should be reminded that while it is important to discuss any prior medications with them even if they were not in the correct frame of mind, they might not remember any negative side effects. As a result, by evaluating the staff notes of those who have worked with the patient and the prior physicians, we may create an effective treatment plan using the patient’s medical record.
     

     Knowing that a patient has had a certain response to a medication or simply a setting is extremely helpful when counseling patients, especially in the psychiatric field. If the patient had previously exhibited manic, aggressive, or self-destructive behaviors in response to a medication, we would make sure that the medication was never given to them again (McGonigle & Mastrian, 2022). We could also flag the medical record, if it has not already been done, to alert others of the reaction. Before providing the doctor with information on the patient, nurses should be aware of any allergies since they are plainly listed on the patient’s chart. Before administering medication to a patient, it should be scanned. If the patient is allergic to the medication, a warning will appear and prompt them with questions if nurses intend to ignore the allergies. I have encountered dangerous situations like this before, but fortunately, the patient’s treatment was promptly modified throughout the process. 
     

    Gaps will persist if clinicians are not involved in creating and implementing. The development of a robust product that is accessible to all healthcare team members can be facilitated by the involvement of healthcare informaticists. Despite the information acquired from the patient record being helpful, it is essential to have first-hand knowledge about the patient from practitioners who have direct contact with them (
    Sweeney,2017)
    . The prior care team is typically the first to notice even the smallest changes in the patient, therefore I want to discuss the patient’s habits with them before sharing that information with my own. Clinical nursing judgment encompasses cognitive, psychomotor, and emotional processes that are expressed through actions and behaviors, whereas clinical reasoning is the metacognitive and cognitive process of interpreting knowledge that is relevant to a certain patient or clinical circumstance (Nagle et al., 2017). When applied correctly, clinical reasoning and judgment contribute to knowledge generation and the development of normative orders in nursing and healthcare. Nursing leaders must thoroughly compile and analyze data regarding the patients’ conditions before implementing any treatment strategies. They must also meticulously document the course of the treatment for future use. The nurse leader accomplishes this by using clinical judgment and reasoning to assess and modify information and data for better decision-making processes inside the information system (
    Sweeney,2017)
    .
     

     

    References
     

     
    Alzu’bi, A. A., Watzlaf, V. J. M., & Sheridan, P. (2021). Electronic Health Record (EHR) Abstraction. 
    Perspectives in health information management
    , 
    18
    (Spring), 1g. 
    http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8120673/
    Links to an external site.
     

     

    McGonigle, D., & Mastrian, K. G. (2022). 
    Nursing informatics and the foundation of knowledge
     (5th ed.). Jones & Bartlett Learning.
     

    Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist…NI 2016, Switzerland. 
    Studies in Health Technology & Informatics
    , 
    232
    , 212–221. 
    https://doi.org/10.3233/978-1-61499-738-2-212
    Links to an external site.
     

     

    Sweeney, J. (2017). Healthcare Informatics. 
    Online Journal of Nursing Informatics
    , 
    21
    (1), 4–1.
     
     

     

    THE NURSE LEADER AS KNOWLEDGE WORKER

    The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, 
    The Landmarks of Tomorrow
     (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?

    Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.

    In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker.

    Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.

     

    RESOURCES

    Be sure to review the Learning Resources before completing this activity.

    Click the weekly resources link to access the resources.

    WEEKLY RESOURCES

    To Prepare:

    Review the concepts of informatics as presented in the Resources.

    Reflect on the role of a nurse leader as a knowledge worker.

    Consider how knowledge may be informed by data that is collected/accessed.

    The Assignment:

    Explain the concept of a knowledge worker.

    Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.

    Include one slide that visually represents the role of a nurse leader as knowledge worker.

    Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.

    BY DAY 7 OF WEEK 2

    Submit your completed Presentation.

    SUBMISSION INFORMATION

    Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the 
    Turnitin Drafts
     from the 
    Start Here
     area.

    To submit your completed assignment, save your Assignment as 
    WK2Assgn_LastName_Firstinitial

    Then, click on 
    Start Assignment
     near the top of the page.

    Next, click on 
    Upload File
     and select 
    Submit Assignment
     for review.

    Rubric

    NURS_5051_Module01_Week02_Assignment_Rubric

    NURS_5051_Module01_Week02_Assignment_Rubric

    Criteria

    Ratings

    Pts

    This criterion is linked to a Learning Outcome
    Develop a 5- to 6-slide PowerPoint presentation that addresses the following:· Explain the concept of a knowledge worker.· Define and explain nursing informatics.

    25
     
    to >
    22.0
     pts

    Excellent

    Ably synthesize the literature and course resources to present a clear and accurate explanation of the 2 concepts….The presentation clearly and accurately explains the concept of a knowledge worker….The presentation clearly and accurately defines and explains nursing informatics.

    22
     
    to >
    19.0
     pts

    Good

    Summarize the literature and course resources to present a clear and accurate explanation of the 2 concepts….The presentation explains the concept of a knowledge worker. …The presentation defines and explains nursing informatics.

    19
     
    to >
    17.0
     pts

    Fair

    The presentation is missing one of the concepts or one of the concepts is superficially addressed.

    17
     
    to >
    0
     pts

    Poor

    The presentation is missing two concepts or the concepts are superficially addressed.

    25
     pts

    This criterion is linked to a Learning Outcome
    Develop a graphic visual representation of the role of the nurse leader as a knowledge worker. On the slide, include an explanation of the role.

    15
     
    to >
    13.0
     pts

    Excellent

    The presentation includes a detailed graphic and explanation of the role of the nurse leader as a knowledge worker.

    13
     
    to >
    11.0
     pts

    Good

    The presentation includes a graphic and an adequate explanation of the role of the nurse leader as a knowledge worker.

    11
     
    to >
    10.0
     pts

    Fair

    The presentation includes a graphic, yet the explanation of the role is not addressed or is superficially addressed.

    10
     
    to >
    0
     pts

    Poor

    The presentation is missing a graphic, an explanation of the role, or both the graphic and explanation of the role are missing.

    15
     pts

    This criterion is linked to a Learning Outcome
    Present the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data you could use, how the data might be accessed/collected, and what knowledge might be derived from the data. Be sure to incorporate feedback received from your colleagues’ replies.

    35
     
    to >
    31.0
     pts

    Excellent

    The presentation clearly and thoroughly includes the hypothetical scenario originally shared in the Discussion Forum, including a detailed and accurate examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data. …The presentation incorporates peer feedback.

    31
     
    to >
    27.0
     pts

    Good

    The presentation includes the hypothetical scenario originally shared in the Discussion Forum, including an accurate examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data. …The presentation incorporates peer feedback.

    27
     
    to >
    24.0
     pts

    Fair

    The presentation includes the hypothetical scenario originally shared in the Discussion Forum; one or two of the criteria are not addressed or are superficially addressed.

    24
     
    to >
    0
     pts

    Poor

    The presentation is missing the hypothetical scenario originally shared in the Discussion Forum or three or more of the criteria are not addressed or are superficially addressed.

    35
     pts

    This criterion is linked to a Learning Outcome
    PowerPoint presentation:The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

    5
     
    to >
    4.0
     pts

    Excellent

    The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

    4
     
    to >
    3.0
     pts

    Good

    Eighty percent of the presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

    3
     
    to >
    2.0
     pts

    Fair

    Sixty to seventy nine percent of the presentation follows these guidelines: presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

    2
     
    to >
    0
     pts

    Poor

    Less than sixty percent of the presentation follows these guidelines: presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.

    5
     pts

    This criterion is linked to a Learning Outcome
    Resources

    10
     
    to >
    8.0
     pts

    Excellent

    Presentation includes: 3 or more peer-reviewed articles and 2 or more course resources.

    8
     
    to >
    7.0
     pts

    Good

    Presentation includes: 2 peer-reviewed articles and 2 course resources.

    7
     
    to >
    6.0
     pts

    Fair

    Presentation includes: 1 peer-reviewed article and 1 course resource.

    6
     
    to >
    0
     pts

    Poor

    Presentation includes: 1 or no resources.

    10
     pts

    This criterion is linked to a Learning Outcome
    Written Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuation

    5
     
    to >
    4.0
     pts

    Excellent

    Uses correct grammar, spelling, and punctuation with no errors.

    4
     
    to >
    3.5
     pts

    Good

    Contains a few (1-2) grammar, spelling, and punctuation errors.

    3.5
     
    to >
    3.0
     pts

    Fair

    Contains several (3-4) grammar, spelling, and punctuation errors.

    3
     
    to >
    0
     pts

    Poor

    Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

    5
     pts

    This criterion is linked to a Learning Outcome
    Written Expression and Formatting – APA:The reference list and image attribution list follow correct APA format

    5
     
    to >
    4.0
     pts

    Excellent

    Uses correct APA format with no errors.

    4
     
    to >
    3.5
     pts

    Good

    Contains a few (1-2) APA format errors.

    3.5
     
    to >
    3.0
     pts

    Fair

    Contains several (3-4) APA format errors.

    3
     
    to >
    0
     pts

    Poor

    Contains many (≥ 5) APA format errors.

    5
     pts

    Total Points: 
    100

    INTERACTION BETWEEN NURSE INFORMATICISTS AND OTHER SPECIALISTS

    Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

    Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

    In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

    RESOURCES

    Be sure to review the Learning Resources before completing this activity.

    Click the weekly resources link to access the resources.

    WEEKLY RESOURCES

    To Prepare:

    Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.

    Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.

    BY DAY 3 OF WEEK 3

    Post
     a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

    BY DAY 6 OF WEEK 3

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
    , offering one or more additional interaction strategies in support of the examples/observations shared or by offering further insight to the thoughts shared about the future of these interactions.

    The observations I have made with technology specialists in my current position with other healthcare professionals have been limited. I mentioned that I work with two child psychiatrists at a behavioral health outpatient clinic with most patients utilizing telehealth services. Telehealth medicine is only beginning to expand and has “received a boost with the COVID-19 pandemic” (McGonigle & Mastrian, 2022, p. 618). Our clinic allows patients to come to the clinic and access their provider via telehealth in a patient exam room, or they can access their provider from home within their EHR (Electronic health records MyAspirus), or Doxylink. Since Aspirus is trying to move away from Doxylink, I will not include further input on this system.

    I do think we all know that with this technology comes technological glitches, connectivity issues, and barriers. That is the only time I have seen the providers I work with reach out to IT, if we cannot get them back online. Typically, we call the patient if they are not onsite and have them go back into the “waiting room” and we reboot the telehealth device before calling IT. What happens in the background with IT and the provider where they are located, I am unsure. What I am curious about and a strategy on how these interactions might be improved is if our nurse informaticists are collecting big data on connectivity issues within their EHR visits and could present this information to us. Big data is information that nurse informaticists work with, collect, analyze, interpret, they notice trends and patterns that could be used to enhance not only our nursing practice but patient/provider outcomes as well (McGonigle & Mastrian, 2022). This data could help our IT specialists and patients and providers potentially with decreasing these issues.

    The American Hospital Association (2022) states that 76% of U.S. hospitals connect with patients via telehealth, video, or other technology (AHA, 2022). Within the behavioral health world, many behavioral health patients may not have the patience or intellectual ability to troubleshoot when technology complications arise. With telehealth just beginning to touch most of the U.S. I was not able to find data on telepsychiatry, connectivity concerns with mental health patients. I do believe the impact of telehealth on primary care, hospital care, and specialty care is only going to grow and with that hopefully we will get more data for improvements. Siegel et al (2021) has assessed benefits to telepsychiatry and has found it to include convenience, and timesaving for both the providers and the clients, a decrease in cancellations, and an increase in parental involvement
     because “barriers such as different households, travel or scheduling conflicts are not as prominent. This has been particularly beneficial for young patients with mood disorders and attention deficit hyperactivity disorders” (Siegel et al, 2021, p. 442). Nursing informatics is going to, telemedicine, and big data are all going to impact our nursing practice.

    References:

    AHA. (2022). 
    Fact Sheet: Telehealth. 
    Retrieved November 28, 2022, from
    https://www.aha.org/factsheet/telehealth
    Links to an external site.

    McGonigle, D., & Mastrian, K. G. (2022). 
    Nursing informatics and the foundation of knowledge
     (5th ed.). Jones & Bartlett Learning.

    Siegel, A., Zuo, Y., Moghaddamcharkari, N., McIntyre, R., & Rosenblat, J. (2021). Barriers, Benefits, and Interventions for Improving the Delivery of Telemental Health Services during the Coronavirus Disease 2019 Pandemic: A Systematic Review. 
    Current Opinions in Psychiatry. 
    34 (4): p.434-443. 
    DOI:10.1097/YCO.0000000000000714

    SAMPLE DISCUSSION POST 2

      Interactions Between Nurse Informaticists and Other Specialists.

    As a specialist in the collection and application of data, Nurse Informaticists (NI) collaborates with other specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions, which will bring about the general wellbeing of patients.

    One way to improve the efficient distribution of information gathered among health care professionals is to ensure that information is shared between disciplines and professions, with compatible organizational approaches (Nordstein & Bystrom, 2018).

    Nursing Informaticists supports nurses, consumers, patients, interprofessional healthcare team, and other stakeholders in their decision-making in all roles and settings to achieve desired outcomes (ANA, 2015). Nurse Informaticists can help with assessing and evaluating projects to see if policies and procedures implemented are having the desired impact on patient care. McGonigle and Mastrian (2018) explained the importance of standardized language in nursing practice. Standardized language is important in the improvement of healthcare. Standardized language help to translate information from discipline to discipline, from provider to administrator.

                                Strategy to improve interactions between Nurse Informaticists and other Specialists.

    At the institution where I work, information is communicated via work email platform to all employees. There is Nurse Informaticist (NI) assigned within the nursing department to disseminate pertinent information among nurses and other professionals. NI frequently update nurses with recent and information to bring about better patient outcome. Due to recent technology, NI can communicate efficiently with thousands of nurses and other professionals via work email. For me, I make sure I check my email daily to keep me informed of any new updates that will help deliver adequate and optimum patient care. Also, we make use of EPIC to document patient care, information on this is updated at least weekly. This approach of communication makes it easier to inform health care team members on ways to improve patient’s outcome. The strategy I will recommend improving interaction between NI and other specialist is occasional in-service training for all employees at all levels. This approach will bring about exchange of ideas and help build more knowledge and 4also bring about better patient outcomes (Laureate, 2012).

                                   Impacts of continued evolution of Nursing Informatics as a Specialty.

    Nurse Informaticists (NI) specialty will continue to be beneficial to healthcare system. As the general saying, “Information is Knowledge”, efficient communication and timely access to information among health care professionals will bring about improvement in patient care. Adequate communication among health care professionals will enhance nursing interventions, better patient outcome, easy access to patient data for outcome analysis, and increased adherence to care standards (Rutherford, 2008).

                                    References

    American Nurses Association. (2015). Nursing Informatics: Scope and Standards of practice; P.1-2(2
    nd
     Ed.). Silver Spring, MD: Author.

    Laureate Education. (2012). Data, information, knowledge, and wisdom continuum. Baltimore, MD: Author.

    McGonigle, D., & Mastrian, K.G. (2018). Nursing Informatics and the foundation of knowledge. (4
    th
     ed.). [Kindle version]. Burlington, MA: Jones and Bartlett learning.

    Nordsteien, A., & Bystrom, K. (2018). Transitions in workplace information practices and culture: The influence of newcomers on information use in healthcare. Journal of Documentation, 74(4), 827-843. 
    www.emeraldinsight.com/0022-0418.htm
    Links to an external site.

