Category: Nursing

VITAL SIGNS & PAIN ASSESSMENT

SKILL
VALIDATION

 

Student Name: _____________________________________                                         Date: _____________________

 

Points Allowed

1
st
Attempt

 

2
nd
Attempt

 

Preparation

 

Perform I-CHECK: Introduce yourself,
Check armband (two patient identifiers),
Hand hygiene, Explain procedure, Check order, Keep privacy

+1

Determine the appropriate arm
for blood pressure measurement (i.e., consider presence of IV-line, mastectomy, fistula, or injury)

+1

Manual Blood Pressure

 

Apply appropriately sized sphygmomanometer with a snug fit, correct alignment, and cuff placed 2-5 cm above the brachial artery

+1

Position patient with arm supported at heart level and feet flat on the floor

+1

Ask patient what their BP typically is
(this step prevents overinflation of cuff & avoids auscultatory gaps)

+1

Obtain the patient’s blood pressure:

·        Put on the stethoscope with earpieces angled forward, place the diaphragm over the brachial artery & inflate cuff 30mmHg above estimated systolic pressure to avoid missing an auscultatory gap

·        Deflate cuff 2mmHg per second while listening for Korotkoff sounds noting when first Korotkoff sound appears (systolic BP) & the last audible Korotkoff sound (diastolic BP)

·        Continue to slowly deflate the cuff for a bit longer to make sure the Korotkoff sounds don’t reappear, and then rapidly deflate the cuff

+3

Correctly state blood pressure measurement (within 4 mmHg)

+1

Heart Rate

 

Place fingertips on radial artery and press lightly until pulse is felt

+1

Count beats for 30 seconds if regular (then double it) or 60 seconds if irregular

+1

Correctly state the heart rate (within 2 bpm),
noting rate, rhythm, and force

(3+ = full, bounding, 2+ = normal, 1+ = weak, thread, 0 = absent)

+1

Respiratory Rate

 

Watch the rise and fall of the chest or abdomen
without letting the patient know
you are counting (e.g., pretend to still be checking the pulse)

+1

Count breaths for 30 seconds if regular (then double it) or 60 seconds if irregular

+1

Obtain oxygen saturation

+1

Correctly state the respiratory rate (within 1 breath per minute)

+1

Temperature (Oral)

 

Ask patient if they have recently eaten, consumed hot or cold liquids, or smoked. If yes, wait 15 minutes prior to assessing an oral temperature

+1

Attach a disposable cover to the thermometer and position the thermometer at the base of the tongue in either of the posterior sublingual pockets and ask the patient to close their lips around it

+1

Wait for the thermometer to beep, indicating the reading is complete and dispose of the cover and read the temperature accurately

+1

Pain

 

Ask if the patient is experiencing any pain (the “patient” should report a common ailment like a headache) and assess using the OPQRST method:

·        Chief Complaint: Are you having any pain? Where is it located?

·        Onset: When the pain began?

·        Provocation: What makes the pain worse?

·        Quality: How do you describe the pain?

·        Radiation: Does the pain spreads elsewhere?

·        Severity Scale: Explain and use the 0-10 scale to assess intensity

·        Timing: Is the pain constant or intermittent? How long does it last?

+7

Post-Procedure

 

Document patient’s vital signs (blood pressure, heart rate, respiratory rate, temperature) and pain assessment
No points but required

Total Points (successful/Unsuccessful) 21 out of 26 needed to be successful

Comments

 

 

 

 

 

 

Evaluator Initials or Signature: _____________________________________                Date: _____________________

1
ST
Attempt Pass ____________/Needs Remediation___________________

 

Evaluator Initials or Signature: _____________________________________                Date: _____________________

2
nd
Attempt Pass ____________/Lab Fail_____________________________

Question 1 of 15 – NSG 522 Chapter 29, Vital Signs Overview of Vital Sign Assessment

 Report content error

Which response indicates a nurse has a correct understanding about the components of a vital sign assessment?

“Oxygen saturation is the measurable intake of oxygen and release of carbon dioxide.”

Respiration is the intake of oxygen and release of carbon dioxide (inhalation and exhalation); oxygen saturation is the measurable amount of oxygen available to tissue.

Correct

“Pulse is the detectable rhythmic expansion of an artery from the pumping action of the heart.”

This is a correct statement because pulse is the detectable rhythmic expansion of an artery from the pumping action of the heart and is measured as the number of beats per minute.

“Respiration is the measurable amount of oxygen available to the tissues.”

Oxygen saturation, not respiration, is the measurable amount of oxygen available to the tissues. Respiration is the intake of oxygen and release of carbon dioxide (inhalation and exhalation).

“Blood pressure is the measurable pressure of blood within the systemic veins.”

Blood pressure is the measurable pressure of blood within the systemic arteries, not veins.

Question 2 of 15

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Which actions are strictly a nurse’s responsibility?

Correct

Assess patients to determine if medically stable.

Patients must be assessed by the nurse and determined to be medically stable, making this a responsibility of the nurse.

Correct

Interpret vital sign measurements.

Interpretation of vital sign data is strictly a nursing function because it requires clinical judgment.

Correct

Report significant vital sign findings to the health care provider.

To report unexpected values and other significant assessment findings to the appropriate health care provider is strictly a nursing responsibility because it requires clinical judgment.

Correct

Reassess any unexpected vital sign values.

To reassess any unexpected vital sign values is strictly a nurse’s responsibility because it requires clinical judgment.

Measure vital signs for stable patients.

The unlicensed assistive personnel may measure, record, and report vital signs for a stable patient; therefore it may be delegated by the nurse.

Question 3 of 15

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Which actions are required for proper documentation of vital signs?

Recording duplicate entries

Recording duplicate entries is not necessary when documenting vital signs as it can produce inconsistencies in the record.

Correct

Documenting in a standardized format

Documenting in a standardized format allows for easy communication to all members of the health care team.

Documenting at the end of the day

Results are documented promptly rather than waiting until the end of the day.

Correct

Recording on a specified form

Recording on the specified form where multiple sets of vital signs are easily visible at one time allows health care staff to identify trends for the patient. NSG 522 Chapter 29, Vital Signs Overview of Vital Sign Assessment

Recording just expected values

Expected and unexpected results are recorded, not just expected values.

Question 4 of 15

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How frequently would the nurse assess vital signs for a patient with a head injury who suddenly reports a severe headache and whose blood pressure rises from 118/62 to 170/94?

Correct

Every 5 minutes

The nurse would monitor the patient’s vital signs every 5 minutes because this patient has experienced a sudden, severe change in condition as evidenced by the severe headache and blood pressure changes. These findings would be reported to the health care provider.

Every 30 minutes

Monitoring vital signs every 15 to 60 minutes is for a postprocedure or postoperative patient; this patient is not stable because of sudden, severe changes in condition, and there is no indication of a recent medical procedure.

Every 4 hours

Monitoring vital signs every 4 hours is for a stable patient, and this patient is not stable because of the severe change in blood pressure.

Every 8 hours

Monitoring vital signs every 8 hours is for a stable patient, and this patient is not stable because of the sudden changes in health status.

Question 5 of 15

 Report content error

Which action would the nurse take for a stable patient who is scheduled for a transfer to the rehabilitation unit later in the afternoon?

Correct

Take vital signs before the transfer.

Vital signs need to be taken before the transfer to confirm that the patient maintains a stable status and is suitable for transfer.

Require every 2-hour monitoring until the transfer.

The patient is stable and does not require 2-hour monitoring.

Monitor the pulse rate once a day after the transfer.

All vital signs, not just the pulse rate, would be monitored before the transfer and upon admission to the rehabilitation unit.

Delay vital signs monitoring since the patient is being transferred.

Although the patient is being transferred, the nurse would not delay vital signs monitoring. All stable hospitalized patients should have vital signs monitored every 4 to 8 hours to observe for early signs of any alteration in condition.

Question 6 of 15

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Which action would the nurse take when the unlicensed assistive personnel (UAP) reports the patient’s pulse increased from 74 beats/min to 100 beats/min and the temperature increased from 99° to 101.8°F (37.2° to 38.8°C)?

Advise the UAP to wait 1 hour and repeat vital signs.

This patient is no longer stable, and waiting to take vital signs in 1 hour is too long; the vital signs are taken more frequently.

Compare the findings to the expected values.

Comparing the findings to the expected values is not indicated because the nurse uses the patient’s baseline.

Correct

Reassess the patient.

The nurse verifies the vital signs since this is a significant change and notifies the health care provider.

Tell the UAP to give fluids to the patient.

The nurse would not tell the UAP to give fluids to the patient; the nurse needs to gather more data before telling the UAP what to do.

Question 7 of 15

 Report content error

Which entries would the nurse include when documenting vital signs?

Correct

Date of assessment

Date of assessment is documented to follow vital sign trends over several days.

Correct

Time of assessment

Time of assessment is documented to follow vital sign trends over time.

Names of visitors in the room

Names of visitors in the room are not necessary for vital sign assessment.

Correct

Numeric results of the assessment

Recording the specific numeric data is documented to accurately note changes.

NSG 522 Chapter 29, Vital Signs Overview of Vital Sign Assessment

Expected values for vital signs

Expected values for vital signs are not entries for documenting because the documentation focuses on the patient’s actual results.

Question 8 of 15

 Report content error

Which patient trend does the vital sign graphic indicate?

The diastolic blood pressure is slowly increasing while the systolic pressure is remaining constant.

This statement is the opposite of what the image is depicting: the systolic blood pressure is slowly increasing while the diastolic blood pressure is relatively stable.

Correct

The systolic blood pressure is rising slightly while the diastolic pressure is steady.

