Tag: Clinical-Nursing

Family structures discussion NRS-429VN Topic 2 DQ 1

What is a definition of family that encompasses the different family structures prevalent today? Discuss the importance of acknowledging nontraditional family structures. Explain how family systems theory can be used to better understand the interactions of a modern family (traditional or nontraditional).

Re: Topic 2 DQ 1

What is a definition of family that encompasses the different family structures prevalent today?The definition of a family that encompasses the different family structures in modern times is the family of choice. According to Green (2018), this type of family is unique in that the individual chooses the individual to care, love and trust for them rather than their family or origin.Discuss the importance of acknowledging nontraditional family structures Family structures discussion NRS-429VN Topic 2 DQ 1.It’s important for the nurse to acknowledge the non- traditional family structure so that health promotion can be implemented according to their family structure. The concerns of a nontraditional family might be different than a traditional family unit. As mentioned in the chapter on health promotion, for the nurse to understand what “family,” is, it’s important to assess so that proper interventions can be placed (Green, 2018). Proper assessment of the family structure of the individual will aid the nurse to promote health and behavioral changes. It’s also important to note that an individual’s illness affects the family’s health as well. The family unit can have a negative or positive impact on each other.

Explain how family systems theory can be used to better understand the interactions of a modern family (traditional or nontraditional)

The family systems theory can be used when interacting with any type of family whether traditional or non-traditional as the approach is the same. In family systems theory, the family is a whole and each member of the unit affect each other. The family member is independent, has personal goals, roles, functions, and individual characteristic, but is interdependent of the family unit. Understanding the importance of each person in the patient’s family unit is crucial to engage the family in promoting changes to improve health outcomes Family structures discussion NRS-429VN Topic 2 DQ 1. The family systems theory helps to aid the Nurse in health promotion to understanding the patient’s behaviors. Among family systems theories the main theme is that they all empower the individual to make decisions that will make them feel valued, loved, and accepted. Individual want others attention, approval, and support as well as feel connected to their family unit. The family unit is an emotional unit that is very emotionally connected (Devlin, 2021).

References

Devlin, K. (2021). Family Systems Theory Definition & What is it? Retrieved October 11, 2021from 
https://www.regain.us

Green, S.Z. (2018). 
Health Promotion: Health and Wellness Across the Continuum. 
Retrieved from

URL:
https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/health-promotion_health-and-wellness-across-the-continuum_1e.php
sample 2

Family systems is defined as “The theory that has every individual or subsystem of relatives or system influences other parts of the system; therefore, a person can’t be studied apart from the family.” (Edelman et al., 2014). So, a standard family might be, a family that has parents male and female and offspring inhabitation with the identical ancestry as a social or grouping, which is traditional. Now nontraditional can consist of a pair and their children is now, families are more complex, multicultural, and dynamic unit consisting of legal, biological, or emotionally linked parents and kids. it’s important to include nontraditional families because family is a component of the care process, as their involvement and opinions often help and encourage the patient to succeed in treatment. The family dynamic plays a will be a template an give the nurse insight about the patient and members of the family and using knowledge about values, beliefs, and cultural background to boost the delivery of care and corresponding plans. Families are invited to figure alongside healthcare leaders to partake in everything from the advancement and implementation of programs to the delivery of care. Especially during time when home health is being turn over to families more delivering care Family structures discussion NRS-429VN Topic 2 DQ 1.

Edelman, C. L., Kudzma, E. C., & Mandle, C. L. (2014). 
Health 
p
romotion 
t
hroughout the 
l
ife 
s
pan
 (8th ed.). St. Louis, MO: Elsevier Mosby.

Wright, Lorraine M, and Maureen Leahey. 
Nurses and Families A Guide to Family Assessment and Intervention : A Guide to Family Assessment and Intervention
, F. A. Davis Company, 2012.
 ProQuest Ebook Central
, http://ebookcentral.proquest.com/lib/gcu/detail.action?docID=1069220.

Created from gcu on 2021-10-12

Green, S. Grand Canyon University (Ed). (2018). 
Health promotion: Health & wellness across the continuum.
Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/

sample 3

Re: Topic 2 DQ 1

Family is a collection of folks that are associated through blood or via marriage. Family now no longer best includes best own circle of relatives however additionally buddies who’re near us and that they too come to be our own circle of relatives. In modern there are numerous kinds of devices found in our society.

The U.S. Census Bureau (2015) considers own circle of relatives to be the ones dwelling in a housing unit associated with the aid of using birth, marriage, or adoption; however, those definitions of own circle of relatives with the aid of using bloodline or family can’t embody the additives of contemporary-day families, main to a number of terminology in use Family structures discussion NRS-429VN Topic 2 DQ 1.

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The family structures approach to people and their houses provides a way to better understand the interactions of a society own circle of relatives unit (Huffman, Mathews, & Irving, 2017). Family members have an impact on each other as well as their own circle of relatives as a whole. The own circle of relatives is categorized as a whole machine of interacting and interdependent own circle of relatives participants, as well as man or woman participants (Huffman et al., 2017). Family structures speak within to the person or girl subsystems and out of doors the appliance with even massive structures or suprasystem that embody the community or community. One instance is Bowen’s own circle of relatives structures plan or model, whole} totally on trendy structures idea, could be a ancient technique to analyzing own circle of relatives techniques and issues (Bitter & Carlson, 2017; Yoder, Ruch, & Hodge, 2016).

According to Dr. Bowen’s Family Theory and Study, even for disconnected family members, Bowen’s Family Systems Theory suggests that the family unit or family center in general always has a profound impact on their emotions. and their actions. Although the degree of interdependence may vary between different families depending on the functioning of their family emotional system or unique family center or human relationship systems, all families have some level of interdependence among family members. their family. Understanding family conditions and theory help the nurses to talk and communicate to the families. Cause families are important to patient Family structures discussion NRS-429VN Topic 2 DQ 1

References:

Green, S. (2018). 
CCC Web Books by AWS & CDD
. Gcumedia.com. https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/4 Family structures discussion NRS-429VN Topic 2 DQ 1

cluster headache essays

Module 11: Discussion

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Bob, a 38 year old male, has been experiencing severe intermittent headaches for about 10 years. When they occur, he experiences intense burning pain on one side of his head, tearing in his eye, congestion and a runny nose. These headaches generally occur several times a day and last approximately one hour. The headaches are episodic; Bob can be headache free for several months but then experience an attack.

Based on the case scenario, provide a diagnosis for Bob. Provide the pathophysiology for this type of headache and discuss current treatment options.

Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to grading rubric for online discussioncluster headache essays.

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Candice Russell posted Mar 30, 2021 5:09 PM

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            “Headache is a common neurologic disorder and is usually a benign symptom” (Boss & Huether, 2020, p. 400). There are times when headaches are associated with serious illness or disease. “Headaches can be so severe that patients and doctors often fear life-threatening underlying cerebral pathologies” (Michl & Michl, 2017, para. 1). There are many different types of headaches, chronic headaches can occur constantly, for many days out of the month. “The constant nature of chronic daily headaches makes them one of the most disabling headache conditions” (Mayo Clinic, 2019). Trigeminal autonomic cephalalgia (TAC) is a primary headache disorder “characterized by pain in the distribution of the first division of the trigeminal nerve in parallel with cranial autonomic features on the same side of the head” (Ljubisavljevic & Jasana, 2019, p. 1059). Cluster headaches (CH) are said to be the most common TAC, “headaches involving the autonomic division of the trigeminal nerve” (Boss & Huether, 2020, p. 401). Cluster headaches are one of the most studied forms of TAC, however, “the pathophysiology of cluster headache is complex and the underlying mechanisms are not fully elucidated” (Wei et al., 2018, para. 11). Neurovascular and chronobiological headache disorder, TAC can be broken down into three major features: trigeminal pain, rhythmicity (particularly in cluster headache), and autonomic signs. Various structures within the peripheral nervous system and central nervous system (CNS) are associated with the causation of CH.Figure 1(Wei et al., 2018) documents a detailed description of the pathophysiology in CH:Due to the severe pain caused by CH, it has earned the nickname “suicide headache”, “and a suicidal risk exists in this condition” (Rozen & Fishman, 2012, as cited by Rossi et al., 2018, p. 57). CH can have a rapid onset without warning, some individuals experience aura and nausea. Some common symptoms include rapid intense pain, usually one-sided head pain, restlessness, tearing, eye redness on the affected side, nasal congestion and runny nose on the affected side, sweating of the face or forehead on the affected side, eye swelling of the affected side. Pallor and dropping of the eye on the affected side may be present, pain is usually continuous. Men between the ages of 20 and 50 are more commonly affected. Episodic headaches may alternate sides, severe stabbing and throbbing pain may be present (Boss & Huether, 2020, p. 401) cluster headache essays. Individuals typically experience 1-3 headaches a day, however, as many as 8 attacks are possible. Another nickname earned by CH is “alarm clock headaches”, as they are linked to circadian rhythm. Attacks can happen around the same time each day, nighttime attacks can be more severe than daytime attacks. CH attacks can last from minutes to hours, for several days, followed by remission.  Huether, S. E., McCance, K. L., & Brashers, V. L. (2020). 
Understanding pathophysiology / Sue E. Huether, Kathryn L. McCance ; section editor, Valentina L. Brashers
 (7th ed.). Elsevier.Ljubisavljevic, S., & Jasna, Z. T. (2019). Cluster headache: pathophysiology, diagnosis and treatment.
 Journal of Neurology, 266
(5), 1059-1066. http://dx.doi.org.wilkes.idm.oclc.org/10.1007/s00415-018-9007-4Michl, M., & Michl, G. M. (2017). headaches.
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View profile card for Amandeep Kaur

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 by Amandeep Kaur

Wei, D. Y., Yuan Ong, J. J., & Goadsby, P. J. (2018). Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. 
Annals of Indian Academy of Neurology
, 
21
(Suppl 1), S3–S8. https://doi.org/10.4103/aian.AIAN_349_17

Rossi, P., PhD., Little, P., De La Torre, Elena Ruiz, & Palmaro, A., PhD. (2018). If you want to understand what it really means to live with cluster headache, imagine… fostering empathy through European patients’ own stories of their experiences.
 Functional Neurology, 33
(1), 57-59. https://wilkes.idm.oclc.org/login?url=https://www-proquest-com.wilkes.idm.oclc.org/scholarly-journals/if-you-want-understand-what-really-means-live/docview/2045245091/se-2?accountid=62703

Mayo Foundation for Medical Education and Research. (2019, April 9). 
Chronic daily headaches
. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891 cluster headache essays.

Hoffmann, J., & May, A. (2018). Diagnosis, pathophysiology, and management of cluster headache.
 The Lancet Neurology, 17
(1), 75-83. http://dx.doi.org.wilkes.idm.oclc.org/10.1016/S1474-4422(17)30405-2 cluster headache essays

Reference:

            Based on symptoms and hx described by our patient, a diagnosis of Cluster Headaches seems appropriate. There is no existing cure for cluster headaches. The goal of treatment is to reduce pain, decrease the time of each headache and prevent CH attacks (Mayo Clinic, 2019). Acute treatment includes oxygen therapy, administration of triptans, octreotide, the use of local anesthetics, and administration of dihydroergotamine. Each of the treatment options has varying effects on CH. For individuals with new-onset cluster headaches, preventive measures are available.  Preventive measures, which should be implemented at the onset of CH episodes. The goal of preventive therapy is to suppress attacks (Mayo Clinic, 2019). Some prevention treatment includes the use of CCB, corticosteroids, Lithium carbonate, and administration of nerve blocking agents. Surgery is rarely used, however, may be recommended for those suffering from chronic cluster headaches who experience no relief from other forms of treatment. Lifestyle modifications may be effective in avoiding attacks.

Pain afferents from the trigeminovascular system traverse the ophthalmic division of the trigeminal nerve, taking signals from the cranial vessels and dura mater (shown by purple fibers). These inputs synapse in the TCC and project to higher brain structures such as the thalamus (T) and cortex resulting in pain perception (shown in blue fibers). Activation of the trigeminovascular system by stimulation of dural structures also causes neuronal activation in the SSN within the pons, which is the origin of cells for the cranial parasympathetic autonomic vasodilator pathway cluster headache essays. There is subsequent activation of this parasympathetic reflex through the outflow from the SSN and is relayed through the SPG (shown by pink fibers), but also through the facial (VII
th
 cranial) nerve (not shown). Activation of both trigeminal and autonomic nerves defines the trigeminal autonomic reflex arc, which is integral to the pathophysiology of cluster headache and the other TACs. The HT is functionally connected to the ipsilateral trigeminal system and other brain areas of the pain matrix. Red dashed lines indicate the pathways by which the HT controls or triggers pain. A third-order sympathetic nerve lesion thought to be caused by vascular changes to the ICA in the cavernous sinus with subsequent irritation of the local plexus of nerve fibers, can give rise to sympathetic symptoms (incomplete Horner syndrome). (Wei et al., 2018, para. 11)

For a sequence of attacks to take place, three key structures need to interact: the trigeminovascular system, the parasympathetic nerve fibers (trigeminal autonomic reflex), and the hypothalamus. Only if all three systems are involved can cluster headache attacks be initiated, and subsequently cortical areas of the CNS—known to be involved in the processing and perception of pain—will be activated. (Hoffmann & May, 2018, p. 77)

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Hilary Szpara posted Mar 30, 2021 8:12 PM

Contains unread posts cluster headache essays.

Based on the case scenario, I would diagnose Bob with cluster headaches. Cluster headaches are characterized by being unilateral, last on average 45 minutes to 90 minutes, happen multiple times during the day, and often include eye discomfort and nasal symptoms such as congestion and/or runny nose (Wei et al., 2018). There are many other symptoms of cluster headaches including aural fullness, throat swelling. Flushing, agitation and restlessness, and ptosis (Wei et al., 2018). The pathophysiology of cluster headaches is complex and not fully understood. They are neurovascular headaches, rather than vascular headaches. Vascular cerebral changes that occur are driven by the effects of trigeminal-autonomic reflex activation (Wei et al., 2018). The cranial autonomic symptoms that arise during cluster headaches, come from the reflex activation of the trigeminal-autonomic reflex pathway through parasympathetic outflow which results in vasodilation and parasympathetic activation (Wei et al., 2018). Due to the clinical presentation of cluster headaches, some believe that the hypothalamus may be involved and that cluster headaches occur more often when the clocks change during daylight savings, which suggests and inability to synchronize internal circannual pacemaker with external environmental light cues (Wei et al., 2018). Since cluster headaches come on quickly and don’t last long, they require fast-acting treatment. The acute treatment drugs of choice are currently subcutaneous sumatriptan and/or high flow oxygen (Brandt et al., 2020). Sumatriptan is thought to be the most effective abortive treatment, with pain relief occurring in 75% of patients within 15 minutes (Brandt et al., 2020). There are also prophylactic treatments available, including verapamil, lithium, and topiramate (Brandt et al., 2020). These pharmacologic treatments require more research but have so far found to be effective in preventing cluster headache attacks.Brandt, R. B., Doesborg, P., Haan, J., Ferrari, M. D., & Fronczek, R. (2020). Pharmacotherapy for Cluster Headache. 
CNS drugs
, 
34
(2), 171–184. https://doi.org/10.1007/s40263-019-00696-2Wei, D. Y., Yuan Ong, J. J., & Goadsby, P. J. (2018). Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. 
Annals of Indian Academy of Neurology
, 
21
(Suppl 1), S3–S8. https://doi.org/10.4103/aian.AIAN_349_17less1 UnreadUnread3 ViewsViews cluster headache essays

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 by Steven Bartos

Cluster Headaches
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Aina Oluwo posted Mar 31, 2021 11:20 AM

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Headaches are generally known to be benign but when it becomes more persistent it is associated with chronic conditions. Based on the few symptoms being experienced by this patient, a diagnosis to consider will be cluster headache (CH). According to Huether et al., (2017), cluster headaches occurs primarily in men between ages 20 and 50 years of age. It occurs in breaks throughout the day and lasts minutes to hours. It is also associated congestion of the mucosa, tearing of the eye and unilateral intense pain. All these symptoms are currently being experienced by Bob. CH is characterized by an alternation of excruciatingly painful attacks and pain‐free periods (Pohl et al., 2020). The recommended treatments are based on an update to the 2010 American Academy of Neurology (AAN) review. Robbins et al., (2016) illustrated the treatment plan for acute CH and maintenance. Acute treatment involves subcutaneous sumatriptan, zolmitriptan nasal spray, high flow oxygen and newly introduced sphenopalatine ganglion stimulation which is not currently practiced in the US. Lithium and verapamil are considered the best for maintenance and prophylactic management of CH.Barloese, M., Jürgens, T., May, A., Lainez, J., Schoenen, J., Gaul, C., Goodman, A., Caparso,stimulation: Experiences in chronic cluster headache patients through 24 months.
 Journal
Pohl, H., Gantenbein, A., Sandor, P., Schoenen, J., & Andrée, C. (2020). Interictal burden ofbased, cross-sectional study of people with cluster headache. 
Headache
, 60(2), 360-369.Robbins, M., Starling, A., Pringsheim, T., Becker, W., & Schwedt, T. (2016). Treatment ofguidelines.
 Headache, 56
(7), 1093-1106. 
https://doi.org/10.1111/head.12866
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View profile card for Hilary Szpara

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April 4 at 9:14 PM
 by Hilary Szpara

cluster headache: The american headache society Evidence‐Based

https://doi.org/10.1111/head.13711

cluster headache: Results of the EUROLIGHT cluster headache project, an internet-

of Headache and Pain, 17
(1), 1-8. 
https://doi.org/10.1186/s10194-016-0658-1

A., & Jensen, R. (2016). Cluster headache attack remission with sphenopalatine ganglion

References

The pathophysiology can be attributed to activation of a trigemino-autonomic reflex that is mediated through the sphenopalatine ganglion (SPG). The SPG connects directly and indirectly with the hypothalamus, superior salivatory nucleus (SSN), trigeminovascular system, meninges, and somatic and autonomic nerves innervating cranial structures (Barloese et al., 2016).