    Rutherford, M.A. (2008). Standardized Nursing Language: What Does it Mean for Nursing, 13(1), 1-12. https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol13No1PPT05.

    BIG DATA RISKS AND REWARDS

    When you wake in the morning, you may reach for your cell phone to reply to a few text or email messages that you missed overnight. On your drive to work, you may stop to refuel your car. Upon your arrival, you might swipe a key card at the door to gain entrance to the facility. And before finally reaching your workstation, you may stop by the cafeteria to purchase a coffee.

    From the moment you wake, you are in fact a data-generation machine. Each use of your phone, every transaction you make using a debit or credit card, even your entrance to your place of work, creates data. It begs the question: How much data do you generate each day? Many studies have been conducted on this, and the numbers are staggering: Estimates suggest that nearly 1 million bytes of data are generated every second for every person on earth.

    As the volume of data increases, information professionals have looked for ways to use big data—large, complex sets of data that require specialized approaches to use effectively. Big data has the potential for significant rewards—and significant risks—to healthcare. In this Discussion, you will consider these risks and rewards.

    RESOURCES

    Be sure to review the Learning Resources before completing this activity.

    Click the weekly resources link to access the resources.

    WEEKLY RESOURCES

    To Prepare:

    Review the Resources and reflect on the web article 
    Big Data Means Big Potential, Challenges for Nurse Execs
    .

    Reflect on your own experience with complex health information access and management and consider potential challenges and risks you may have experienced or observed.

    BY DAY 3 OF WEEK 5

    Post
     a description of at least one potential benefit of using big data as part of a clinical system and explain why. Then, describe at least one potential challenge or risk of using big data as part of a clinical system and explain why. Propose at least one strategy you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using big data you described. Be specific and provide examples.

    BY DAY 6 OF WEEK 5

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
    , by offering one or more additional mitigation strategies or further insight into your colleagues’ assessment of big data opportunities and risks.

    *Note:
     Throughout this program, your fellow students are referred to as colleagues.

    Benefits of Big Data

    Yang et al. (2018) stated that “big data analytics capability refers to the ability to manage a huge volume of disparate data to allow users to implement data analysis and reaction” (p.6). The use of big data in healthcare is improving information accumulation and processing. Big data helps to store a large amount of information for a long period of time which healthcare providers can access to better understand patients’ health conditions and provide appropriate medical interventions. “In health care, it is being used to improve efficiency and quality, resulting in better healthcare practices and improved patient outcomes” (McGonigle & Mastrian, 2018, p. 1234). In addition, the use of big data over time in healthcare can help providers monitor patient health trends and improve patient care over time based on these trends due to a large amount of information stored.

    Challenges of Big Data

    As with everything backed up by technology, there are downsides to it as well. The major challenge associated with the use of big data is that it will require the allocation of large resources to maintain or manage it. Combing through high magnitudes of data can be overwhelming and time-consuming and often the manpower and time required to analyze this data can prove to be quite a challenge. According to Thew (2016), “when a chief nurse executive (CNE) is analyzing and synthesizing data, it’s typically done manually and is a very time- and labor-intensive process, in part, because technology systems have traditionally been built in silos” (para. 7).

    Mitigation of Big Data

    While working at the hospital, one thing I often notice is the lack of access to certain patient information when in another department. Although storing information in silos might have its benefits, it does not benefit healthcare workers if they must navigate twice as hard to access the same information because they are in different hospital departments. “Healthcare silos prevent information exchange and limit sharing of quality data, which constricts efforts to improve care” (Reams, n.d., para. 9). Understanding that the integration of technology in healthcare should bring about unity and not division is a way to mitigate challenges posed by using big data. Collaborating to eliminate or decrease the use of data silos in healthcare and shifting to integrated data will help improve patient care and outcomes.

    References

    McGonigle, D., & Mastrian, K. G. (2018). 
    Nursing informatics and the foundation of knowledge
     (4th ed.). Jones & Bartlett Learning.

    Reams, k. (n.d.). 3 Ways Disrupting Healthcare Silos Helps Achieve Triple Aim Goals. 
    Freedassociates.com
    , 
    https://www.freedassociates.com/knowledge-center/disrupting-healthcare-silos-helps-achieve-triple-aim-goals/
    Links to an external site.

    Thew, J. (2016). Big data means big potential, challenges for nurse execs. 
    Healthleadersmedia.com,
     
    https://www.healthleadersmedia.com/nursing/big-data-means-big-potential-challenges-nurse-execs
    Links to an external site.

    Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. 
    Technological Forecasting and Social Change,
     126(1), 3–13, 
    https://www.sciencedirect.com/science/article/pii/S0040162516000500?via=ihub
    Links to an external site.

     
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    Raymond Mwanje

    Raymond Mwanje

    Dec 27, 2022
    Dec 27, 2022 at 3:02am

    Manage Discussion Entry

    Big Data Risks and Rewards

    The benefit of using big data as part of a clinical system

    According to Wang et al. (2018), one perceived benefit of utilizing big data as a component of a clinical system is the capability to enhance care delivery by analyzing and evaluating vast amounts of information from multiple sources. A clinic, for instance, might use big data to spot patterns in health outcomes, such as the therapeutic interventions that are most suitable for particular illnesses. Such information can be utilized to enhance medical decisions and clinical outcomes.

    One challenge of using big data as part of a clinical system

    Dash et al. (2018) indicate that the concern of security and data privacy is one potential challenge or danger of employing big data in a clinical system. With the increased collection and digital storage of personal health-related information, there is a high chance of security breaches or mishandling of such data. Such acts can result in patient privacy violations and possibly dire consequences for individuals and medical institutions (McGonigle & Mastrian, 2022).

    Strategy to mitigate the challenge

    According to Glassman (2017), implementing solid security protocols, like secure data storage and authentication controls, is one strategic approach for mitigating the risks and challenges of utilizing big data in a medical system. It is also critical to have concise policies established for the utilization and dissemination of patient data, along with continuing employee training on data protection and information system security practices. It might be beneficial to collaborate with outside specialists or institutions specializing in the security and privacy of data to ensure that all necessary protective measures are in place. Thew (2016) concludes that it is critical for care providers to contemplate the potential advantages and hazards of big data and begin taking the steps needed to safeguard and use patients’ data ethically.

     

     

    References

    Dash, S., Shakyawar, S. K., Sharma, M., & Kaushik, S. (2019). Big data in healthcare: management, analysis, and future prospects. Journal of Big Data, 6(1), 1-25.

    Glassman, K. (2017). Using data in nursing practice. American Nurse Today, 12(11), 45-47.

    McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.

    Thew, J. (2016, April 19). Big data means big potential, challenges for nurse execs. Retrieved from https://www.healthleadersmedia.com/nursing/big-data-means-big-potential-challenges-nurse-execs

    Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological forecasting and social change, 126, 3-13.

     
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    Dawn Cahill

    Dawn Cahill

    Dec 27, 2022
    Dec 27, 2022 at 2:47pm

    Manage Discussion Entry

    First response

    Raymond

    I believe security and privacy will continue to be the most concerning issue with big data. Having almost immediate access to all this data seems like a cybersecurity problem waiting to happen. More data is available every day, as our technology and education expand which can lead to more data breaches. According to McKeon (2022) there have been 48.6 million data breaches in 2022 vs. the previous year of 40 million breaches, 2021 (p.1). Having a plan in place to reduce this risk is exactly what is needed. It is critical that organizations have security measures in place. One such method could be implementing a program of monitoring and auditing the organizations network to catch an intrusion and quickly deeming it malicious (Abouelmehdi et al, 2018).

    References:

    McKeon, J. (2022). 
    This Year’s Largest Healthcare Data Breaches. 
    HealthIT Security. 
    https://healthitsecurity.com/features/this-years-largest-healthcare-data-breaches
    Links to an external site.

    Abouelmehdi, K., Beni-Hessane, A. & Khaloufi, H. (2018).  Big healthcare data: preserving security and privacy. 
    Journal of Big Data
    . 
    5
    (1). https://doi.org/10.1186/s40537-017-0110-7

     
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    Damacrine Morangi Anyuga

    Damacrine Morangi Anyuga

    Dec 27, 2022
    Dec 27, 2022 at 10:55pm

    Manage Discussion Entry

    Response #1

    Hi Raymond,

    It is true that one of the challenges of big data in Clinical setting is the risk for breach of privacy. With healthcare being one of the biggest generators of big data of different varieties. This is more likely to happen especially as data is handled by various people in different departments and due to the personal nature of the data. This could lead to ethical and legal issues due to flaws in analyzing the data and lack of infrastructures for proper storage of data (Pastorino et al., 2019). It is therefore important to implement security measures like encryption and authentication and use multi-level security to protect these data from hackers using data mining techniques to gain access to this sensitive data (Bahri et al., 2018)

    References

    Bahri, S., Zoghlami, N., Abed, M., & Tavares, J. M. R. (2018). Big data for healthcare: a survey. 
    IEEE access
    , 
    7
    , 7397-7408.

    Pastorino, R., De Vito, C., Migliara, G., Glocker, K., Binenbaum, I., Ricciardi, W., & Boccia, S. (2019). Benefits and challenges of Big Data in healthcare: an overview of the European initiatives. 
    European journal of public health
    , 
    29
    (Supplement_3), 23-27.

     
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    Imelda Briones Balili

    Imelda Briones Balili

    Dec 29, 2022
    Dec 29, 2022 at 1:04pm

    Manage Discussion Entry

    Hi Raymond,

     

    Thank you for your thorough discussion post regarding big data, its benefits, disadvantages, and informative strategy for implementing a solid security protocol to prevent cybersecurity issues. Healthcare organizations store highly sensitive information, such as medical research and patient records. Exposure, theft, and destruction of these data have devastating consequences. Electronic health records (EHRs), commonly used in a healthcare setting as the primary digital storage of personal health-related information, offer time-efficient patient data access; however, EHRs also present security challenges. According to Advent Health University (2020), based on a 2019 report, there were 41,335.889 patients’ records leaked. Hackers sell this valuable information for up to $1,000 for just a single medical record, which results in fraud and identity theft extortion. In addition, 90% of hospitals face email-based cyberattacks in their pursuit to access private data. Mobile devices used by healthcare institutions are also under attack; according to Verizon there where 38% of health organizations reported breaches to their devices. In response to this vicious cycle, strategic actions were implemented by healthcare administration leaders to safeguard patients’ information and systems by promoting access control in managing the organization’s data by authenticating a user’s identity and monitoring log-in attempts. Secondly, performing ongoing risk assessments allows organizations to act preemptively to prevent security breaches. Healthcare organizations should implement risk assessments for third-party networks and comply with government regulations on healthcare data protection, such as HIPAA security standards.

     

    The Administration for Strategic Preparedness and Response (2022) highlighted its goal to fill gaps in the healthcare system’s preparedness capabilities in a timely, innovative way to share information in the prevention of large-scale cyberattacks. Effective mitigation of cyberattacks involves careful planning by the facility’s leadership, providers, and ancillary departments. When vulnerabilities are detected, patch management, blocking, and the management should apply other effective practices for addressing weaknesses within the organization. The ASPR recommends implementing cyber hygiene programs and services by promoting education, training, and drills for medical staff in response to a possible cyber event. In addition, investment in data backup and redundancy across the IT department while observing external mirroring is crucial for protecting vulnerable systems and reporting a cyber incident as soon as it is identified. The Cyber Event Information Sharing Factsheet (CISA) provides details and guidance on incident reporting, ensuring personnel across the health system are familiarized with its mitigating process while ensuring its reporting policies comply with federal, state, or local reporting mandates.

     

                                                                                References:

    Advent Health University. (2020). 
    Five Important Elements to Establish Data Security in Healthcare.

    https://www.ahu.edu/blog/data-security-in-healthcare
    Links to an external site.

    Healthcare System Cybersecurity (2022). 
    Readiness & Response Considerations.

    https://files.asprtracie.hhs.gov/documents/aspr-tracie-healthcare-system-cybersercurity-readiness-response.pdf
    Links to an external site.

     

     

     
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    Shannon Marlar

    Shannon Marlar

    Dec 31, 2022
    Dec 31, 2022 at 8:46pm

    Manage Discussion Entry

    Yes, in my job I have an email address the corporation issued to me when I started. The email address has so much security that it will really only allow me to receive corporate email correspondence. I can send emails to others outside the corporation, but not receive them. Even emails from Access Medical (where are NPs are employed) are not received. In the group me app we use, there is a protocol to follow in order not to reveal HIPAA information. The integration of Big Data from electronic health records and other information systems within and across healthcare enterprises provides an opportunity to develop actionable predictive models that can increase confidence of nursing leaders’ decisions to improve patient outcomes and safety and control costs. As health care shifts to the community, mobile health applications add to the Big Data available. There is an evolving national action plan that includes nursing data in Big Data science, spearheaded by the University of Minnesota School of Nursing (Westra et al, 2015).

    References

    Pruinelli L. (2021). Nursing and Data: Powering Nursing Leaders for Big Data Science. 
    Revista brasileira de enfermagem
    , 
    74
    (4), e740401. 
    https://doi.org/10.1590/0034-7167.2021740401
    Links to an external site.

    Westra, B. L., Clancy, T. R., Sensmeier, J., Warren, J. J., Weaver, C., & Delaney, C. W. (2015). Nursing Knowledge: Big Data Science-Implications for Nurse Leaders. 
    Nursing administration quarterly
    , 
    39
    (4), 304–310. 
    https://doi.org/10.1097/NAQ.0000000000000130
    Links to an external site.

     

     

     

     

     
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    Alicia Brooke Richardson

    Alicia Brooke Richardson

    Dec 27, 2022
    Dec 27, 2022 at 8:06am

    Manage Discussion Entry

    When working in nursing one never thinks much about what big data is until they reach a point in their career where data becomes important and is monitored for statistics. What is big data? According to McGonigle and Mastrian, big data is a large collection of large data yet growing exponentially with time. Big data is so large and complex that none of the traditional data management tools can store it or process it efficiently (Mastrian & McGonigle, 2022). So, what does this mean for a nurse? Big data can be used in research or to pinpoint out issues that are happening but going unknown to the ones doing it every day.

    One potential benefit of using big data is its ability to pinpoint an issue that most people would never notice was happening. Such as Sepsis protocols and the amount that are being used in the emergency department. Most nurses just click the box and go on about their day not thinking anything else about the sepsis protocol or how many times that shift it has been used. Big data however keeps up with this and tracks the sign and symptoms that led to the clicking of that button. According to 
    Using Big Data to See the Big Picture in Sepsis
    , the authors evaluated all critically ill patients in their database to break down the criteria and pinpoint the different types of septic patients. This allowed them to see how many patients met the criteria upon arrival at the hospital compared to how many met it after admission. This is where big data was a benefit to the health care system.

    One potential challenge of using big data is that data is not a static entity, but rather a volatile being. With many elements in place, healthcare data must be periodically updated so the most recent and accurate information is always at hand. Additionally, data comes from many sources, which is another challenge for organizations. Aggregating data that is spread across multiple sources helps healthcare organizations pull and arrange all data into a more collaborative space but leaves them open to leaks or hacking for personal information.