The image depicts a systolic blood pressure that is rising slightly (from 142 mm Hg to 150 mm Hg) while the diastolic pressure is remaining constant and steady (around 86 mm Hg to 90 mm Hg).

The diastolic blood pressure is more varied than the systolic blood pressure.

This statement is the opposite of what the image is depicting: there is more variation in the systolic blood pressure than the diastolic blood pressure.

Both systolic and diastolic blood pressure readings require the nurse to immediately notify the health care provider.

While both systolic and diastolic blood pressures are high, all are within the patient’s baseline and do not require the nurse to immediately notify the health care provider. However, if the systolic blood pressure continues to rise, the nurse may have to notify the health care provider.

Question 9 of 15

 Report content error

Which vital sign finding indicates the adult patient is improving?

Blood pressure changes from 120/78 to 80/60.

A drop in blood pressure indicates the patient is deteriorating, not improving.

Pulse rate increases from 85 to 110.

The pulse rate was in an expected range and increased to an unexpected range, indicating the patient is worsening, not improving.

Oxygen saturation changes from 90% to 85%.

This patient’s oxygen saturation level was lower than expected and decreased even further, indicating the patient is deteriorating, not improving.

Correct

Respiratory rate decreases from 36 to 20.

Respiratory rate was elevated and decreased to expected range, indicating the patient is improving.

Question 10 of 15

 Report content error

Which actions are responsibilities of the nurse when assigning vital signs to the unlicensed assistive personnel (UAP)?

Correct

Ensure that the UAP uses the proper technique for measuring vital signs.

Since the task of vital sign measurement can be delegated, the nurse ensures accurate procedures are followed to obtain valid results.

Correct

Validate that the UAP knows what values need to be reported immediately for each patient.

The nurse validates that the UAP knows which values for each patient are immediately reported to the nurse to provide safe care.

Determine that the UAP knows to report unexpected values to the health care provider.

It is the nurse’s responsibility (not the UAP’s) to notify the health care provider of unexpected values.

Correct

Ensure that the UAP is competent to perform vital signassessments.

The nurse ensures that the UAP is competent to perform a vital sign assessment to obtain accurate, valid results.

Correct

Validate that the UAP uses appropriate equipment.

Since the task of vital sign measurement can be delegated, the nurse ensures appropriate equipment is used to obtain accurate readings.

Question 11 of 15

 Report content error

Which factors influence the interpretation of a patient’s vital signs?

Correct

Patient status

Interpretation of vital signs depends on patient status being stable,improving, or worsening.

Length of time the nurse is on duty

The length of time the nurse is on duty is irrelevant to the interpretation of vital signs.

Correct

Consideration of patient’s baseline vital signs

Consideration of the patient’s baseline vital signs assists in identifying trends.

Correct

Standard range for vital sign values

The standard range is a guide the nurse uses to interpret vital sign measurements.

Correct

Patient’s unique medical condition

The patient’s unique medical condition may explain vital signs being higher or lower (e.g., increased blood pressure in hypertension diagnosis).

Question 12 of 15

 Report content error

Which finding is unexpected for a 15-year-old patient?

Pain level 0

This is an expected pain level. A pain level of 0 indicates the patient is having no pain; the higher the number, the worse the pain.

Pulse rate 88

This is an expected pulse rate; the pulse rate for a 15-year-old is 50 to 90.

Correct

Respirations 30

This is an unexpected (abnormal) finding; respirations within expected ranges are 14 to 20.

O
2
 sat 97%

This is an expected finding; O
2
sat above 95% is within the expected range. NSG 522 Chapter 29, Vital Signs Overview of Vital Sign Assessment

Question 13 of 15

 Report content error

Which information about a patient’s pain is accurate?

Correct

It is a subjective experience.

Pain is a subjective experience of discomfort as described by a patient.

A high score on the rating scale indicates little pain.

A high score on the rating scale indicates a high level of pain; in fact, the higher the number, the worse the pain.

The nurse is the expert on the patient’s pain.

Pain is described by the patient, not the nurse; pain is a subjective experience.

A measurement of 0 to 10 mm Hg is expected.

A measurement of mm Hg is used for blood pressure, not pain. A pain scale of 0 to 10 measures the pain level.

Question 14 of 15

 Report content error

Which vital sign measurements are unexpected?

99.5°F (37.5°C) temperature for a newborn

96° to 99.5°F (35.5° to 37.5°C) is an expected temperature for a newborn; thus this newborn’s temperature is expected, not unexpected.

Correct

60 pulse rate for a 1-year-old

80 to 150 (awake) or 70 to 120 (asleep) pulse rate is expected for a 1-year-old; thus this pulse rate is unexpected.

Correct

35 respirations for a 6-year-old

20 to 24 respirations are expected for a 6-year-old; thus this patient’s respirations are unexpected.

Correct

SpO
2
 90% for a 15-year-old

Greater than 95% is expected for a 15-year-old; thus this patient’s SpO
2
 is unexpected.

110/68 blood pressure for an older adult

90 to <120 systolic and 60 to <80 diastolic are expected for an older adult; thus this patient’s blood pressure is expected, not unexpected. Question 15 of 15  Report content error Which vital sign measurements of adult patients would require the nurse to immediately notify the health care provider? Correct 158 pulse rate This is an extremely elevated pulse rate and would require the nurse to immediately notify the health care provider; the expected rate is 60 to 100. Correct 8 respirations This is an extremely low respiratory rate and would require the nurse to immediately notify the health care provider; the expected rate is 12 to 20. 99.5°F (37.5°C) temperature Although this is a high value, it is expected and does not require the nurse to immediately notify the health care provider. 98% oxygen saturation Oxygen saturation above 95% is expected and does not require notification of the health care provider. Correct 50/30 blood pressure This is an extremely low blood pressure and would require the nurse to immediately notify the health care provider; expected is 90 to <120/60 to <80. NSG 522 Chapter 29, Vital Signs Overview of Vital Sign Assessment

NURS-6512 Week 2: Assignment 1 Building a Health History: Communicating Effectively to Gather Appropriate Health-Related Information

Effective health history-taking is critical to clinical decision-making. However, its success is dependent on the clinician’s ability to adapt to the patient’s linguistic and cultural context, communicate clearly, and establish rapport (Edelman & Kudzma, 2022). The case of WH, a 62-year-old Chinese male who has limited proficiency in the English language, demonstrates the importance of clinicians adopting culturally responsive interviewing techniques. This paper explores the socioeconomic, spiritual, lifestyle, and cultural factors relevant to WH, identifies the potential issues that may require sensitivity, discusses appropriate communication strategies, summarizes an interview approach, provides targeted questions for health history taking, and justifies the risk assessment instrument suitable for the patient’s clinical context.

Socioeconomic, spiritual, lifestyle, and other cultural factors

Socioeconomic factors

WH is identified as a widower living with his daughter and grandchild. His social support is limited. His daughter is a nurse and acts as his primary caregiver. However, the cultural norms may cause his reluctance to accept care from his daughter. His limited proficiency in the English language may restrict his access to community support, health resources, and healthcare autonomy. WH may face socioeconomic constraints if he is financially dependent on his daughter, and this raises concerns about autonomy and role reversal within the family (Edelman & Kudzma, 2022).

Spiritual factors

Many older Chinese adults maintain traditional spiritual beliefs, which may be influenced by folk practice, Buddhism, Taoism, or Confucianism (Chan & Ho, 2022). WH’s understanding of hypertension as an imbalance rather than a biomedical condition may be influenced by his spiritual interpretation of illness. In addition, the Confucian principle of filial piety may contribute to his ambivalence about burdening his progeny with the caregiving responsibilities, fueling his resistance to his daughter’s involvement in his health management (Giger & Powell-Young, 2025).

GET HELP HERE

Lifestyle factors

The Chinese culture is suffused with dietary patterns, such as high sodium intake from traditional broths, preserved foods, or soy sauce. The dietary patterns can exacerbate WH’s hypertension risk. In addition, he may have limited physical activity, as he adheres to a sedentary lifestyle, which is common in older adults, although he may be engaging in traditional exercises, such as Tai Chi. Alcohol consumption, particularly rice wine, may be culturally relevant (Giger & Powell-Young, 2025).

Other cultural factors

WH may be underreporting his symptoms, owing to the cultural norms regarding stoicism and avoidance of expressing distress. Traditional medicine practices, such as acupuncture or herbal remedies, may be used concurrently with prescribed antihypertensive therapy. Unfamiliarity with Western medicine and mistrust could further complicating treatment adherence. Additionally, linguistic barriers could compound the cultural dynamics, limiting the patient’s ability to fully articulate preferences, concerns, and symptoms (Li & Dong, 2021) NURS-6512 Week 2: Assignment 1 Building a Health History: Communicating Effectively to Gather Appropriate Health-Related Information
 

Issues requiring sensitivity

Five main issues that warrant sensitivity when interacting with WH. First, language and health literacy as WH has limited proficiency in the English language. This could undermine his comprehension of health recommendations and medication instructions. Miscommunication could result in non-adherence and poor outcomes. Second, family involvement versus autonomy could present some concerns. Within the Chinese culture, health decisions are typically family centered. While his daughter is a nurse and may support understanding, WH could perceive his daughter’s involvement in his care as intrusive and threatening his masculinity and independence. Third, cultural interpretation of the illness may present a concern. WH could attribute his hypertension to fate, stress or imbalance in yin and yang, rather than biomedical causes. Clinicians provide evidence-based education even as they respect these beliefs. Fourth, generational and gender expectations may present sensitivity concerns. WH is an older male and may feel obligated to maintain his authority in the family. This may make him resistant to being dependent on his daughter. Fifth, there are end-of-life considerations. Although this may not be immediately relevant, the cultural beliefs around illness and death may influence his engagement in long-term care planning. Sensitivity in the five identified areas is essential for promoting patient-centered care, ensuring adherence, and establishing trust (Giger & Powell-Young, 2025).