Module 11
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Joanne Hogan posted Mar 30, 2021 4:37 PM

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Module 11Cluster headache is considered one of the more rare headache disorders, only affecting roughly 0.1% of the population and typically affects males more than females (Ljubisavljevic & Trajkovic, 2018). People who suffer from cluster headache typically have an increased level of calcitonin gene related peptide (CGRP) (Ljubisavljevic & Trajkovic, 2018). Not enough is known regarding the mechanism of CGRP to know the specifics regarding why this causes cluster headache, but this is generally what therapy is targeted to in treatment (Buture et al., 2019). Most research suggests that the parasympathetic nervous system goes into a type of overdrive and causes disturbances in the hypothalamus which leads to vasodilation (Ljubisavljevic & Trajkovic, 2018).   Ljubisavljevic, S., & Trajkovic, J. Z. (2018). Cluster headache: Pathophysiology, diagnosis and treatment. 
Journal of Neurology
, 
266
(5), 1059–1066. 
https://doi.org/10.1007/s00415-018-9007-4
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View profile card for Tallona Boddy

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 by Tallona Boddy

Buture, A., Boland, J. W., Dikomitis, L., & Ahmed, F. (2019). Update on the pathophysiology of cluster headache: Imaging and neuropeptide studies. 
Journal of Pain Research
, 
Volume 12
, 269–281. 
https://doi.org/10.2147/jpr.s175312

References

High flow oxygen is typically used for patients who are in the midst of an attack and often times reduces the need for rescue medications as traditional rescue medications can be ineffective in providing comfort (Ljubisavlejevic & Trakjovic, 2018). Triptans can be useful in the midst of an attack if parentally administered but does not always work effectively so the main goal in treatment of cluster headaches lies with preventative treatment (Ljubisavelejevic & Trakjovik, 2018). Preventative treatment includes corticosteroids which has been proven effective in reducing the reoccurrence of the frequency of attacks and lithium or verapamil can be effective in reducing the frequency of attacks in patients who suffer from chronic cluster headaches (Ljubisavelejevic & Trakjovik, 2018).

Based on the information given in the case study this week, Bob appears to be suffering from cluster headaches. According to Ljubisavljevic & Trajkovic (2018), cluster headache is noted to be severe pain that occurs unilaterally to either the orbital, supraorbital, or temporal area. The duration of pain can last anywhere from 15 minutes to up to 3 hours and can occur up to 8 times a day in some cases (Buture et al., 2019). Cluster headache effects trigeminal nerve and is the most common type of trigeminal autonomic cephalgia headache disorders (Ljubisavljevic & Trajkovic, 2018). Like Bob, people who suffer from cluster headache can have rhinorrhea, nasal congestion, and ptosis alongside the severe unilateral pain (Buture et al., 2019). Additional symptoms include eyelid edema, agitation, and facial sweating (Buture et al., 2019) cluster headache essays.

Bob
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Tallona Boddy posted Mar 30, 2021 6:43 PM

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Bob most likely is experiencing a cluster headache. A cluster headache can occur unilaterally, it can last for 15 minutes to 3 hours.  Runny nose, excessive tearing and restlessness are all signs and symptoms of a cluster headache. Episodes of recurrent headaches throughout the day can happen for days, weeks or months at time. Cluster headaches can have periods of no signs or symptoms, this can last for up to 12 months at a time. The cause of cluster headaches is not yet known, a current theory is a disruption in the body’s hypothalamus as a contributing factor (Mayo Clinic, 2019). 
References
University of Michigan Medicine. (4 August, 2020). 
Medicines for cluster headaches
. 
https://www.uofmhealth.org/health-library/abk7653
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View profile card for Dennies Jones

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Mayo Clinic. (04 June, 2019).
 Cluster headaches
. 
https://www.mayoclinic.org/diseases-conditions/cluster-headache/symptoms-causes/syc-20352080

High-flow oxygen has been shown to stop a cluster headache for seven out of 10 people, within 15 minutes. Triptans can be used via injection, oral, or nasal spray, for relief of the pain and pressure from a cluster headache. Lithium has been shown to help prevent cluster headaches. Ergotamine can be used at night to prevent cluster headaches. Opioids are not recommended for use to alleviate a cluster headache (University of Michigan Medicine, 2020).  Understanding the person’s severity and pattern of their cluster headaches will help the provider determine the best medication regimen.

Week 11 Discussion Post – Cluster Headaches
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Gisselle Mustiga posted Mar 30, 2021 8:05 PM

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The symptoms experienced by the patient are an indication of cluster headaches. The disease is associated with symptoms that include strictly unilateral headaches, excruciating pain precisely on one side of the head, commonly referred to as proximal hemicrania (Huether et al. 2020). The headaches are short-lasting, typically lasting from minutes up to one hour. There is also a recurrence of headaches during the day. A patient also may have redness of the face and nasal congestion. Other symptoms are autonomic, which entails lacrimation. Tearing and ptosis of the eye on the affected side is also another indication. The disease is prevalent in males. The descriptions in the case study match cluster headaches symptoms. As such, the client should be given urgent medical attention to counter its effects.
References
Huether, S. E., McCance, K. L. & Brashers, V. L. (2020). 
Understanding  
May, A., Schwedt, T. J., Magis, D., Pozo-Rosich, P., Evers, S., & Wang, S. J. (2018). Cluster headache. 
Nature Reviews Disease Primers
, 
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View profile card for Candice Russell

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April 4 at 6:18 PM
 by Candice Russell

     Pathophysiology 7
th
 ed. 
 Elsevier Mosby.

Hoffmann, J., & May, A. (2018). Diagnosis, pathophysiology, and management of cluster headache. 
The Lancet Neurology
, 
17
(1), 75-83.

Cluster headaches are associated with regions of the brain, specifically the hypothalamus. Abnormal activity of this region causes both pain and autonomic symptoms. The pain is also a result of the release of vasoactive substances and neurogenic inflammation formation (May et al., 2018). The other key player is the trigeminovascular system which induces episodic headaches. For the treatment, abortive drugs like triptans and sumatriptan are used since they are the most effective in countering the consequences of the symptoms (Hoffmann & May 2018). To prevent a recurrence, verapamil and lithium carbonate should be administered. However, the clinician should be worried about the side effects. In a case where the side effects are adverse, topiramate is considered the preventative drug. For transitional treatment, the acute attacks are managed with oxygen inhalation, and occipital nerve stimulation. Patients have an important role to play by adopting a regular sleep schedule and avoiding alcohol intake.

Bob’s cluster headaches
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Jennifer Bryant posted Mar 31, 2021 12:45 AM

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Bob’s symptoms meet the International Classification of Headache Disorders classification for cluster headaches. Diagnostic criteria include more than 5 attacks, severe unilateral pain, lacrimation, congestion and frequency occurring between one every other day and 8 per day (IHS, 2018). The duration of 10 years of episodic episodes would put Bob at 28 for age of onset. Typical age of onset is 20-40 and men are afflicted three times often than women (IHS, 2018).ReferencesInternational Classification of Headache Disorders, 3rd edition. 
Cephalalgia
 
38
, 1–211.headache, 
The Lancet Neurology, 
17(1) 75-83.May, A., Schwedt, T., Magis, D., Pozo-Rosich, P., Evers, S., Wang, S.J. (2018). Clusterless1 UnreadUnread3 ViewsViews

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headache. 
Nat Rev Dis Primers
 
4
. https://doi.org/10.1038/nrdp.2018.6

https://doi.org/10.1016/S1474-4422(17)30405-2.

Hoffmann, J & May, A., (2018) Diagnosis, pathophysiology, and management of cluster

Headache Classification Committee of the International Headache Society (2018). The

The pathophysiology of cluster headache is not fully understood but includes alterations in both the central and peripheral nervous systems, including activation of the trigeminovascular system (May et al, 2018). Treatment options include management of acute attacks, prophylaxis and trigger avoidance. Triptans, oxygen and lidocaine are effective in aborting acute attacks (Hoffman & May, 2018). Prevention has been effective with verapamil and lithium (Hoffman & May, 2018). Future treatments include clinical trials for monoclonal antibodies and botulinum toxin and other medications suggest effectiveness in uncontrolled trials (Hoffman & May, 2018) cluster headache essays.

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Melissa Morgan posted Mar 27, 2021 9:46 PM

The patient in this case study, Bob, is experiencing cluster headaches. According to Huether, et al., this type of headache occurs primarily in men who are 20-50 years old, has a rapid onset, can last for minutes to hours and up to 8 attacks per day, and patients can experience lacrimation and rhinorrhea (2020). The patient who has cluster headaches can experience spontaneous remission, which Bob is noted in the case study to have also. 
Treatment. 
Cluster headaches affect only about 1% of the population, but it represents one of the most painful conditions (Kingston & Didick, 2018).
 
Treatment for this disorder includes prophylactic drugs; avoidance of triggers; and managing acute attacks with oxygen inhalation, sumatriptan, or inhaled ergotamine administration, and nerve stimulation (Huether, et al., 2020). Delivering oxygen via a nonrebreather face mask has been shown to be an effective treatment (Kingston & Didick, 2018). A drawback to using oxygen is that it can be cumbersome for people to carry oxygen around all day. However, unlike triptans, there is no set limit of how many times a person can use oxygen, especially for those who experience multiple attacks per day. Preventative drugs used to treat cluster headaches are verapamil and lithium. They are the most widely used in first-line preventive treatment, and if they are not effective or contraindicated then topiramate can be used (Brandt, et al., 2020).  Brandt, R. B., Doesborg, P., Haan, J., Ferrari, M. D., & Fronczek, R. (2020). Pharmacotherapy for Cluster Headache. 
CNS drugs
, 
34
(2), 171–184. https://doi.org/10.1007/s40263-019-00696-2Kingston, W. S., & Dodick, D. W. (2018). Treatment of Cluster Headache. 
Annals of Indian Academy of Neurology
, 
21
(Suppl 1), S9–S15. https://doi.org/10.4103/aian.AIAN_17_18less0 UnreadUnread

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View profile card for Gisselle Mustiga

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April 3 at 5:53 PM
 by Gisselle Mustiga

Huether, S., McCance, K., and Brashers, V. (2020).  
Understanding Pathophysiology
 (7
th
 ed.).  Elsevier

References

Pathophysiology. 
Cluster headaches involve the autonomic division of the trigeminal nerve and are one of a group of disorders called trigeminal autonomic cephalalgias (Huether, et al., 2020). The mechanism for trigeminal activation is unknown, but “The pathogenic mechanism for pain is related to the release of vasoactive substances and the formation of neurogenic inflammation” (Huether, et al., 2020, p. 401). This disorder is characterized by sympathetic underactivity and parasympathetic activation with unilateral trigeminal distribution and ipsilateral autonomic manifestations (Huether, et al., 2020).

Module 11, Eleany Yasein
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Eleany Yasein posted Mar 31, 2021 12:17 PM

Contains unread posts cluster headache essays

          Based on the symptoms that are described, Bob is experiencing cluster headaches. Cluster headaches are rare, but are considered one of the most severe types of headache (Kandel & Mandiga, 2020). Cluster headaches are described as a unilateral headache that can happen anywhere from every other day, to eight times a day. Although they occur mainly during night time, they also occur around the same time during the day as well. There is not a clear understanding of cluster headaches, but there are different research studies suggesting the root of this headache. Trigeminovascular system and the parasympathetic nerve fibers are involved. There is a defect in the central pathway that controls pain and dysregulation in the autonomic nervous system. The supraspinal control of pain does not function normally and cognitive processing is affected. Studies also state that there is a dysfunction of intracellular signaling pathways of neurotransmitters, ion channels, and inflammation related molecules (Kandel & Mandiga, 2020).ReferenceWei, Y. D., Yuan Ong, J. J., & Goadsby, J. P. (2018, April). Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. 
Annals of Indian Academy of Neurology
, 
21
(1), S3–S8. 
https://doi.org/10.4103/aian.AIAN_349_17
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View profile card for Jazmin Jerez-Rivera

Last post 
April 3 at 4:44 PM
 by Jazmin Jerez-Rivera

Kandel, A. S., & Mandiga, P. (2020, June 30). Cluster Headache. 
StatPearls. 
https://www.ncbi.nlm.nih.gov/books/NBK544241/

Moreover, there is activation of the posterior hypothalamus during cluster headache attacks (Wei et al., 2018). The involvement of the hypothalamus provides support for clinical presentation and treatments (Wei et al., 2018). Acute treatment for cluster headaches includes 100% oxygen therapy, triptans, intranasal lidocaine, octreotide and ergotamine (Kandel & Mandiga, 2020). Preventative treatments include verapamil, lithium, valproic acid and oral steroids (Kandel & Mandiga, 2020).  Electrical stimulation including deep brain stimulation of the hypothalamus has also been effective (Wei et al., 2018).

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Amandeep Kaur posted Mar 29, 2021 12:19 PM

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Based on the case scenario one can infer that Bob’s symptoms are consistent with cluster headaches. Cluster headaches have a clinical manifestation of severe unilateral pain, with agitation and restlessness (Wei et al., 2018) cluster headache essays. These attacks can last anywhere from 15 minutes to a couple of hours, up to eight times a day. These headaches can also cause eye redness, tearing and discomfort, nasal congestion, aural fullness, throat swelling, and flushing. These types of headaches occur predominantly in males, age of onset being 20-49 years old. The pathophysiology of these headaches is not fully understood. The symptoms and imaging lead to the theorization that the hypothalamus may be involved (Blanda, 2021). This is due to the nature of the attacks being intermittent and the hypothalamus controls circadian rhythm (biologic clock). There is also involved with central disinhibition of the nociceptive and autonomic pathways, specifically the trigeminal nociceptive pathways. Vascular dilation is also cited as possible causation for these headaches; however, studies show inconsistent results. The extracranial blood flow is increased but only after the initiation of pain. These cluster headaches also seem to initiate after the release of histamines, antihistamines have no effect in stopping these headaches. There are two forms of treatment for these headaches, symptomatic and prophylactic. Symptomatic treatments can include administration of oxygen, anesthetics, etc. NSAIDs have proven to give some pain relief in these headaches. Galcanezumab is one drug that has gotten FDA approval for prophylactic usage. It is cited to decrease the frequency of these headaches. Depending on the individual there are procedures that can be performed on the trigeminal nerve or the autonomic pathways. These include alcohol injections or even avulsion of nerves for chronic refractory cases.Wei, D. Y., Yuan Ong, J. J., & Goadsby, P. J. (2018). Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. 
Annals of Indian Academy of Neurology
, 
21
(Suppl 1), S3–S8. https://doi.org/10.4103/aian.AIAN_349_17 less1 UnreadUnread3 ViewsViews

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View profile card for Joanne Hogan

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April 3 at 12:57 AM
 by Joanne Hogan

Blanda, M. (2021, March 01). Cluster headache. Retrieved March 29, 2021, from https://emedicine.medscape.com/article/1142459-overview

References

Cluster Headaches
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Caroline Otto posted Apr 1, 2021 7:44 AM

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Pathophysiology of the Cluster Headache.They occur in one side of the head, and men between the ages of 20 and 50 years old are mostly affected. The source may alternate sides with each headache episode, and they are commonly described as stabbing and throbbing (Huether, S. E., McCance, K.L. & Brashers, V.L. 2020).The triggers are like those that cause migraine headaches, and these involve triggers that decrease the threshold for a migraine. They may be genetic, or associated with fatigue, oversleeping, missed meals, overexertion, weather change, stress or relaxation from stress, hormonal changes, or over stimulation from either bright lights, strong smells, and chemicals such as alcohol or nitrates.Current Treatment options for Patients who present with Cluster headaches.The medical treatment relies on prophylactic drugs.According to the American Headache Society evidenced based guidelines; Sumatriptan subcutaneous, zolmitriptan nasal spray, and high flow oxygen remain the treatments with a level A recommendation. For prophylactic therapy suboccipital steroid injections have emerged as the only treatment to received Level A recommendation. Notably what did receive a Level C recommendation – meaning a positive study was warfarin, I would personally not want to take warfarin ever, unless I absolutely had to.There has been some success noted with Zolmitriptan 5mg and 10mg, however it has been identified that these patients remain undertreated if treated at all. The main goal and focus should adhere to evidence based practice guidelines, as in all other areas of Medicine.References:7
th
 ed. Elsevier MosbyRobbins, M. S., Starling, A. J., Pringsheim, T. M., Becker, W. J., & Schwedt, T. J. (2016). Treatment of Cluster Headache: The American Headache Society Evidence-Based Guidelines. 
Headache
, 
56
(7), 1093–1106. https://doi.org/10.1111/head.12866less1 UnreadUnread5 ViewsViews

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View profile card for Sheryl Dixon

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April 2 at 8:53 PM
 by Sheryl Dixon

Kingston, W. S., & Dodick, D. W. (2018). Treatment of Cluster Headache. 
Annals of Indian Academy of Neurology
, 
21
(Suppl 1), S9–S15. https://doi.org/10.4103/aian.AIAN_17_18

Huether, S. E., McCance, K.L. & Brashers, V.L. (2020). Understanding Pathophysiology.

According to another source, Oxygen at 6-15 L/min by a nonrebreather face mask has been shown to improve headaches in these clients. This continues to be the mainstay of treatment with much debate surrounding other options.

Acute Cluster headache attacks are treated with oxygen inhalation, sumatriptan or inhaled ergotamine administration and nerve stimulation.

Overall, the patient’s main goal should be to identify and become aware of what triggers these attacks and avoiding those triggers, such as caffeine, tyramine, fluorescent lighting, and alcohol.

When a Cluster headache develops there is trigeminal activation, but the mechanism of action is unclear. The pathogenic mechanism for pain is related to the release of vasoactive substances and the formation of neurogenic inflammation. Autonomic dysfunction is characterized by sympathetic underactivity and parasympathetic activation. There is unilateral trigeminal distribution of severe with ipsilateral autonomic manifestations, including tearing and ptosis of the eye on the affected side, and congestion of the nasal passages.

These headaches occur in clusters, thereby getting its name, and individuals may have up to 8 attacks per day, and they often last for minutes to hours for a period of days, followed by a long period of spontaneous cessation. These headaches are episodic and chronic varying between extreme pain intensity and short duration. If these headaches present without spontaneous cessation, they are referred to as; chronic cluster headaches which involve 10% to 20% of cases.

Cluster headaches are commonly referred to as trigeminal autonomic cephalalgias, meaning headaches that involve the autonomic division of the trigeminal nerve.

Cluster headache
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Jazmin Jerez-Rivera posted Mar 30, 2021 9:55 PM

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After analyzing the patient’s symptoms further, it looks like Bob is suffering from Cluster Headaches. The pathophysiology can be complex and underlying causes are not fully clarified. The headache is neurovascular in nature and it stems from the trigeminal-autonomic reflex activation. This pathway “consists of a brainstem connection between the trigeminal nerve and facial cranial nerve parasympathetic outflow” (Wei et. al., 2018, p. 4). It is triggered by the stimulation of the trigeminovascular pathways. Pain afferents cross the ophthalmic division and receive signals from cranial vessels and dura mater. These synapse in the Trigeminocervical complex (TCC) and projects to brain structures that trigger pain, including the thalamus, cortex and hypothalamus (Wei et. al., 2018). The hypothalamus is connected to the ipsilateral trigeminal system which causes associated symptoms of tearing, ptosis of the eye, and nasal congestion (Huether et. al. 2020). Treatments for cluster headaches include oxygen therapy, and sumatriptan (Imitrex) injectable and nasal spray, which is frequently used for migraines. Another fast-acting nasal spray used is zolmitriptan (Zomig). Other injectables prescribed are ocreotide and dihydroergotamine (MFMER, 2019).ReferencesMayo Foundation for Medical Education and Research. (2019). Cluster headache. Retrieved from https://www.mayoclinic.org/diseases-conditions/cluster-headache/symptoms-causes/syc-20352080less1 UnreadUnread1 ViewsViews

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View profile card for Jennifer Bryant

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April 2 at 1:34 AM
 by Jennifer Bryant

Wei, D. Y., Yuan Ong, J. J., & Goadsby, P. J. (2018). Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. 
Annals of Indian Academy of Neurology
, 
21
(Suppl 1), S3–S8. https://doi.org/10.4103/aian.AIAN_349_17

Huether, S. E., McCance, K. L., Brashers, V. L. (2020). Understanding Pathophysiology (7 Ed.).  Elsevier.