    One strategy I have experienced in big data is the sepsis protocol collection within the emergency department. Before the use of big data patients were often overlooked when sepsis showed its nasty face. Nobody was taking the time to put the pieces together and say yes, this patient has sepsis, and we must treat them now. After the use and collection of big data, systems were put in place where the computer picks up on the main symptoms and says “hey do something” whether it is a popup box or a set protocol that automatically comes into play. This is where I feel big data has been a benefit. It has helped to save many lives. “Big data will help us manage the upcoming transformation into value-based care,” (Thew, 2016).

     

    References

    Mastrian, k., & McGonigle, D. (2022). 
    Nursing informatics and the foundation of knowledge (5th ed.).
     Jones & Bartlett Learning.

    Savel, Richard H. MD, FCCM; Shiloh, Ariel L. MD; Simon, Ronald J. MD, FACS; Kupfer, Yizhak MD, FCCP. Using Big Data to See the Big Picture in Sepsis*. Critical Care Medicine 46(4): p 640-641, April 2018. | DOI: 10.1097/CCM.0000000000002976

    Thew, J. (2016, April 19). 
    BIG DATA MEANS BIG POTENTIAL, CHALLENGES FOR NURSE EXECS
    . Retrieved from healthleaders: https://www.healthleadersmedia.com/nursing/big-data-means-big-potential-challenges-nurse-execs?page=0%2C1

  • Citation Machine

    Full Guide on Citation Machine

    A citation machine is a software application that automatically creates citations in several citation styles, including APA, MLA, Chicago, and Harvard. It facilitates the process of citing sources in academic papers, essays, and other forms of writing. Finding a reliable citation website and understanding how to use it is challenging for most people.

    This guide will walk you through the process of using a citation generator. Keep browsing through this article to understand the different citation styles that are commonly used. However, you don’t need to stress yourself writing and citing.
    Our experienced writers can help you write and reference your work
    with no stress at all and ensure the work is plagiarism-free.

    Steps on how to use a citation machine

    Step 1: Find a reliable citation machine

    You can find various citation tools on the web and use whichever works best for you. The following are examples of common and reliable citation tools that you should use:

    EasyBib

    Citation Machine

    BibMe

    Cite This For Me

    Understanding different tools and choosing a citation machine that fits your needs is important because each has special features.

    Step 2: Choose your reference format

    It would be best to decide on a citation style before you can cite your sources. APA, MLA, Chicago, and Harvard are the most frequently used citation formats in academic writing. Citation machines typically feature a pull-down menu or dedicated page where you can choose your preferred referencing format.

    Step 3: Type the original data

    After deciding on a specific referencing format, you’ll be prompted to enter details about the source you’re citing. The specifics of what’s needed will change depending on the type of source being used but in general. Below are some of the information you should include:

    Name of Author

    Source Title

    Day and month of publication

    Name of Publisher Pages (for books and journal articles)

    For online resources, including the full URL and the date you accessed the site.

    Step 4: Generate your references

    After completing the form, click the “Generate Citation” button to generate your citation. The citation generator will produce a citation in the chosen format. The reference is formatted so you can copy and paste it into your paper depending on the related information.

    Step 5: Revise and proofread the used citation

    After the citation has been generated, it should be reviewed and edited to ensure it is formatted properly and includes all the appropriate information. Ensure that there are no typing errors, grammatical mistakes, or missing details.

    Step 6: Prepare and document your citations

    You must keep a record of the sources cited in your work. To properly structure your references, save them to a document or use a citation manager tool such as Zotero or Mendeley.

    What is a citation machine APA?

    Citation machine APA is an online tool that generates
    citations in APA style format
    for various sources, including books, journal articles, websites, and more. It is designed to help students, researchers, and writers create accurate and properly formatted citations quickly and easily.

    With citation machine APA, you can enter the required information about the source you want to cite, such as the author, title, publication date, and publisher. The tool will then generate a citation in APA format, which you can copy and paste into your document.

    Citation machine APA is an effective tool for ensuring the accuracy and consistency of your citations in APA style. As a professional writer, it is also important to note that you should always double-check the citation generated by the tool for accuracy and formatting before including it in your work. Additionally, it’s important to follow any specific guidelines your instructor or institution provides for citation formatting.

    Uses of APA citation machine

    1.     It helps you save ample time

    One of the primary uses of the APA citation machine is that it saves time for students, researchers, and writers who need to create citations in APA style. By automating the citation process, the tool can generate accurate and properly formatted citations quickly and efficiently, allowing users to focus on their research and writing.

    2.     Ensures accuracy

    Another important use of the APA citation machine is that it helps ensure the accuracy of citations. APA style has specific guidelines for formatting citations, and the tool can help users avoid errors in formatting or citation details that could impact the credibility of their work.

    3.     Streamlines the citation process

    Using an APA citation machine can help streamline the citation process, making it easier for users to manage their sources and track their research. With the tool, users can easily input information about their sources and generate properly formatted citations, saving time and reducing the risk of errors.

    4.     Promotes consistency

    APA citation machine also promotes consistency in citation formatting. Using a standardized citation format, users can ensure that their work is consistent and follows the same guidelines as other works in their field. This can help ensure other researchers and readers easily recognize and understand the work.

    It is also important to note that an APA citation machine is a valuable tool for anyone who needs to create citations in APA style. Automating the citation process can save time, ensure accuracy, and promote consistency, helping users produce high-quality research and writing.

    How to select a citation machine MLA

    Step 1: Find a reliable MLA citation machine tool

    Several
    MLA citation
    machine tools are available online, and it’s important to choose a reliable one. Some popular MLA citation machine tools include EasyBib, Citation Machine, BibMe, Cite This For Me, and MLA Citation Generator.

    Step 2: Enter the details of your source

    Once you’ve chosen a citation machine tool, you will need to enter the details of your source. This usually includes the author’s name, the title of the source, the publication date, and the publisher. Depending on the source type, you may also include the name of the website or journal, the URL, or the page numbers.

    Step 3: Choose the citation format

    Most citation machine tools will allow you to choose the citation format you want to use. Make sure to select MLA as the citation format.

    Step 4: Review and edit the citation

    Once you’ve entered all the necessary details, the citation machine will generate a citation in MLA format. Reviewing the citation and making any necessary edits or corrections is important. Check for spelling, punctuation, and capitalization errors, as well as any missing information.

    Step 5: Save and use the citation

    Once satisfied with the citation, you can save it in your paper or bibliography. Ensure to follow the guidelines and rules your instructor or institution sets regarding citation formatting.

    Using an MLA citation machine can save you time and ensure the accuracy of your citations. However, it’s important to double-check the citation and make any necessary edits or corrections before using it in your paper.

    How to use a citation machine AMA

    AMA citation machine is a tool that can help you create citations in AMA (American Medical Association) style format. Here is a step-by-step cheat code on how to use a citation machine AMA:

    Step 1: Find a reliable AMA citation machine tool

    Several AMA citation machine tools are available online, and it’s important to choose a reliable one. Some popular AMA citation machine tools include EasyBib, Citation Machine, BibMe, and AMA Citation Generator.

    Step 2: Select the source type

    Most AMA citation machine tools will ask you to select the type of source you are citing, such as a book, journal article, or website. It is always important to ensure you choose the correct source type for your citation.

    Step 3: Enter the details of your source

    Once you’ve selected the source type, you’ll need to enter the details of your source. This usually includes the author’s name, the title of the source, the publication date, and the publisher. Depending on the source type, you may include the journal’s name, the volume and issue number, the page numbers, and the Digital Object Identifier tool.

    Step 4: Choose the citation format

    Most AMA citation machine tools will allow you to choose the citation format you want to use. Ensure that you select AMA as the citation format from the list of citations.

    Step 5: Review and edit the citation

    Once you’ve entered all the necessary details, the citation machine will generate a citation in AMA format. Reviewing the citation and making any necessary edits or corrections is important. Check for spelling, punctuation, and capitalization errors, as well as any missing information.

    Step 6: Save and use the citation

    Once satisfied with the citation, you can save it in your paper or bibliography. Ensure to follow the guidelines and rules your instructor or institution sets regarding citation formatting.

    Using an AMA citation machine can save you time and ensure the accuracy of your citations. It is important to double-check the citation and make any necessary edits or corrections before using it in your paper.

    Final remarks

    Using a citation machine is an easy and efficient way to generate bibliographic citations. Following the steps outlined in this guide, you can easily use a citation machine to
    create citations for your research papers, essays, and other academic works
    . Remember to review and edit the citations to ensure they are accurate and follow the correct format.

    Before selecting the citations to use in your paper, it is also important to consider the format of citations needed for your paper. You can also consult our professional writers for more insights.

  • APA-style paper

    Step-by-step guide for creating an APA-style paper

    You’re putting a lot of effort into your thesis, but due to formatting issues, you may not get high grades. Don’t stress! Why should you struggle to get good marks because of poor formatting when we can guide you? Composing a college essay or paper requires extensive study, careful planning or organization, and dedication. The commencement of the semester is ideal for learning how to write and format an
    APA Style paper.

    This article walks you through formatting requirements for APA Style student papers, beginning with a fundamental setup that applies to the textual content (font, spacing, line paragraph alignment and indentation, and margins). However, students should follow the format guidelines of their institution.

    Understanding APA style format

    So, what does APA stand for? APA stands for American Psychological Association. It was founded in 1929 for the benefit of the writers. The primary objective is to develop a unique citation and quotation style. Additionally, it draws the viewer in and gives the information the right headlines.

    APA is mostly used for scientific documents, lab papers, written records, etc.

    Writing an APA-style paper

    Writing an APA paper can be challenging at first, but following these steps can create a quality paper that satisfies the APA format guidelines.

    Formatting the title page

    Layout the basic standards

    An APA-style document should have double spacing throughout and a 12-point font size. It’s also advised to leave one-inch gaps all around. Every sheet of your work should follow this simple format.

    Create a brief description

    The APA advises that titles be direct, short, and concise. The title should clearly describe the topic of your paper to readers. A decent length is ten to twelve words. For instance, the title “Age-Based Influences on the Perception of Access to Healthcare in Cities” is a good example of a good topic

    APA format title page should be centered.

    Put your name and the name of your institution after the heading

    You should apply double spacing. The title and these details don’t require any additional spaces. It should resemble something like this:

    Age as a Factor Affecting Healthcare Availability Perceptions in Cities

    Utilize the page header

    Your essay should have a running heading on each page, excluding the title page for APA6, but APA 7 has no running head. This should be a precise description of the topic of your essay. Keep it under 50 characters, and style it in all uppercase.

    For instance, age and perceived access to social services

    Place the page number in the top right corner

    The page number should display to the right, along the same line as the running header. The page number can be made to appear automatically on each consecutive page.

    Writing the main body

    Introduce your work.

    The introduction is the first part of an APA-style paper, but it does not have to be identified. On the first line of the following sheet, type the title of your essay, followed by the first sentence of your introduction.

    Your introduction should give a brief overview of your matter, how it relates to the research, and how you reached your theory.

    Name the methods area

    The phrase “Method” should be center-bolded and placed just after your introduction.  It should clearly explain how your research was conducted. Make subheadings to detail the subjects, resources, and methods you used in your research. There should be no page breaks between any of the parts of your paper, including these subheadings.

    Each subheading should be titled in bold, with the titles aligned entirely to the left. Start each paragraph on the following line

    Present your findings

    After the final subheading of your methods, center the term “Findings” in bold type. Be sure to include any relevant statistics that analyze your research.

    For detailed instructions on how to format statistics APA format references, consult the APA guidelines on our website for your particular discipline

    Explain the significance of your writing in the discussion section

    Just after the findings section, center this part and write the word “Discussion” in bold print. Discuss issues like whether your observations support your theory. Be careful to spot any constraints on your research.

    You can also suggest potential future research topics for other academics based on your results

    Executing the final touches

    Add the references section

    You must reference every source you use in your research in accordance with the most recent APA style paper manual. You can check our APA 7
    th
    edition sample paper to learn more. If you are wondering which APA format citation generator you can use, the Purdue owl APA citation generator can come in handy. However, pay close attention to the following;

    The word “References” should be centered in bold type after your discussion section, followed by a summary of the complete bibliographical details for these references

    List the citations in alphabetical order, starting with the last name of the first source

    A space should not be added between each citation

    Include any charts or graphs you prepared

    Tables and figures should be formatted according to your area and study’s design. If you want suggestions, consult the most current APA style manual or experts in the subject. Assign each table and figure its sheet if you’re using multiple.

    Set aside a sheet for the abstract

    Summarize the subject, procedures, findings, and discussions in one line. Aim for 150–250 lines maximum.

    Here, you should;

    Center the phrase “Abstract” in the regular font on the line above the paragraph

    After finishing your paper, you should write the abstract and place it on a separate sheet just below the title page

    Common rules for APA style paper

    Each page has a numeric value at the upper right, along with a brief title related to the job

    Double-spacing in Times New Roman should be used between lines in the text

    It is recommended to double-space the note at the foot of the pages

    The heading should be in the middle

    The first word of the regular publishing title must be capitalized, per the rule. There are no quotation marks present

    The collection of references must be formatted according to a specific standard, with the last name, the first syllable of the name, and the middle name appearing in that order

    Bibliographies comprise the list of references, and the lengthier document should include summaries as well as numerous others

    Students must therefore be familiar with the American Psychological Association’s citation guidelines in order to write an essay of high quality. Writing an APA-style paper is difficult for most students.

    Steps to writing a paper in APA format

    So, how do you write an APA paper step by step? If this question is worrying you, don’t worry. We will help you out. But before composing an APA essay, you must first decide how you will manage your content.

    Similar to other style manuals, the APA style includes a wide range of subjects, such as references, grammar issues, tables and figures, and organizing research papers. Below are some things to keep in mind when managing your essay structure in APA style:

    Textual style

    Select a common and easy-to-read text format, such as Times New Roman. Similar to other styles, the APA demands the use of serif-free writing

    Margins

    Use one-inch margins on each of the page’s four edges

    Title page

    The subject of the essay in APA format should be centered on the page, followed by your name and school name, both centered and double-spaced

    Size

    Use a 12-inch font size

    Space

    Indent the first 12 inches of a section; indent square citations 1/2 inch from the left border as well

    Number of pages

    In the top right corner, number the pages in order starting with the title sheet. Avoid including your name after the page number

    Running heads

    A running head must appear on every page when using APA style. The running head, which appears at the top of each page with its alignment set to the left, is a succinct (under 12 words) description of your title.

    In your Running head, the title should appear after the heading on the title page. The running head should appear in the upper left corner of every following page.

    Spacing

    Double-space the entire document, including references and any quotes.

    APA format examples

    The common question is, what is APA format examples? Even though it might initially seem challenging, everything becomes obvious when you look at the APA format example pdf. If you need an illustration, this visualization of proper formatting might be helpful. Additionally, you should examine the precision of the essay structure and add your content.

    If you’re trying to figure out “how do you write a paper in APA format?”, check on the APA in-text citation guideline on our website. Also, take into account the previously mentioned factors.

    Final thoughts

    Writing an APA-style paper can appear stressful, but adhering to the above-detailed guidelines can make it much more manageable. Each step is essential to the success of your paper, from correct formatting to organizing your paper to properly citing sources to writing an effective abstract and conclusion. Additionally, keep in mind that errors and inconsistencies can reduce the quality of your paper, so make sure to carefully proofread and revise your work. If you want a top-notch essay formatted in APA style, we can help you. We offer students the top APA essay style at affordable prices.

  • NRS-434VN Health Assessment Full Course GCU

    NRS-434VN Health Assessment Full Course GCU

    Topic 1 DQ 1

    Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low-birth-weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community or a population in your community. Provide the link to the resource in your post.