Communication techniques and strategies

Six communication techniques and strategies are identified. First, cultural humility by demonstrating openness to WH’s use of traditional practices. This helps to foster trust. It may involve asking questions that validate the patient’s cultural identity, such as whether there are any traditional remedies he is currently using that should be considered alongside the prescribed medication. Second, respect for human involvement by acknowledging that his daughter has a role while reinforcing that he has autonomy, thereby promoting shared decision-making. This ensures that WH’s voice remains central by asking questions, such as asking to hear from him about his feelings on an issue being discussed or a decision to be made. Third, use of visual aids and plain language. It is important to avoid jargon, supplement explanation with translated handouts, and use visual tools to enhance comprehension. Visual tools may include pictorial medication schedules and blood pressure charts. Fourth, adopting the teach-back method. Given the possible low health literacy, it is important to encourage WH to repeat instructions using his own words. This approach helps to verify understanding without appearing condescending. Fifth, adopting culturally sensitive non-verbal communication. In the Chinese culture, excessive physical touch may be inappropriate, and direct eye contact may be perceived as confrontational. A clinician should maintain a respectful posture, use a gentle tone, and allow pauses for processing information (DeMarco & Healey-Walsh, 2024). Sixth, professional interpreters should be used. While WH’s daughter may be bilingual, a reliance on a family member for interpretation could risk role conflicts, omissions, and errors. A certified medical interpreter could ensure communication accuracy while preserving family dynamics (Flores, 2021). The six identified communication techniques and strategies collectively build rapport, empower the patient, and minimize miscommunication.

Health history interview

A comprehensive health history interview should be conducted with WH, and this should integrate the biomedical, psychosocial, and cultural dimensions. The interview would focus on the chief complaint and follow-up on antihypertensive therapy, review of symptoms (edema, chest pain, dizziness, and headaches), medication adherence and potential side effects, and diet, physical activity and lifestyle factors. In addition, it would explore the use of complementary practices and traditional Chinese medicine, and explore the psychosocial context, including social support, caregiving dynamics, and grief from widowhood. Besides that, the interview would explore the spiritual and cultural beliefs influencing illness perception and treatment adherence (DeMarco & Healey-Walsh, 2024) NURS-6512 Week 2: Assignment 1 Building a Health History: Communicating Effectively to Gather Appropriate Health-Related Information.

Five targeted questions are identified for the patient. First, asking WH to tell in his own words how he has been feeling since he started taking the medication. For instance, “Can you tell me in your own words how you have been feeling since starting your new medication?” This is an open-ended question that would elicit the patient’s subjective experience, ensuring his voice is prioritized despite the language barriers. In addition, it assesses adherence and side effects. Second, asking what kinds of foods the patient usually eats on a typical day. For instance, “What kinds of foods do you usually eat in a typical day?” The rationale for this question is that hypertension is strongly influenced by diet. The question is neutrally framed to avoid judgment while uncovering cultural dietary patterns, such as high-sodium foods. Third, ask if the patient uses any traditional practices, herbs or remedies for his health. For instance, “Do you use any traditional remedies, herbs, or practices for your health?” The rationale for this question is that many Chinese patients integrate traditional medicine. Acknowledging this helps to foster cultural respect, avoid conflict, and identify potential drug-herb interactions. Fourth, asking how the patient usually manages worries or stress in his life. For instance, “How do you usually manage stress or worries in your life?” The rationale for this question is that stress is linked to blood pressure control. The response to the question would help with assessing coping strategies, potential mental health concerns, and cultural or spiritual practices. Fifth, asking who the patient relies on for support when he has health concerns. For instance, “Who do you rely on for support when you have health concerns?” The rationale for this question is that social support can influence adherence and emotional well-being. The question explores caregiving dynamics and highlights the patient’s reliance on his daughter and grandchild. Each of the five questions is framed in simple, patient-centered language that enhances comprehension and cultural sensitivity (Edelman & Kudzma, 2022).

Risk assessment instrument

The Hypertension Self-Care Activity Levels Effects (H-SCALE) is an appropriate risk assessment instrument for use in the case study. This instrument evaluates the patient’s self-care behaviors, such as medication adherence, low-sodium diet, physical activity, weight management, and avoidance of tobacco and alcohol. It is relevant because WH has hypertension, and the instrument directly measures adherence to treatment and lifestyle modification. In addition, it is culturally adaptable as it can be translated into Cantonese or Mandarin, thereby enhancing accessibility. Besides that, it has cultural utility as the results can help to identify specific self-care deficits and guide targeted interventions, such as in exercise or diet. Additionally, it is evidence-based as it demonstrates validity and reliability in diverse populations, including Asian patients (Chen et al., 2024). H-SCALE quantifies self-care practices, thereby supplementing the health history and informing individualized care planning.

Conclusion

Building a health history for WH requires more than biomedical questioning. It necessitates sensitivity to language barriers, cultural humility, and an appreciation for traditional health beliefs and Chinese values such as filial piety. The use of targeted history taking, culturally attuned communication strategies, and employing professional interpretation ensures trust is fostered while accurate information is elicited. Tools such as the H-SCALE complement this process by operationalizing the self-care behaviors that are critical to hypertension management. Ultimately, adopting culturally competent interviewing would not only improve diagnostic accuracy, but also empower WH, and other patients in similar situations, to engage actively in their health.

References

Chan, E. A., & Ho, E. Y. (2022). Chinese cultural perspectives on health and illness.
Journal of Transcultural Nursing, 33
(2), 110–118. https://doi.org/10.1177/10436596211050965

Chen, T.-Y., Kao, C.-W., Cheng, S.-M., & Liu, C.-Y. (2024). Translation, adaptation, and validation of a Chinese version of the Hypertension Self-Care Activity Level Effects (H-SCALE) for patients with hypertension.
BMC Nursing, 23
(1), Article 334.
https://doi.org/10.1186/s12912-024-01993-y

DeMarco, R., Healey-Walsh, J. (2024). 
Community and Public Health Nursing: Evidence for Practice
(4th ed.). Wolters Kluwer Health.

Edelman, C., & Kudzma, E. C. (2022). 
Health Promotion Throughout the Life Span
(10th ed.). Elsevier Health Sciences.

Flores, G. (2021). The impact of medical interpreter services on the quality of health care: A systematic review.
Medical Care Research and Review, 78
(4), 356–372.
https://doi.org/10.1177/1077558720928478

Giger, J. N., & Powell-Young, M. (2025). 
Transcultural Nursing
(9th ed.).  Elsevier.

Li, H., & Dong, X. (2021). Cultural factors and barriers to healthcare for older Chinese immigrants.
Journal of Aging and Health, 33
(5–6), 387–396.
https://doi.org/10.1177/0898264321991168

 

BUILDING A HEALTH HISTORY: COMMUNICATING EFFECTIVELY TO GATHER APPROPRIATE HEALTH-RELATED INFORMATION

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting.

There may also be significant cultural factors. In May 2012, Alice Randall wrote an article for 
The New York Times
on the cultural factors that encouraged Black women to maintain a weight above what is considered healthy. Randall explained from her observations and her personal experience, as a Black woman, that many African American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012) NURS-6512 Week 2: Assignment 1 Building a Health History: Communicating Effectively to Gather Appropriate Health-Related Information.

Randall’s statements sparked a great deal of controversy and debate at the time; however, they emphasize an underlying reality in the healthcare field: Different populations, cultures, and groups have diverse beliefs and practices that impact their health. APRNs and other healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

As an advanced practice nurse, you must build a patient health history that takes into account all of the factors that make a patient unique and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with each patient, but it will also enable you to more effectively gather the information needed to assess a patient’s health risks.

For this first Assignment, you will take on the role of an APRN who is building a health history for a particular patient assigned by your Instructor. You will consider how social determinants of health and specific cultural considerations will influence your interview and communication techniques as you work in partnership with the patient to gather data for an accurate health history.

Note:
 You are expected to draw on the resources for 
both 
Week 1 and Week 2 when completing your Assignment.

Resources

 

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

Click the weekly resource links to access the resources.

WEEK 1 WEEKLY RESOURCES

To prepare:

Reflect on your experience as an advanced practice nurse and on the information provided in the Week 1 Learning Resources on building a health history and the Week 2 Learning Resources on diversity issues in health assessments.

By Day 1 of this week, your Instructor will assign a case study for this Assignment. 
Note:
 Please see the 
Course Announcements
 section of the classroom for your Case Study Assignment.

Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of your assigned patient.

Consider how you would build a health history for the patient. What questions would you ask? How might you target your questions based on the patient’s social determinants of health? How would you frame the questions to be sensitive to the patient’s background, lifestyle, and culture?

Identify any potential health-related risks, based on the patient’s age, gender, ethnicity, or environmental setting, which should be taken into consideration.

What risk assessment instruments would be appropriate to use with this patient?

What questions would you ask to assess the patient’s health risks?

Select 
one (1)
 risk assessment instrument discussed in the Learning Resources, or another tool with which you are familiar, related to your selected patient.

Develop 
five (5)
 targeted questions you would ask the patient to build their health history and to assess their health risks.

Think about the challenges associated with communicating with patients from a variety of specific populations. What communication techniques would be most appropriate to use with this patient? What strategies can you as an APRN employ to be sensitive to different cultural factors while gathering the pertinent information?

Assignment: Building a Health History With Cultural and Diversity Awareness  

Include the following:

Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Be specific.