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Sheryl Dixon posted Mar 31, 2021 6:13 PM

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A cluster headache is an uncommon type of headache “Cluster” is a descriptive term that refers to the way the attacks occur in groups, bursts or clusters, which can last from days to months and then go into remission, often for years at a time. The clusters occur with some seasonal regularity, most often in the spring or fall. During a cluster period, a patient may have one or several headaches in a day. The attacks frequently occur at night, waking the patient from a sound sleep. The pain is of short duration, lasting from a few minutes to several hours, though most often for 30 to 45 minutes. The pain is rarely present longer than four hours (Phelps, 2008).Cluster headaches may be triggered by alcohol and cigarette smoking, high altitudes (trekking and air travel), bright light (including sunlight), exertion (physical activity), heat (hot weather or hot baths), foods high in nitrites (bacon and preserved meats), certain medicines and cocaine (Medlineplus, 2020).Medications to improve quality of life. Prescription medications can shorten a headache cycle. They can also make the headaches less severe. Calcium channel blockers, verapamil, lithium carbonate, divalproex sodium, melatonin or topiramate may help. There is a new preventive therapy that is a calcitonin gene-related peptide (CGRP) monoclonal antibody.                                                                                                           ReferencesMedlineplus, (2020).
Cluster headache
. Retrieved from https://medlineplus.gov/ency/article/000786.htmless1 UnreadUnread6 ViewsViews

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View profile card for Cassie Fritzinger

Last post 
April 1 at 11:04 AM
 by Cassie Fritzinger

Phelps. P. (2008), 
Case Studies in Headache: Cluster Headache
. Retrieved from https://headaches.org/2008/05/06/case-studies-in-headache-cluster-headache/

Clevelandclinic, (2018).
Cluster Headaches
. Retrieved from https://my.clevelandclinic.org/health/diseases/5003-cluster-headaches

Other options when needed Surgeons have tried operations for cluster headaches. But they haven’t had much success preventing them. Researchers are now testing newer therapies to see if they can work. One option uses mild electrical stimulation on the neck. Another creates electrical stimulation by placing a medical device through the upper gums (Clevelandclinic, 2018).

Unfortunately, there is no cure for cluster headaches. But you do have treatment options that can make them a little less painful. Treatment options include Abortive treatment to stop attacks: Often, a headache will stop before you have a chance to see a healthcare provider. But if you get there in time, there are several effective ways to stop a cluster headache. A healthcare provider may give you injected medications or a nasal spray. These include sumatriptan, dihydroergotamine and zolmitriptan. The provider may also give you oxygen through a mask.

Doctors do not know exactly what causes cluster headaches. They seem to be related to the body’s sudden release of histamine (chemical in the body released during an allergic response) or serotonin (chemical made by nerve cells) in the area of a nerve in the face called the trigeminal nerve. A problem in a small area at the base of the brain called the hypothalamus may be involved. More men than women are affected. The headaches can occur at any age, but are most common in the 20s through middle age cluster headache essays. They tend to run in families.

Dennies Jones
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Dennies Jones posted Mar 31, 2021 6:38 PM

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Bob is suffering from clustered headaches. According to Huether et al. (2020), “cluster headaches are part of a group of disorders known as trigeminal autonomic cephalalgias, headaches involving the autonomic division of the trigeminal nerve. CH headache is usually felt on one side of the head and is seen primarily in males between the age of 20 and 50” (p. 970. The headaches occur in clusters and can last from minutes to hours for several days, followed by months of nonrecurrence (Huether et al., 2020). Signs and symptoms are lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating miosis, ptosis, eyelid edema, and restlessness or agitation.       less1 UnreadUnread6 ViewsViews

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View profile card for Cassie Fritzinger

Last post 
April 1 at 10:44 AM
 by Cassie Fritzinger

Ljubisavljevic, S., & Zidverc Trajkovic, J. (2019). Cluster headache: pathophysiology, diagnosis, and treatment. Journal of neurology, 266(5), 1059–1066. https://doi.org/10.1007/s00415-018-9007-4

Huether, S., McCance, K., & Brashers, V. (2020). 
Understanding Pathophysiology
 
(7th ed.). Elsevier.

Guo, X. N., Lu, J. J., Ni, J. Q., Lu, H. F., Zhao, H. R., & Chen, G. (2019). The role of oxygen in cluster headache. Medical gas research, 9(4), 229–231. https://doi.org/10.4103/2045-9912.273961

References

            According to (Huether et al., 2020), “prophylactic drugs are used to treat CH. Avoiding things that trigger headaches is essential; acute attacks are treated with oxygen inhalation, sumatriptan, or inhaled ergotamine administration and nerve stimulation” (p. 971). High flow oxygen has been recommended for alleviating acute attacks of CH and is one of the first-line acute treatments. Oxygen is better when compared to other acute medications, such as sumatriptan and zolmitriptan; oxygen causes very few side effects or long-term harm (Guo et al., 2019).

Module 11
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Steven Bartos posted Mar 31, 2021 11:02 PM

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Based on this week’s scenario, I would provide a diagnosis of Cluster Headaches. Bob met the following diagnostic criteria for cluster headaches, which includes having severe unilateral orbital, supraorbital, and/or temporal pain lasting 15 – 180 min, up to eight times a day, if left untreated. Furthermore, Bob had at least one of the following: conjunctival injection and/or lacrimation, nasal congestion and/or rhinorrhea, eyelid edema, forehead and facial sweating, and miosis and/or ptosis (Ljubisavljevic & Trajkovic, 2019).            Acute cluster headaches are typically treated with inhaled oxygen, recommended at 12 – 15 L/min for 15 – 20 min through a non-rebreathing facemask. Parenteral treiptans have also been shown to be effective, however, oral triptans have not. Sumatriptan subcutaneously is the most effective triptan. Sumatriptan and Zolmitriptan nasal spray have both been proven to be effective. If these interventions are ineffective or contraindicated, Lidocaine has been effective in approximately one third of patients (Hoffmann & May, 2018). Preventative options include verapamil 360 mg and lithium 900 mg doses have been shown effective in research. Research into neurostimulation of the hypothalamus and occipital nerve also shows promise for treating cluster headaches (Ljubisavljevic & Trajkovic, 2019).Hoffmann, J., & May, A. (2018) cluster headache essays. Diagnosis, pathophysiology, and management of cluster headache. 
Lancet Neurology, 17
(1), 75 – 83. 
https://dx.doi.org/10.1016/S1474-4422(17)30405-2
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View profile card for Caroline Otto

Last post 
April 1 at 8:15 AM
 by Caroline Otto

Ljubisavljevic, S., & Trajkovic, J.Z. (2019). Cluster headache: Pathophysiology, diagnosis and treatment. 
Journal of Neurology, 266
(5), 1059 – 1066. 
https://dx.doi.org/10.1007/s00415-018-9007-4

References

Cluster headaches involve the autonomic division of the trigeminal nerve. The exact mechanism in the pathophysiology of cluster headaches remains unclear, but it is believed to involve several structures of the peripheral nervous system and central nervous system. When the trigeminovascular system is activated, and the pain associated with cluster headaches is related to the release of CGRP, a vasodilator that regulates the nociceptive trigeminal neurons. Furthermore, the parasympathetic system is connected to the trigeminal nerve through the superior salivatory nucleus, via the facial nerve; this regulates conjunctival injection, lacrimation and rhinorrhea, and cranial and extracranial vasodilation. Recently, research with MRI’s and animal studies has also shown that the hypothalamus may be involved as well, possibly related to melatonin, the GABAergic, and the glutamatergic receptor systems (Hoffmann & May, 2018).

Fritzinger, Discussion wk 11
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Cassie Fritzinger posted Mar 28, 2021 11:41 PM

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Based on Bob’s presentation I would diagnosis him with Cluster Headaches. According to Heuther, McCance & Brasher (2020), cluster headaches are also known as trigeminal autonomic cephalalgias. The usual presentation of these types of headaches includes pain on one side of the head such as stabbing and throbbing (which can alternate sides with each episode), unilateral tearing of the eye, ptosis, as well as nasal congestion. Cluster headaches typically present in males between the ages of 20 and 50 (Heuther, McCance, Brasher, 2020). Bob is exhibiting typical signs/symptoms of cluster headaches and does have periods of remission when he is headache free for several months thus he does not have chronic cluster headaches which occurs in a small percentage of cases (Heuther, McCance, & Brasher, 2020).Cluster headaches have also been seen to be related to abnormal melatonin levels. These patients have a low nocturnal melatonin level, thus have had some success with supplementation. However, Wei & Jensen (2018) report that those with chronic cluster headaches did not have relief with the melatonin treatments, and those with episodic cluster headaches had minimal relief. Although with the low potential adverse effects one may suggest adding melatonin to other treatments as an adjunctive therapy (Wei & Jensen, 2018). ReferencesChrisholm-Burns, M. A., Schwinghammer, T.L., Malone, P.M., Kolesar, J.M., Lee, K.C., Bookstaver, P.B. (2019). Pharmacotherapy: Principles and practices (5th ed.) McGraw-Hill Education.Wei, D. & Jensen, R. (2018) Therapeutic Approaches for the Management of Trigeminal Autonomic Cephalalgias. Neurotherapeutics. 15(2): 346-360. 
10.1007/s13311-018-0618-3

Heuther, S. E., McCance, K. L., & Brashers, V. L. (2020). Understanding Pathophysiology (7th ed.). Elsevier.

Barloese, M.C.J. (2018) cluster headache essays. The pathophysiology of the trigeminal autonomic cephalalgias, with clinical implications. 
Clin Autonomic Research
 28, 315–324. 
https://doi.org/10.1007/s10286-017-0468-9

While there are different views on the treatments of headaches, it would be important for the patient to evaluate their headaches and start a headache journal to document any triggers. Knowing triggers will assist the patient in attempting to avoid these triggers potentially lessening the frequency of their headaches. Chrisholm-Burns, Schwinghammer, Malone, Kolesar, Lee & Bookstaver (2019), recommend the treatment for cluster headaches begin with the administration of 100% oxygen via a high glow nonrebreather mask at 12-15L/min for a time of 15 minutes. This is suggested secondary to the reported increased amount of cluster headaches with high-altitude exposure suggesting hypoxemia as a cause of cluster headaches (Chrisholm-Burns, Schwinghammer, Malone, Kolesar, Lee & Bookstaver, 2019). Should the administration of oxygen be ineffective to the treatment of these cluster headaches, another suggestion would be to begin adjunctive therapy using triptan class medications. For the acute cluster headache, it is suggested to use intranasal or subcutaneous sumatriptan for a more rapid onset of relief of symptoms. The oral use of triptans may play a better role in the limiting of recurrence cluster attacks secondary to their delayed onset. A caution with triptans is the vasoconstrictive property which should be avoided in patients with underlying ischemic vascular disease. For these patients, octreotide a somatostatin analogue administered subcutaneously, can be used. Octreotide does not have the vasoconstrictive properties (Chrisholm-Burns, Schwinghammer, Malone, Kolesar, Lee & Bookstaver, 2019).

Cluster headaches or trigeminal autonomic cephalalgias are poorly understood in means of pathology. The presentation of these headaches is only a portion of the complex symptoms associated with the pathophysiology of this type cephalalgia. There is an activation of the trigeminal-autonomic reflex, this reflex which is controlled by higher centers in an important part of the wide range of symptoms likely indicating a homeostatic disturbance. It has been suggested that the hypothalamus plays a key role in these headaches (Barloese, 2018). Unique symptomology of cluster headaches is the “circannual and circadian tendency, as well the neurohormonal changes in testosterone, cortisol, and melatonin”, supporting the hypothalamus as being a part of these symptoms (Wei & Jensen, 2018) cluster headache essays. Wei & Jensen (2018), also report that Nitric oxide also plays a part in cluster headaches, and it was found that patients with cluster headaches have a higher level of nitric oxide in their plasma. Because of this the use of nitroglycerin has been found to trigger cluster headaches. While indomethacin is classified as a nonsteroidal anti-inflammatory drug (NSAIDs) it is not equal to all other NSAIDs and has been found to affect the Nitric Oxide mechanism associated with cluster headaches. This treatment is part of a Nitric Oxide-cyclic guanosine monophosphate (NO-cGMP) cascade which is a therapeutic target for treatment cluster headache essays.

Family Health Assessment Part I GCU NRS-429VN

Family Health Assessment Part-1

Performing a family health assessment is a way that nurses can interact with the family.  Obtaining knowledge about one’s family structure, how they function, and the way they process situations, and perform task will inform the nurse on how they can optimize a nursing care educational plan to in cooperate in their family structure and can provide individualized nursing care plans that will be unique to their family system. According to (Kaakinen, 2018).

I have chosen a family that is very dear to me, but that has endured great tragedy recently and other medical and mental health problems. I thought this would be a great family to conduct this interview. In this family there are four members that consist of three teenagers that include a 15-year-old boy, girl A who is 19, Girl B who is 17, a mother and a recently deceased father Family Health Assessment Part I GCU NRS-429VN.

They all work well in supporting each other, especially with the recent loss of their father. The current health of the family is not the best due to their circumstances, they all know this though and are willing and taking appropriate steps to achieve a healthy outcome. Some of the areas they could improve would be the nutritional, exercise, and following medication orders provided by the doctor.

The Family states that their health is important to them especially since the untimely death of the kids’ father was due to a massive heart attack at age 34 who was extremely overweight. The eldest daughter has recently gained a substantial amount of weight and is not making the best decisions on what she eats states the mother. The son is extremely active and plays basketball and football, he states that he works out regularly during the week at school Family Health Assessment Part I GCU NRS-429VN.

Nutrition

The mother said that during the week it is hard for them to eat at home all together due to everyone’s busy schedules, school activities, and work. She said that when they are all home on the weekends though that they do eat at home and a well-balanced meal. However, the eldest daughter has been eating a lot of sweets and carbs said she is worried that the loss of her father is making her depressed, and she has been eating a lot due to that.

Sleep/rest

All the family members stated that they do not get enough sleep and do not feel very rested in the mornings, the son stated that he comes home every day from school and lays down till around 7 or 8pm. The middle daughter takes melatonin to assist in falling asleep, and mother states she is only getting about four hours of sleep at night, she lies awake every night and worries about her kids in this difficult time and stresses out over her financial situation. (Radek, 2021) states that the recommended amount of sleep is 7-8 hours of sleep.

 

Elimination

All family members stated they do not have any problems with their bowels or bladder except mother, she stated she has a large kidney stone, but she cannot have surgery due to Covid right now and that the hospital will only do emergency surgeries at this time. According to (Ferraro, 2020) it is recommended to increase fluid intake, and maintain a healthy well-balanced diet with reducing intake of sodium and animal proteins, and to also increase fiber intake Family Health Assessment Part I GCU NRS-429VN.

Activity and exercise

Except for the son, the family states that they do not have a regular exercise routine and the eldest daughter cannot exercise due to a foot injury she had a few years ago that she is still suffering from. However, they do stay active and are always on the go.

Cognitive

The mother reports all the children are doing well in school and the son is in all honors classes and making all A’s, the eldest daughter just started college and the middle daughter is doing well also, they also all hold down a job with no issues.

Sensory/ perception

All members of the family report they do not wear glasses or contacts, they are up to date on their eye exams and deny any hearing problems.

Self-perception

When asked about this all members stated they are very depressed, and life is not very enjoyable at this moment however they do know that it will get better they are just dealing with a hard time in life right now. I deny any feelings of self-harm and are all currently in counseling to help grieve their loss.

Role relationship

The mother is the head of household but states the oldest daughter helps a lot as well, she assists in taking the other kids to and from school and anywhere else they need to go while the mother is working and helps a lot with housework Family Health Assessment Part I GCU NRS-429VN.

Sexuality

The kids are not in relationships and deny having any sexual partners. The mother States that she has zero sex drive since her hysterectomy two years ago. She states that she tried the hormones, but she could not stand the way that they made her feel, so she stopped taking them and now suffers from vaginal dryness and painful sex. She states that she knows that she needs to see the doctor and inquire about trying a different kind of medication.

Coping

This family has had a recent tragedy and all state that they are doing the best they can to just get by. The kids are in counseling, and mother states she thinks it is slowly helping. The mother states that she just deals by not thinking about it, which then immediately stated she knew that was not the healthy thing to do.

 

Family focused questions and answers

Values/ Health perception

How do you view your overall health as a family? Mother states “I think we have our

moments where a kid will get sick here or there but overall, I feel like we’re a pretty normal and healthy family”

Have you had any major surgeries, or does anyone have any chronic illness?

“I had several surgeries on my foot after I stepped on a big piece of glass in the lake three years ago, I went to the hospital and they did not clean it, and just stitched it up. They didn’t even give me any antibiotics. I ended up being care flighted to a children’s hospital where I had to have several more surgeries to save my foot.” Says daughter 1

Do any of you smoke or drink on a regular basis?

“They better not” laughs mom, then adds “I vape”

Nutrition

Would you all say of your eating habits are healthy? “I don’t know about healthy, but I also wouldn’t say it was the best” says Mom

Do you all drink enough water throughout the day? Son states “That is all I drink, I don’t drink anything else, well except tea occasionally.” All others state they drink plenty of water.

Do you eat more home cooked meals or eat out for the most part? “Honestly, we eat out a lot, like a lot. We are all so busy with school, sports, and work during the week that we mostly just grab something on our own.” Says mom

Sleep/ Rest

How many hours on average do you think you all get a night? “Anywhere from 3-8 hours depending on the day.

Do any of you take any medications to assist with falling asleep? Girl 2 started taking melatonin recently after the death of her father.

Do you feel rested in the mornings? They all agree they do Family Health Assessment Part I GCU NRS-429VN.

Elimination

Do you all have regular bowel movements? All 3 girls respond together while laughing saying that the son “has no problem at all going.” Then say they are regular as well.