    ORDER
    ESSAY
    OR
    SHADOW HEALTH
    HELP HERE

    Extremely low birth weight babies (LBWB) have a huge impact on the families and communities in which they happen. Those LBWB will need to be in a neonatal intensive care unit (NICU), and if you are in a rural community, that means a likely transfer to a bigger city hospital. It is stressful to have a baby, let alone one that needs intensive care. This can impact the family in several ways. Who is going to be able to be with the baby in the NICU, can impact the families finances and resources. This is especially true if the baby has to be sent to a hospital in a bigger city, you have housing, food, transportation costs that impact a family’s ability to provide. Long-term financial issues can include the need for continued supportive care and equipment. LBWB can have a myriad of complications including but not limited to respiratory distress syndrome (RDS), intraventricular hemorrhage (IVF), patent ductus arteriosus (PDA), necrotizing enterocolitis, retinopathy of prematurity, jaundice, and infections (March of Dimes, 2021). All of these complications can lead to lifetime disabilities and/or developmental delays that require ongoing care and support. Preterm labor (PTL), one of the leading causes of LBWB, is not equally affecting different ethnic/cultural groups. Non-Hispanic black mothers have the highest rates of LBWB, and PTL at 13.1% and 13.3% respectively. As compared to non-Hiospanic white mothers, at 7.0% and 9.0% (Almeida et al, 2018). Non-Hispanic black mothers are also more likely to live in low socioeconomic settings with fewer resources than their non-hispanic white mother counterparts (Almeida et al, 2018). In my community we have several different programs that are specific to providing resources and aid for LBWB, and those with lower socioeconomic resources. One that is state wide in California is the program called First 5, and my cities chapter is First 5 LA. They are funded through the tobacco and alcohol taxes in California, and the program goes from prenatal care through the age of 5 NRS-434VN Health Assessment Full Course GCU. Their goal is to provide services and referrals to help support and create healthy children regardless of ability to pay (First 5 LA, n.d.). Another local resource for LBWB, and Preterm infants is through Los Angeles County Health Services. They have programs for monitoring the development and early interventions for preterm infants, and those that had complications at birth (n.d.). These are just a few of the local resources for families that have LBWB, but there are more out there, including federal resources.

    References:

    Almeida, J., Erbetta, K., Bécares, L., Bettegowda, V. R., & Ahluwalia, I. B. (2018). Racial/Ethnic inequities in low birth weight and preterm birth: The role of multiple forms of stress. 
    Maternal & Child Health Journal
    , 
    22
    (8), 1154–1163. 
    https://doi-org.lopes.idm.oclc.org/10.1007/s10995-018-2500-7

    First 5 LA: 
    https://www.first5la.org

    Health Services Los Angeles County: 

    Premature Infant

    March of Dimes: 
    https://www.marchofdimes.org/find-support/topics/birth/low-birthweight

     

    Topic 1 DQ 2

    Consider the following patient scenario:

    A mother comes in with
    9-month-old girl
    . The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).

    Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice NRS-434VN Health Assessment Full Course GCU.

    The presented nine-month-old girl’s head circumference is 43 cm, which is typically the average head measurement for girls, according to the CDC. The CDC estimates that girls’ average head circumference at this age is 43.83 centimeters (Miles, 2022). “The average length for a nine-month-old is 27.6 inches for girls, according to the World Health Organization” (The Bump Editors, 2017, para 4). The presented 9-month-old girl’s length is 68.5 cm, which is below average. Lastly, the weight of the nine-month-old girl is 6.75 kg, compared to the average weight of 18.1 pounds for girls (The Bump Editors, 2017).

    In terms of growth, babies develop at a phenomenal rate. In fact, at month nine, the baby typically grows alarmingly. Miles (2022) stated that most infants see a noticeable increase in weight throughout the third trimester. The 9-month-old presented in this discussion is developing slower than the average newborn, weight- and length-wise. The nurse should advise the mother to continue breastfeeding or using formula but to introduce baby food if she has not already started. The mother “can expand her baby’s diet to include soft foods such as yogurt, oatmeal, mashed banana, mashed potatoes, or even thicker or lumpy pureed vegetables” (AAP, 2022, para 2). “Eggs (including scrambled) are an excellent source of protein, as are cottage cheese, Greek yogurt, and avocado” (AAP, 2022, para 2). Let the baby get plenty of rest. Have her child examined by her primary care provider once a month to monitor growth and development and to learn about proper weaning techniques.

    For healthcare providers to spot newborns at risk for delay, they must correctly identify the developmental milestones. There is a wide variety of evidence-based screening methods available to help healthcare providers determine whether newborns are on track to fulfill developmental milestones or are at risk for delays. The Centers for Disease Control and Prevention (CDC) have made a list of evaluation checkpoints that doctors and nurses can use as a basis by the end of a 9-month-old’s evaluation. This includes the Ages and Stages Questionnaire, the Child Development Inventory, and the Parent’s Evaluation of Developmental Status (CDC, 2022). These trackers come in digital milestone tracker mobile apps for iOS and Android devices, and one can use the digital online checklist or print the checklist sheet (CDC, 2022). For social/emotional milestones, the CDC states that a nine-month-old should be able to show expressions such as clinginess, happiness, anger, sadness, shyness, and fear around unfamiliar faces; be able to look when their names are mentioned, react to being left behind, like crying or reaching out for their guardian; and smile or giggle when playing pee-a-boo with them (CDC, 2022).

    In the cognitive milestones, such as thinking, problem-solving, and learning, a 9-month-old should be able to bang two objects together and seek toys or any item when dropped or hidden out of sight (CDC, 2022). For language and communication, a nine-month-old should be able to lift their arms as an indication to be lifted up and make sounds like “babababa” or “mamamama” (CDC, 2022, para 4). For the physical/movement milestones, a nine-month-old is expected to be able to move objects from one hand to the other, get into a sitting position without help or support, and use their fingers to “rake” food towards them (CDC, 2022).

    Per the CDC, parents are their baby’s first teachers (CDC, 2022). It is crucial for parents to be familiar with the developmental milestones of their child/children. With this knowledge, it is easier for parents to include these activities in their babies’ daily routines and become aware of any unfulfilled milestones that need to be addressed with their healthcare experts.

    References

    American Academy of Pediatrics. (2022, August 12). 
    Sample menu for a baby 8 to 12 months old
    . 
    https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/sample-one-day-menu-for-an-8-to-12-month-old.aspx

    Centers for Disease Control and Prevention. (2022, July 5). 
    What developmental milestones is your 9-month-old reaching?
     
    https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html

    Miles, K. (2022, April 7). 
    Average newborn head circumference
    . BabyCenter. 
    https://www.babycenter.com/baby/baby-development/baby-head-circumference_40009394

    The Bump Editors. (2017, June 19). 
    9-Month-Old baby – Baby month by month
    . TheBump.com – Pregnancy, Parenting and Baby Information. 
    https://www.thebump.com/baby-month-by-month/9-month-old-bab

     

    Environmental Factors and Health Promotion Presentation: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants

    Assessment Traits

    Requires Lopeswrite

    Assessment Description

    The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and 
    develop a health promotion that can be presented to parents and caregivers
    .

    Create a 10-12-slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end.

    In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored.

    Include the following in your presentation:

    Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants.

    Create a health promotion plan that can be presented to parents and caregivers to address the environmental factor and improve the overall health and well-being of infants.

    Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.

    Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly sources are required. Two of the three sources must be peer-reviewed and no more than 5 years old.

    Provide readers with four resources:  two community resources, one national resource, and one web-based resource. Include a brief description and contact information for each resource.

    You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

    Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

    Refer to the resource, “Loom,” located in the Student Success Center, for additional guidance on recording your presentation.

    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, which can be found in the APA Style Guide, located in the Student Success Center.

    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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

    Topic 2 DQ 1

    Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. Identify two factors that increase the vulnerability of a child for abuse in the age group you have selected.

    There are several forms of child abuse. The World Health Organization (WHO) identifies them under the term maltreatment, and it includes abuse that is physical, emotional, and sexual. It also includes negligence, neglect and exploitation that can be commercial in nature (World Health Organization, 2022).

    The most common abuse for toddlers is that of neglect. As nurses we can watch for toddlers that are withdrawn and nervous along with not meeting milestones or potentially regressing on milestones reached as red flags that there is a potential issue emotionally with the child (Gonzalez, D., et al., 2022). Neglect includes many environmental deficiencies such as lack of food and water, not taking a child to needed healthcare appointments, not providing a safe place to live, and not maintain a child’s hygiene. Neglect is reported to be more prevalent in homes that are in the poverty line, homes where domestic violence occurs, and homes that have more than two children (Gonzalez, D., et al., 2022).

    I reside in the state of Idaho and our main contact for reporting abuse is the Idaho Department of Health and Welfare. Once contacted and reported, a case is created, and a social worker is assigned. Follow-up is then completed by the assigned social worker for further investigation if warranted. We do have to be mindful as nurses when reporting potential abuse as there are many cultures that have different practices for health management. Cupping is one practice that can leave marks or bruising on the body that can be easily mistaken for physical abuse (Xun Lin., et al., 2018). Regardless of cultural practices, it is best to report any instance that could potentially be abuse as it is better to over report than under report.

    References:

    Gonzalez D, Bethencourt Mirabal A, McCall JD. (2022). Child Abuse and Neglect. 
    StatPearls Publishing.
     https://www.ncbi.nlm.nih.gov/books/NBK459146/

    Idaho Department of Health and Welfare. (n.d.). Report neglect, abuse and abandonment. https://healthandwelfare.idaho.gov/services-programs/children-families/child-and-family-services-and-foster-care/reporting-neglect

    World Health Organization. (2022). 
    Responding to child maltreatment: A clinical handbook for health professionals.
     https://www.who.int/publications/i/item/toolkit-on-mapping-legal-health-and-social-services-responses-to-child-maltreatment

    Xun Lin, Hon Foong Wong, & Shih Chau Ng. (2018). Cupping, the past and present application. 
    Chinese Medicine and Culture
    , 
    1
    (3), 121–126. https://doi-org/10.4103/CMAC.CMAC_37_18

    Topic 2 DQ 2

    Mar 20
    –
    24, 2023

    Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.

    Developmental Assessment and the School-Aged Child

    Assessment Traits

    Requires Lopeswrite

    Assessment Description

    The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

    ORDER HERE

    Describe the different physical characteristics/findings within the school-aged child. Explain how you would modify assessment techniques to match the age and developmental stage of this child.

    Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.

    Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

    You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, 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.

    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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

    Adolescence: Contemporary Issues and Resources

    REVIEW SUBMISSION

    Start Date

    Mar 27, 2023, 12:00 AM

    Due Date

    Apr 2, 2023, 11:59 PM

    Points

    90

    Rubric

    View Rubric

    Status

    Ungraded

    Assessment Traits

    Requires Lopeswrite

    Assessment Description

    Research the range of
    contemporary issues teenagers face today
    . In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

    Describe the contemporary issue and explain what external stressors are associated with this issue.

    Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.

    Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented. NRS-434VN Health Assessment Full Course GCU

    You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, 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 NRS-434VN Health Assessment Full Course GCU.

    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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

    Topic 4: Health Assessment Of The Young And Middle-Aged Adult

    Apr 3
    –
    9, 2023

    Max Points:
    198

    Objectives:

    Discuss strategies to reduce at-risk behavior in adults.

    Evaluate assessment of diverse populations.

    Perform and document a comprehensive health assessment.

    Assessments

    Collapse All Assessments
    Collapse All

    Topic 4 DQ 1

    GO TO DISCUSSION

    Start Date

    Apr 3, 2023, 12:00 AM

    Due Date

    Apr 5, 2023, 11:59 PM

    Points

    8

    Status

    Upcoming

    Assessment Description

    You are admitting a 19-year-old female college student to the hospital for fevers. Using the patient information provided, choose a culture unfamiliar to you and describe what would be important to remember while you interview this patient. Discuss the health care support systems available in your community for someone of this culture. If no support systems are available in your community, identify a national resource.

    Topic 4 DQ 2

    GO TO DISCUSSION

    Start Date

    Apr 3, 2023, 12:00 AM

    Due Date

    Apr 7, 2023, 11:59 PM

    Points

    8

    Status

    Upcoming

    Assessment Description

    For the middle-aged adult, exercise can reduce the risk of various health problems. Choose two at-risk health issues that regular physical exercise and activity can help prevent and manage. Discuss the prevalence of each of these health problems in society today. Describe measures that you would take as a nurse to assist patients with health promotion measures to incorporate exercise and physical activity into their lives. Include the kind of activities you would recommend, the amount of exercise, and the approach you would use to gain cooperation from the patient. Support your response with evidence-based literature.

    Shadow Health: Comprehensive Assessment

    SUBMIT ASSIGNMENT

    Start Date

    Apr 3, 2023, 12:00 AM

    Due Date

    Apr 9, 2023, 11:59 PM

    Points

    150

    Status

    Upcoming

    Assessment Description

    Within the Shadow Health platform, complete the Comprehensive Assessment. The estimated average time to complete this assignment each time is 3 hours. Please note, this is an average time. Some students may need longer.

    This clinical experience is a comprehensive exam. Students must score at the level of “Proficient” in the Shadow Health Digital Clinical Experience. Students have three opportunities to complete this assignment and score at the Proficient level. Upon completion, submit the lab pass through the assignment dropbox.

    Students successfully scoring within the Proficient level in the Digital Clinical Experience on the first attempt will earn a grade of 150 points; students successfully scoring at the Proficient level on the second attempt will earn a grade of 135 points; and students successfully scoring at the Proficient level on the third attempt will earn a grade of 120 points. Students who do not pass the performance-based assessment by scoring within the Proficient level in three attempts will receive a failing grade (102 points).

    If the Proficient level is not achieved on the first attempt it is recommended that you review your answers with the correct answers on the Experience Overview page. Review the report by clicking on each tab to the left titled; Transcript, Subjective Data Collection, Objective Data Collection, Documentation, and SBAR to compare your work. Reviewing this overview and course resources may help you improve your score.

    Please review the assignment in the Health Assessment Student Handbook in Shadow Health prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Topic 5: Health Assessment Of The Older Adult

    Apr 10
    –
    16, 2023

    Max Points:
    258

    Objectives:

    Describe characteristics of the aging process.

    Recommend strategies for supporting patients in end-of-life care.

    Apply use of a focused assessment to an assigned individual patient.

    Assessments

    Collapse All Assessments
    Collapse All

    Topic 5 DQ 1

    GO TO DISCUSSION

    Start Date

    Apr 10, 2023, 12:00 AM

    Due Date

    Apr 12, 2023, 11:59 PM

    Points

    8

    Status

    Upcoming

    Assessment Description

    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.

    Topic 5 DQ 2

    GO TO DISCUSSION

    Start Date

    Apr 10, 2023, 12:00 AM

    Due Date

    Apr 14, 2023, 11:59 PM

    Points

    8

    Status

    Upcoming

    Assessment Description

    End-of-life care becomes an issue at some point for elderly patients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your patients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.

    Benchmark – Human Experience Across the Health-Illness Continuum

    SUBMIT ASSIGNMENT

    Start Date

    Apr 10, 2023, 12:00 AM

    Due Date

    Apr 16, 2023, 11:59 PM

    Points

    110

    Rubric

    View Rubric

    Status

    Upcoming

    Assessment Traits

    Benchmark

    Requires Lopeswrite

    Assessment Description

    Research the health-illness continuum and its relevance to patient care. In a 750-1,000-word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

    Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.