Explain the issues that you would need to be sensitive to when interacting with the patient, and why.

Describe the communication techniques you would use with this patient. Include strategies to demonstrate sensitivity with this patient. Be specific and explain why you would use these techniques.

Summarize the health history interview you would conduct with this patient. Provide at least 
five (5)
 targeted questions you would ask the patient to build their health history and to assess their health risks. Explain your reasoning for each question and how you frame each for this specific patient.

Identify the risk assessment instrument you selected, and then justify why it would be applicable to your assigned patient. Be specific.

Include a reference list with a minimum of 3 scholarly articles.

By day 7 of Week 2

Submit
 your Assignment.

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 
WK2Assgn1_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_6512_Week 2_Assignment 1_Rubric

NURS_6512_Week 2_Assignment 1_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome
Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Be specific NURS-6512 Week 2: Assignment 1 Building a Health History: Communicating Effectively to Gather Appropriate Health-Related Information

15
 
to >
12.0
 pts
Excellent
The response clearly, accurately, and in detail explains the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the assigned patient.

12
 
to >
9.0
 pts
Good
The response accurately explains the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the assigned patient.

9
 
to >
6.0
 pts
Fair
The response vaguely and with some inaccuracy explains the socioeconomic, spiritual, lifestyle, and other cultural factors associated with the assigned patient.

6
 
to >
0
 pts
Poor
The response is inaccurate and/or missing explanations of the socioeconomic, spiritual, lifestyle, and other cultural factors associated with the assigned patient.

15
 pts

This criterion is linked to a Learning Outcome
Explain the issues that you would need to be sensitive to when interacting with the patient, and why.

15
 
to >
12.0
 pts
Excellent
The response clearly, accurately, and in detail explains the issues to be sensitive to when interacting with the patient; explanations why are clear, accurate, and detailed.

12
 
to >
9.0
 pts
Good
The response accurately explains the issues to be sensitive to when interacting with the patient; explanations why are accurate.

9
 
to >
6.0
 pts
Fair
The response vaguely and with some inaccuracy explains the issues to be sensitive to when interacting with the patient; explanations why are vague and/or inaccurate.

6
 
to >
0
 pts
Poor
The response is inaccurate and/or missing explanations of the issues to be sensitive to when interacting with the patient; explanations why are inaccurate or missing.

15
 pts

This criterion is linked to a Learning Outcome
Describe the communication techniques you would use with this patient. Include strategies to demonstrate sensitivity with this patient. Be specific and explain why you would use these techniques.

15
 
to >
12.0
 pts
Excellent
The response clearly and accurately identifies and describes in detail communication techniques to use with the patient, including specific strategies to demonstrate sensitivity with this patient, and a detailed explanation of why to use these techniques.

12
 
to >
9.0
 pts
Good
The response accurately identifies and describes communication techniques to use with the patient, including specific strategies to demonstrate sensitivity with this patient, and an explanation of why to use these techniques.

9
 
to >
6.0
 pts
Fair
The response vaguely and with some inaccuracy identifies and describes communication techniques to use with the patient, including strategies to demonstrate sensitivity with this patient, and a vague explanation of why to use these techniques.

6
 
to >
0
 pts
Poor
The response identifies inaccurately and/or is missing descriptions of communication techniques to use with the patient, including inaccurate or missing strategies to demonstrate sensitivity with this patient, and an inadequate or missing explanation of why to use these techniques.

15
 pts

This criterion is linked to a Learning Outcome
Summarize the health history interview you would conduct with this patient. Provide at least five (5) targeted questions you would ask the patient to build their health history and to assess their health risks. Explain your reasoning for each question and how you frame each for this specific patient.

25
 
to >
22.0
 pts
Excellent
The response clearly, accurately, and in detail summarizes the health history interview to conduct with this patient, including at least five targeted questions to ask to build the health history and assess health risks, with detailed explanations for the wording of each question and why it is asked.

22
 
to >
19.0
 pts
Good
The response accurately summarizes the health history interview to conduct with this patient, including five targeted questions to ask to build the health history and assess health risks, with explanations for the wording of each question and why it is asked.

19
 
to >
16.0
 pts
Fair
The response vaguely summarizes the health history interview to conduct with this patient, including five questions to ask that are vague or lacking specificity to build the health history and assess health risks, with vague explanations for the wording of each question and why it is asked.

16
 
to >
0
 pts
Poor
The response inadequately summarizes the health history interview to conduct with this patient, including fewer than five questions that are inadequate for building the health history and assessing health risks, with inadequate or missing explanations for the wording of each question and why it is asked.

25
 pts

This criterion is linked to a Learning Outcome
Identify the risk assessment instrument you selected, and then justify why it would be applicable to your assigned patient. Be specific.

15
 
to >
12.0
 pts
Excellent
The response clearly and accurately identifies the selected risk assessment instrument, and provides detailed and specific justification for why it is applicable to the assigned patient.

12
 
to >
9.0
 pts
Good
The response accurately identifies the selected risk assessment instrument, and provides specific justification for why it is applicable to the assigned patient.

9
 
to >
6.0
 pts
Fair
The response vaguely identifies the selected risk assessment instrument, and provides vague justification for why it is applicable to the assigned patient.

6
 
to >
0
 pts
Poor
The response inadequately identifies the selected risk assessment instrument, and provides inadequate or missing justification for why it is applicable to the assigned patient.

15
 pts

This criterion is linked to a Learning Outcome
Written Expression and Formatting: Paragraph Development and Organization — Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused and neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5
 
to >
4.0
 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4
 
to >
3.0
 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3
 
to >
2.0
 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

2
 
to >
0
 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. 5  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 >
3.0
 pts
Good
Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3
 
to >
2.0
 pts
Fair
Contains several (3 or 4) grammar, spelling, and punctuation errors.

2
 
to >
0
 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with understanding.

5
 pts

This criterion is linked to a Learning Outcome
Written Expression and Formatting: APA The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list with minimum of 3 scholarly articles. NURS-6512 Week 2: Assignment 1 Building a Health History: Communicating Effectively to Gather Appropriate Health-Related Information

5
 
to >
4.0
 pts
Excellent
Uses correct APA format with no errors. Contains 3 references.

4
 
to >
3.0
 pts
Good
Contains a few (1 or 2) APA format errors. Contains at least 2 references

3
 
to >
2.0
 pts
Fair
Contains several (3 or 4) APA format errors. Contains less than 2 references.

2
 
to >
0
 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with understanding. No references listed.

5
 pts

Total Points: 
100

Concept Paper: Christian Worldview Problem Statement Assignment

CONCEPT PAPER: PROBLEM STATEMENT ASSIGNMENT INSTRUCTIONS

OVERVIEW

Write a one or two-paragraph problem statement in the current APA format that introduces

the general topic of your research, define the problem to be addressed, and summarize the existing

research, explains shortcomings of existing research, and concludes with a focused statement

about the contribution your research will make to this problem.

INSTRUCTIONS

– The Problem Statement should be one to two paragraphs in length. It should be concise,

around one page, and no more than two pages. Length does not necessarily equate to

quality.

– The abstract should be in current APA format.

– You are asked to highlight relevant shortcomings of existing research, but please do not

treat this as a literature review. Instead, identify the handful of sources most critical to

your research.

– A well-crafted Problem Statement makes the case that there is a concrete problem in

public policy or administration, and that the proposed study makes a legitimate academic

contribution to solving that problem. Concept Paper: Christian Worldview Problem Statement Assignment

Please follow the instructions in the Client’s upload file.

Note: The assignment will be checked for originality via the Turnitin plagiarism and AI tool.

My Topic of Interest is A Policy Analysis of Recidivism of “Violent Criminals”: those without parole supervision and those released to parole supervision for a period of six (6) months in the state of New Jersey.

Please refer to the Dissertation Abstract Assignment for more information.

Required Reading/watching:

-Read: Hird: Part One

-Watch: Writing a Problem Statement

Note: Your assignment will be checked for originality via the Turnitin plagiarism  and AI tool.

ORDER HERE

Concept Paper:
Christian
Worldview Problem Statement Assignment

Problem Statement Assignment

The US has been experiencing a dramatic decrease in violent crime rates in most states. However, the current prevalence of offenders convicted for violent crimes across the country is still high compared to other developed countries (Zimring & Hawkins, 2020). An extremely high rate of lethal violence within the US is a significant social issue that exposes Americans to anger and fear (Zimring & Hawkins, 2020). In particular, violent crime threatens minorities, who are the most significant victims of violent offenses. Blacks represent approximately 14% of the U.S. population (Kurek et al., 2020). Surprisingly, this minority group represents 60% of Americans killed by firearm homicides by 2020 (Kurek et al., 2020). Besides, Black males aged 18 to 24 had a possibility of being killed by firearm homicide that was 23 times higher than their white counterparts between 2017 and 2021 (Wilson et al., 2023). This trend was observed in several states across the US, causing trauma to the affected groups. As a result, the US federal and state governments have adopted various policies, such as parole rehabilitative programs for citizens incarcerated for violent crimes (Prescott et al., 2019). These policies focus on molding violent offenders before releasing them back into the community.

Nonetheless, existing research has not explored the effectiveness of the US state prison system particularly New Jersey CJS in preventing violent criminals from reoffending despite increasing recidivism rates. According to Prescott et al. (2019), current policies ignore violent criminals in their efforts to reduce recidivism rates and mass incarceration despite violent offenders representing highest percentage of imprisoned population in the US. Thus, the proposed qualitative research project will bridge a gap in the existing literature by analyzing how parole policies implemented within New Jersey hinder violent criminals, including offenders released to six months of parole supervision and those without parole supervision from recidivating. Policy changes will be recommended based on findings of the qualitative research project to reduce recidivism rates among violent criminals within New Jersey. From a Christian perspective, sinners should be given an opportunity to repent their sins. In the Bible, individuals who repented their sins were forgiven. “Repent, for the kingdom of heaven is at hand” (Matthew 4:17) Concept Paper: Christian Worldview Problem Statement Assignment.