Do you have any problems urinating? “I have a large kidney stone that makes it difficult sometimes” states mom.

Any complaints of constipation? They all deny

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Activity/ Exercise

Family Health Assessment Part I

 

Understanding family structure and style is essential to patient and family care. Conducting a family interview and needs assessment gathers information to identify strengths, as well as potential barriers to health. This information ultimately helps develop family-centered strategies for support and guidance.

This family health assessment is a two-part assignment. The information you gather in this initial assignment will be utilized for the second assignment in Topic 3.

Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following:

Values/Health Perception

Nutrition

Sleep/Rest

Elimination

Activity/Exercise

Cognitive

Sensory-Perception

Self-Perception

Role Relationship

Sexuality

Coping

Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview.

Upon completion of the interview, write a 750-1,000-word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment.

Include the following in your paper:

Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment.

Summarize the overall health behaviors of the family. Describe the current health of the family.

Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified.

Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Materials if you need assistance.

Do you exercise regular? “No”, says mom, well son 1 “does because he is in athletics, and they have to go to weight room every day.” She added

Are there any barriers that would prevent any of you to exercise? “My foot shoots pain if I lift heavy things.” States daughter 1, mom says “No, just time and motivation.”

Would you say you are all active throughout the day? “Yes.” reply all Family Health Assessment Part I GCU NRS-429VN

Cognitive

How are your grades in school, do you feel like you are able to understand and comprehend when the teacher is teaching? “Yes” state the kids.

While at work do any of you have any problems completing task? They all deny any issues

Do any of you have any problems focusing or remembering things? Mom says “I am so forgetful, but I think it’s just because I have so much going on, and things I have to remember. Kids deny any problems

Sensory perception

Do any of you wear glass or contacts? No

Do any of you wear hearing aids? No

Have you all had your vision and hearing test done recently? “We just had ours all done actually” says mom

Self- perception

Do any of you struggle with feeling depressed? Yes, they all answer and all 4 tear up, these sweet kids lost their dad very unexpectedly recently and they are all struggling with coping with it. Daughter one states “everyday” while the others nod yes.

Do you ever have any thoughts of self- harm? “No” they all say

Are any of you on any anti-depressants? “I am” says daughter 2. She was a daddy’s girl, and as a close friend of the family I know how bad she is struggling with this sudden loss.

Role relationship

Mom is the head of the house, but the oldest daughter helps with taking the other kids to school, and to and from work.

Sexuality

I asked this question to mom in private and she told me that she has “zero desire” she explained that she had to have a hysterectomy at age 35 so 2 years ago and she has not taken her hormone pills. Kids deny being intimate with anyone.

Coping

“All 3 kids just started counseling” says mom,” they are all dealing with this loss in their own way and that she cannot stand that she cannot take their pain away. She also adds that daughter 2 with just start whaling and crying uncontrollably and mom states “it is the hardest thing we have ever had to handle and so I knew I had to get them in to see someone.”Family Health Assessment Part I GCU NRS-429VN

 

References

Ferraro, P. M. (2020, March 15). 
Risk of kidney stones: Influence of dietary factors, dietary patterns, and vegetarian–vegan diets
. MDPI. 
https://www.mdpi.com/2072-6643/12/3/779

Kaakinen, J. (2018). 
Family health care nursing
. Google Books. 
https://books.google.com/books?hl=en&lr=&id=wNFJDwAAQBAJ&oi=fnd&pg=PR1&dq=family+health+assessment+nursing&ots=29hQpo5to6&sig=48onmdHtUQpNQCDCjyIA912xGrQ#v=onepage&q=family%20health%20assessment%20nursing&f=false

Radek, K. (2021, June 3). 
An overview of worldwide sleep disturbance | Highlights on medicine and medical science Vol. 3
. Book Publisher International. 
https://stm.bookpi.org/HMMS-V3/article/view/1609

 

Course Code

Class Code

Assignment Title

Total Points

NRS-429VN

NRS-429VN-O502

Family Health Assessment Part I

150.0

Criteria

Percentage

Unsatisfactory (0.00%)

Less than Satisfactory (75.00%)

Satisfactory (79.00%)

Good (89.00%)

Excellent (100.00%)

Comments

Points Earned

Content

80.0%

Interview Questionnaire Assessing Functional Health Patterns

15.0%

Interview questionnaire is omitted. The interview questionnaire presented does not include family-focused functional health patterns. More than three of the functional heath patterns have been omitted. Four or more of the functional health patterns have fewer than three open-ended questions.

The interview questionnaire presented is incomplete. One or two of the functional heath patterns have been omitted. Two or three of the functional health patterns have fewer than three open-ended questions. Overall, the interview questionnaire is inconsistent with the assignment criteria.

The interview questionnaire presented. One of the functional heath patterns has been omitted. One of the functional health patterns has fewer than three open-ended questions. Overall, the interview questionnaire is consistent with the assignment criteria. Some of the open-ended questions are not family-focused or not relevant to the scope of the assignment.

The interview questionnaire presented. All functional heath patterns are included, and each has three open-ended questions that are family focused and relevant to functional health patterns. The interview questionnaire is consistent with the assignment criteria. Overall, the open-ended questions are family-focused and relevant to the scope of the assignment.

The interview questionnaire presented and demonstrates strong insight into family-focused assessment strategies.  All functional heath patterns include three highly relevant open-ended questions.

Family Structure (individuals, relevant attributes of family composition, race/ethnicity, social class, spirituality, environment)

15.0%

Description of family structure omitted.

A partial description of family structure is presented. Not all individuals are included. Relevant attributes are listed but incomplete. Some attributes are missing. There are inaccuracies.

A summary of family structure is presented. All individuals are included. Most relevant attributes listed are summarized. Some aspects are vague. There are minor inaccuracies.

The family structure is described. All individuals and relevant attributes are presented. Overall, the discussion provides insight into the family structure.

The family structure is clearly described. All individuals and relevant attributes are discussed in detail. The discussion demonstrates an in-depth perspective into family structure.

Family Health and Health Behaviors

15.0%

Health behaviors and current health of the family are not presented.

Health behaviors and current health of the family are partially presented. Overall, the health and health behaviors of the family are unclear.

Health behaviors and current health of the family are summarized. Overall, the health and health behaviors of the family are generally presented.

Health behaviors are identified and presented. The current health behaviors of the family are described.

Health behaviors are identified and presented in detail.  The current health of the family is described. A clear understanding of family health and health behavior is demonstrated.

Findings (functional health patterns strengths, health problems or barriers to health)

15.0%

Functional health pattern strengths, health problems, and barriers to health are not presented as indicated in assignment criteria.

Two functional health pattern strengths, and three health problems or barriers to health are partially presented. Some aspects presented are not relevant, or are not consistent with findings.

Two functional health pattern strengths, three health problems, and barriers to health are summarized. Aspects presented are relevant and generally consistent with findings.

Two functional health pattern strengths, three health problems, and barriers to health are discussed. Aspects presented are relevant and consistent with findings.

Two functional health pattern strengths, three health problems, and barriers to health are discussed. Discussion identifies and assesses key aspects from findings. Discussion demonstrates insight into assessment of findings to identify functional health pattern strengths and health problems or barriers.

Application of Family Systems Theory

20.0%

Application of family systems theory is not presented.

Application of family systems theory is partially presented. It is unclear how the theory will be applied to positively change overall family functions over time. There are inaccuracies in the application or representation of the theory.

Application of family systems theory is presented. A general discussion on how the theory will be applied to initiate positive changes in family functions over time is presented. There are minor inaccuracies in the application or representation of the theory.

Application of family systems theory to initiate positive changes in family functions over time is discussed. The manner in which the theory is applied is relevant and generally supports steps toward the desired outcomes.

Application of family systems theory to initiate positive changes in family functions over time is thoroughly discussed. The manner in which the theory is applied is highly relevant and strongly supports steps to achieving the desired outcomes.

Organization and Effectiveness

15.0%

Thesis Development and Purpose

5.0%

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction

5.0%

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing  (includes spelling, punctuation, grammar, language use)

5.0%

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

Format

5.0%

Paper Format  (use of appropriate style for the major and assignment)

2.0%

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

3.0%

Sources are not documented.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Total Weightage

100%

Family Health Assessment Part I GCU NRS-429VN

Module 10: Discussion

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A 28-year-old male presents to the primary care office for evaluation of left calf pain, swelling, and redness. He reports that this started one day ago and worsened today. He ran a 27-mile marathon 2 days ago and traveled for 3 hours in a car today. He reports slight pain on walking and a swollen red calf. He took Ibuprofen 600 mg twice today without relief. Patient reports being an experienced runner, running 3-5 miles daily. He trained for the marathon for 4 months. Patient also reports a history of exercise induced asthma and uses albuterol sulfate HFA as needed.

On physical exam patient appears in good health T 99 P 68 R 18 BP 118/78 wt. 175 lb, height 72 in. BMI 23.1. Heart rate is regular without murmurs, rubs, or gallops. Lungs clear bilaterally. HEENT WNL. Strength lower extremities +5 and DTRs + 2. Left calf erythematous, edematous, warm and tender on palpation. Pulses 3+ acute renal failure in rhabdomyolysis Essay.

Two possible diagnoses were considered: deep vein thrombosis (DVT) and rhabdomyolysis.

Stat ultrasound of left leg to rule out DVT was ordered and read as normal

CBC WNL

Creatine Kinase (CK) 23,000 U/L (normal 24-170 U/L)

BUN and Creatinine WNL

A diagnosis of rhabdomyolysis was made.

Discuss the pathophysiology of acute renal failure in rhabdomyolysis.

Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to grading rubric for online discussion.

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a kaur
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Amandeep Kaur posted Mar 24, 2021 10:58 PM

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Rhabdomyolysis occurs when muscle tissue begins to break down and die, specifically skeletal muscle (Cabral et al., 2021). This releases the intracellular contents of the cell into the blood. This occurs as the sarcolemmal membrane is broken down. Rhabdomyolysis diagnosis will be made if and when the serum creatine kinase level is 5 times the upper limit normal level. This can present in many different ways clinically; asymptomatic increase in serum enzymes, damaged muscles, volume depletion, metabolic abnormities, and acute kidney injury. Significant increases in myoglobin can also be indicative of rhabdomyolysis. These toxins are processed through the kidney, in which they release hydroxyl radical (OH) (Petejova & Martinek, 2014). The release of this reactive species is nephrotoxic, causing acute kidney injury.  In the case of this gentleman, his rhabdomyolysis was exercise-induced (Kim et al., 2015). Excessive use of muscles due to marathon training led to muscle injury by the increased intercellular calcium levels. Rhabdomyolysis can be easily overlooked in athletes is just muscle pain or soreness.Cabral, Brian Michael I., Sherida N. Edding, Juan P. Portocarrero, and Edgar V. Lerma. “Rhabdomyolysis.” 10 June 2020. Web. 25 Mar. 2021.Kim, Jooyoung, Joohyung Lee, Sojung Kim, Ho Young Ryu, Kwang Suk Cha, and Dong Jun Sung. “Exercise-induced Rhabdomyolysis Mechanisms and Prevention: A Literature Review.” 
Journal of Sport and Health Science
. Elsevier, 03 June 2015. Web. 25 Mar. 2021.less2 UnreadUnread7 ViewsViews

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View profile card for Aina Oluwo

Last post 
March 28 at 11:47 PM
 by Aina Oluwo

Petejova, N., & Martinek, A. (2014). Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. 
Critical care (London, England)
, 
18
(3), 224.

References

Mod 10
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Candice Russell posted Mar 22, 2021 12:14 AM

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            “Rhabdomyolysis is a syndrome that involves skeletal muscle necrosis and lysis followed by the release of intracellular content to peripheral blood, which may cause electrolyte imbalance, cardiac arrhythmias and multifactorial acute renal failure” (Khan, 2009, as cited by De Gracia-Nieto et al., 2016, 329). Rhabdomyolysis can result from traumatic and non-traumatic injury to the skeletal muscle acute renal failure in rhabdomyolysis Essay. “Since skeletal muscle comprises about 40% of body mass, such an insult can result in the accumulation of cellular contents that could eventually overwhelm the underlying elimination mechanism” (Cervellin et al., 2017, as cited by Cabral et al., 2020, p. 2).As the myocyte degenerates, large quantities of intracellular substances particularly potassium, myoglobin and CK leak into the circulation. If more than 100 grams of skeletal muscle is damaged, the circulating myoglobin levels will exceed the protein-binding capacity of the plasma and can precipitate in the glomerular filtrate. Excess myoglobin may thus cause renal tubular obstruction, direct nephrotoxicity, and acute renal failure. (Vanholder et al., 2000; Knochel, 1993; Bosch, 2009; as cited by Cabral et al., 2020, p. 6)Reference:De Gracia-Nieto, A. E., Angerri, O., Bover, J., Salas, D., Villamizar, J. M., & Villavicencio, H. (2016). Acute Renal Failure Secondary to Rhabdomyolysis as a Complication of Major Urological Surgery: The Experience of a High-Volume Urological Center. 
Medical principles and practice : international journal of the Kuwait University, Health Science Centre
, 
25
(4), 329–335. https://doi.org/10.1159/000445115Michelsen, J., Cordtz, J., Liboriussen, L., Behzadi, M. T., Ibsen, M., Damholt, M. B., Møller, M. H., & Wiis, J. (2019). Prevention of rhabdomyolysis‐induced acute kidney injury – A DASAIM/DSIT clinical practice guideline.
 Acta Anaesthesiologica Scandinavica, 63
(5), 576-586. 
https://doi.org/10.1111/aas.13308
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View profile card for Amandeep Kaur

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March 28 at 10:35 PM
by Amandeep Kaur acute renal failure in rhabdomyolysis Essay

Díaz-Tejeiro, R., Regidor, D., Morales, J., Padrón, M., Cueto, L., Muñoz, M. A., Torres, M., Ahijado, F. J., & García Díaz, J. E. (2018). Acute renal failure due to rhabdomyolysis. renal replacement therapy with intermediate cut-off membranes (EMIC2).
 Nefrología, 38
(6), 664-665. 
https://doi.org/10.1016/j.nefroe.2018.04.009

Cabral, B. M. I., Edding, S. N., Portocarrero, J. P., & Lerma, E. V. (2020). rhabdomyolysis.
 Disease-a-Month, 66
(8), 101015-101015. 
https://doi.org/10.1016/j.disamonth.2020.101015

Prevention of AKI by early fluid resuscitation and intravascular volume is suggested. Proposal of multiple supportive therapies such as diuretics, alkalinisation, antioxidants, and renal replacement therapy may assist in AKI prevention (Bosch et al., 2009; as cited by Michelsen et al., 2019, p. 577).

Cabral et al. (2020) documented Acute Kidney Injury (AKI) as one of the most dreaded complications of rhabdomyolysis. Strenuous muscular exercise or activity is an exertional non-traumatic cause of rhabdomyolysis. “The more strenuous or prolonged the activity, the more damage there is” (Cabral et al., 2020, p. 4). A change in body temperature has also be associated with Rhabdomyolysis. Michelesen et al. (2019) described the first account of rhabdomyolysis was observed by Bywaters and Beall, severe renal failure in crush injured victims in 1941 London. During an autopsy, an examination of the kidneys displayed “eosinophilic casts in the loops of Henle and collecting tubules, which were later identified as myoglobin” (Michelesen et al., 2019, p. 576). Diaz-Tejeiro et al. (2018) stated the release of myoglobin is responsible for acute kidney failure (AKF). He described “three myoglobin-mediated nephrotoxic mechanisms have been described. Renal vasoconstriction, the formation of intratubular casts, and direct damage to tubular cells” (Ronco et al., 2009; Zager et al., 2012; as cited by Diaz-Tejeiro et al., 2018, p. 664).

Module 10 Discussion

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Melissa Morgan posted Mar 23, 2021 5:05 PM

Acute renal failure is the most serious complication of rhabdomyolysis, which happens as a result of myoglobin precipitates in the tubules through which the flow of ultrafiltrate through the nephron is obstructed and produces injury. (Huether, et al., 2020). The patient has a creatine kinase of 23,000 units/L, which is more than 5-10 times the upper limit of normal CK. A diagnosis of acute renal failure is likely once the CK level is past 15,000 units/L (Huether, et al., 2020). According to Esposito, et al., the mechanism of acute renal failure in rhabdomyolysis is the massive release of myoglobin into the circulation (2018). Myoglobinuria may be the only symptom of rhabdomyolysis, but it is not a definite diagnosis of the condition since the renal threshold for myoglobin is low (Huether, et al., 2020). The release of myoglobin in the urine “causes cast formation and accumulation of iron in proximal tubules, with intratubular obstruction and proximal tubular cell injury” (Esposito, et al., 2018, p. 2). Sequestration, or third spacing, of fluids into injured muscles causes volume depletion, which results in acute tubular injury and AKI (Esposito, et al., 2018). The exact incidence of AKI in rhabdomyolysis is unknown, and ranges possibly from 10% 10 55% and does not have a good prognosis especially in the presence of multiple organ failure (Chavez, et al., 2016). The goal of treatment is to maintain adequate kidney perfusion with rapid intravenous hydration (Huether, et al., 2020).Chavez, L. O., Leon, M., Einav, S., & Varon, J. (2016). Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical practice. 
Critical care (London, England)
, 
20
(1), 135. https://doi.org/10.1186/s13054-016-1314-5Huether, S., McCance, K., and Brashers, V. (2020).  
Understanding Pathophysiology
 (7
th
 ed.).  Elsevierless0 UnreadUnread

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March 28 at 9:59 PM
 by Gisselle Mustiga

Esposito, P., Estienne, L., Serpieri, N., Ronchi, D., Comi, G. P., Moggio, M., Peverelli, L., Bianzina, S., & Rampino, T. (2018). Rhabdomyolysis-Associated Acute Kidney Injury. 
American journal of kidney diseases : the official journal of the National Kidney Foundation
, 
71
(6), A12–A14. https://doi.org/10.1053/j.ajkd.2018.03.009

References

Rhabdomyolysis
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Aina Oluwo posted Mar 24, 2021 10:27 PM

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Rhabdomyolysis (RBD) is defined as the breakdown of muscle that causes the release of intracellular contents into the extracellular space and bloodstream (Huether et al., 2020).  It can be caused by traumatic and non-traumatic causes. Traumatic like physical trauma to the muscle and non-traumatic which can be hereditary or metabolic. It is important to note that the symptoms of rhabdomyolysis are muscle pain, weakness and dark urine but only 10% of patients exhibit the three symptoms at a presentation (Zhou & Bagga, 2020). This condition is life threatening and interventions should be applied immediately.The pathophysiology of acute renal injury is explained by Navarro-Blackaller et al., (2019) as the Tubular obstruction and oxidative injury due to the precipitation of the Tamm-Horsfall protein with myoglobin. Under physiological conditions, myoglobin is reabsorbed by the renal tubule cells, but when the presence of this pigment exceeds the re-absorptive capacity, it precipitates in the tubules as pigmentary cylinders, forming hyaline cylinders and causing endothelial dysfunction and tissue damage acute renal failure in rhabdomyolysis Essay. This in turn activates the sympathetic nervous system, the renin-angiotensin-aldosterone system and vasopressin release, which together reduce urine output. Huether, S., McCance, K., and Brashers, V.  (2020).  
Understanding
Navarro-Blackaller, G., Chávez-Iñiguez, J. S., Maggiani-Aguilera, P., Gómez-Hernández, G. L.,Rhabdomyolysis and acute kidney injury associated with clostridium difficile infection,Zhou, S., & Bagga, A. (2020). Rhabdomyolysis and acute kidney injury associated with
Disease
,
 7
https://doi.org/10.1177/2054358120951371
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View profile card for Hilary Szpara

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March 28 at 7:52 PM
 by Hilary Szpara

terbinafine use: A case report.
 Canadian Journal of Kidney Health and

case report.
 Nefrología, 39
(2), 208-209. 
https://doi.org/10.1016/j.nefroe.2018.07.009

Carreón-Bautista, E. E., Moreno-Alvarado, R. A., & Garcia-Garcia, G. (2019).