    Explain how understanding the health-illness continuum enables you, as a health care provider, to better promote the value and dignity of individuals or groups and to serve others in ways that promote human flourishing and are consistent with the Christian worldview.

    Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.

    Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

    You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, 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.

    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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

    Benchmark Information

    This benchmark assesses the following programmatic competency:

    RN-BSN

    5.3: Understand the human experience across the health-illness continuum.

    ORDER SHADOW HEALTH HELP HERE

    Shadow Health: Focused Exam: Abdominal Pain

    SUBMIT ASSIGNMENT

    Start Date

    Apr 10, 2023, 12:00 AM

    Due Date

    Apr 16, 2023, 11:59 PM

    Points

    100

    Status

    Upcoming

    Assessment Description

    Within the Shadow Health platform, complete the Focused Exam: Abdominal Pain. The estimated average time to complete this assignment is 1 hour and 25 minutes. Please note, this is an average time. Some students may need longer.

    This clinical experience is a focused exam. Students have one opportunity to complete this assignment and score at the Proficient level. Upon completion, submit the lab pass through the assignment dropbox.

    Students successfully scoring within the Proficient level in the Digital Clinical Experience will earn a grade of 100 points. Students who do not pass the performance-based assessment and scoring within the Proficient level will receive a failing grade (68 points).

    Please review the assignment in the Health Assessment Student Handbook in Shadow Health prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite NRS-434VN Health Assessment Full Course GCU.

  • NRS-434VN Adolescence: Contemporary Issues and Resources

    NRS-434VN Adolescence: Contemporary Issues and Resources

    Adolescence: Contemporary Issues and Resources

    REVIEW SUBMISSION

    Start Date

    Mar 27, 2023, 12:00 AM

    Due Date

    Apr 2, 2023, 11:59 PM

    Points

    90

    Rubric

    View Rubric

    Status

    Ungraded

    Assessment Traits

    Requires Lopeswrite

    Assessment Description

    Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

    Describe the contemporary issue and explain what external stressors are associated with this issue.

    Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.

    NRS-434VN Adolescence: Contemporary Issues and Resources

    Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented.

    You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, 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 NRS-434VN Adolescence: Contemporary Issues and Resources.

    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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

    Adolescence: Contemporary Issues and Resources – Rubric

    LIST
    GRID

    PRINT TO PDF

    Rubric Criteria

    Total
    90 points

    Criterion

    1. Unsatisfactory

    2. Insufficient

    3. Approaching

    4. Acceptable

    5. Target

    Contemporary Issue and Associated External Stressors

    A description of the contemporary issue and explanation of what external stressors are associated with the issue are provided.

    0 points

    A description of the contemporary issue and explanation of what external stressors are associated with the issue are omitted or inaccurate.

    16.88 points

    A description of the contemporary issue and explanation of what external stressors are associated with the issue lack detail or are incomplete.

    17.78 points

    A description of the contemporary issue and explanation of what external stressors are associated with the issue are present.

    20.03 points

    A detailed description of the contemporary issue and explanation of what external stressors are associated with the issue are present.

    22.5 points

    A thorough and accurate description of the contemporary issue and explanation of what external stressors are associated with the issue are present.

    Assessment Strategies to Screen for the Issue and External Stressors

    An outline includes assessment strategies to screen for the issue including external stressors during an assessment for an adolescent patient and a description of what additional assessment questions one would need to ask. A definition of the ethical parameters regarding what you can and cannot share with the parent or guardian is provided.

    0 points

    An outline that includes assessment strategies to screen for the issue, including external stressors during an assessment for an adolescent patient and a description of what additional assessment questions one would need to ask, is omitted or inaccurate. A definition of the ethical parameters regarding what you can and cannot share with the parent or guardian lacks detail or is omitted or inaccurate NRS-434VN Adolescence: Contemporary Issues and Resources.

    16.88 points

    An outline that includes assessment strategies to screen for the issue, including external stressors during an assessment for an adolescent patient and a description of what additional assessment questions one would need to ask, lacks detail or is incomplete. A definition of the ethical parameters regarding what you can and cannot share with the parent or guardian lacks sufficient detail or is incomplete.

    17.78 points

    An outline that includes assessment strategies to screen for the issue, including external stressors during an assessment for an adolescent patient and a description of what additional assessment questions one would need to ask, is present. A definition of the ethical parameters regarding what you can and cannot share with the parent or guardian is present.

    20.03 points

    A detailed outline that includes assessment strategies to screen for the issue, including external stressors during an assessment for an adolescent patient and a description of what additional assessment questions one would need to ask, is present. A detailed definition of the ethical parameters regarding what you can and cannot share with the parent or guardian is present.

    22.5 points

    A thorough and accurate outline that includes assessment strategies to screen for the issue, including external stressors during an assessment for an adolescent patient and a description of what additional assessment questions one would need to ask, is present. A thorough and accurate definition of the ethical parameters regarding what you can and cannot share with the parent or guardian is present.

    Support Options for Adolescents Encountering External Stressors

    A discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue presented is provided.

    0 points

    A discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue presented is omitted or inaccurate.

    13.5 points

    A discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue presented lacks detail and is incomplete.

    14.22 points

    A discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue is present.

    16.02 points

    A detailed of includes support options for adolescents encountering external stressor and specific support options for the contemporary issue presented is present NRS-434VN Adolescence: Contemporary Issues and Resources.

    18 points

    A thorough and accurate discussion of support options for adolescents encountering external stressor and specific support options for the contemporary issue presented is present.

    Thesis, Position, or Purpose

    Communicates reason for writing and demonstrates awareness of audience NRS-434VN Adolescence: Contemporary Issues and Resources.

    0 points

    The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.

    4.73 points

    The thesis, position, or purpose is unfocused or confused. There is very little awareness of the intended audience.

    4.98 points

    The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.

    5.61 points

    The thesis, position, or purpose is adequately presented. An awareness of the appropriate audience is demonstrated.

    6.3 points

    The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.

    Development, Structure, and Conclusion

    Advances position or purpose throughout writing; conclusion aligns to and evolves from development.

    0 points

    No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.

    4.73 points

    Writing lacks logical progression of the thesis, position, or purpose. Some organization is attempted, but ideas are disconnected. Conclusion is unclear and not supported by the overall development of the purpose.

    4.98 points

    Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.

    5.61 points

    The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.

    6.3 points

    The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and logical conclusion aligns to the development of the purpose.

    Evidence

    Selects and integrates evidence to support and advance position/purpose; considers other perspectives.

    0 points

    Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.

    4.05 points

    Evidence is limited or irrelevant. The interpretation of other perspectives is superficial or incorrect.

    4.27 points

    Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.

    4.81 points

    Relevant evidence that includes other perspectives is used.

    5.4 points

    Specific and appropriate evidence is included. Relevant perspectives of others are clearly considered.

    Mechanics of Writing

    Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.

    0 points

    Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.

    4.05 points

    Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.

    4.27 points

    Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.

    4.81 points

    Few mechanical errors are present. Suitable language choice and sentence structure are used.

    5.4 points

    No mechanical errors are present. Appropriate language choice and sentence structure are used throughout.

    Format/Documentation

    Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.

    0 points

    Appropriate format is not used. No documentation of sources is provided.

    2.7 points

    Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.

    2.84 points

    Appropriate format and documentation are used, although there are some obvious errors.

    3.2 points

    Appropriate format and documentation are used with only minor errors.

    3.6 points

    No errors in formatting or documentation are present NRS-434VN Adolescence: Contemporary Issues and Resources.

  • NRS-434VN Health Assessment Topic 1 DQ 2

    NRS-434VN Health Assessment Topic 1 DQ 2

     

    Topic 1 DQ 2

    Consider the following patient scenario:

    A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).

    Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

    SEEK HELP HERE

    DQ

    As a nurse, some developmental markers that I would assess for a 9-month-old female infant include:

    One of the developing skills are gross motor skills the infant should be able to sit without support, crawl, and possibly stand while holding onto a support NRS-434VN Health Assessment Topic 1 DQ 2.

    Furthermore another skill is fine motor skills they be able to pick up small objects with their thumb and index finger, called a pincer grasp
    (
    Orange County, 2023)

    another developing skills is communication skills , nine month old should be able to respond to their name, understand simple commands, and babble in a way that sounds like talking.

    Another one is social skills where infant should be showing signs of stranger anxiety and beginning to show preferences for certain people.

    Based on the growth measurements and developmental markers, I would recommend to the mother that she continues to encourage her child’s development by engaging in activities that support these milestones. For example, providing toys that encourage fine motor skills, such as blocks or stacking toys, and reading or talking to the child to support communication skills.These recommendations are based on evidence-based practice because research has shown that engaging in activities that support developmental milestones can improve outcomes in areas such as language development, cognitive function, and social-emotional development (Ferguson, 2012). Additionally, monitoring the child’s growth and development is important for identifying any potential delays or concerns that may require further evaluation or intervention. (CDC, 2023) NRS-434VN Health Assessment Topic 1 DQ 2

    References:

    (
    Child Development: Milestones, Ages and Stages – Children’s Hospital of Orange County
    , 2023) https://www.choc.org/primary-care/ages-stages/

    (CDC, 2023) Important Milestones: Your Baby By Nine Months https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html

     

    responses

    Hey xx

    I liked that you included multiple different markers of infant development in your post. This makes it a more well rounded approach of looking at the child’s health overall. There are a couple of different growth charts that are available for provider use online. This includes both the CDC’s and the WHO’s growth chart. The CDC actually recommends that providers use the WHO’s growth chart for children that are less than 24 months old. WHO’s growth chart is considered to be more accurate because it uses the average healthy breastfed infant as their standard to compare other infants to. Thus it can be a way to indicate which infants may be more malnourished (Grummer-Strawn, Reinold & Krebs, 2010).

    Reference:

    Grummer-Strawn, L.M., Reinold, C. & Krebs, N.F. (2010). 
    Use of world health organization and CDC growth charts for children aged 0-59 months in the United States.
     CDC. 
    https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5909a1.htm

    REPLY

    Hi xx

    You have discussed the expectations of measurements and development of the respective age in this scenario. There are a few things parents should look out for and speak to their pediatrician if they note their child is not able to sit without assistance, does not attempt to put weight on their legs, and does not grasp toys from hand to hand (UNICEF, n.d.) NRS-434VN Health Assessment Topic 1 DQ 2. A few tips for parents to encourage some of these milestones, is during interactions place the child close to furniture something to grab on and try to raise their bodies up (UNICEF, n.d.). Further encourage your child to grab small objects by handing them toys and playing games where the objective is to pick up the toy (UNICEF, n.d.). These tips can help increase motor milestones by focusing on the age and developmental markers. For language and communications, parents should be aware if their child is not recognizing family, does not respond to their own name, and is not babbling words such as mama and dada (UNICEF, n.d.). These may indicate further investigation into with the pedestrian so they may evaluate how the child is developing.

     

    Reference

    UNICEF. (n.d.). 
    Your baby’s developmental milestones at 9 months
    . https://www.unicef.org/parenting/child-

    development/your-babys-developmental-milestones-9-months

     

    Hi xx

    It is very true, talking to the child is vital to supporting communication. A child can be facilitated in language expansion by mere interactions like spelling out what you are doing and allowing the baby time to respond, repeating the same approach after you say something and waiting for her to try to imitate the sounds. One can also chat with the baby in a way that she will respond beyond just a no or yes response. Reading books aloud is also another way to stimulate a child’s language development and this can be done in a more creative and interesting way to capture her attention NRS-434VN Health Assessment Topic 1 DQ 2.

    Reference:

    Mayo Clinic. (2022). Infant development: Milestones from 7 to 9 months
    : https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/infant-development/art-20047086

  • Focused Exam: Cough – Danny Rivera Shadow health Objective & Subjective Data

    Focused Exam: Cough – Danny Rivera Shadow health Objective & Subjective Data

    Objective Data Collection: 15 of 15 (100.0%)

     Correct

     Partially correct

     Incorrect

     Missed

     Inspected eyes and orbital area

    1 of 1 point

    Orbital Area 
    (1/4 point)

     No visible abnormal findings

     Ptosis

     Eyelid

     Lesion

    Sclera 
    (1/4 point)

     White

     Yellow tint

     Redness

    ORDER SHADOW HEALTH HELP HERE

    Conjunctiva 
    (1/4 point)

     Moist and pink

     Dry appearance

     Redness

     Swelling

    Conjunctival Discharge 
    (1/4 point)

     No discharge

     Clear, watery discharge

     Purulent discharge

     Inspected nasal cavities

    1 of 1 point

    Color 
    (1/4 point) – Focused Exam: Cough – Danny Rivera Shadow health Objective & Subjective Data

     Pink

     Red

     Bluish

    Discharge 
    (1/4 point)

     No discharge

     Clear discharge

     Bloody discharge

     Purulent discharge

    Turbinate Patency 
    (1/4 point)

     Patent

     Decreased patency

     Not patent

    Observations 
    (1/4 point)

     No additional visible abnormal findings

     Foreign body present

     Polyp

     Septum perforated

     Septum deviated

     Lesion

     Inspected ears

    0.8 of 1 point

    Right: Auditory Canal Color 
    (No point)

     Pink

     Red

     Pallor

    Right: Tympanic Membrane Color 
    (No point)

     Pearly gray

     Red

     Opaque

     Yellow

     Not visible because of cerumen

    Right: Tympanic Membrane Appearance 
    (1/10 point)

     No visible abnormal findings

     Fluid observed

     Visible scars

     Bulging

     Perforation

     Retraction

    Right: Cone Of Light 
    (1/10 point)

     5:00

     Cone of light distorted

    Right: Discharge 
    (1/10 point)

     No discharge

     Cerumen

     Clear discharge

     Bloody discharge

     Purulent discharge

    Left: Auditory Canal Color 
    (1/10 point)

     Pink

     Red

     Pallor

    Left: Tympanic Membrane Color 
    (1/10 point)

     Pearly gray

     Red

     Opaque

     Yellow

     Not visible because of cerumen

    Left: Tympanic Membrane Appearance 
    (1/10 point)

     No visible abnormal findings

     Fluid observed

     Visible scars

     Bulging

     Perforation

     Retraction

    Left: Cone Of Light 
    (1/10 point)

     7:00

     Cone of light distorted

    Left: Discharge 
    (1/10 point)

     No discharge

     Cerumen

     Clear discharge

     Bloody discharge

     Purulent discharge

     Inspected mouth and throat

    1 of 1 point

    Oral Mucosa 
    (1/5 point)

     Moist and pink

     Dry appearance

     Redness

    Tonsils 
    (1/5 point)

     No visible abnormal findings

     Swelling

     Redness

    Throat Color 
    (1/5 point)

     Pink

     Red

    Throat Texture 
    (1/5 point)

     No abnormal findings

     Cobblestoning

     Exudate

    Post Nasal Drip 
    (1/5 point)

     No discharge

     Clear discharge

     Purulent discharge

     Inspected neck

    1 of 1 point

    Symmetry 
    (1/2 point)

     Symmetric

     Asymmetric

    Appearance 
    (1/2 point)

     No visible abnormal findings

     Swelling

     Visible pulsation

     Visible mass

     Discoloration

     Inspected chest

    1 of 1 point

    Symmetry 
    (1/2 point)

     Symmetric

     Asymmetric

    Appearance 
    (1/2 point)

     No visible abnormal findings

     Rash

     Barrel chest

     Intercostal retraction while breathing

     Excessive use of accessory muscles while breathing

     Skin growths (freckles or moles)