References

Kurek, N., Darzi, L. A., & Maa, J. (2020). A worldwide perspective provides insights into why a US Surgeon General Annual Report on Firearm Injuries is needed in America. 
Current Trauma Reports
, 
6
, 36-43.
https://link.springer.com/article/10.1007/s40719-020-00189-4

Prescott, J. J., Pyle, B., & Starr, S. B. (2019). Understanding violent-crime recidivism. 
Notre Dame L. Rev.
, 
95
, 1643.
https://heinonline.org/HOL/LandingPage?handle=hein.journals/tndl95&div=47&id=&page=

The English Standard Version Bible: Containing the Old and New Testaments with Apocrypha. (2016). Oxford University Press.

Wilson, R. F., Fortson, B. L., Zhou, H., Lyons, B. H., Sheats, K. J., Betz, C. J., … & Self-Brown, S. (2023). Trends in homicide rates for US children aged 0 to 17 years, 1999 to 2020. JAMA pediatrics, 177(2), 187-197.
https://jamanetwork.com/journals/jamapediatrics/article-abstract/2799356

Zimring, F. E., & Hawkins, G. (2020). Crime is not the problem: Lethal violence in America. In 
Crime, Inequality and the State
(pp. 125-136). Routledge. Concept Paper: Christian Worldview Problem Statement Assignment

Dissertation Abstract Assignment

Society perceives violent criminals as the most dangerous offenders due to the harm they cause to the victims and the local community. For this reason, the federal and state criminal justice systems (CJS) focus on molding persons convicted of violent offenses before releasing them back into the community. The effectiveness of the CJS in reforming these offenders remains a significant concern following high recidivism rates among violent criminals in various states across the US. New Jersey is among the states with the highest rates of recidivism rates of violent offenders despite the state’s crime rate remaining significantly low in the past few years. Therefore, this dissertation project focuses on analyzing policies implemented by New Jersey’s CJS to curb the recidivism of individuals convicted of violent crimes in the state. The study uses a qualitative phenomenological research design. The project team would use semi-structured interview questions to gather data from the sample population, including 25 parole officers who have served in the selected correctional facilities for three years and above. Sixty (60%) of respondents would be male, while 40% would be female. Qualitative data related to the research question would be collected from individual participants during the interview and documented in an audio recorder. The project team would apply phenomenological data analysis to ensure data is analyzed based on respondents’ feedback. Lastly, thematic analysis would be used to establish significant themes from qualitative data, informing policy change in New Jersey to prevent violent criminal offenders from recidivating. In my opinion, this dissertation project aligns with Biblical teachings that encourage sinners to repent and seek forgiveness to be accepted by other Christians.

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DISSERTATION ABSTRACT ASSIGNMENT INSTRUCTIONS

OVERVIEW

You will write a one-paragraph dissertation abstract that offers a clear and concise summary of

your planned research project. The abstract should explain the purpose and significance of

the study and should detail the methodology. Descriptions of the methodology should include the

design, the sample, setting, and data collection and analysis methods. The abstract should be

brief and concise; approximately 250 words is recommended, but not more than one page. The

abstract should be written as one, double-spaced paragraph. Citations are not necessary.

INSTRUCTIONS

– The abstract should be approximately 250 words. It should be presented as one paragraph

and should not exceed one page in length.

– The abstract should be in the current APA format.

– Applying a biblical perspective is important, please be sure to clarify whether the biblical

perspective is your opinion or will be used in addressing members and/or other officials.

– Citations are not necessary.

Please follow the instructions in the Client’s upload file.

Note: The
assignment
will be checked for originality via the Turnitin plagiarism tool.

My Topic of Interest is A Policy Analysis of Recidivism of “Violent Criminals”: those without parole supervision and those released to parole supervision for a period of six (6) months in the state of New Jersey.

Please refer
here
for more information.

Required Reading/watching:

-Read Constructing the Prospectus

-Developing the Dissertation Prospectus

Watch: Welcome to Doctoral Scholarship

Watch: The Research Concept Paper

Dissertation Abstract Assignment

Research proposal assignment example with Christian Worldview

Research Proposal Final Draft

Recidivism of offenders of violent crimes has gained attention among scholars in the 21
st
Century. Most researchers have focused on this topic due to the high number of violent criminals retained in various correctional facilities in the US. In the US state prisons, violent criminals represent approximately 3 out of 5 (62%) offenders (Prescott et al., 2019). Besides, violent criminals pose a significant threat to community members than other offenders due to the adverse effects of their criminal activities on society (O’Connell et al., 2019). Consequently, several policies have been implemented at the state and federal levels to prevent violent criminals from reoffending in the future. Nonetheless, the effectiveness of current policies and measures in preventing the recidivism of violent criminals has not been explored, creating a gap in the literature. The proposed dissertation proposal analyzes policies adopted in New Jersey to curb recidivism of violent crime offenders: Those released to parole supervision for six months and offenders without parole supervision. This final draft of the dissertation proposal captures various aspects of the qualitative research study, including a statement of the research question, research sub-questions being investigated, reviewing existing literature surrounding research questions, the theoretical and practical significance of research questions, methodology description and rationale, proposed investigation means, data interpretation approach, reasons for undertaking proposed research, and the study’s implications on the policy decision-making process in the future.

Statement of the Research Question

Recidivism of criminals is the most commonly used measure for assessing the efficacy of the US state or federal criminal justice system (CJS). States with lower recidivism rates are associated with effective rehabilitative programs. On the contrary, high recidivism rates imply that CJS is ineffective in molding offenders’ behaviors during the imprisonment period. The rate of recidivism of offenders remains significantly high in New Jersey despite implementing the current rehabilitative measures within the state’s prisons. Statistical data on recidivism is an important metric by which to measure the efficacy of New Jersey’s criminal justice system. The state’s data indicated that approximately 30% of inmates imprisoned in New Jersey prisons in 2017 were re-incarcerated a few years later (Fox et al., 2019). PSO data indicated that 42.3% of 16,043 offenders released from New Jersey’s jail in 2017 were re-incarcerated within the next three years (Fox et al., 2019). This trend raises concerns regarding the efficacy of rehabilitative policies and programs implemented by New Jersey’s CJS in preventing criminals, especially violent offenders, from re-encountering law enforcement officers and the state after being released from prison. Therefore, a study should be conducted to analyze policies adopted by New Jersey’s CJS to curb recidivism among violent criminals within New Jersey.

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Sub-Questions Being Investigated in this Qualitative Study

Qualitative studies are mainly conducted to collect qualitative data related to a topic of interest or a specific social issue. However, qualitative studies are usually broad, necessitating the formulation of sub-questions, which guide researchers throughout the data collection process. In the proposed qualitative research study, the inquiry process was informed by three significant research sub-questions, including current rehabilitative programs and policies that the New Jersey CJS has adopted to prevent violent criminals from reoffending after being released from the state’s correctional system; stakeholders’ perceptions of New Jersey’s CJS policies to lower recidivism rates among violent criminals; and respondents’ explanations of additional measures needed to enhance the efficacy of current policies, programs, and procedures in reducing recidivism within New Jersey’s correctional system. These sub-questions have narrowed down the qualitative study, facilitating the data collection process. Consequently, qualitative data regarding New Jersey’s policies targeting the recidivism of violent offenders within the state would be collected from the study’s respondents. This data would indicate additional measures that should be included in the state’s current policies to reduce rates of recidivism involving violent criminals.

Reviewing Literature Surrounding Research Questions

Study findings inform practice change at state and federal levels. Thus, several studies have been conducted to explore policies implemented in New Jersey to prevent recidivism of violent crime offenders. New Jersey’s state government is committed to reducing crime rates and incredibly violent offenses. As a result, New Jersey’s CJS has adopted various rehabilitative programs to mold the behaviors of inmates. New Jersey’s CJS ensures that offenders released from the state’s jails and prisons are molded into law-abiding citizens (Galletta et al., 2021). Thus, inmates are prepared to reenter society as productive citizens from potential harm. However, New Jersey’s rehabilitative programs for inmates seem ineffective based on the state’s recidivism rate. Data released in 2023 indicated that approximately 30% of offenders released from various rehabilitative facilities within New Jersey reoffended within three years (Criminon International, 2023). The high rate of recidivism in New Jersey demonstrates the inefficacy of the state’s prison system in rehabilitating and molding behaviors of individuals convicted of various criminal activities, including violent offenses.

The Theoretical and Practical Significance of Research Questions

In qualitative studies, sub-research questions guide the inquiry process. Qualitative data collected from the study’s respondents is analyzed using significant themes and patterns. These findings indicate gaps in theory and practice that require improvement. In the proposed qualitative study, data collected by reviewing literature related to the research’s sub-questions indicate the inefficacy of New Jersey’s rehabilitative measures in preventing reoffending among violent criminals. This qualitative data indicates theoretical and practical gaps. From the theoretical perspective, qualitative findings indicate that scholars further explore policies implemented by New Jersey’s CJS. For instance, researchers should assess the efficacy of the state’s rehabilitative programs in preventing re-incarceration among other types of offenders, such as domestic violence offenders. Alternatively, studies should examine the efficacy of similar rehabilitative measures in preventing recidivism among criminal offenders in other US states, such as Florida or North Carolina.