Pathophysiology
 (7
th
 ed.).  Elsevier.

References

The goal is preventing further complications such as disseminated intravascular coagulation (DIC). Treatments for this patient will be rapid intravenous hydration to maintain kidney function and urinary flow (Huether et al., 2020).

            With regards to the case study, it was right to consider DVT and RBD as patient also presented with symptoms of DVT. The diagnostic marker for RBD is the creatine kinase (CK) which if 5 to 10 times more than the normal level or >5000 U/L is concerning for rhabdomyolysis (Zhou & Bagga, 2020). The patient had 23, 000 U/L which is 10 times more than the normal indicated. It is known that once the CK levels exceed 15000 u/L, there is a high possibility of acute renal failure.

Dennies Jones
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Dennies Jones posted Mar 24, 2021 8:39 PM

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      A 28-year-old male presents to the primary care office for evaluation of left calf pain, swelling, and redness. He reports that this started one day ago and worsened today. The male patient was diagnosed with rhabdomyolysis. According to Harding et al. (2020), “rhabdomyolysis is a syndrome caused by the breakdown of damaged skeletal muscle cells. This breakdown causes the release of myoglobin into the bloodstream. Myoglobin precipitates and obstructs renal tubules” (p. 78469). The patient’s signs and symptoms were all associated with muscle injury and breakdown. The severity of the muscle injury led to myoglobinuria, which resulted in acute kidney injury (AKI). Díaz-Tejeiro et al. (2018) explained that “the mechanism responsible for AKF lies in the release of myoglobin. Three myoglobin-mediated nephrotoxic mechanisms have been described. Renal vasoconstriction, the formation of intratubular casts, and direct damage to tubular cells” (p. 664). Myoglobin is reabsorbed into the glomerular filtrate, is catabolized within proximal tubule cells, and easily filtered through the glomerular basement membrane. Rhabdomyolysis includes direct tubular toxicity mediated by myoglobin-associated oxidative injury and tubular obstruction due to myoglobin casts’ formation (Choy et al., 2020). With AKI patient could start experiencing decrease urinary output, swelling due to fluid retention, nausea, fatigue , and shortness of breath.    Choy, K. H., McVeigh, M., Holgate, S., Delmenico, L., & Friedman, N. D. (2020). Rhabdomyolysis cases and acute kidney injury: a 10-year experience at a regional tertiary center. Renal Society of Australasia Journal, 16(3), 98–105. https://doi-org.wilkes.idm.oclc.org/10.33235/rsaj.16.3.98-105Harding, Mariann M., Kwong, Jeffrey, Roberts, Dottie, Hagler, Debra, Reinisch, Courtney. Lewis’s Medical-Surgical Nursing E-Book (Kindle Locations 78469-78470). Elsevier Health Sciences. Kindle Edition.less2 UnreadUnread11 ViewsViews

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View profile card for Steven Bartos

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March 28 at 7:18 PM
 by Steven Bartos

Díaz-Tejeiro, R., Regidor, D., Morales, J., Padron, M., Cueto, L., Munoz, M., . . . Garcia Diaz, J. (2018). Acute renal failure due to rhabdomyolysis. Renal replacement therapy with intermediate cut-off membranes (EMIC2). Acute Renal Failure Due to Rhabdomyolysis. Renal Replacement Therapy with Intermediate Cut-off Membranes (EMIC2). doi:https://doi.org/10.1016/j.nefro.2017.11.001

References

Rhabdomyolysis & AKI
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Jazmin Jerez-Rivera posted Mar 23, 2021 8:44 PM

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In our case study this week the DVT diagnosis was ruled out and rhabdomyolysis was determined. Creatine kinase (CK) is the marker for muscle damage and when it is higher than 1000 units/l rhabdomyolysis is considered, and in this example it is 23,000 u/l and normal value is (24-170u/l). If CK levels surpass 15,000 u/l acute renal failure may be evident (Huether et. al., 2020). Rhabdomyolysis is characterized as “muscle injury leading to the disintegration of muscle constituents into the extracellular fluid and systemic circulation” (Choy et. al., 2020, p. 98). Research by Nielson et. al. suggests that high CK levels are associated with a higher risk of acute kidney injury (2020). Renal injury is caused by the fast breakdown of the muscle, which releases protein, myoglobin and cellular contents into the bloodstream. The cellular content and myoglobin casts infiltrate the nephron and tubules in the kidneys causing obstruction which leads to oxidative injury, and tubular toxicity (Choy et. al., 2020). Clinical manifestations include dark urine, weakness, and muscle pain.Choy, K. H., McVeigh, M., Holgate, S., Delmenico, L., & Friedman, N. D. (2020). Rhabdomyolysis cases and acute kidney injury: a 10-year experience at a regional tertiary centre. 
Renal Society of Australasia Journal
, 
16
(3), 98–105. 
https://doi-org.wilkes.idm.oclc.org/10.33235/rsaj.16.3.98-105
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View profile card for Jennifer Bryant

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March 28 at 6:23 PM
 by Jennifer Bryant

Nielsen, F. E., Cordtz, J. J., Rasmussen, T. B., & Christiansen, C. F. (2020). The Association Between Rhabdomyolysis, Acute Kidney Injury, Renal Replacement Therapy, and Mortality. 
Clinical epidemiology
, 
12
, 989–995. https://doi.org/10.2147/CLEP.S254516

References

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Steven Bartos posted Mar 24, 2021 8:21 PM

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Rhabdomyolysis is the breakdown and necrosis of muscle that subsequently leads to the release of intracellular content into the bloodstream. The pathophysiology of rhabdomyolysis begins with the breakdown of the sarcolemmal cell membrane and ATP depletion, which causes an increase of intracellular calcium, leading to the activation of cell apoptosis pathways, mitochondrial dysfunction, and ultimately cell death (Chavez et al., 2016).ReferencesChavez, L.O., Leon, M., Einav, S., & Varon, J. (2016). Beyond muscle destruction: A systematic review of rhabdomyolysis for clinical practice. 
Critical Care, 20
(135). 
https://dx.doi.org/10.1186%2Fs13054-016-1314-5
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 by Eleany Yasein

Cabral, B.M., Edding, S.N., Portocarrero, J.P., & Lerma, E.V. (2020). Rhabdomyolysis. 
Disease-a-Month, 66
(8), 1 – 21. 
https://doi-org.wilkes.idm.oclc.org/10.1016/j.disamonth.2020.101015

One pathophysiological cause of acute kidney failure is renal vasoconstriction. When these muscles are destroyed, intracellular fluid is sequestered to the extracellular spaces, which decreases intravascular volume and initiates the renin-angiotensin-aldosterone system, antidiuretic hormone, and the sympathetic nervous system. This contributes to vasoconstriction, renal water and salt retention. Myoglobin circulating in the kidneys also increases the release of vasoconstrictors and decreases vasodilators (Cabral et al., 2020). Another cause of kidney failure is from Myoglobin being released into the blood stream. This causes a cytotoxic effect on the nephrons of the kidneys, forming casts which subsequently lead to tubular obstruction. Necrotic muscle also releases uric acid, which further contributes to tubular obstruction (Chavez et al., 2016).

Discuss the pathophysiology of acute renal failure in rhabdomyolysis.
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Caroline Otto posted Mar 25, 2021 6:56 AM

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Rhabdomyolysis is the rapid breakdown of muscle that causes the release of intracellular contents, including the protein pigment myoglobin, into the extracellular space and bloodstream. It is my understanding that these protein molecules are too large to pass through the intramedullary cellular system inside the kidneys while being excreted and cause obstruction thereby causing Acute renal failure.A classical triad of muscle pain, weakness and dark urine is considered typical of rhabdomyolysis. The renal threshold for myoglobin is low (approximately 0.5 mg/dl or urine); therefore, only 200g of muscle needs to be damaged to cause visible changes in the urine. Along with the release of myoglobin, creatine kinase (CK) and other serum enzymes are released in massive quantities, the efflux of intracellular proteins and enzymes includes loss of potassium, phosphate, nucleotides, creatinine, and creatine. The risk of renal failure increases proportionately to the increase in the levels of serum CK, potassium and phosphorus.Raised levels of Serum Creatinine levels has been reported immediately after endurance events, and even a small increase or rise in serum creatinine can put the sportsman at risk (Hodgson, et.al 2017).
References:
Huether, S. E., McCance, K.L. & Brashers, V.L. (2020). Understanding Pathophysiology. 7
th
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Rojas-Valverde, D., Sánchez-Ureña, B., Crowe, J., Timón, R., & Olcina, G. J. (2021). Exertional rhabdomyolysis and acute kidney injury in endurance sports: A systematic review. 
European journal of sport science
, 
21
(2), 261–274.

Hodgson, L. E., Walter, E., Venn, R. M., Galloway, R., Pitsiladis, Y., Sardat, F., & Forni, L. G. (2017). Acute kidney injury associated with endurance events-is it a cause for concern? A systematic review. 
BMJ open sport & exercise medicine
, 
3
(1), e000093. 
https://doi.org/10.1136/bmjsem-2015-000093

Just another reason, why Id rather stick to sports that are not so high in endurance because the overall toll overtime, I believe outweighs the risks compared to the health gains.

According to study that was published in the European journal of sport science by Rojas-Valverde and team; there has been quite a few studies that have been done with regards to endurance events in sports such as open water swimming, cycling, running and triathlons and there has been a rise in concerns related to the potential implications of renal function and kidney health. This study found that most cases of patients monitored who developed Rhabdomyolysis, and then developed acute kidney injury associated to the activity, was indeed found in long distance runners acute renal failure in rhabdomyolysis Essay.

Acute renal failure is one of the most clinically significant complication associated to Rhabdomyolysis. Myoglobin precipitates in the tubules, obstructing the flow of ultrafiltrate through the nephrons thereby producing injury.

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Hilary Szpara posted Mar 24, 2021 11:37 PM

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Rhabdomyolysis is a condition that is characterized by the breaking down and necrosis of damaged skeletal muscles and the release of the contents of the muscle. The substances released include myoglobin and sarcoplasmic protein into the extracellular fluid and circulation (Makris & Spanou, 2016). The myoglobin then moves to the glomeruli of the kidneys and can lead to acute kidney injury (AKI) in different ways (Gaut & Liapis, 2020). Examples of ways in which the release and buildup of myoglobin can lead to AKI include intratubular obstruction secondary to protein precipitation, renal vasoconstriction, and inflammation and tubular damage associated with reactive oxygen production (Makris & Spanou, 2016). Unfortunately diagnosing rhabdomyolysis can be difficult due to patients often not displaying what are thought to be classic symptoms, such as muscle pain, weakness, and dark urine (Gaut & Liapis, 2020). The laboratory value which can help to identify rhabdomyolysis is creatinine phosphokinase (CPK). CPK tends to increase within 12 hours of the onset of the muscle injury and declines about three to five days after cessation of the injury. Unfortunately, at the time of the biopsy, the CPK may have already dissipated (Gaut & Liapis, 2020). It is also believed that myoglobin alone will rarely lead to kidney injury, but that it requires other risk factors such as ischemia, volume depletion, and hypotension to lead to AKI (Gaut & Liapis, 2020).Gaut, J. P. & Liapis, H. (2020). Acute kidney injury pathology and pathophysiology: A retrospective review. 
Clinical Kidney Journal
 
14,
(2), 526-536.Makris, K. & Spanou, L. (2016). Acute kidney injury: Definition, pathophysiology, and clinical phenotypes. 
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Tallona Boddy posted Mar 23, 2021 4:02 PM

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There is not one specific mechanism that causes rhabdomyolysis.  Rhabdomyolysis can result from a variety of causes, such as trauma, ischemic injury, drugs, infection and extreme physical exercise. The case presented in this week’s discussion, suggests that the most likely cause of the patient’s rhabdomyolysis is extreme exercise (running a 27 mile marathon). Rhabdomyolysis is essentially the breakdown of injured skeletal muscle. As the skeletal muscle breaks down intracellular muscle components are released into the bloodstream.  One of the muscle components released is, myoglobin (Torres et al., 2015). Acute renal failure proceeding rhabdomyolysis is theorized to be caused by the myoglobin, a toxin to the kidney. 10%-40% of patients that experience rhabdomyolysis will experience acute renal injury (Esposito et al., 2018). Myoglobin is believed to cause renal vasoconstriction, formation of intratubular casts and direct toxicity of myoglobin to the kidney (Petejova & Martinek, 2014).   Another factor that contributes to acute renal failure is volume depletion due to third spacing at the sight of the muscle injury.  As the skeletal muscle continues to break down metabolic acidosis, hyperkalemia, hyperphosphatemia, and/or a high anion gap could become present which can exacerbate acute renal failure. (Esposito et al., 2018). 
Esposito
, P., 
Estienne
, L., 
Serpieri
, N., 
Ronchi
, D., 
Comi
, G.P., 
Moggio
, M., 
Peverelli
, L., 
Bianzina
, S. & 
Rampino
, T. (2018, June 01). Rhabdomyolysis-associated acute kidney injury. 
American Journal of Kidney Disease. 71
(6), PA12-acute renal failure in rhabdomyolysis EssayA14. 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056317/
Torres, P. A., Helmstetter, J. A., Kaye, A. M., & Kaye, A. D. (2015). Rhabdomyolysis: pathogenesis, diagnosis, and treatment. 
The Ochsner journal, 15
(1), 58–69. 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365849/
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Petejova, N., & Martinek, A. (2014). Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. 
Critical Care (London, England), 18
(3), 224. 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056317/

References

Module 10, Eleany Yasein
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Eleany Yasein posted Mar 24, 2021 1:02 PM

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         Rhabdomyolysis is a result of muscle injury that has systemic effect (Stanley & Adigun, 2021). The muscle injury is caused by destruction of myocyte cell membrane. Destructive enzymes such as phospholipase and protease are activated, which cause myolysis and cell death. There is a leakage of muscle intracellular components (ex. potassium, myoglobin, creatine kinase, and phosphate) into the blood. This leads to hyperkalemia, hyperphosphatemia and hyperuricemia. It can eventually lead to acute kidney injury, electrolyte imbalance and intravascular coagulation (Stanley & Adigun, 2021). About 10% to 40% of patients who suffer from rhabdomyolysis develop acute kidney injury (Esposito et al., 2018). The release of myoglobin into the blood causes nephrotoxicity. It can cause buildup of iron in the proximal tubules and cause intratubular obstruction and tubular cell injury. Third spacing is also seen due to fluids moving into the injured muscles. Moreover, the release of intracellular constituents can lead to metabolic acidosis which can further damage the tubular (Esposito et al., 2018).  Acute renal failure is a major factor in mortality from rhabdomyolysis (Stanley & Adigun, 2021).  Patients with acute renal failure in rhabdomyolysis will present with increased serum creatine, increased phosphate levels, decreased bicarbonate, decreased calcium levels. Furthermore, increased BUN and hypoalbuminemia can be seen (Stanley & Adigun, 2021).  Esposito, P., Estienne, L., Serpieri, N., Ronchi, D., Comi, P. G., Moggio, M., Peverelli, L., Bianzina, S., & Rampino, T. (2018, June 01). Rhabdomyolysis-Associated Acute Kidney Injury. 
American Journal of Kidney Diseases
, 71(6), xii-xiv. 
https://www.ajkd.org/action/showPdf?pii=S0272-6386%2818%2930549-3
Stanley, M., & Adigun, R. (2021, February 15). Rhabdomyolysis. 
StatPearls. 
https://www.ncbi.nlm.nih.gov/books/NBK448168/
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Sheryl Dixon posted Mar 24, 2021 1:26 AM

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The clinical syndrome of rhabdomyolysis is caused by injury of skeletal muscles, leading to the release of various intracellular muscle constituents. Rhabdomyolysis occurs frequently but is usually asymptomatic (i.e., lab abnormalities only). However, in more serious cases, severe electrolyte disorders and acute renal failure may occur, leading to life-threatening situations. Rhabdomyolysis can develop in any circumstances where energy demands in muscles exceed the available energy supplies; it accounts for between 2 and 5% of all cases of acute renal failure in the ICU. Frequent causes of severe rhabdomyolysis include crush injuries, prolonged immobilization, seizures, severe infections and drug toxicity. Factors contributing to the development of more severe clinical symptoms include hypovolemia, hyperthermia, electrolyte disorders and the presence of pre-existing (congenital) muscle disorders(Polderman,2004).The pathophysiology of RM-induced AKI is believed to be triggered by myoglobin as the toxin causing renal dysfunction. This claim is given substance from studies in animal models of glycerol-induced AKI. Intramuscular injection of glycerol in the rabbit induces a model of AKI at a dose of 10 mg/kg that resembles the AKI caused by massive release of myoglobin in crush syndrome in humans. Glycerol-induced AKI is characterized by myoglobinuria, tubular necrosis and renal vasoconstriction. The most important role in glycerol-induced nephrotoxicity has been attributed to reactive oxygen metabolites (reactive oxygen species), in particular the hydroxyl radical (OH.), the same cause as for myoglobin-induced AKI (Petejova & Martinek,2016).                                                                                          ReferencesPolderman K. H. (2004). 
Acute renal failure and rhabdomyolysis
. The International journal of artificial organs, 27(12), 1030–1033. https://doi.org/10.1177/039139880402701204less0 UnreadUnread

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Petejova, N., & Martinek, A. (2014). 
Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. 
Critical care (London, England), 18(3), 224. https://doi.org/10.1186/cc13897 acute renal failure in rhabdomyolysis Essay

The diagnosis is established by elevation of serum muscle enzymes and muscle constituents such as creatinine phosphokinase and myoglobin. Preventive measures include maintenance of normal or high intravascular volume and administration of diuretics (loop diuretics rather than mannitol) once hypervolemia/euvolemia have been achieved. Some evidence suggests that early initiation of renal replacement therapy can help improve outcome. Administration of bicarbonate to induce urinary alkalosis can be considered, but it has not been proven to be effective (Polderman,2004).