     Auscultated breath sounds

    1 of 1 point

    Breath Sounds 
    (1/3 point)

     Present in all areas

     Diminished in some areas

     Absent in some areas

    Adventitious Sounds 
    (1/3 point)

     No adventitious sounds

     Wheezing

     Fine crackles

     Stridor

     Rhonchi

     Rales

    Location 
    (1/3 point)

     All areas clear

     Adventitious sounds in anterior right upper lobe

     Adventitious sounds in anterior right middle lobe

     Adventitious sounds in anterior right lower lobe

     Adventitious sounds in anterior left upper lobe

     Adventitious sounds in anterior left lower lobe

     Adventitious sounds in posterior right upper lobe

     Adventitious sounds in posterior right lower lobe

     Adventitious sounds in posterior left upper lobe

     Adventitious sounds in posterior left lower lobe

     Auscultated for bronchophony

    1 of 1 point

    Bronchophony 
    (1/1 point)

     Positive

     Negative

     Auscultated heart sounds

    1 of 1 point

    Heart Sounds 
    (1/2 point)

     S1 and S2 audible

     S1, S2, and S3 audible

     S1, S2, and S4 audible

     S1, S2, S3, and S4 audible

    Extra Heart Sounds 
    (1/2 point)

     No extra sounds

     Gallops

     Murmur

     Friction rub

     Valve clicks

     Percussed chest wall

    1 of 1 point

    Observations 
    (1/2 point)

     All areas resonant

     Some areas dull, some resonant

     Some areas hyperresonant, some resonant

    Location 
    (1/2 point)

     No areas of dullness

     Dullness, anterior right upper lobe

     Dullness, anterior right middle lobe

     Dullness, anterior right lower lobe

     Dullness, anterior left upper lobe

     Dullness, anterior left lower lobe

     Dullness, posterior right upper lobe

     Dullness, posterior right lower lobe

     Dullness, posterior left upper lobe

     Dullness, posterior left lower lobe

     Measured diaphragmatic excursion

    1 of 1 point

    Range 
    (1/1 point)

     3-5 cm

     Greater than 3-5 cm

     Less than 3-5 cm

     Palpated sinuses

    1 of 1 point

    Frontal 
    (1/2 point)

     None reported

     Tenderness reported

    Maxillary 
    (1/2 point)

     None reported

     Tenderness reported

     Palpated lymph nodes

    1 of 1 point

    Head And Neck 
    (1/3 point)

     No palpable nodes

     Palpable nodes on right side

     Palpable nodes on left side

    Supraclavicular 
    (1/3 point)

     No palpable nodes

     Palpable nodes on right side

     Palpable nodes on left side

    Axillary 
    (1/3 point)

     No palpable nodes

     Palpable nodes on right side

     Palpable nodes on left side

     Palpated fremitus

    1 of 1 point

    Symmetry 
    (1/2 point)

     Equal bilaterally

     Unequal bilaterally

    Vibration 
    (1/2 point)

     Expected fremitus

     Decreased fremitus

     Palpated chest expansion

    1 of 1 point

    Symmetry 
    (1/1 point)

     Equal bilaterally

     Unequal bilaterally

    Subjective Data Collection: 22 of 22 (100.0%)

    Hover To Reveal…

    Hover over the 
    Patient Data 
    items below to reveal important information, including 
    Pro Tips
     and 
    Example Questions
    .

    Found:

     Indicates an item that you found.

    Available:

     Indicates an item that is available to be found.

    Category

    Scored Items

    Experts selected these topics as essential components of a strong, thorough interview with this patient.

    Patient Data

    Not Scored

    A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

    Chief Complaint

    Finding:

    Established chief complaint

    Finding:

    Reports cough

    (Found)

    Pro Tip: Asking a patient broadly about their chief complaint allows them to answer in their own words and confirm information that you may have already received from another source.

    Example Question:

    Do you have a cough?

    History of Presenting Illness

    Finding:

    Asked about onset of cough

    Finding:

    Reports cough started 3 days ago

    (Found)

    Pro Tip: Whenever you are assessing a symptom or a health condition, in this case the patient’s cough, inquiring about onset assesses the severity and the progression of the problem.

    Example Question:

    How long have you had a cough?

    Finding:

    Asked about characteristics of cough

    Finding:

    Reports cough is wet

    (Found)

    Pro Tip: The characteristics of a cough, such as whether it is dry or wet, can indicate key information about the type of illness the patient has.

    Example Question:

    Is your cough a wet cough?

    Finding:

    Reports clear sputum with cough

    (Found)

    Pro Tip: The characteristics of a cough, such as whether it is productive, can indicate key information about the type of illness the patient has.

    Example Question:

    Do you produce any phlegm or sputum with your cough?

    Finding:

    Asked about frequency and duration of cough

    Finding:

    Reports coughing every few minutes

    (Found)

    Pro Tip: Establishing how frequently Danny coughs will illustrate how long he has been suffering these particular symptoms and might indicate possible triggers.

    Example Question:

    How frequently are you coughing?

    Finding:

    Reports coughs last a few seconds

    (Available)

    Pro Tip: Establishing how long Danny’s coughs last will illustrate how long he has been suffering these particular symptoms and might indicate possible triggers.

    Example Question:

    How long do your coughs last?

    Finding:

    Asked about aggravating factors for cough

    Finding:

    Reports cough is worse at night

    (Found)

    Pro Tip: Establishing a timeline for Danny’s coughing will illustrate how long he has been suffering these particular symptoms and might indicate possible triggers.

    Example Question:

    Is the cough worse at night?

    Finding:

    Denies smoking

    (Available)

    Pro Tip: Tobacco use puts the patient at risk for many medical conditions. Asking even young patients about whether they consume tobacco products helps you assess this risk factor.

    Example Question:

    Do you smoke?

    Finding:

    Reports being exposed to secondhand smoke through father

    (Found)

    Pro Tip: Tobacco use puts the patient at risk for many medical conditions. Asking about whether a patient is exposed to secondhand smoke allows you to assess this risk factor.

    Example Question:

    Are you ever around cigarette smoke?

    Finding:

    Reports he doesn’t know what triggers the cough

    (Found)

    Pro Tip: Asking about aggravating factors of Danny’s cough will allow you to determine potential causes and educate the patient on what to avoid.

    Example Question:

    What makes your cough worse?

    Finding:

    Asked about exposure to germs

    Finding:

    Reports playing with an ill classmate

    (Found)

    Pro Tip: Asking about Danny’s exposure to illnesses will allow you to counsel him on effective hygiene, as well as potentially determine the cause of his current symptoms.

    Example Question:

    Have you come in contact with anyone sick?

    Finding:

    Asked about hand hygiene

    Finding:

    Reports infrequent hand washing

    (Found)

    Pro Tip: Asking about Danny’s hand washing practices will allow you to counsel him on effective hygiene.

    Example Question:

    How often do you wash your hands?

    Finding:

    Reports occasionally putting fingers in eyes, nose, or mouth

    (Available)

    Pro Tip: Asking about Danny’s hand washing practices will allow you to counsel him on effective hygiene.

    Example Question:

    Do you ever touch your eyes, nose, or mouth?

    Finding:

    Asked about cough etiquette

    Finding:

    Denies covering mouth when coughing

    (Found)

    Pro Tip: Asking about Danny’s cough etiquette will allow you to counsel him on effective hygiene and reduce the risk of him infecting other people.

    Example Question:

    Do you cover your mouth when you cough?

    Finding:

    Asked about relieving factors for cough

    Finding:

    Reports cough is temporarily relieved by cough medicine

    (Found)

    Pro Tip: Asking about how the patient has been managing their pain assesses their current condition and their approach to self-care. The results of their previous treatment may be helpful in your diagnosis and the development of their new treatment plan, as well as a good opportunity to educate the patient on effective self-care practices.

    Example Question:

    Have you done anything to treat your cough?

    Finding:

    Followed up on cough medicine

    Finding:

    Reports cough medicine was purple

    (Found)

    Pro Tip: The type of cough medicine a patient takes, and how they take it, can impact its effectiveness. Following up on the cough medicine’s color may help you identify the type of medication it is.

    Example Question:

    What color was the cough medicine?

    Finding:

    Reports taking one spoonful of cough medicine

    (Found)

    Pro Tip: The type of cough medicine a patient takes, and how they take it, can impact its effectiveness. Following up on the dose of cough medicine allows you to determine whether it is being taken correctly.

    Example Question:

    How much medicine did you take?

    Finding:

    Reports mother gave him the medicine

    (Found)

    Pro Tip: Children should only take medication under the supervision of an adult who can assure it is taken as directed. You should ask younger patients whether the medicine was given to them and by whom.

    Example Question:

    Who gave you the medicine for your cough?

    Finding:

    Reports only took the medicine this morning

    (Found)

    Pro Tip: The type of cough medicine a patient takes, and how they take it, can impact its effectiveness. Following up on the frequency Danny took cough medicine allows you to determine whether it is being taken correctly.

    Example Question:

    How many times have you taken the cough medicine?

    Finding:

    Denies home remedies

    (Available)

    Pro Tip: Patients sometimes try non-medicinal home remedies to treat coughs, such as breathing steam, or drinking tea with honey. Not all home remedies are effective or advisable, so it’s important to find out what remedies the patient has tried Focused Exam: Cough – Danny Rivera Shadow health Objective & Subjective Data.

    Example Question:

    Have you tried any home remedies for your cough?

    Finding:

    Asked about typical medication use

    Focused Exam: Cough – Danny Rivera Shadow health Objective & Subjective Data

    ORDER SHADOW HEALTH HELP HERE

    Finding:

    Denies taking medication

    (Available)

    Pro Tip: Knowing a patient’s current medication regimen helps you determine if any future treatments will be safe and effective.

    Example Question:

    Do you take any medications from a doctor?

    Finding:

    Reports taking daily vitamin

    (Found)

    Pro Tip: Some symptoms can occur as a result of a vitamin deficiency, and others as a result of vitamin excess. Vitamins can also interfere with some treatments, so it’s important to know what your patient is taking.

    Example Question:

    Do you take vitamins?

    Finding:

    Asked about activity level

    Finding:

    Reports typical high activity level

    (Found)

    Pro Tip: Establishing a patient’s typical activity level is an important baseline to help you determine how an illness is affecting his life.

    Example Question:

    Are you usually active?

    Finding:

    Reports activity level low since getting sick

    (Available)

    Pro Tip: Establishing a patient’s activity level, and whether it has been impacted since becoming ill, is an important baseline to help you determine how an illness is affecting his life.

    Example Question:

    Have you been less active since getting sick?

    Finding:

    Reports still able to run or play

    (Available)

    Pro Tip: Ability to remain active indicates that the patient’s breathing is not dangerously affected, and that the patient isn’t seriously fatigued.

    Example Question:

    Are you able to keep up when you play with your classmates?

    Finding:

    Reports focusing in class is difficult

    (Found)

    Pro Tip: Mental lethargy and difficulty concentrating are common symptoms when a patient is sick.

    Example Question:

    Are you able to focus in class?

    Finding:

    Asked about nasal symptoms

    Finding:

    Reports current runny nose

    (Found)

    Pro Tip: Asking your patient if his nose is running will allow you to determine the symptoms he is experiencing and possible triggers.

    Example Question:

    Do you currently have a runny nose?

    Finding:

    Denies sneezing

    (Found)

    Pro Tip: Asking your patient if he has been sneezing will allow you to determine the symptoms he is experiencing and possible triggers.

    Example Question:

    Have you been sneezing?

    Finding:

    Followed up on nasal discharge

    Finding:

    Reports nasal discharge is clear

    (Found)

    Pro Tip: The color of a patient’s nasal discharge can provide you key information as to the type of condition the patient has.

    Example Question:

    What color is your snot?

    Finding:

    Reports nasal discharge is thin

    (Found)

    Pro Tip: The consistency of a patient’s nasal discharge can provide you key information as to the type of condition the patient has.

    Example Question:

    What is the consistency of your nasal discharge?

    Finding:

    Asked about ear symptoms

    Finding:

    Denies ear pain

    (Found)

    Pro Tip: Ear pain is often coincident with coughs and sinus problems. Asking about them allows you to ascertain if Danny needs follow-up care for his ears.

    Example Question:

    Do you have any ear pain?

    Finding:

    Reports history of frequent ear infections

    (Found)

    Pro Tip: Asking about Danny’s history of ear infections allows you to ascertain his risk for current and future ear infections.

    Example Question:

    Have you ever had ear infections?

    Focused Exam: Cough – Danny Rivera Shadow health Objective & Subjective Data

    Finding:

    Denies ear discharge

    (Found)

    Pro Tip: Asking Danny about ear discharge, which are often coincident with of ear infections, allows you to ascertain his risk for current and future ear infections.

    Example Question:

    Do you have any ear discharge?

    Finding:

    Denies hearing problems

    (Found)

    Pro Tip: Simply talking with the patient assesses his hearing; however, some types of hearing loss are only apparent in specific settings such as noisy environments. Asking the patient about hearing problems identifies conditions that may not be readily apparent.

    Example Question:

    Do you have any hearing problems?

    Finding:

    Asked about throat symptoms

    Finding:

    Reports sore throat

    (Found)

    Pro Tip: Sore throats are often coincident with coughs and sinus problems. Asking about them allows you to ascertain if Danny needs follow-up care for his throat.

    Example Question:

    Is your throat sore?

    Finding:

    Reports a little pain with swallowing

    (Found)

    Pro Tip: Pain when swallowing helps you understand how severe the patient’s sore throat is.

    Example Question:

    Does it hurt when you swallow?

    Past Medical History

    Finding:

    Asked about relevant medical history

    Finding:

    Reports frequent runny noses

    (Found)

    Pro Tip: Asking how often Danny experiences runny noses like the one he has now may help you determine the source of the problem.

    Example Question:

    Do you get runny noses often?

    Finding:

    Reports past frequent coughs

    (Available)

    Pro Tip: A patient experiencing a cough should be asked about their history of coughs so you can determine whether their current condition fits into a recurring pattern.

    Example Question:

    Do you have coughs very often?

    Finding:

    Reports past pneumonia

    (Found)

    Pro Tip: Pneumonia is a serious medical condition that can be life-threatening if not managed appropriately. Regardless of the patient’s presenting illness, it is critical to identify current medical conditions in order to treat the patient appropriately. Specific questions should be asked about previous medical problems, even if the patient doesn’t notice current symptoms.

    Example Question:

    Have you had pneumonia?

    Finding:

    Denies asthma diagnosis

    (Found)

    Pro Tip: Asthma is a serious medical condition that can be life-threatening if not managed appropriately. Regardless of the patient’s presenting illness, it is critical to identify current medical conditions in order to treat the patient appropriately. Specific questions should be asked about previous medical problems, even if the patient doesn’t notice current symptoms.

    Example Question:

    Do you have asthma?

    Finding:

    Reports immunizations as current

    (Found)

    Pro Tip: A health assessment should include an evaluation of the patient’s immunization status in order to identify diseases to which the patient is vulnerable.

    Example Question:

    Do you have current immunizations?

    Finding:

    Asked about allergies

    Finding:

    Denies seasonal allergies

    (Found)

    Pro Tip: Seasonal allergies can cause symptoms like runny nose, cough, and discomfort. Asking Danny if he has seasonal allergies can help you to ascertain possible triggers for symptoms. Focused Exam: Cough – Danny Rivera Shadow health Objective & Subjective Data

    Example Question:

    Do you have seasonal allergies?