On the other hand, study findings are applicable in the practical context. Reviewed literature reported a high rate of recidivism among violent crime offenders within New Jersey. For instance, Criminon International (2023) reported re-incarceration in 30% of offenders rehabilitated in New Jersey correctional facilities. The high recidivism rate implies that the state’s correctional facilities are ineffective in changing inmates’ behaviors. Thus, additional measures should be introduced in New Jersey to complement the state’s current rehabilitative programs, making them more effective in molding inmates’ behaviors. Consequently, the possibility of reengaging in criminal activities among offenders incarcerated in New Jersey’s prison system, including violent criminals, would reduce significantly.

Recommended Methodology and Rationale

A qualitative phenomenological research design is the most appropriate methodology in the proposed dissertation project. According to Hennink et al. (2020), a qualitative research design supports the exploration of a specific phenomenon, enhancing understanding of a particular social issue of concern. A phenomenology approach to qualitative studies focuses on exploring individuals’ experiences with a specific phenomenon, supporting the collection of quality and reliable qualitative data (Dela Fuente, 2021). For this reason, the phenomenology approach is considered the best qualitative research approach. In this qualitative research project, a qualitative phenomenological design would allow the project team to explore various rehabilitative programs and measures implemented within New Jersey CJS to prevent criminals from reoffending after being released via respondents’ shared experiences. Additionally, qualitative research design supports structure or semi-structured open-ended research questions. Ahmad et al. (2020) uses open-ended research questions in qualitative studies as the most effective approach to exploring human behaviors and patterns that cannot be studied via quantitative research methodologies. In the proposed qualitative study, semi-structured research questions would be prepared before the interview to guide the interviewers in collecting relevant qualitative data from respondents, including parole officers from New Jersey CJS. Thus, a qualitative research design is considered the most appropriate methodology for the proposed qualitative research project.

The Proposed Investigation Means

           
In the proposed dissertation project, qualitative data would be collected through fieldwork. The study will be conducted in two New Jersey correctional facilities. Participants would include parole officers from the selected correctional facilities. The project team would use a purposive sampling method during the participants’ selection. Nyimbili and Nyimbili (2024) reported the efficacy of the purposive sampling technique in selecting the best informants in qualitative studies. Thus, applying this approach during sample selection would ensure that the most appropriate respondents are engaged during data collection. Twenty-five (25) parole officers selected via purposive sampling would be interviewed during data collection. Males and females would be represented in the sample population to promote gender equality. Male parole officers represent 60% of the total informants (15), while females represent 40% (10) respondents.

Potential respondents must meet the inclusion criteria to participate in the interview. First, respondents must be aged between 30 and 50. Secondly, an individual respondent must be a parole officer currently working in one of two correctional facilities selected for the study. Besides, qualified respondents must be involved in rehabilitation programs for violent criminals. Moreover, parole officers involved in the study must have worked with New Jersey CJS for three years or more.

In contrast, potential respondents would be disqualified based on the study’s exclusion criteria. Parole officers working in other correctional facilities except two institutions selected for data collection would be excluded. Secondly, the project team would disqualify parole officers working in the selected correctional facilities if they have served in New Jersey CJS for less than three years. Moreover, parole officers from these facilities who are not involved in rehabilitating offenders of violent crimes would be eliminated from the study. The project team would also eliminate parole officers who have met other conditions if they are below 30 or above 50 years. Research proposal assignment example with Christian Worldview.

Semi-structured research questions would gather relevant data from selected respondents during the study. This interview approach uses pre-determined research questions related to the social issue to gather data from informants during the interview (Naz et al., 2022). Studies show that open-ended interview questions allow researchers to collect in-depth qualitative data through the informant’s shared experience (Busetto et al., 2020). Thus, semi-structured research questions are recommended in the proposed qualitative research project. These questions would support data collection through in-depth discussions with individual respondents, hence answering sub-research questions.

Data Interpretation Approach

In the proposed qualitative project, data collected from parole officers during interviews would be documented in an audio recorder. A phenomenological focus will be applied to analyze the qualitative data collected during the study. According to Williams (2021), in qualitative studies, the phenomenological approach targets the lived experience of informants regarding a specific phenomenon. In phenomenological focus, researchers are mainly interested in how the study’s target group experienced a specific aspect or social issue. Thus, in the proposed qualitative project, incorporating a phenomenological focus into data interpretation would allow the research team to focus on parole officers’ experience with policies targeting the recidivism of violent criminals within New Jersey. Qualitative data would then be analyzed through thematic analysis to identify the most significant patterns and themes related to recidivism policies.

Why was the Proposed Research Study Undertaken?

The qualitative research project is a policy analysis targeting reducing recidivism rates among violent criminals in New Jersey. This qualitative study was necessitated by alarming recidivism rates involving offenders of violent crimes in New Jersey. Although the state has reported a remarkable decrease in crime rates recently, recidivism rates remain significantly high within New Jersey (Criminon International, 2023). State data indicated that about 30% of New Jersey’s offenders are likely to recidivate within three years following release (Criminon International, 2023). This trend raises a concern about current rehabilitative measures and programs, especially those targeting violent criminals. Thus, data collected from parole officers during this qualitative study would indicate if the high rate of recidivism among violent criminals in New Jersey is due to a gap in the state’s current rehabilitative policies.

The Study’s Implications for Policy Decision-Making Process in the Future

Recidivism rates are considered the most appropriate measure of the efficacy of the state’s CJS or prison system. A state’s parole rehabilitative programs are perceived as ineffective if the recidivism rate is relatively high. It is believed that inmates can only reoffend in the future if their behaviors were not molded appropriately during their imprisonment period. Recidivism rates of inmates within a few years after release are relatively high in New Jersey (Criminon International, 2023). Based on the above perspective, measures adopted by the New Jersey CJS to influence offenders of violent crimes to change their behaviors during their imprisonment period are ineffective. Thus, policymakers should consider introducing new rehabilitative measures or amending current strategies to enhance their efficacy in reducing recidivism rates, particularly among violent criminals within New Jersey.

Additional Research Report Components

Proposal’s Anticipated Milestones

The proposed research project will be broken down into three significant phases. The first phase is the planning stage, which consists of three milestones. The first milestone is the project’s approval. The project team will only proceed with the proposed research study upon acquiring approval from the supervisor. The second milestone involves identifying settings where data will be collected. The project team will also secure permission to conduct the study from the management of selected settings. The last milestone of the planning phase is securing the funds needed for project implementation Research proposal assignment example with Christian Worldview.

The second stage, the project phase, consists of several milestones. The first milestone involves selecting the most appropriate research design to be applied during data collection. The choice of research design will depend on the research sub-questions being addressed during the study. Secondly, the project team will email potential participants, including parole officers from two prisons selected for data collection, to inform them about the project. Thirdly, researchers will apply a purposive sampling technique to select the most appropriate informants for this study. Fourthly, the research team will prepare semi-structured interview questions before the interview. Moreover, the research team will use a semi-structured interview questions guide to collect data from respondents during the interview and document data using a tape recorder. The last milestone is data analysis. Quantitative data gathered from respondents during the interview will be analyzed using thematic analysis to identify common patterns and themes.

The last phase is the post-project stage. In this stage, the research team will analyze the implications of the project of policies adopted to curb the recidivism of violent criminals within New Jersey. The study findings will then be presented to relevant authorities to inform policy-making decisions in the future. Consequently, the recidivism rate among violent criminals within New Jersey will reduce remarkably.

 Required Resources

A laptop is needed to facilitate communication via email between the project team and key stakeholders, including the supervisor and respondents. The laptop would also prepare a soft copy of semi-structured interview questions before data collection. It will also store data collected from parole officers during the interview. An audio tape recorder will also be needed to record respondents’ answers during the interview.

Timeframe for the Project Accomplishment

The proposed project will be accomplished within twelve weeks. The first two weeks will be spent accomplishing milestones of the planning stage, including seeking project approval and securing permission from the management of correctional facilities selected for data collection. The project phase will be collected within nine weeks. During this period, the project team will select the study’s participants, prepare semi-structured interview questions, collect and transcribe data, and analyze data collected from respondents via thematic analysis to establish the most appropriate themes. The last week will be spent presenting project findings to relevant professionals, particularly key stakeholders in New Jersey’s CJS.

World Christian Perspective

Christianity embraces offenders who repent the sins. The Bible states that God readily takes back sinners who repent their sins as part of His kingdom and gives them eternal life. “So then, even to Gentiles God has granted repentance that leads to life” (Acts 11:18). Therefore, New Jersey CJS should focus on introducing rehabilitative measures and programs that allow violent criminals to reform and avoid reoffending in the future.

 

References

Ahmad, S., Wasim, S., Irfan, S., Gogoi, S., Srivastava, A., & Farheen, Z. (2019). Qualitative v/s. quantitative research-a summarized review. 
Population
, 
1
(2), 2828-2832. DOI: 10.18410/jebmh/2019/587

Busetto, L., Wick, W., & Gumbinger, C. (2020). How to use and assess qualitative research methods. 
Neurological Research and Practice
, 
2
(1), 14.
https://link.springer.com/article/10.1186/s42466-020-00059-z

Criminon International. (2023). Criminal Rehabilitation and Justice in New Jersey.
Criminon.Org
.
https://www.criminon.org/where-we-work/united-states/new-jersey/#:~:text=New%20Jersey%20Recidivism,re%2Dincarcerated%20within%20three%20years
.