Week 10 Discussion Post – Rhabdomyolysis

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Gisselle Mustiga posted Mar 24, 2021 12:30 AM

Rhabdomyolysis is a potentially life-threatening syndrome resulting from the breakdown of skeletal muscle fibers with leakage of muscle contents into the bloodstream (Huether et al. 2020). These components are the sarcoplasmic proteins myoglobin (MB), creatine kinase (CK), and alanine transaminase (ALT). The condition’s causative agents include crush injury, overexertion, alcohol abuse, toxic substances, and medications, such as antihistamines and antibiotics. Additionally, as in the case of the male patient in the case study, the condition can be caused by muscle breakdown associated with strenuous exercise or normal exercise under extreme circumstances and is termed Exertional Rhabdomyolysis (ER) (Das et al. 2020).  A person suffering from this illness may present with clinical features that comprise of muscle pain, muscle weakness, oliguria, and myoglobinuria – a pigmented and dark brown urine. In ER, the level of serum concentration of CK rises 5-10 folds the average amount. The rise in CK concentration is directly associated with acute renal failure. Hyperthermia and repetitive eccentric muscle loads are the key contributors to the presence of both ER and acute kidney failure.
References
Das, S., Hanuman, S. B., & Mylapalli, J. L. (2020). Rhabdomyolysis associated acute renal failure–Report of two fatal cases and a brief review of literature. 
Journal of forensic and legal medicine
, 
71
, 101941. less0 UnreadUnread

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Huether, S. E., McCance, K. L. & Brashers, V. L. (2020). 
Understanding  
Pathophysiology 7
th
 ed. 
 Elsevier Mosby.

Abbas, M., Brown, V., Rietveld, A. P., & Hoek, A. E. (2019). A marathon runner with rhabdomyolysis. 
Nederlands tijdschrift voor geneeskunde
, 
163
.

If undiagnosed, both conditions can have adverse effects on the patient, notably, Acute Kidney Failure. The diagnostic biomarkers are Myoglobinuria and CK and early detection is critical. Standard treatment is the administration of IV fluids, mannitol, which decreases osmotic swelling and edema in the injured muscle cells and helps restore the skeletal muscle function, as well as bicarbonate, which neutralizes the urine. In case of Exercise –induced Rhabdo, patients can take preventive measures, such staying hydrated, becoming acclimatized to one’s physical activity and environmental conditions, since hot and humid climates are contributing factors.  (Abbas, et al. 2019).

Rhabdomyolysis
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Jennifer Bryant posted Mar 23, 2021 2:54 PM

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     Rhabdomyolysis is the breakdown of skeletal muscle that causes the release of its cellular contents, including protein pigment myoglobin into the systemic circulation (Manis et al., 2019). The causes are varied but may include excessive exercise like the runner in our case study. CPK is an enzyme found in the mitochondria and cytoplasm of various tissues throughout the body including, skeletal and cardiac muscle, and brain tissue. The release of CPK resulting in a level approximately 5 times the upper limits of the reference range, approximately 1000 U/L, is considered confirmatory for the diagnosis of rhabdomyolysis (Manis et al, 2019). In this case, the patients level is 23,000 for a positive diagnosis.References Rhabdomyolysis, 
Disease-a-Month
, 66(8).Manis, T., George-Varghese, B., & Kashani, J. (2019). Rhabdomyolysis – go big or godoi:http://dx.doi.org.wilkes.idm.oclc.org/10.1016/j.ajem.2019.03.024rhabdomyolysis.
 Sports Medicine, 47
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 by Melissa Morgan

doi:http://dx.doi.org.wilkes.idm.oclc.org/10.1007/s40279-017-0689-z

Rawson, E. S., Clarkson, P. M., & Tarnopolsky, M. A. (2017). Perspectives on exertional

home.
 The American Journal of Emergency Medicine, 37
(12), 2194-2196.

https://doi.org/10.1016/j.disamonth.2020.101015.

Cabral, B.M., Edding, S. N., Portocarrero, J. P., Lerma, E. V. (2020).

            What we do not know in this case is the urine myoglobin. Myoglobin is cleared by the kidneys. Myoglobin, and likely other proteins, can precipitate in the kidney or be directly nephrotoxic (oxidative stress), resulting in acute renal failure that-if left untreated-could be life threatening (Rawson et al, 2017). Acute kidney injury can occur in 7-10% of all patients who have rhabdomyolysis. The exact mechanism by which rhabdomyolysis impairs glomerular filtration rate is unclear, but there is growing evidence that suggests: renal vasoconstriction; direct and ischemic tubule injury and tubular obstruction (Cabral et al, 2020). Exertional muscle damage produced by eccentric exercise in healthy individuals can cause profound CK and myoglobin elevations without renal impairment, and elevated CK is likely a population-specific bio-marker (Rawson et al, 2017). Maintaining adequate urinary flow and prevention of kidney failure is the goal of treatment with rapid IV hydration.

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Joanne Hogan posted Mar 23, 2021 1:18 PM

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Module 10While complications from rhabdomyolysis vary, acute kidney injury occurs in up to 40% of patients and those with acute kidney injury have an increased mortality rate of up to 80% (Cabral et al., 2020). In a patient with acute kidney injury caused by rhabdomyolysis, the urine will be dark and tea colored (Rawson et al., 2017). According to Rawson et al. (2017), urine dip stick analysis will show acidic urine with myoglobin casts and epithelial cells. Proteinuria can commonly occur in these patients due to the increased excretion of globin (Cabral et al., 2020).  Elevated CK levels, potassium, creatine, and creatinine all increase risk for acute kidney injury as well (Huether et al., 2020). According to Huether et al. (2020), once CK levels reach levels of 15,000, renal failure becomes more likely. Due to increased fluid depletion, the RAAS system is activated and ADH is activated, increasing fluid and salt retention (Rawson et al., 2017). Cabral, B. I., Edding, S. N., Portocarrero, J. P., & Lerma, E. V. (2020). Rhabdomyolysis. 
Disease-a-Month
, 
66
(8), 101015. 
https://doi.org/10.1016/j.disamonth.2020.101015
Rawson, E. S., Clarkson, P. M., & Tarnopolsky, M. A. (2017). Perspectives on exertional rhabdomyolysis. 
Sports Medicine
, 
47
(S1), 33–49. 
https://doi.org/10.1007/s40279-017-0689-z
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Huether, S. E., McCance, K. L., & Brashers, V. L. (2020). 
Understanding pathophysiology
 (7th ed.). Elsevier.

References

To prevent renal failure, it is important to treat patients suffering from rhabdomyolysis with IV fluids to prevent excess fluid loss and to prevent the formation of casts and to ensure adequate renal perfusion (Cabral et al. 2020). In cases where the cause of the rhabdomyolysis can be isolated, such as in cases where the illness is caused by medications or drugs, it is imperative to alter lifestyles to prevent further illness (Rawson et al., 2017). IV sodium bicarbonate should also be administered to prevent acidosis, and mannitol may also be given IV to ensure adequate urine output (Rawson et al., 2017).

Rhabdomyolysis is a potentially life-threatening disease where muscle tissue is broken down and intracellular contents are released into the blood stream (Rawson et al., 2017).  It is caused by an injury to the muscle and due to the large quantity of muscle in the body, the spilling of intracellular contents into the systemic circulation can be overwhelming for the body (Rawson et al., 2017). ATP is depleted and calcium level in the cells increase causing cell lysis (Rawson et al., 2017).

Fritzinger, Discussion Wk10
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Cassie Fritzinger posted Mar 22, 2021 10:21 PM

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Rhabdomyolysis is a condition following the breakdown of skeletal muscle, releasing intracellular contents into the extracellular space and bloodstream. Common causes being trauma, overexertion, toxic substances including alcohol abuse. Complications secondary to this condition due to muscle cell necrosis include hyperkalemia, hypocalcemia, acute kidney injury (AKI) and hypovolemic shock. AKI occurs in approximately 19%-58% of those patients who have rhabdomyolysis (Candela, et al., 2020).            Symptoms of AKI may include muscle pain, weakness, and dark urine. While dark urine is often seen, this alone is not a reliable indicator of rhabdomyolysis acute renal failure in rhabdomyolysis Essay. Labs studies noted in the evaluation of rhabdomyolysis may include CK, potassium, phosphorus, blood urea nitrogen (BUN) to creatinine ratio, and calcium. The CK level of 5-10 times normal is seen in rhabdomyolysis. A CK level of greater than 15,000 units/L indicates a likelihood of acute renal failure (Chrisholm-Burns, Schwinghammer, Malone, Kolesar, Lee & Bookstaver, 2019).            The patient of discussion has a CK level of 23,000 which is over 135 times greater than the normal level. His presentation of pain, swelling and redness of his left calf are also consistent with the diagnosis of rhabdomyolysis. His risk factors of significant strenuous activity of running the marathons and training significantly for the past few months is another additional risk factor of rhabdomyolysis. While his BUN and Creatinine are currently within normal limits it would be important to start fluid rehydration and monitor any electrolyte imbalances. The BUN/Creatinine indicate he has not yet progressed into AKI. However, as stated previously a CK greater than 15,000units/L would be highly suggestive of impending AKI and prevention of this progression if possible or limiting this progression is of great importance. Candela, N., Silva, S., Georges, B., … Faguer, S. (2020). Short- and Long-Term Rental Outcomes Following Severe Rhabdomyolysis: A French Multicenter Retrospective Study of 387 Patients. Annals of Intensive Care. 10:27. 
https://doi.org/10.1186/s13613-020-0645-1
Diaz-Tejeiro, R., Regidor, D., Morales, J., Padron, M., Cueto, L. Munoz, MA, et al. (2018). Acute Renal Failure due to Rhabdomyolysis. Renal Replacement Therapy with Intermediate Cut-Off Membranes (EMIC2). Nefrologia. 38(6) 660-680. 
https://doi.org/10.1016/j.nefroe.2018.06.013

Chrisholm-Burns, M. A., Schwinghammer, T.L., Malone, P.M., Kolesar, J.M., Lee, K.C., & Bookstaver, P.B. (2019). Pharmacotherapy: Principles and practices (5th ed.) McGraw-Hill Education.

References

            The treatment for rhabdomyolysis is to improve urinary output with adequate hydration ultimately working to prevent secondary AKI. Diaz-Tejeiro, et al. (2018), found that not all patients will have resolution of kidney function with simple hydration and may require renal replacement therapy such as dialysis. The early initiation of replacement therapy with improved myoglobin clearance and decreased serum levels equated to improved and earlier recovery from AKI (Diaz-Tejeiro, et al, 2018).

            AKI secondary to rhabdomyolysis results from the release of myoglobin, lactate dehydrogenase, creatine kinase (CK) and other electrolytes into the circulation and interstitial space. The circulation of myoglobin reaching the renal tubules leads to an obstruction creating injury of the kidney filtration function. AKI is characterized by a sudden decrease in kidney function with decreased glomerular filtration (GFR) and decreased urine output. Renal vasoconstriction, intratubular casts, and the direct tubular cell damage are three nephrotoxic mechanisms which cause the AKI (Chrisholm-Burns, Schwinghammer, Malone, Kolesar, Lee, & Bookstaver, 2019)acute renal failure in rhabdomyolysis Essay.

NRS 429VN – Transtheoretical model (TTM)

Re: Topic 1 DQ 2

A health promotion model used for behavioral change is the transtheoretical model (TTM). An example of a behavioral change is smoking cessation. According to Whitney (2018), this method helps to identify a patient’s level of readiness to make necessary to changes to improve their health. It is broken down into 6 stages:

Precontemplation

Contemplation

Preparation

Action

Maintenance

Termination

This model aids in behavioral changes by using it as an assessment tool. It helps to identify in what stage a person is in to begin a behavioral change. Knowing what stage a person is in can help guide behavioral strategies that can influence behaviors towards a better health outcome. The first stage of this model is the first barrier that can affect the patient’s ability to learn. The precontemplation stage is when a person is not even considering making a change, they may have thought about it, but they don’t have the confidence or will to make a change. They know smoking is bad for them they know the side effects, but they are just not mentally ready to even think about smoking cessation. If a patient is not ready or motivated to learn or change their behavior, a positive learning outcome will not be met NRS 429VN – Transtheoretical model (TTM).

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Reference

Whitney, S. (2018). Teaching and Learning Styles. Retrieved October 7, 2021, from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/1

Describe a health promotion model used to initiate behavioral changes. How does this model help in teaching behavioral changes? What are some of the barriers that affect a patient’s ability to learn? How does a patient’s readiness to learn, or readiness to change, affect learning outcomes?

response

The transtheoretical model is a good theory for patients to self reflect. This model holds the patient accountable to really understand what the real problem is. Also the great thing about this theory is that it is done in stages, or baby steps to the patient.The theory helps with staying motivated to continue reaching the next goal. By assessing the patient’s readiness to change, the nurse can create appropriate behavioral objectives for the patient’s current stage (Whitney, 2018). I do agree with you that if a patient is not ready or motivated to learn or change their behavior no goals will be met NRS 429VN – Transtheoretical model (TTM).

Whitney, S. (2018). Teaching and Learning Styles. Retrieved October 7, 2021, from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/1 NRS 429VN – Transtheoretical model (TTM)

Evita Alonso GI ihuman assignment

Week 7: Evaluation and Management of Renal and Genitourinary Conditions

The renal and genitourinary system is critical to the function of the entire body. As an advanced practice nurse, obtaining a relevant, focused history is critical. Conditions involving the genitourinary system, such as prostate cancer, often create a feeling of powerlessness, frustration, anxiety, and embarrassment in patients. Having provider-patient conversations about symptoms, potential treatment options, and patient education can be overwhelming for patients under such stress. It is your role to sensitively facilitate the treatment and management process through these difficult conversations and ultimately promote their well-being and empowerment. An accurate assessment will help you recognize and address any impact on the renal and genitourinary system in order to manage and prevent damages to the kidneys or other components of the system. Your role in the clinical setting is unique, as it is not only your responsibility to evaluate, diagnose, manage, and educate patients on their conditions, but also to provide emotional and psychological support to patients and their families Evita Alonso GI ihuman assignment.

For this week, you will analyze an i-Human simulation case study about an adult patient with a gastrointestinal condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and then create an appropriate treatment plan for the patient.

Learning Objectives

Students will:

Formulate differential diagnoses for adult patients with renal and genitourinary conditions

Analyze pattern recognition in adult patient diagnoses

Analyze the role of patient information in differential diagnosis

Evaluate pharmacologic and non-pharmacologic treatment options for adult patients

Create an appropriate treatment plan that includes health education and follow-up care

Learning Resources

Required Readings
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Required Media
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Assignment: i-Human Case Study: Evaluating and Managing Genitourinary or Gastrointestinal Conditions

Urinary frequency is an example of a genitourinary condition that presents problems for adults across the lifespan. It can be the result of various systemic conditions such as diabetes, urinary tract infections, enlarged prostates, kidney infections, or prostate cancer. Many of these conditions have very serious implications requiring thorough patient evaluations. When evaluating patients, it is essential to carefully assess the patient’s personal, medical, and family history prior to recommending certain physical exams and diagnostic testing, as sometimes the benefits of these exams do not outweigh the risks Evita Alonso GI ihuman assignment.

Photo Credit: Crystal light / Adobe Stock

For this Case Study Assignment, you will analyze an i-Human simulation case study about an adult patient with a gastrointestinal condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and then create an appropriate treatment plan for the patient.

To prepare:

Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with GI or GU conditions.

Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with GI or GU conditions Evita Alonso GI ihuman assignment.

Assignment

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the 
i-Human Graduate Programs Help 
link within the i-Human platform.

By Day 7

Complete your Assignment in i-Human.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.

Click the 
Week 7 Assignment Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 7 Assignment 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK7Assgn+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
 button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment draft and review the originality report.

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Submit Your Assignment by Day 7

To participate in this Assignment:

Week 7 Assignment Evita Alonso GI ihuman assignment

What’s Coming Up in Week 8?

Week 8 Knowledge Check

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Week 8, you will complete the next Knowledge Check, which covers the Module 3 topics from Weeks 6, 7, and 8. Refer to the Week 8 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly.

To go to the next week:

NRNP_6531_Week7_Assignment_Rubric

Novice

Competent

Proficient

HPI statement

0 
(0%)
 – 5 
(5%)

Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills

6 
(6%)
 – 10 
(10%)

Well written HPI statement but may be missing 1-2 key components from the history

11 
(11%)
 – 15 
(15%)

Clearly written HPI statement with comprehensive information gathering from case questions.

History

0 
(0%)
 – 6 
(6%)

Incomplete history missing 3 or more aspects of the OLDCARDS critical to patient’s diagnosis.

7 
(7%)
 – 8 
(8%)

Fairly complete history covering most of the requirements but may be missing 1-2 aspects of OLDCARDS critical to patient’s diagnosis.

9 
(9%)
 – 10 
(10%)

Complete history covering all critical components of a focus exam. Includes all aspects of OLDCARDS

Physical Exam

0 
(0%)
 – 6 
(6%)

Incomplete physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis.

7 
(7%)
 – 8 
(8%)

Fairly complete physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis.

9 
(9%)
 – 10 
(10%)

Complete physical examination covering all critical components of a focus exam.

Testing

0 
(0%)
 – 6 
(6%)

Includes 3 or more inappropriate exams or tests. May include contraindicated testing.

7 
(7%)
 – 8 
(8%)

Tests ordered are generally apprropriate. May include 1-2 unnecessary exams or tests.

9 
(9%)
 – 10 
(10%)

Tests that are ordered are appropriate for patient and cost effective.

Differential Diagnosis Summary

0 
(0%)
 – 9 
(9%)

Primary diagnosis may be wrong.Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components.

10 
(10%)
 – 14 
(14%)

Correct primary diagnosis identified. Well written differential diagnoses. May be missing 1-2 critical components. Priority list may be out of order

15 
(15%)
 – 20 
(20%)

Primary diagnosis identified. Clearly written differential diagnoses.

Plan for patient

0 
(0%)
 – 15 
(15%)

Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.

16 
(16%)
 – 25 
(25%)

Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.

26 
(26%)
 – 30 
(30%)

Clearly written plan covering all critical components for patient’s final diagnosis.

Exercises

0 
(0%)
 – 2 
(2%)

Correctly answered 0-69% of the clinical questions.