    Finding:

    Denies food allergies

    (Available)

    Pro Tip: Knowing if your patient has food allergies is important and relevant medical history. Asking your patient about food allergies will allow you to most effectively treat him.

    Example Question:

    Do you have food allergies?

    Finding:

    Denies medication allergies

    (Available)

    Pro Tip: Knowing if your patient has allergies to medicine is important and relevant medical history. Asking your patient about medicine allergies will allow you to most effectively treat him.

    Example Question:

    Are you allergic to any medication?

    Finding:

    Asked relevant family history

    Finding:

    Reports father has history of asthma

    (Found)

    Pro Tip: Medical problems such as asthma that are present in a patient’s immediate family can represent increased risk factors to respiratory conditions such as the ones the patient currently has.

    Example Question:

    Do you have a family history of asthma?

    Finding:

    Denies family history of allergies

    (Found)

    Pro Tip: Medical problems such as allergies that are present in a patient’s immediate family can represent increased risk factors to respiratory conditions such as the ones the patient currently has.

    Example Question:

    Do you have a family history of allergies?

    Review of Systems

    Finding:

    Asked about constitutional health

    Finding:

    Denies chills

    (Found)

    Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has chills will illustrate the way his symptoms manifest.

    Example Question:

    Do you have chills?

    Finding:

    Denies fever

    (Found)

    Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has a fever will illustrate the way his symptoms manifest.

    Example Question:

    Do you have a fever?

    Finding:

    Reports feeling somewhat fatigued

    (Found)

    Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has fatigue will illustrate the way his symptoms manifest.

    Example Question:

    Do you have fatigue?

    Finding:

    Denies night sweats

    (Found)

    Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has night sweats will illustrate the way his symptoms manifest.

    Example Question:

    Do you have night sweats?

    Finding:

    Reports cough makes it difficult to sleep

    (Found)

    Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has had difficulty sleeping will illustrate the way his symptoms manifest.

    Example Question:

    Have you been sleeping okay?

    Finding:

    Denies swelling

    (Available)

    Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has had swelling will illustrate the way his symptoms manifest.

    Example Question:

    Have you noticed any swelling?

    Finding:

    Asked about additional review of systems for HEENT

    Finding:

    Reports frequent colds

    (Found)

    Pro Tip: A patient such as Danny who is presenting with a cough and a runny nose may have a cold, so you should ask about his history of colds to determine whether this is part of a larger pattern.

    Example Question:

    Do you have unusually frequent colds?

    Finding:

    Denies headaches

    (Found)

    Pro Tip: Headaches are a common complaint that can be caused by a variety of benign conditions. However, headaches can be an indicator of serious underlying neurological conditions such as cerebral hemorrhage, meningitis, or brain tumors. They may also be a symptom of sinus infection.

    Example Question:

    Do you get headaches?

    Finding:

    Denies nosebleeds

    (Found)

    Pro Tip: When a patient presents with symptoms that are often seen with respiratory infections, you should ask about similar signs of respiratory infections such as nosebleeds.

    Example Question:

    Do you have nosebleeds?

    Finding:

    Denies vision difficulty

    (Found)

    Pro Tip: Eye or vision problems can lower one’s ability to function and can be a major safety risk.

    Example Question:

    Do you have any problems with your vision?

    Finding:

    Denies dizziness

    (Found)

    Pro Tip: Asking about dizziness helps you assess the risk for inner ear, neurological, or cardiovascular problems.

    Example Question:

    Do you have any dizziness?

    Finding:

    Denies watery eyes

    (Available)

    Pro Tip: Whether a patient has watery eyes may help you indicate the type of sinus problem he is experiencing.

    Example Question:

    Do you have watery eyes?

    Finding:

    Denies eye redness

    (Available)

    Pro Tip: Whether a patient has eye redness may help you indicate the type of sinus problem he is experiencing.

    Example Question:

    Do you have eye redness?

    Finding:

    Denies eye pain

    (Available)

    Pro Tip: Eye pain can lower one’s ability to function and can be a major safety risk.

    Example Question:

    Do you have any eye pain?

    Finding:

    Denies sinus pain

    (Available)

    Pro Tip: Patients with sinus problems such as a runny nose may be at greater risk for sinus pain.

    Example Question:

    Do you have any sinus pain?

    Finding:

    Asked about review of systems for respiratory

    Finding:

    Denies chest tightness

    (Available)

    Pro Tip: Chest pain may indicate cardiac conditions, muscular inflammation, gastric upset, or respiratory distress. If chest tightness is present, asking about its location, characteristics, and related factors helps to determine the cause of the discomfort.

    Example Question:

    Do you have chest tightness?

    Finding:

    Denies chest pain

    (Found)

    Pro Tip: Chest pain may indicate cardiac conditions, muscular inflammation, gastric upset, or respiratory distress. If chest pain is present, asking about its location, characteristics, and related factors helps to determine the cause of the discomfort.

    Example Question:

    Do you have any chest pain?

    Finding:

    Denies difficulty breathing

    Focused Exam: Cough – Danny Rivera Shadow health Objective & Subjective Data

  • Focused exam cough care plan

    Care Plan
     
    : 10 of 10 (100.0%) – Focused exam cough care plan

     Nursing Diagnosis

    3.5 out of 3.5

    Nursing Diagnoses: Definitions & Classifications 2018-2020 © NANDA-International, 2017 used by arrangement with Thieme Medical Publishers, Inc., a division of the Thieme Group. All rights reserved. Authorized translation from the English language edition published by Thieme Medican Publishers Inc. No part of this material may be reproduced in any form without the written permission of the agent of the copyright holder, NANDA-International. Direct inquires to nanda-i@thieme.com. Link for more information: http://www.nanda.org/.

    Status

    ORDER SHADOW HEALTH HELP HERE

    Student Response

    Model Answer

    Explanation

    Points Earned

    is at risk for

    is at risk for

    The correct status for the nursing diagnosis is “is at risk for,” because Danny’s most pressing vulnerability is to an infection that he has not yet, but could, develop.

    0.5 out of 0.5

    Diagnosis

     

    Student Response

    Model Answer

    Explanation

    Points Earned

    infection

    infection

    While a cough can be unpleasant, the most alarming thing it indicates about Danny’s health is that he is at risk for an infection.

    0.5 out of 0.5

    Etiologies

     

    Student Response

    Model Answer

    Explanation

    Points Earned

    rare hand washing

    rare hand washing

    Danny Rivera is at risk for infection as evidenced by: his playing with a sick peer; how he touches his face often, especially his eyes/nose/mouth; how rarely he washes his hands; and his exposure to secondhand smoke.

    0.5 out of 0.5

    played w/ sick peer

    played w/ sick peer

    Danny Rivera is at risk for infection as evidenced by: his playing with a sick peer; how he touches his face often, especially his eyes/nose/mouth; how rarely he washes his hands; and his exposure to secondhand smoke.

    0.5 out of 0.5

    secondhand smoke

    secondhand smoke

    Danny Rivera is at risk for infection as evidenced by: his playing with a sick peer; how he touches his face often, especially his eyes/nose/mouth; how rarely he washes his hands; and his exposure to secondhand smoke Focused exam cough care plan.

    0.5 out of 0.5

    touches face often

    touches face often

    Danny Rivera is at risk for infection as evidenced by: his playing with a sick peer; how he touches his face often, especially his eyes/nose/mouth; how rarely he washes his hands; and his exposure to secondhand smoke.

    0.5 out of 0.5

    Signs & Symptoms

     

    Student Response

    Model Answer

    Explanation

    Points Earned

    N/A

    N/A

    Because the infection that Danny may develop hasn’t happened yet, he is not currently presenting with any signs or symptoms, so the correct answer here is “N/A.”

    0.5 out of 0.5

     Self Assessment

    Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor.

    Prompt

    Student Response

    Model Answer

    Explanation

    Why would a nursing diagnosis of a cough be incorrect, compared to a risk for infection? Consider the difference between nursing and medical diagnoses.

    A persistent and unpleasant cough could be a symptom of something more sever, and the immune system is at a risk of infection. The effective nursing care to prioritize is educating a patient on how to avoid more severe outcomes.

    While a cough can be unpleasant and frequent, it is actually a symptom of something more alarming: the immune system being at risk for an infection. The most effective nursing care you should prioritize is to educate your patient on avoiding this more serious outcome.

    Your nursing diagnosis should always take into account what condition is most serious, receiving the greatest benefit from your help. This diagnosis may not be the most obvious physical symptom to you or your patient, so always consider what is jeopardizing a patient’s health the most.

     Planning

    4 out of 4

    Short-Term Goal

    ORDER SHADOW HEALTH HELP HERE

    Student Response

    Model Answer

    Explanation

    Points Earned

    To have the patient and his guardian verbalize and agree to their instructions on how to avoid infection & practice respiratory hygiene, by end of the healthcare visit.

    To have the patient and his guardian verbalize and agree to their instructions on how to avoid infection & practice respiratory hygiene, by end of the healthcare visit.

    A risk-based diagnosis does not require medical interventions as the problem is hypothetical; the goal that does suit the diagnosis involves teaching the patient and his guardian about risk-reduction methods.

    0.5 out of 0.5

    Interventions

     

    Student Response

    Model Answer

    Explanation

    Points Earned

    Instruct family and patient on washing hands or using hand sanitizer before eating and after using the restroom

    Instruct family and patient on washing hands or using hand sanitizer before eating and after using the restroom

    Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again.

    0.5 out of 0.5

    Instruct family and patient that patient should increase fluid intake

    Instruct family and patient that patient should increase fluid intake

    Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again.

    0.5 out of 0.5

    Instruct family to keep their house smoke-free (reducing exposure to environmental pathogens)

    Instruct family to keep their house smoke-free (reducing exposure to environmental pathogens) Focused exam cough care plan

    Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again.

    0.5 out of 0.5

    Instruct patient on washing hands or using hand sanitizer after coughing or being near someone sick Focused exam cough care plan

    Instruct patient on washing hands or using hand sanitizer after coughing or being near someone sick

    Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again.

    0.5 out of 0.5

    Instruct patient to avoid touching fingers to eyes, nose, or mouth

    Instruct patient to avoid touching fingers to eyes, nose, or mouth

    Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again.

    0.5 out of 0.5

    Instruct patient to cough into tissue, or sleeve if tissue is unavailable

    Instruct patient to cough into tissue, or sleeve if tissue is unavailable

    Many of these instructions work toward shrinking the patient’s likelihood of contact with harmful pathogens, which can lead to infection. Some instructions here also help prevent illness being spread to Danny’s environment and family members, which promotes community health and reduces the patient’s risk of becoming sick again.

    0.5 out of 0.5

    Intervention Rationale

    Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor.

    Prompt

    Student Response

    Model Answer

    Explanation

    In 1 or 2 sentences, explain how your selected interventions work to accomplish your goal.

    The intervention will teach tha patient and guardian various ways to keep their hands and lungs clean, whichhelps eliminate pathogens and reduce risk for infection.

    These interventions will teach Danny and his guardian how to keep their hands and lungs clean in a variety of ways, so that Danny’s risk for infection is reduced as pathogens are eliminated.

    Infection can be caused by multiple culprits, so it’s important that your patient teaching covers a thorough and specific array of anti-infection habits. Focused exam cough care plan

    Data Collections

     

    Student Response

    Model Answer

    Explanation

    Points Earned

    Ask patient and family members to verbalize and agree to their instructions on infection prevention & respiratory hygiene

    Ask patient and family members to verbalize and agree to their instructions on infection prevention & respiratory hygiene Focused exam cough care plan

    It is important that your patient and his guardian agree to their instructions, as changing lifestyle habits can be intimidating but necessary for the patient’s health. Having Danny and his father verbalize back their instructions also assures they remember and understand the details.

    0.5 out of 0.5

     Discussion Of Care

    Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor.

    Prompt

    Student Response

    Model Answer

    Explanation

    Explain the rationale behind your nursing diagnosis.

    Danny, we want to make sure you dont develop an infection and become more sick by taking you through the different that can prevent that and the focus will be on your risk factors. Some of your risk factors include you being close to a sick friend, exposure to cigar smoke, having touches your face with uncleaned fingers. They may sound a lot but by working together and mitigating your risk factors can be easy and effective

    Danny, given that you aren’t feeling well, we want to make sure you don’t develop an infection, which for you just means getting even sicker. We’re going to talk about the ways we can work to prevent that, especially focusing on your risk factors, which are just things that give you a bigger chance of being sick. Some of your risk factors are that you were near a sick friend, have been exposed to cigar smoke, could stand to wash your hands more, and have touched your face with your fingers. I know that sounds like a lot, but if we work together, reducing your risk factors for infection can be easy and effective.

    A patient should understand their nursing diagnosis and the rationale behind it to increase their sense of involvement and to identify areas for future improvement.

    Explain your goal for Danny and the interventions and data collections through which you will achieve it.

    To make sure you dont become sicker, I will talk to you and your father and what must e done. The three of us will collaborate and agree to your health goals. Then both of you will repeat what you have learnt to be sure you have understood all which should be done.

    Let’s talk about how we’re going to help you not get sicker! So, I’m going to have a conversation with you and your father about things to do to ensure your health. You, he, and I will work together to discuss, and then have you agree to your goals. Then I’m going to have you and your father repeat what you’ve learned, so we can make extra sure you’ve got it down pat!

    You should communicate the Care Plan to the patient, allowing them to exercise involvement and agency in their own healthcare.

    Explicitly ask for Danny’s consent to the Care Plan.

    Does the plan sound good to you?

    Does this plan I just talked about sound good to you?

    A patient must consent to all interventions in their Care Plan. Disagreements are opportunities to provide further patient education and to consider alternative options.

    Inform Danny you will now begin educating him and will then call to educate his guardian.

    If you don’t have any other question, we can start our discussion.

    Danny, if you don’t have any other questions, we can start our discussion now!

    It’s time to begin your education interventions, so let your patient know!

     Intervention & Evaluation

    2.5 out of 2.5

     

    Student Response

    Model Answer

    Explanation

    Points Earned

    Partially

    Partially

    While Danny correctly verbalizes and agrees to his instructions for reducing infection risks, his father only agrees to some of his instructions, expressing apprehension toward not smoking inside the house. Your goal has been partially achieved.

    2.5 out of 2.5

     Intervention & Evaluation Rationale

    Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor.

    Prompt

    Student Response

    Model Answer

    Explanation

    Did you achieve your goal for your patient and his guardian by the end of the visit, getting each of them to agree to and verbalize your instructions for avoiding infection and practicing respiratory hygiene?

    Danny agreees and has verbalized a full and correct understanding on what to do. However, is father is reluctant on reducing his smoking inside the house as one of the intervention was to keep the house free from smoke to reduce the risk of infection. Thus this aspect is yeto to be achieved. Nevertheless, Danny and his father verbally agree to all other instructions so the overall goal has been partially achieved.

    While Danny agrees to his instructions and has verbalized a complete and correct understanding of what to do, his father expresses reluctance about reducing his smoking inside of the house. One of his instructions was to keep the house smoke-free in order to reduce Danny’s risk of infection, so this aspect of your goal has not been achieved. However, both parties verbally agree to most of their other instructions, so your overall goal has been partially achieved.

    Even with progress being made in almost all aspects of your patient teaching, you must adhere to your goal and consider your work incomplete if certain agreements have not been reached.

  • Focused exam: Cough shadow health answers

    Transcript

    Started:
    February 04, 2023 |
    Total Time:
    170 min focused exam: cough shadow health answers

    All Lines (173)
    Interview Questions (61)
    Statements (16)
    Exam Actions (96)

    Hello!