Dela Fuente, J. A. (2021). Implementing inclusive education in the Philippines. College teacher experiences with deaf students.
Issues in Educational Research
, 31(1), 94-110.
http://www.iier.org.au/iier31/dela-fuente.pdf

Fox, B., Verona, E., & Fournier, L. (2019). Psychological assessment of risk in a county jail: Implications for reentry, recidivism and detention practices in the USA. 
Journal of Criminal Psychology
, 
9
(4), 173-186.
https://doi.org/10.1108/JCP-11-2019-051

Galletta, E., Fagan, T. J., Shapiro, D., & Walker, L. E. (2021). Societal reentry of prison inmates with mental illness: Obstacles, programs, and best practices. 
Journal of Correctional Health Care
, 
27
(1), 58-65. Doi: 10.1089/jchc.19.04.0032

Hennink, M., Hutter, I., & Bailey, A. (2020). 
Qualitative research methods
. Sage.

Naz, N., Gulab, F., & Aslam, M. (2022). Development of qualitative semi-structured interview guide for case study research. 
Competitive Social Science Research Journal
, 
3
(2), 42-52.
https://cssrjournal.com/index.php/cssrjournal/article

Nyimbili, F., & Nyimbili, L. (2024). Types of Purposive Sampling Techniques with Their Examples and Application in Qualitative Research Studies.
British Journal of Multidisciplinary and Advanced Studies,
5(1), 90-99. DOI:
https://doi.org/10.37745/bjmas.2022.0419
.

O’Connell, D., Visher, C., & Liu, L. (2019). Violent offending, desistance, and recidivism. 
Marq. L. Rev.
, 
103
, 983.
https://heinonline.org/HOL/LandingPage?handle=hein.journals/marqlr103&div=35&id=&page=

Prescott, J. J., Pyle, B., & Starr, S. B. (2019). Understanding violent-crime recidivism. Notre Dame L. Rev., 95, 1643.
https://heinonline.org/HOL/LandingPage?handle=hein.journals/tndl95&div=47&id=&page=

The English Standard Version Bible: Containing the Old and New Testaments with Apocrypha. (2016). Oxford University Press.

Williams, H. (2021). The meaning of “Phenomenology”: Qualitative and philosophical phenomenological research methods.
The Qualitative Report
, 26(2), 366-385.
https://doi.org/10.46743/2160-3715/2021.4587
.

 

Research proposal assignment example with Christian Worldview

RESEARCH PROPOSAL ASSIGNMENT INSTRUCTIONS

OVERVIEW

For this assignment, you will write a qualitative research proposal directed at investigating a

specific public policy concern. This document will culminate from your Working Papers. This

document will culminate from your Working Paper Assignments. Given the sequence of

working papers you have completed, each addressing an aspect of the research proposal

development process, you are to generate the final proposal.

INSTRUCTIONS

– The final draft of this research proposal should conform to the commonly understood

elements of a qualitative investigation, i.e. statement of the research question and sub-

questions under investigation; a brief review of the literature surrounding the question(s);

the practical and theoretical significance of the question(s); description and rationale for

the methods employed; the description of the proposed means of investigation, and the

approach to interpretation. Give the reasons why such research should be undertaken,

highlighting the implications for future policy decision-making.

– Make sure all additional research report components that may be required are well-

labeled: i.e. proposal’s anticipated milestones, required resources, timeframe for

accomplishment, letter of transmittal, foundations, and professional audiences that would

welcome to the proposed study.

– The assignment should be a minimum of 10 pages and is to be produced according to

current APA formatting.

Note: The Turnitin plagiarism tool will check this paper for originality.

My Topic of Interest is A Policy Analysis of Recidivism of “Violent Criminals”: those without parole supervision and those released to parole supervision for a period of six (6) months in the state of New Jersey.

Any sources cited must have been published within the last five years. Acceptable sources include the assigned readings, articles in top-tier peer-reviewed academic journals, analytical reviews of policy-related think tanks, and the Bible.

 

Required Reading and Watching:

-Read: Tolley, Ulin, Mack, Robinson & Succop: Chapter 8

-Watch: How to write a research Methodology in 4 steps

Watch: What is Research Methodology in A Dissertation or Thesis? SIMPLE Explainer With Examples

Research proposal assignment example with Christian Worldview

Health Illness Continuum nursing essay assignment

Research the health-illness continuum and its relevance to patient care. In a paper of 750-1,000 words, discuss the relevance of the continuum to patient care and present a holistic perspective of your current state of health in relation to the wellness spectrum by including 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 from a holistic perspective. Discuss what behaviors support or detract from your health, well-being, and self-care. Explain where you currently fall on the health-illness continuum. Describe how you might improve your self-care practices and overall wellness using evidence-based strategies.

Discuss at least two specific options and resources available to you in your community or virtually 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 past 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

Health Illness Continuum nursing essay assignment

Health Illness Continuum & Its Relevance to Patient Care

The view and understanding of health has evolved over recent years, evolving to not just mean the absence of disease but instead to include different dimensions such as social, spiritual, psychological, and physical, among others. The health illness continuum first came into use in 1972, having been introduced by Travis John. Over the years, the ideology has received refinement from later theorists, hence portraying health as a spectrum between optimal wellness and premature death. The trend has subsequently changed the view and understanding of being well and sick, and in its place, focuses on a person’s lifelong and holistic process of growth and adaptation. On the other hand, for nurses and other healthcare professionals, the continuum offers a strong foundation or framework to understand patients, their uniqueness, and hence foster care practices which promote resilience, dignity, and human flourishing. This paper discusses the relevance of the health-illness continuum in patient care, its alignment with the Christian worldview, and reflects on personal health and the exploration of community-based resources to support wellness.

Health-Illness Continuum in Patient Care

The Continuum positions individuals in a spectrum that includes high wellness on one side and premature death on the other.  This in turn identifies with the understanding that individuals may move back and forth on the continuum based on diverse factors such as healthcare access, lifestyle choices, genetics, and environmental conditions, among others (Hansen & Dysvik, 2022). It, in turn, denotes health as non-static but dynamic and multidimensional.

In regard to patient care, the health-illness continuum is key as it frames care professionals’ position and role as more than just diagnosing and treating disease. Instead, care providers are encouraged to develop and implement a preventive and proactive approach that offers support to patients, hence promoting growth and attaining wellness. I.e., a patient diagnosed with hypertension may need more than just medication to include lifestyle change, counseling, and spiritual encouragement. By nurses recognizing where the patient is positioned along the continuum, it is critical to the provision of personalized and realistic care practices, which are also empowering and culturally informed Health Illness Continuum nursing essay assignment.

Additionally, the continuum aligns with the holistic nature of human experience. Different aspects inform patients’ experience and understanding of wellness, including emotions, family setting, personal experiences, histories, and beliefs, all together or individually shape how illness and healing are perceived. Care providers who positively incorporate the continuum into practice are equipped to understand the interplay between the mentioned aspects, hence able to promote well-being and engage their patients actively in the health journeys (American Nurses Association, 2021).

Christian Worldview and Human Flourishing

Understanding of the health-illness continuum also aligns and resonates with the Christian worldview, which, on its part, emphasizes the value, dignity, and worth of every person as he is created in God’s image. Based on this, the continuum is hence not just a technical practice but also a moral calling to care and serve people with integrity, compassion, and respect. It hence reminds care providers that all of their patients, regardless of their position on the whole spectrum, are of value and have the potential to heal and grow.

On the other hand, Christian tradition promotes human flourishing. This is a state in which individuals live with purpose and well-being. By helping their patients move towards wellness, either through physical care, emotional support, or spiritually, healthcare providers participate in the ministry of healing, which also aligns with biblical teachings on loving your neighbor and stewardship (Perkins, 2021).  The framework also calls for nurses to advocate for justice in care delivery, ensuring vulnerable populations receive care that promotes their holistic well-being and dignity.

Personal View on Health and Self-Care

Based on a holistic perspective, my health reflects challenges and strengths. On the physical aspect, I strive to observe a balanced diet while engaging in moderate exercise, which offers support to energy levels and cardiovascular health, among others. Spiritually, there is the practice of prayers and community worship, which provide meaning and resilience in times of challenges. On emotional support, I maintain close relationships with families and friends, hence having a sense of stability and belonging.

However, in some cases, some behaviors are detractors from optimal wellness; these include irregular sleep and lapses in stress management, which place my wellness at the midpoint of the continuum. According to Alnawwar et al. (2023), different evidence-based strategies can be integrated to improve my overall well-being. These include practicing consistent sleep hygiene practices, setting and practicing regular physical activities, and practicing mindfulness, all of which can significantly improve overall well-being (McVeigh et al., 2022).

In summary, presently I can place myself at the moderately healthy side. My stressors and risk factors do not primarily dominate my entire health, but instead denote areas that need self-care. By improving on the practices, I can attain a close position of high-level wellness, hence enhancing my overall health and capacity to care for others.

Resources and Options for Wellness

Different resources are available to support the journey towards greater wellness. Two of these include the local community wellness center, which offers different exercise programs, preventive screening, and nutritional workshops. Based on research, evidence indicates that planned physical activity programs lower risks for chronic diseases, improve sleep quality, and hence enhance one’s overall life quality. By engaging regularly with this resource, there would be key gains in maintaining physical fitness and building one’s accountability towards practicing and maintaining health behaviors.

A second resource is virtual mental health platforms, i.e., telehealth counseling, which ensures availability and accessible support for stress management, hence an integral facet in one’s emotional well-being. According to Luo et al. (2020), online-based CBT practices effectively reduce depression and anxiety, which improves patients’ resilience. In my case, by utilizing these services, I can be assured of positive stress management and coping mechanisms fostering emotional and mental well-being. These two resources complement each other by meeting both physical and psychological aspects of health, hence supporting the move towards wellness at the end of the health-illness continuum. Health Illness Continuum nursing essay assignment

Conclusion

The health-illness continuum offers an indispensable lens for understanding the paradigm of health as a multidimensional and dynamic process. In patient care, the model empowers care providers to accord their patients with care defined by respect for human dignity, aligning with the Christian call and promoting holistic wellness. Reflecting on myself, there is a need to improve my self-care practices, such as sleep and stress management. Integration of diverse resources can be critical in providing support towards the growth and wellness side of the continuum. By embracing the health-illness continuum, there are benefits for patients and care-providing professionals, as it affirms the possibility of wellness at every life stage while promoting comprehensive and compassionate care.