3 
(3%)
 – 4 
(4%)

Correctly answered 70-89% of the clinical questions.

0 
(0%)
 – 5 
(5%)

Correctly answered 90-100% of the clinical questions.

Total Points: 100

Name: NRNP_6531_Week7_Assignment_Rubric Evita Alonso GI ihuman assignment

Darius Davis ihuman case study

NRNP_6531_Week4_Assignment_Rubric

Novice

Competent

Proficient

HPI statement

0 
(0%)
 – 5 
(5%)

Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills

6 
(6%)
 – 10 
(10%)

Well written HPI statement but may be missing 1-2 key components from the history

11 
(11%)
 – 15 
(15%)

Clearly written HPI statement with comprehensive information gathering from case questions.

History

0 
(0%)
 – 6 
(6%)

Incomplete history missing 3 or more aspects of the OLDCARDS critical to patient’s diagnosis.

7 
(7%)
 – 8 
(8%)

Fairly complete history covering most of the requirements but may be missing 1-2 aspects of OLDCARDS critical to patient’s diagnosis Darius Davis ihuman case study.

9 
(9%)
 – 10 
(10%)

Complete history covering all critical components of a focus exam. Includes all aspects of OLDCARDS

Physical Exam

0 
(0%)
 – 6 
(6%)

Incomplete physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis.

7 
(7%)
 – 8 
(8%)

Fairly complete physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis.

9 
(9%)
 – 10 
(10%)

Complete physical examination covering all critical components of a focus exam.

Testing

0 
(0%)
 – 6 
(6%)

Includes 3 or more inappropriate exams or tests. May include contraindicated testing.

7 
(7%)
 – 8 
(8%)

Tests ordered are generally apprropriate. May include 1-2 unnecessary exams or tests.

9 
(9%)
 – 10 
(10%)

Tests that are ordered are appropriate for patient and cost effective.

Differential Diagnosis Summary

0 
(0%)
 – 9 
(9%)

Primary diagnosis may be wrong.Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components.

10 
(10%)
 – 14 
(14%)

Correct primary diagnosis identified. Well written differential diagnoses. May be missing 1-2 critical components. Priority list may be out of order

15 
(15%)
 – 20 
(20%)

Primary diagnosis identified. Clearly written differential diagnoses.

Plan for patient

0 
(0%)
 – 15 
(15%)

Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.

16 
(16%)
 – 25 
(25%)

Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.

26 
(26%)
 – 30 
(30%)

Clearly written plan covering all critical components for patient’s final diagnosis.

Exercises

0 
(0%)
 – 2 
(2%)

Correctly answered 0-69% of the clinical questions.

3 
(3%)
 – 4 
(4%)

Correctly answered 70-89% of the clinical questions Darius Davis ihuman case study.

0 
(0%)
 – 5 
(5%)

Correctly answered 90-100% of the clinical questions.

Total Points: 100

Name: NRNP_6531_Week4_Assignment_RubricAssignment: i-Human Case Study: Evaluating and Managing Cardiovascular Conditions

Because cardiovascular conditions are preventable and manageable, it is important that the advanced practice nurse use both their understanding of the cardiovascular system and the impact of patient factors and behaviors that might increase patient risk of such conditions. This critical information can guide you in immediately identifying signs and symptoms that can inform differential diagnoses and lead to identification of appropriate treatment options and a treatment plan Darius Davis ihuman case study.

Photo Credit: yodiyim / Adobe Stock

For this Case Study Assignment, you will analyze an i-Human simulation case study about an adult patient with a cardiovascular condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient.

To prepare:

Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with cardiovascular conditions.

Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with cardiovascular conditions.

Assignment

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the 
i-Human Graduate Programs Help 
link within the i-Human platform Darius Davis ihuman case study.

  ORDER A PLAGIARISM FREE PAPER NOW

By Day 7

Complete
 and 
submit
 your Assignment in i-Human.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.

Click the 
Week 4 Assignment Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 4 Assignment 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
button to complete your submission Darius Davis ihuman case study.

NRNP – 6531 Week 2: Kaylee Hales Derm ihuman case study

The following information is to be included in your i-Human cases:

HPI: You will type this in the EMR section of the case (NOT the problem statement)

This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. This is for subjective findings. Use LOCATES or OLDCARTS Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. Include any pertinent history information that might impact the differential diagnosis formulation. If the CC was “headache,” the LOCATES for the HPI would include the following information:NRNP – 6531 Week 2: Kaylee Hales Derm ihuman case study

Location: head

Onset: 3 days ago

Character: pounding, pressure around the eyes and temples

Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia

Timing: after being on the computer all day at work

Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not completely better

Severity: 7/10 pain scale

 

Plan: Type the information regarding each of the following sections into the i-Human Plan section of your case. You must address each of the 6 topics. For example, if you will not be consulting anyone then you must write “no consults indicated”. Each section of the plan is worth 5 points to total 30 points.

Additional labs or diagnostic tests: Additional laboratory and diagnostic tests may be necessary to establish or evaluate a condition. Some tests, such as MRI, may require prior authorization from the patient’s insurance carrier.

Consults: referrals to specialists, therapists (physical, occupational), counselors, or other professionals. If you are sending to hospital, what orders would you write for a direct admit?

Therapeutic modalities: pharmacological and nonpharmacological management. Give specific medications, dosing and duration. Include anticipated therapeutic modalities/symptomatic treatment for patients if they are sent to ED or directly admitted.

Health Promotion: Address risk factors as appropriate. Consider age-appropriate preventive health screening. What immunizations do they need?

Patient education: Explanations and advice given to patient and family members about diagnosis and treatment plan.

Disposition/follow-up instructions: include when to follow up in clinic, follow up sooner, or go to ER. When should they be seen by a specialist or therapist. When the patient is to return sooner, and when to go to another facility such as the emergency department, urgent care center, specialist or therapist NRNP – 6531 Week 2: Kaylee Hales Derm ihuman case study.

Finally, be sure to include a minimum of 3 timely, scholarly references, that proves this plan and follows current standards of care. The course text may NOT be used as a reference. The references must be professional and not general patient education websites.

Assignment:
i-Human Case Study
: Evaluating and Managing Integumentary Conditions

This course will require you to complete a series of case studies using the i-Human software application. The i-Human Patients (IHP) Case Player enables you to interact with virtual patients for the purpose of learning patient-assessment and diagnostic-reasoning skills. With IHP, you will be able to independently interview, examine, diagnose, and treat virtual patients and receive expert feedback on your performance.

Photo Credit: RFBSIP / Adobe Stock

The integumentary system is susceptible to a variety of diseases, conditions, and injuries, ranging from the bothersome but relatively innocuous bacterial or fungal infections that are categorized as disorders to skin cancer and severe burns, which can be life-threatening.

For this Case Study Assignment, you will examine your first case study and work with a patient with an integumentary condition. You will formulate a differential diagnosis, evaluate treatment options, and then create an appropriate treatment plan for the patient.

To prepare:

Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with integumentary conditions.

Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be most appropriate to gather more information about the patient’s condition.

Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with integumentary conditions NRNP – 6531 Week 2: Kaylee Hales Derm ihuman case study.

Assignment

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform.

 

NRNP_6531_Week2_Assignment_Rubric

Grid View

List View

Novice

Competent

Proficient

HPI statement

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0 (0%) – 5 (5%)

Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills

6 (6%) – 10 (10%)

Well written HPI statement but may be missing 1-2 key components from the history

11 (11%) – 15 (15%)

Clearly written HPI statement with comprehensive information gathering from case questions.

History

0 (0%) – 6 (6%)

Incomplete history missing 3 or more aspects of the OLDCARDS critical to patient’s diagnosis.

7 (7%) – 8 (8%)

Fairly complete history covering most of the requirements but may be missing 1-2 aspects of OLDCARDS critical to patient’s diagnosis.

9 (9%) – 10 (10%)

Complete history covering all critical components of a focus exam. Includes all aspects of OLDCARDS

Physical Exam

0 (0%) – 6 (6%)

Incomplete physical examination. May be missing 3 or more key exam findings that are critical to patient’s diagnosis.

7 (7%) – 8 (8%)

Fairly complete physical examination but may be missing 1-2 key exam findings critical to patient’s diagnosis.

9 (9%) – 10 (10%)

Complete physical examination covering all critical components of a focus exam.

Testing

0 (0%) – 6 (6%)

Includes 3 or more inappropriate exams or tests. May include contraindicated testing.

7 (7%) – 8 (8%)

Tests ordered are generally apprropriate. May include 1-2 unnecessary exams or tests.

9 (9%) – 10 (10%)

Tests that are ordered are appropriate for patient and cost effective.

Differential Diagnosis Summary NRNP – 6531 Week 2: Kaylee Hales Derm ihuman case study

0 (0%) – 9 (9%)

Primary diagnosis may be wrong.Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components.

10 (10%) – 14 (14%)

Correct primary diagnosis identified. Well written differential diagnoses. May be missing 1-2 critical components. Priority list may be out of order

15 (15%) – 20 (20%)

Primary diagnosis identified. Clearly written differential diagnoses.

Plan for patient

0 (0%) – 15 (15%)

Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis.

16 (16%) – 25 (25%)

Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis.

26 (26%) – 30 (30%)

Clearly written plan covering all critical components for patient’s final diagnosis.

Exercises

0 (0%) – 2 (2%)

Correctly answered 0-69% of the clinical questions.

3 (3%) – 4 (4%)

Correctly answered 70-89% of the clinical questions.

0 (0%) – 5 (5%)

Correctly answered 90-100% of the clinical questions.

Total Points: 100

Name: NRNP_6531_Week2_Assignment_Rubric NRNP – 6531 Week 2: Kaylee Hales Derm ihuman case study

NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies
Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

As I start on the course on “Primary Care Adults Across the Lifespan,” I anticipate gaining some understanding on some of the complex nature in the diagnosing and management of healthcare needs for adult patients. The course, based on my present understanding, provides the learners with learning experience, particularly in the focus on art and science of clinical decision-making, which is a skill critical for my future role as an Adult-Gerontology Primary Nurse Practitioner (AGPCNP). Throughout the course, I remain expectant to increase my knowledge in both the physical and behavioral elements of the disease process. More so, I aim at refining my skills in developing the best treatment programs for my patients. The opportunity to be a part of assignments that reflect the actual life situation will further help prepare me and align my expectations to the state of illnesses within the primary healthcare setting.

One of my expectations for the course lies in strengthening my diagnostic skills. My background in skilled nursing and sub-acute care will help me to have a solid foundation in the assessment of patients and planning for their care as well. I acknowledge that transitioning to a nurse practitioner role mandates an understanding of the processes of diagnosis. The course will help me to build on my existing knowledge and sharpen my skills in diagnosing conditions impeccably, which is a critical competency when working with adult patients across the lifespan.

Another major expectation is deepening my understanding of therapeutic treatment planning. My experience in long-term care has given me insight to the essence of individualized care plans, but the course will take that understanding to a higher level. I look forward to learning more about the latest evidence-based practices in planning for treatment and how to evaluate and adjust the treatment programs based on outcomes for a patient. Such a skill is critical as I aim at providing the highest quality care to patients while ensuring that the treatment plans are effective and tailored to the unique needs of a patient.

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In reflecting on my strengths and challenges as they relate to the competencies, I believe that the experience in the development of care plans and my dedication to patient education are some of my major strengths. Over the years, I have sharpened my ability to work with physicians, nurse personnel, and different health providers in the creation of individualized care plans addressing each of the unique needs of a patient. The experience has reinforced the essence of patient and family education, which I regard to be effective in healthcare. Besides, I still acknowledge that the expanded practice scope as an AGPCNP presents certain challenges, especially in areas of advanced diagnostic reasoning and pharmacologic management. Despite my foundational knowledge in the areas, I remain eager to deepen my expertise and acquire confidence in making complex clinical decisions independently.

The course is usually directly linked with my career goals of becoming a skilled AGPCNP who can make significant impact in the lives of the adult patients, especially those in the long-term situation. Reducing fragmentation of care is one of my goals, especially between acute care and long-term care, and making sure that patients continue receiving exceptional care when they are moved to the next level of care (Mann et al., 2021). The following knowledge and skills are expected to be acquired from this course and will help in the achievement of this goal. Also, I have the desire to be not only a professional in my sphere but also a specialist who will introduce new standards in the healthcare system and work towards enhancing the overall quality of patients’ treatment. NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

A review of the literature has recommended enhanced clinical decision-making competencies to enhance patient outcomes, especially in scenarios where NPs work in primary healthcare facilities. A study conducted by Evans et al. (2021) identified that Advanced Practice Nurse practitioners with an understanding of acute conditions requiring a first point of contact were more effective in delivering the best care by quickly identifying these conditions and satisfying patient needs. Additionally, the capacity to write effective patient care plans is also significant, considering the various problems that adults have, as indicated by Htay and Whitehead (2021). These understandings highlight the significance of the competencies that I will acquire within this course and the potential for their application towards the improvement of my practice in the future.

Therefore, I anticipate starting this course as it will help me to develop the competencies that are necessary to become an AGPCNP. Thus, I am confident that the acquired knowledge and practical experience will help me achieve high results in my future position, where I will have a chance to enrich the lives of my patients and their families.

References

Evans, C., Poku, B., Pearce, R., Eldridge, J., Hendrick, P., Knaggs, R., Blake, H., Yogeswaran, G., McLuskey, J., Tomczak, P., Thow, R., Harris, P., Conway, J., & Collier, R. (2021). Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: A scoping review. 
BMJ Open
, 
11
(8), e048171. 
https://doi.org/10.1136/bmjopen-2020-048171

Htay, M., & Whitehead, D. (2021). The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review. 
International Journal of Nursing Studies Advances
, 
3
, 100034. 
https://doi.org/10.1016/j.ijnsa.2021.100034

Mann, C., Timmons, S., Evans, C., Pearce, R., Research, C. O., Hinsliff-Smith, K., & Conway, J. (2021). Exploring the role of advanced clinical practitioners (ACPs) and their contribution to health services in England. 
Nurse Education in Practice
. 
https://doi.org/10.21203/rs.3.rs-602519/v1
  NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

 

 

NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

Wk1 Competencies Initial Discussion Post

The expectations that I have, as an Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) student in NRNP 6531, are to become affluent in the examinations, procedures, and documentation skills that are expected in this advanced practice clinical course.  I have been apprehensive about starting this initial clinical because I may not immediately remember everything that I have been taught in this program, up to this point, when assessing patients with my preceptor.  I do realize that this is a learning experience, and the skills will become easier to implement with practice NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

Strengths and challenges are evident while self-appraising one’s ability in any professional setting.  The strengths that I bring to this clinical course, and subsequent career as an autonomous nurse practitioner, are that I display critical thinking and reasoning in my patient assessments and health management, develop trusting relationships with my patients and their families, displays empathy for others, and provides education to patients and their caregivers throughout their treatment and care.  These strengths relate to the AGPCNP competencies provided by the American Association of Colleges of Nursing.  Nurse practitioner core competencies require that the provider critically evaluates information and evidence for improving advanced nursing practice and incorporates this knowledge from the humanities and sciences within the context of nursing science.  The ACPCNP competencies require that reputable sources of national data on aging be analyzed and included in patient care.  Such sources include the Centers for Disease Control and Prevention (CDC), Healthy Aging Data Portfolio, and National Health and Aging Trends Study.  Competencies also include creating a climate of mutual trust while providing comfort and emotional support to patients and their families.  Educating the patients and caregivers is required by educating management strategies among normal development, aging, and mental and physical disorders (
The American Association,
2016).  The challenges that I have are that I tend to think and work in the moment, with not much thought on the patient’s future.  Advanced practice nurses are more expected to modify their care to patient responses, to contemplate beyond the immediate situation, and to relate past patient experiences with conceivable paths.  AGPCNP’s must recognize clinical trends and anticipate variations from the standard findings (Flanders et al., 2017) NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

My career goals are to become a AGPCNP in a palliative care setting.  I want to provide primary and palliative care to adult-gerontology oncology patients in need.  This course will assist me in accomplishing my goals by preparing me for advanced clinical assessments in a primary care setting.  Performing clinicals in a primary care setting will have a significant impact on the application of knowledge by immersing one’s self in skills required to care for palliative care patients (Gentry & Dahlin, 2020).

References

The American Association of Colleges of Nursing (AACN …
 American Association of Colleges of Nursing. (2016). Retrieved December 1, 2021, from 
https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Adult-Gero-NP-Comp-2016.pdf
.

Flanders, S. A., Gunn, S., Wheeler, M., Newsome, E., & Altman Klein, H. (2017) Accelerating the Development of Higher-Level Clinical Thinking in Novice Nurses. 
Journal for Nurses in Professional Development, 33
(5), 240-246.

Gentry, Jennifer, DNP, ANP-BC, GNP, ACHP, Dahlin, Constance, MSN, ANP-BC & ACHPN, FPCN. (2020). The Evaluation of a Palliative Care Advanced Practice Nursing Externship. 
Journal of Hospice & Palliative Nursing
, 
22
, 172-179. 
https://doi.org/10.1097/NJH.0000000000000637
.

response

Great post!  I can relate to your challenge and have not previously been mindful of planning the patient’s future on my own.  I worked with a nurse for several years in the emergency department that went back to pursue her FNP.  As I have been in this program, I have spoken with her about the journey.  I have discussed multiple challenges that I have faced throughout the program so far.  She told me once that as my role changes from RN to APRN, my perspective will change.  How I look at my responsibilities to the patient will help develop my skills as a practitioner.  She said you just look at things differently.  As I have progressed in the program, I have begun to understand what she was talking about.  I feel like as we grow and learn, we will start to put it all together and be able to make a plan for our patient’s future NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

According to Barnes et al (2018), advanced practice nurses play a vital role in expanding patients’ access to healthcare and the delivery of healthcare.  As we pursue an advanced degree, we are positively contributing to the patient’s healthcare.  The more we learn about our new role, the more we will be able to see the big picture, which involves positively contributing to our patient’s future healthcare.  Popejoy et al (2017) report that advanced practice nurses that have support to develop their skills can make positive changes.  Through our studies of evidenced-based practices, we will learn the best ways to treat and take care of our patients, therefore, positively improving patient outcomes (Moore et al, 2019).