    Question

    04/02/23 2:08 PM MDT

    Hi. I’m Preceptor Diana. I will explain the details of this assignment and your objectives, just as a preceptor would in real life. 
    Pay close attention to this information as it will help guide your exam.
     At the end of this prebrief, you will 
    answer a short question about the upcoming assignment.
     During the simulation, you may 
    return to these instructions at any time
     by scrolling to the top of your transcript.

    What is the situation?

    Question

    04/02/23 2:10 PM MDT

    Your patient is Danny Rivera, an 8-year-old Puerto Rican boy presenting with a cough in the Shadowville Elementary nurse’s office. Your role in this simulation is that of a healthcare provider who will 
    perform a focused history and physical examination
     in order to collect data, assess Danny’s condition, and transfer care. In this simulation, you will be able to perform procedures not always typical to a school setting so you can gather as much data as possible.

    What are my objectives in this assessment?

    ORDER SHADOW HEALTH HELP HERE

    Question

    04/02/23 2:11 PM MDT

    Danny is very health literate and a good historian of his own health history; he can answer questions that not every child may be able to. In your interview with Danny, you will 
    ask about the history of his presenting illness and the functioning of relevant systems
     in order to obtain subjective data related to his cough. If you discover any disease states, 
    ask about symptoms and the patient’s experiences of them.
     Your questioning should cover a broad array of the symptoms’ characteristics. You will also 
    inquire into the health history of Danny’s family
     so you can determine his genetic predisposition to any diseases. In addition to collecting subjective data, you will 
    perform a physical exam on Danny to gather objective data
     about his health and physiology. Throughout the conversation, you should 
    educate and empathize with Danny
     when appropriate to increase his health literacy and sense of well-being. While you should 
    communicate with patients using accessible, everyday language,
     it is standard practice to 
    use professional medical terminology everywhere else, such as in documenting physical findings and nursing notes.
     You may complete the exam activities in any order and move between them as needed.

    What else will this exam involve?

    Question

    04/02/23 2:12 PM MDT

    Because Danny is a pediatric patient, you will also be required to 
    make a phone call to his guardian’s home to gather additional information.
     You can 
    document your findings, including vital signs,
     in the Electronic Health Record. This record provides necessary information for healthcare professionals who will continue patient care. You will then move onto the Care Plan activity, in which you will synthesize your subjective and objective data to complete the nursing process. You will 
    develop a nursing diagnosis
     for Mr. Rivera’s condition, 
    identify a treatment goal, plan your interventions and evaluations,
     and finally 
    assess if your goal was achieved
    . You may also need to call Danny’s guardian again to involve them in his treatments. The Care Plan is just as important as your assessment, and the patient’s well-being will be greatly affected by your diagnosis and interventions.

    How will I be evaluated?

    Question

    04/02/23 2:12 PM MDT

    The activities evaluated by the simulation are Subjective and Objective Data Collection, Education and Empathy, and the Care Plan activity. Nursing tasks and Documentation, while they provide valuable practice for their real-world counterparts, are not automatically evaluated by the simulation. The evaluation of your interview is dependent on how you 
    word your questions therapeutically and precisely
     and 
    explore all relevant topics with comprehensive breadth and depth.
     The evaluation of your physical exam is based on how successfully you 
    report on your physical findings by selecting among clinical terms in the Electronic Health Record.
     Your success in Education and Empathy is based on whether you 
    promptly respond after identifying a moment worthy of therapeutic communication.
     Your success in the Care Plan activity is based on whether you 
    accurately identify Mr. Rivera’s nursing diagnosis, select a goal most immediately beneficial to him, select and prioritize the most effective treatments,
     and 
    accurately evaluate your results.
     The Care Plan will make up a signficant part of your grade, so be sure to 
    carefully choose your answers based on evidence.
     This assignment takes on average 
    between 80 and 100 minutes.
     You can 
    pause and resume the assignment at any time;
     your work is always saved automatically.

    How does this assignment prepare me for the real world?

    Question

    04/02/23 2:13 PM MDT

    In this assessment, you will familiarize yourself with the structure and content of a cough focused exam so that with real-life patients, you can: º 
    ask effective and comprehensive questions
     º 
    obtain and assess objective data
     º 
    educate and empathize with the patient
     º 
    develop a nursing diagnosis
     º 
    create an effective and expedient care plan
     º and 
    evaluate your results to determine your goal’s achievement.

    In 1 or 2 sentences, answer this question
     to help prepare for the upcoming exam: What strategies can you use to develop rapport with a pediatric patient?

    Being friendly with the patient

    Statement

    04/02/23 2:15 PM MDT

    Time to begin.

    Hello. xxx  interview and examine you.

    Greet

    04/02/23 2:18 PM MDT

    Hi.

    What is your name? (Clarified to What is your name?.)

    Question

    04/02/23 2:24 PM MDT

    My name is Daniel Rivera, but I just go by Danny. (Clarified to what is my name.)

    What brings you to the clinic today?

    Question

    04/02/23 2:24 PM MDT

    My music teacher Mr. Hillman sent me here because he said I look sick. I have been coughing a lot. . . and I feel kinda tired.

    Am sorry to hear that you are sick.

    Empathize

    04/02/23 2:25 PM MDT

    That is nice of you.

    Do you have a cough?

    Question

    04/02/23 2:26 PM MDT

    I guess I’m kind of sick. . . I’ve been coughing a lot.

    How long have you had a cough?

    Question

    04/02/23 2:27 PM MDT

    I think the cough started two . . . No, it started three days ago.

    Is your cough a wet or a dry one?

    Question

    04/02/23 2:27 PM MDT

    My cough seems kind of gurgly and watery.

    That sounds like a wet cough.

    Empathize

    04/02/23 2:28 PM MDT

    Thanks for saying that.

    Are you ever around cigarette smoke?

    Question

    04/02/23 2:28 PM MDT

    Well . . . sometimes Papi smokes cigars in the house and my mom has to tell him to go outside. I breathe it a little bit then, but it’s not all the time or anything. I don’t like how it smells, and I don’t like that he is hurting himself. He could get sick.

    Am sorry about that, I understand your concerns

    Empathize

    04/02/23 2:29 PM MDT

    Thank you.

    What makes your cough worse?

    Question

    04/02/23 2:29 PM MDT

    I don’t think anything makes my cough be worse.

    Have you tried to treat your cough?

    Question

    04/02/23 2:31 PM MDT

    My mom gave me some medicine this morning. . . that helped my cough a little. I don’t remember what it was called though, sorry.

    What is the name of the medicine?

    Question

    04/02/23 2:32 PM MDT

    I don’t know. It was the purple one.

    Who gave you the medicine?

    Question

    04/02/23 2:32 PM MDT

    My mom gave it to me.

    How much medicine do you take?

    Question

    04/02/23 2:32 PM MDT

    It was just a spoonful.

    Thanks for saying that.

     Washed hands.

    Exam Action

    04/02/23 3:08 PM MDT

     Measured blood pressure

    Exam Action

    04/02/23 3:09 PM MDT

     Measured heart rate

    Exam Action

    04/02/23 3:09 PM MDT

     Measured pulse oximetry

    Exam Action

    04/02/23 3:09 PM MDT

     Measured respiratory rate

    Exam Action

    04/02/23 3:09 PM MDT

     Measured temperature

    Exam Action

    04/02/23 3:09 PM MDT

     Tested lung capacity with spirometer: FEV1: 1.549 L, FVC 1.78 L (FEV1/FVC: 87%)

    Exam Action

    04/02/23 3:10 PM MDT

     Inspected upper conjunctiva

    Exam Action

    04/02/23 3:10 PM MDT

     Inspected right orbital area and sclera

    Exam Action

    04/02/23 3:10 PM MDT

     Inspected left orbital area and sclera

    Exam Action

    04/02/23 3:10 PM MDT

     Inspected lower conjunctiva

    Exam Action

    04/02/23 3:10 PM MDT

     Performed otoscopic examination of right ear

    Exam Action

    04/02/23 3:11 PM MDT

     Performed otoscopic examination of left ear

    Exam Action

    04/02/23 3:11 PM MDT

     Performed otoscopic examination of right naris

    Exam Action

    04/02/23 3:11 PM MDT

     Performed otoscopic examination of left naris

    Exam Action

    04/02/23 3:11 PM MDT

     Inspected mouth

    Exam Action

    04/02/23 3:11 PM MDT

     Inspected front of neck

    Exam Action

    04/02/23 3:11 PM MDT

     Inspected right side of neck

    Exam Action

    04/02/23 3:11 PM MDT

     Inspected back of neck

    Exam Action

    04/02/23 3:11 PM MDT

     Inspected left side of neck

    Exam Action

    04/02/23 3:11 PM MDT

     Inspected anterior chest wall

    Exam Action

    04/02/23 3:12 PM MDT

     Inspected posterior chest wall

    Exam Action

    04/02/23 3:12 PM MDT

     Palpated frontal sinuses: No tenderness reported

    Exam Action

    04/02/23 3:12 PM MDT

     Palpated maxillary sinuses: No tenderness reported

    Exam Action

    04/02/23 3:12 PM MDT

     Palpated lymph nodes of head and neck: Enlarged and reported tenderness on the right side

    Exam Action

    04/02/23 3:13 PM MDT

     Palpated supraclavicular lymph nodes: Not palpable

    Exam Action

    04/02/23 3:13 PM MDT

     Palpated axillary lymph nodes: Not palpable

    Exam Action

    04/02/23 3:13 PM MDT

     Palpated fremitus in anterior upper chest wall: Present and equal bilaterally

    Exam Action

    04/02/23 3:14 PM MDT

    Ninety-nine.

     Palpated fremitus in anterior lower chest wall: Present and equal bilaterally

    Exam Action

    04/02/23 3:14 PM MDT

    Ninety-nine.

     Palpated fremitus in posterior upper chest wall: Present and equal bilaterally

    Exam Action

    04/02/23 3:14 PM MDT

    Ninety-nine.

     Palpated fremitus in posterior middle chest wall: Present and equal bilaterally

    Exam Action

    04/02/23 3:14 PM MDT

    Ninety-nine.

     Palpated fremitus in posterior lower chest wall: Present and equal bilaterally

    Exam Action

    04/02/23 3:14 PM MDT

    Ninety-nine.

     Palpated chest expansion: Both sides rise symmetrically

    Exam Action

    04/02/23 3:14 PM MDT

     Auscultated breath sounds in anterior right upper lobe

    Exam Action

    04/02/23 3:15 PM MDT

     Auscultated breath sounds in anterior left upper lobe

    Exam Action

    04/02/23 3:15 PM MDT

     Auscultated breath sounds in anterior right upper lobe

    Exam Action

    04/02/23 3:15 PM MDT

     Auscultated breath sounds in anterior left middle lobe

    Exam Action

    04/02/23 3:15 PM MDT

     Auscultated breath sounds in anterior right middle lobe focused exam: cough shadow health answers

    Exam Action

    04/02/23 3:15 PM MDT

     Auscultated breath sounds in anterior left middle lobe

    Exam Action

    04/02/23 3:15 PM MDT

     Auscultated breath sounds in anterior right lower lobe

    Exam Action

    04/02/23 3:15 PM MDT

     Auscultated breath sounds in anterior left lower lobe

    Exam Action

    04/02/23 3:15 PM MDT

     Auscultated breath sounds in posterior left upper lobe

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior right upper lobe focused exam: cough shadow health answers

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior left mid-back (lower lobe)

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior right mid-back (lower lobe)

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior left lower lobe near spine

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior right lower lobe near spine

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior left lower lobe on side

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior left lower lobe

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior right lower lobe

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated breath sounds in posterior right lower lobe on side

    Exam Action

    04/02/23 3:16 PM MDT

     Auscultated voice sounds in anterior right upper lobe

    Exam Action

    04/02/23 3:16 PM MDT

    Ninety-nine.

    Ninety-nine.

     Auscultated voice sounds in anterior left upper lobe

    Exam Action

    04/02/23 3:16 PM MDT

    Ninety-nine.

     Auscultated voice sounds in anterior right upper lobe

    Exam Action

    04/02/23 3:16 PM MDT

    Ninety-nine.

     Auscultated voice sounds in anterior left mid-chest (upper lobe)

    Exam Action

    04/02/23 3:16 PM MDT

    Ninety-nine.

     Auscultated voice sounds in anterior right middle lobe

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in anterior left mid-chest (upper lobe)

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in anterior right lower lobe

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in anterior left lower lobe

    Exam Action

    04/02/23 3:17 PM MDT

     Auscultated voice sounds in posterior left upper lobe

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

    Ninety-nine.

    Ninety-nine.

     Auscultated voice sounds in posterior right upper lobe

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

    Ninety-nine.

    Ninety-nine.

     Auscultated voice sounds in posterior left mid-back (lower lobe)

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in posterior right mid-back (lower lobe)

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in posterior left lower lobe near spine

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in posterior right lower lobe near spine

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in posterior left lower lobe on side

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in posterior left lower lobe

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

     Auscultated voice sounds in posterior right lower lobe

    Exam Action

    04/02/23 3:17 PM MDT

    Ninety-nine.

    Ninety-nine.

    Ninety-nine.

     Auscultated aortic area with the bell

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated pulmonic area with the bell

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated Erb’s point with the bell

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated tricuspid area with the bell

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated mitral area with the bell

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated mitral area with the diaphragm focused exam: cough shadow health answers

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated aortic area with the diaphragm

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated pulmonic area with the diaphragm

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated Erb’s point with the diaphragm

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated tricuspid area with the diaphragm

    Exam Action

    04/02/23 3:18 PM MDT

     Auscultated mitral area with the diaphragm

    Exam Action

    04/02/23 3:18 PM MDT

     Percussed anterior right upper lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed anterior left upper lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed anterior right middle lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed anterior left mid-chest (upper lobe)

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed anterior right lower lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed anterior left lower lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior left upper lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior right upper lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior left mid-back (lower lobe)

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior right mid-back (lower lobe)

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior left lower lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior right lower lobe

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior left lower lobe on side

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior left lower lobe near spine

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior right lower lobe near spine

    Exam Action

    04/02/23 3:23 PM MDT

     Percussed posterior left right lobe on side

    ORDER SHADOW HEALTH HELP HERE

    Exam Action

    04/02/23 3:23 PM MDT

     Measured diaphragmatic excursion: 3 cm

    Exam Action

    04/02/23 3:24 PM MDT

    Danny, we want to make sure you dont develop an infection and become more sick by taking you through the different that can prevent that and the focus will be on your risk factors. Some of your risk factors include you being close to a sick friend, exposure to cigar smoke, having touches your face with uncleaned fingers. They may sound a lot but by working together and mitigating your risk factors can be easy and effective

    Educate

    04/02/23 4:43 PM MDT

    OK. I get it!

    To make sure you dont become sicker, I will talk to you and your father and what must e done. The three of us will collaborate and agree to your health goals. Then both of you will repeat what you have learnt to be sure you have understood all which should be done.

    Educate

    04/02/23 4:48 PM MDT

    Alright.

    Does the plan sound good to you?

    Educate

    04/02/23 4:49 PM MDT

    We can do it! I love learning and I’m really a good learner.

    If you don’t have any other question, we can start our discussion.

    Educate

    04/02/23 4:49 PM MDT

    Okie dokie artichokey.