References

Alnawwar, M. A., Alraddadi, M. I., Algethmi, R. A., Salem, G. A., Salem, M. A., & Alharbi, A. A. (2023). The Effect of Physical Activity on Sleep Quality and Sleep Disorder: A Systematic Review. 
Cureus
, 
15
(8), e43595.
https://doi.org/10.7759/cureus.43595

American Nurses Association. (2021).
nursing: Scope and standards of practice
 (4th Ed.). ANA Publishing.

Hansen, B. S., & Dysvik, E. (2022). Expanding the theoretical understanding in Advanced Practice Nursing: Framing the future. 
Nursing forum
, 
57
(6), 1593–1598.
https://doi.org/10.1111/nuf.12827

Luo, C., Sanger, N., Singhal, N., Pattrick, K., Shams, I., Shahid, H., Hoang, P., Schmidt, J., Lee, J., Haber, S., Puckering, M., Buchanan, N., Lee, P., Ng, K., Sun, S., Kheyson, S., Chung, D. C., Sanger, S., Thabane, L., & Samaan, Z. (2020). A comparison of electronically-delivered and face-to-face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis. 
EClinicalMedicine
, 
24
, 100442.
https://doi.org/10.1016/j.eclinm.2020.100442

McVeigh, C., Ace, L., Ski, C. F., Carswell, C., Burton, S., Rej, S., & Noble, H. (2021). Mindfulness-Based Interventions for Undergraduate Nursing Students in a University Setting: A Narrative Review. 
Healthcare (Basel, Switzerland)
, 
9
(11), 1493.
https://doi.org/10.3390/healthcare9111493

Perkins, I. (2021). Human Flourishing in Christ: A Journey of Hope in the Christian Community. 
The Linacre Quarterly
, 
88
(2), 175–183.
https://doi.org/10.1177/0024363920920409
 
 Health Illness Continuum nursing essay assignment

Anti-infectives Patient 2: A 64-year-old male patient presents with reports of headache, fatigue, and a painful red blistery rash on his upper back.

History and Physical

A 64-year-old male patient presents with reports of headache, fatigue, and a painful red blistery rash on his upper back. The patient shares that the area where the rash appeared had been itching and burning for 2 days prior to the appearance of the rash.

On examination, the healthcare provider discovers an erythematous area with maculopapular lesions in a linear formation on the patient’s upper back. As a child, the patient had chickenpox with no complications.

Orders

1020

Acyclovir 800 mg every 4 hours (5 times a day) for 7 days

Rationale:

Potential Complications

Herpes zoster (shingles) 
is characterized by 
an erythematous red rash with maculopapular lesions. Chicken pox manifests as red, raised blister-filled bumps that do not appear in a straight line. Psoriasis appears as thick, silvery scales on the skin. Eczema causes dry, cracked, scaly patches that do not appear in a linear pattern.

 

Actions to Take

Herpes zoster is often treated with acyclovir, an antiviral medication. Extreme caution should be taken when administering acyclovir to patients who have known renal impairment. Acyclovir can minimize the symptoms of herpes zoster. Therefore, pain should be assessed both before and after treatment to monitor the medication’s effectiveness. It is not necessary to perform a skin biopsy or allergy testing to diagnose herpes zoster. CBC values are not required before administering acyclovir.

 

Patient Education

Neuropathy is an adverse effect of acyclovir and should be reported to the healthcare provider immediately. To minimize acyclovir’s side effect of nausea, the medication can be taken with food. Acyclovir does not interfere with birth control or cause dizziness on rising. Weaning off acyclovir is not required.

Anti-infectives Patient
2: A 64-year-old male patient presents with reports of headache, fatigue, and a painful red blistery rash on his upper back.

Vaginal candidiasis –
A 24-year-old female patient presents
at the healthcare provider’s office with the primary report of itching and burning in the vaginal area.

A 24-year-old female patient presents at the healthcare provider’s office with the primary report of itching and burning in the vaginal area.

History and Physical

A 24-year-old female patient presents at the healthcare provider’s office with the primary report of itching and burning in the vaginal area. The patient shares that she has had a thick, white vaginal discharge for the past 4 days. The patient also claims to have had a sinus infection a week ago and to have just finished an antibiotic. The sinus infection has resolved. The patient has only had one sexual partner and takes oral contraceptives.

Upon examination, the healthcare provider notices that the vagina and vulva areas are red, with a cottage-cheese–like, odorless discharge.

Nurses’ Notes

1035:
 Patient presents with report of itching and burning in the vaginal area. In addition, she shares that she has had a thick, white vaginal discharge.

1050: 
Healthcare provider orders fluconazole.

Orders

1050

Fluconazole 150 mg orally one-time dose

So close!

Rationale:

Potential Conditions

Vaginal candidiasis (yeast infection) presents with itching, burning, or irritation, along with a white, odorless, cottage-cheese–like discharge from the vagina. Trichomoniasis, bacterial vaginosis, or chlamydia do not present with a thick, white, cottage-cheese–like discharge.

 

Actions to Take

Fluconazole is an antifungal medication that is often used to treat vaginal candidiasis. Precautions should be taken when administering fluconazole to those pregnant or breastfeeding. In addition, fluconazole is 
not recommended for people 
who are hypersensitive to any of the antifungal azole drugs. An ECG or a vaginal culture is not needed before treating vaginal candidiasis with fluconazole. Oral contraceptives do not interact or interfere with fluconazole.

 

Patient Education

Patients should be advised to take fluconazole with food to avoid gastrointestinal issues. Hepatotoxicity is an adverse reaction to fluconazole, and patients should learn to recognize symptoms of hepatotoxicity. Oral contraceptives do not interact with fluconazole so the patient should not be advised to refrain from using birth control for 7 days. There is no need to avoid citrus foods or acetaminophen while taking fluconazole. Blood pressure does not need to be monitored while taking fluconazole.

Anti-infectives – The patient is a 20-year-old man who presents to the clinic today for a follow-up with the pulmonologist after being diagnosed with tuberculosis (TB) of the lungs as a result of infection with Mycobacterium tuberculosis 3 weeks ago

Anti-infectives – Patient 1

Patient Data

History and Physical

The patient is a 20-year-old man who presents to the clinic today for a follow-up with the pulmonologist after being diagnosed with tuberculosis (TB) of the lungs as a result of infection with 
Mycobacterium tuberculosis
 3 weeks ago. A positive purified protein derivative (PPD) resulted in a chest x-ray, which revealed active TB. After 2 weeks in the hospital, the patient returned home, and directly observed therapy (DOT) is being delivered by the public health nurse daily. Patient’s weight is 160 lb. (72.73 kg).

The DOT LPN collaborates with the organization RN to prepare a care plan for the patient.

 

Nurses’ Notes

 

Directly Observed Therapy (DOT) Notes

Day 1
: Medications administered. Patient reports no side effects from the medication. Patient reports slight cough persists.

Day 2
: Medication administered. No reports of side effects.

Day 3
: Medication administered. No reports of side effects. Patient shares frustration with the need to take so many medications daily. Patient’s frustrations acknowledged.

Day 4
 Medication administered. No reports of side effects. Patient reports feeling much better. Cough has resolved. Appetite returned.

Day 5
: Medication administered. No reports of side effects. Patient shares that he cried today, and his tears were red. Education provided.

Day 6
: Medication administered. No report of side effects. Patient expresses desire to drink alcohol. Shares that he drank 1-3 beers every night before diagnosis. Education provided.

 

Laboratory Results

Test

Value

Reference Range

Bilirubin

6.2

5.1 to 17 μmol/L

Alkaline phosphatase

60

30 to 120 U/L

Aspartate transaminase

38

0 to 35 U/L

Alanine transaminase

36

4 to 36 U/L

Gamma-glutamyl transpeptidase

18

Male and female age 45 years and older: 8 to 38 units/L (8 to 38 international units/L)

Female younger than age 45 years: 5 to 27 units/L (5 to 27 international units/L)

Albumin

4.2

3.5 to 5 g/dL

Prothrombin time

11.9

11.0 to 12.5 seconds

 

Flow Sheet

Initial Vital Signs:

T 97.8 ⁰F (36.5 ⁰C)

HR 74 beats/min

RR 16 breaths/min

BP 128/66 mm Hg

 

Orders

 

1105

Isoniazid 300 mg PO daily

Rifampin 600 mg PO daily

Pyrazinamide 1500 mg PO daily

Ethambutol 1200 mg PO daily

 

Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.

That’s right!

 

Rationale:

Hepatotoxicity is a risk with antitubercular medications. Regular alcohol consumption can cause liver inflammation. Patients who consume alcohol while taking antitubercular medications are more likely to develop hepatotoxicity. Citrus foods have no effect on antitubercular medications. Rifampin causes reddish orange secretions (including tears) and excretions; however, this side effect is not harmful to the patient. Because alcohol consumption increases the risk of hepatotoxicity with all antitubercular medications, it would not necessitate a medication change.

Anti-infectives – The patient is a 20-year-old man who presents to the clinic today for a follow-up with the pulmonologist after being diagnosed with tuberculosis (TB) of the lungs as a result of infection with Mycobacterium tuberculosis 3 weeks ago