References

Barnes, H., Richards, M. R., McHugh, M. D., & Martsolf, G. (2018). Rural And nonrural primary care physician practices increasingly rely on nurse practitioners. 
Health Affairs (Project Hope)
, 
37
(6), 908–914. doi: 10.1377/hlthaff.2017.1158

Moore, E. R., Watters, R., & Wallston, K. A. (2019). Effect of evidence‐based practice (EBP) courses on MSN and DNP students’ use of EBP. 
Worldviews on Evidence-Based Nursing
, 
16
(4), 319–326. https://doi.org/10.1111/wvn.12369

Popejoy, L., Vogelsmeier, A., Galambos, C., Flesner, M., Alexander, G., Lueckenotte, A., Lyons, V., & Rantz, M. (2017). The APRN Role in Changing Nursing Home Quality: The Missouri Quality Improvement Initiative. 
Journal of Nursing Care Quality
, 
32
(3), 196–201. doi: 10.1097/NCQ.0000000000000264 NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

An advanced practice nurse collaborates and communicates with patients, families, doctors, nurses, and specialists to ensure patients receive the care they need. As they diagnose, treat, manage, and educate patients, they are responsible for ensuring patient safety and maintaining ethical behavior. Competencies have been developed to help the advanced practice nurse to understand the practice knowledge, skills, and attitudes they need to be successful.

Photo Credit: michaeljung / Adobe Stock

For this Discussion, you will examine advanced nursing practice competencies and reflect on your strengths and challenges related to the competencies. In light of your reflection, you will consider how this course may help you attain your career goals or objectives NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

To prepare:

Review the Learning Resources for this week, specifically the advanced nursing practice competencies. As you review the competencies, reflect on your own strengths and challenges when working with adults across the lifespan.

By Day 3

Post
 a summary of your expectations of this course. Also, include a brief explanation of your strengths and challenges as they relate to nursing practice competencies when working with adults. Describe any career goals or objectives this course may help you accomplish in the Family Nurse Practitioner (FNP) or 
Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) 
role and explain why. Use your research to support your explanations by providing credible and scholarly sources.

Read
 a selection of your colleagues’ responses.

By Day 6

Respond
 to 
at least two
 of your colleagues on 
two different days
 by offering a suggestion or resources to help your colleagues in addressing their personal strengths or challenges, or their career goals. Use your research to support your suggestions. Provide at least 3 credible and current scholarly sources.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the 
Post to Discussion Question
 link and then select 
Create Thread
 to complete your initial post. Remember, once you click 
Submit
, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
Submit! NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

 

NRNP_6531_Week1_Discussion_Rubric

Grid View

List View

Excellent

Point range: 90–100

Good

Point range: 80–89

Fair

Point range: 70–79

Poor

Point range: 0–69

Main Posting:

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

40 
(40%)
 – 44 
(44%)

Thoroughly responds to the discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least 3 current credible sources.

35 
(35%)
 – 39 
(39%)

Responds to most of the discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least 3 current credible references.

31 
(31%)
 – 34 
(34%)

Responds to some of the discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with fewer than 2 credible references.

0 
(0%)
 – 30 
(30%)

Does not respond to the discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only 1 or no credible references.

Main Posting:

Writing

6 
(6%)
 – 6 
(6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Further adheres to current APA manual writing rules and style.

5 
(5%)
 – 5 
(5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

4 
(4%)
 – 4 
(4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 
(0%)
 – 3 
(3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

9 
(9%)
 – 10 
(10%)

Meets requirements for timely, full, and active participation.

Posts main discussion by due date.

8 
(8%)
 – 8 
(8%)

Posts main discussion by due date.

Meets requirements for full participation.

7 
(7%)
 – 7 
(7%)

Posts main discussion by due date.

0 
(0%)
 – 6 
(6%)

Does not meet requirements for full participation.

Does not post main discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 
(9%)
 – 9 
(9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 
(8%)
 – 8 
(8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 
(7%)
 – 7 
(7%)

Response is on topic, may have some depth.

0 
(0%)
 – 6 
(6%)

Response may not be on topic, lacks depth.

First Response:

Writing

6 
(6%)
 – 6 
(6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

5 
(5%)
 – 5 
(5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

4 
(4%)
 – 4 
(4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 
(0%)
 – 3 
(3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:

Timely and full participation

5 
(5%)
 – 5 
(5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 
(4%)
 – 4 
(4%)

Meets requirements for full participation.

Posts by due date.

3 
(3%)
 – 3 
(3%)

Posts by due date.

0 
(0%)
 – 2 
(2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 
(9%)
 – 9 
(9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 
(8%)
 – 8 
(8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 
(7%)
 – 7 
(7%)

Response is on topic, may have some depth.

0 
(0%)
 – 6 
(6%)

Response may not be on topic, lacks depth.

Second Response:

Writing

6 
(6%)
 – 6 
(6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

5 
(5%)
 – 5 
(5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

4 
(4%)
 – 4 
(4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 
(0%)
 – 3 
(3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:

Timely and full participation

5 
(5%)
 – 5 
(5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 
(4%)
 – 4 
(4%)

Meets requirements for full participation.

Posts by due date.

3 
(3%)
 – 3 
(3%)

Posts by due date.

0 
(0%)
 – 2 
(2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

Name: NRNP_6531_Week1_Discussion_Rubric

Career goals: Strengths and challenges related to nursing practice competencies

Advanced nurse practitioners have core competencies that need to be accomplished in order for nurse practitioners to practice independently and successfully.  As nurse practitioner students, we must use current competencies for our practice.  This course is designed to introduce and guide us through the practicum experience by allowing us to learn our own strengths and weaknesses as nurses.  The purpose of this discussion is to explain my expectations of this course, my strengths and challenges when working with adults, and the career goals that this course may help me accomplish.

  ORDER A PLAGIARISM FREE PAPER NOW

Summary of expectations of this course

I am anticipating this course to be the place where everything comes together as we start our practicum experience.  I expect this course to be eye-opening and satisfying as we put everything we have learned in theory together in the clinical world.  I also expect to learn even more from my preceptor, instructors, and colleagues in both the NRNP and practicum courses.  I hope to gain more confidence as I learn from my preceptor during practicum NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

Brief explanation of your strengths and challenges as they relate to nursing practice competencies when working with adults

My strengths related to nursing practice competencies are advocating for patients and their best interests by communicating and collaborating with the interdisciplinary team to improve patient outcomes and quality of care (The National Organization of Nurse Practitioner Faculties, 2017).  My experience as a registered nurse at a rehabilitation hospital has improved my communication techniques between the patients, family, physicians, and colleagues.  Education is very important for both the patient and family for them to fully take advantage of their health, so I try to educate my patients whenever possible (Chan et al., 2019).  I contribute to the design of clinical information systems in my unit because I am efficient with technology and dealing with computers on my unit.

The challenges that I am afraid of as an advanced nurse practitioner are facing ethical and legal issues with misdiagnosing and treating patients with the wrong treatments (The National Organization of Nurse Practitioner Faculties, 2017).  I am afraid of missing important details or critical tests and making mistakes all because I lack the confidence and experience in that role.

Describe any career goals or objectives this course may help you accomplish in the FNP role and why

As I explore all the opportunities that an FNP can do, I feel like I would like to start with family practice in a clinic to gain experience and confidence in the field.  I would like that time to learn and grow as a novice nurse practitioner treating patients of all age groups.  The surrounding towns I live in are all rural areas and I would like that opportunity to serve the community to promote education and provide more resources for healthy living.  I would also consider public health or community health by working closely with the outreach program at the local hospital in town.  This course can help me accomplish this FNP role by guiding me to analyze my professional growth and development related to advanced nursing practice (Walden University, 2020).  By the end of this course, I will be able to analyze conditions of body systems and formulate diagnoses and treatment plans for adult patients (Walden University, 2020) NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

Summary

I am looking forward to learning and growing into the advanced practice nurse role in this next term.  I am excited to incorporate all that I have learned into the real world to find my strengths and weaknesses in this practice so I can work on strengthening those weaknesses.  I am prepared to face challenges so I can find ways to improve and be the best advocate for my patients.

References

Chan, T. E., Lockhart, J. S., Thomas, A., Kronk, R., & Schreiber, J. B.  (2019).  An integrative review of nurse practitioner practice and its relationship to the core competencies.  
Journal of Professional Nursing, 36
(4), 189-199.  
https://doi.org/10.1016/j.profnurs.2019.11.003
.

The National Organization of Nurse Practitioner Faculties.  (2017).  
Nurse practitioner core competencies contents.  
https://nursing.lsuhsc.edu/Docs/Quality/Nurse%20Practitioner%20Core%20Competencies%20(2017).pdf
.

Walden University.  (2020).  
Outcomes/Alignment Chart, NRNP 6531: Primary care of adults across the lifespan.
  
https://content.waldenu.edu/e96ba5fcda8f577a44864e45d4902cd2.pdf
.

REPLY QUOTE 
EMAIL AUTHOR

 
9 days ago

Rowena Manzano 

RE: Rowena Manzano-Discussion Response 1 to Esai Seechan

COLLAPSE

Discussion Response 1 to Esai Seechan

Hi Esai,

Good post. I agree that educating the patient, a collaborative attitude, and good communication are vital for patient care. Collaboration with other healthcare professionals will open the channels of best practice possibilities (Haddad & Geiger, 2021). In addition, cooperation in clinical practice improved the quality of patient care as professionals shared expertise ( Buttaro et al., 2021). As we start with our practicum, there are always challenges met, but preparation is vital to gain more confidence and overcome the fear. Stimulation courses can provide interactive and real learning experiences, enhance knowledge and skills in a caring patient with a different health problem (Torkshavand et al., 2020). Therefore, it is vital to practice with our stimulation courses in I Human continually NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

Ethical and legal issues are also a challenge for me being a novice in this field. Haddad & Geiger (2021) stated that nurses must be familiar with legal and ethical issues. The authors further noted that nurses must have high-level support for all individuals and allow dignity concerning care and communication. In addition, nurses must be familiar with professional guidelines in practice and always consider the patient first. It is also an obligation to gain competence by committing to continued learning. It is vital to continue to grow with improvements to care, adopt changes or trends through research and evidence-based practice, and have the ability to practice in various healthcare settings with continued acts of advocacy (Haddad & Geiger, 2021). Getting to know the preceptor and establishing a trusting relationship are also crucial for students’ learning ‌(Nyhagen & Strøm, 2016).

 

                                       References

Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2021).

Primary care: Interprofessional collaborative practice (6th ed.).

Elsevier.

Haddad, L. M., & Geiger, R. A. (2021, August 30). 
Nursing Ethical 

      Considerations
. Nih.gov; StatPearls Publishing.

https://www.ncbi.nlm.nih.gov/books/NBK526054/

‌Nyhagen, R., & Strøm, A. (2016). Postgraduate students’ perceptions of

high-quality precepting in critical care nursing. 
Nurse Education in 

       Practice
, 
21
, 16–22. https://doi.org/10.1016/j.nepr.2016.09.002

‌Torkshavand, G., Khatiban, M., & Soltanian, A. R. (2020). Simulation-

based learning to enhance students’ knowledge and skills in

educating older patients. 
Nurse Education in Practice
, 
42
, 102678 NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies.

https://doi.org/10.1016/j.nepr.2019.102678

response

You brought up a great point when you mentioned you are afraid of missing important details that could impact the patient’s healthcare.  I think that would probably be a fear of everyone in this course at this moment.  Smith and Rushton (2018) report student nurses are often lacking experience and confidence.  We are only beginning the training that will prepare us for such a responsibility.  As we work with experienced healthcare providers, we will gain knowledge that will help prepare us.  Torrens et al (2020) report that developing interprofessional relationships helps advanced practice nurses to be successful.  Drayton-Brooks et al (2017) report that advanced practice nursing students will further develop skills by having practicum experiences with multiple providers that see different types of patients.  As we continue through this program and have these experiences, our skills will improve, therefore, improving our confidence.

References

Drayton-Brooks, S. M., Gray, P. A., Turner, N. P., & Newland, J. A. (2017). Building clinical education training capacity in nurse practitioner programs. 
Journal of Professional Nursing
, 
33
(6), 422–428. https://doi.org/10.1016/j.profnurs.2017.02.002

Smith, J., & Rushton, M. (2018). Improving student nurses’ confidence in managing the acutely ill patient. 
British Journal of Nursing
, 
27
(3), 124–129. doi: 10.12968/bjon.2018.27.3.124

Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. 
International Journal of Nursing Studies
, 
104
. doi: 10.1016/j.ijnurstu.2019.103443 NRNP- 6531 Week 1 Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Week 1: Competencies of Advanced Nursing Practice

Advanced nursing practice competencies focus on the unique practice knowledge, skills, and attitudes a nurse practitioner must demonstrate as they work with adults across the lifespan in clinical settings. They are developed by experts in the field and provide clarity about what is needed to be successful in your career. Competencies need to be practiced so they can be used to effectively address a wide range of situations. In addition to real-world settings, there are virtual opportunities that can facilitate the development of competencies. For example, throughout this course, you will complete case study simulation assignments with virtual i-Human patients presenting a variety of medical conditions. These types of virtual simulations provide you with the formative practice needed to help guide and prepare you for the real-world clinical experience.

For this week, you will examine advanced nursing practice competencies and reflect on your strengths and challenges related to the competencies. In light of your reflection, you will consider how this course may help you attain your career goals or objectives.

Learning Objectives

Students will:

Analyze strengths and challenges related to nursing practice competencies

Describe professional career goals or objectives NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Learning Resources

Required Readings
 (click to expand/reduce)

Required Media
 (click to expand/reduce)

Class Café: Introductions

Photo Credit: nakophotography / Adobe Stock

This Class Café is a place for discussions that do not necessarily relate to the formal content of this course and will not be assessed. However, we encourage you to get to know your colleagues and familiarize yourselves with everyone’s background and personal history. 
Note
: If your posting is of a personal nature or involves issues that are of concern only to you and require an individual response from the Instructor, please email the Instructor directly.

By Day 2

Post
 and introduce yourself to your colleagues and ask any questions you might have about the course or questions in general.

Respond
 to your colleagues and answer any questions or ask any questions that you might have.

Note
: This Class Café is not required and will not be assessed; however, you are encouraged to get to know your colleagues.

Submission and Grading Information

Post by Day 2

To Participate in this Discussion:

Class Café: Introductions NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Discussion: Career Goals: Strengths and Challenges Related to Nursing Practice Competencies

An advanced practice nurse collaborates and communicates with patients, families, doctors, nurses, and specialists to ensure patients receive the care they need. As they diagnose, treat, manage, and educate patients, they are responsible for ensuring patient safety and maintaining ethical behavior. Competencies have been developed to help the advanced practice nurse to understand the practice knowledge, skills, and attitudes they need to be successful.

Photo Credit: michaeljung / Adobe Stock

For this Discussion, you will examine advanced nursing practice competencies and reflect on your strengths and challenges related to the competencies. In light of your reflection, you will consider how this course may help you attain your career goals or objectives.

To prepare:

Review the Learning Resources for this week, specifically the advanced nursing practice competencies. As you review the competencies, reflect on your own strengths and challenges when working with adults across the lifespan.

By Day 3

Post
 a summary of your expectations of this course. Also, include a brief explanation of your strengths and challenges as they relate to nursing practice competencies when working with adults. Describe any career goals or objectives this course may help you accomplish in the Family Nurse Practitioner (FNP) or 
Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) 
role and explain why. Use your research to support your explanations by providing credible and scholarly sources NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Read
 a selection of your colleagues’ responses.

By Day 6

Respond
 to 
at least two
 of your colleagues on 
two different days
 by offering a suggestion or resources to help your colleagues in addressing their personal strengths or challenges, or their career goals. Use your research to support your suggestions. Provide at least 3 credible and current scholarly sources.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the 
Post to Discussion Question
 link and then select 
Create Thread
 to complete your initial post. Remember, once you click 
Submit
, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To Participate in this Discussion:

Week 1 Discussion

Assignment

Practicum Manual Acknowledgment

The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

Field Experience: MSN Nurse Practitioner Practicum Manual

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

What’s Coming Up in Week 2?

Practicum – Upcoming Deadline

In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, 
you will need to submit your application via 
Meditrek
 .

For information on the practicum application process and deadlines, please visit the 
Field Experience: College of Nursing: Application Process – Graduate
 web page.

Please take the time to review the 
Appropriate Preceptors and Field Sites
 for your courses.

Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the 
Field Experience: College of Nursing: Student Resources and Manuals
 web page.

Field Experience: College of Nursing Quick Answers

Field Experience: MSN Nurse Practitioner Practicum Manual

Student Practicum Resources: NP Student Orientation

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will analyze an i-Human simulation case study about an adult patient with an integumentary condition and formulate a differential diagnosis, based on the patient’s information. Using the findings of your analysis, you will evaluate treatment options and then create an appropriate treatment plan for the patient NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Looking Ahead:

In this course and beginning in Week 2, you will be required to complete case study assignments using the web-based software i-Human. You should have received an email with your i-Human Patients login and password information. If you have not received this information, please contact the Course Instructor.

Ensure that you are able to log in to the software and review the 
i-Human Patients Case Player Student Manual
 as needed to familiarize yourself about how to navigate i-Human.

Week 3: Evaluation and Management of HEENT Conditions

Last week, observing external characteristics of a patient was introduced as an important initial component of a physical examination. In addition to those observations, additional patient information can be learned by examining the head, eyes, ears, nose and throat, referred to as the HEENT system. Abnormal or disease manifestations may cause changes to one or more parts of the HEENT system, and understanding those manifestations is a critical skill for the advanced practice nurse.

For this week, you will not have a simulation case study however, it will be important for you to recognize that your continued observations and additional patient information are critical to your advanced nursing skills. This Week 3 concludes Module 1, and you will complete a Knowledge Check assessment covering the Module 1 topics examined in Weeks 1–3.

Learning Objectives

Students will:

Identify key terms, concepts, and principles related to the primary care of adults across the lifespan NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

Learning Resources

Required Readings
 (click to expand/reduce)

Required Media
(click to expand/reduce)

Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions

In this exercise, you will complete a 10- question Knowledge Check to gauge your understanding of this module’s content.  Please note that this is a formative practice to help you better prepare for your Midterm and Final Exam as well as your Nurse Practitioner (NP) certification exam. The questions in this Knowledge Check are related to the topics from Weeks 1, 2, and 3 Topics include:

Nursing competencies

Billing and coding

Integumentary conditions

HEENT conditions

It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

Photo Credit: [DirtyDog_Creative]/[Vetta]/Getty Images

By Day 7

Complete 
and 
submit 
your Knowledge Check.

Submission Information

Submit Your Knowledge Check by Day 7

To submit your Knowledge Check:

Week 3 Knowledge Check

What’s Coming Up in Module 2?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 2, you will examine the evaluation and management of cardiovascular conditions in Week 4 and respiratory conditions in Week 5. You will consider how to assess, diagnose, and treat two i-Human patients—one presenting a cardiovascular condition and one presenting a respiratory condition.

Week 5 Knowledge Check

In Week 5, you will experience your next Knowledge Check which covers the Module 2 topics from Weeks 4 and 5. Refer to the Week 5 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Week 4: Evaluation and Management of Cardiovascular Conditions

Many of the factors that contribute to cardiovascular conditions are preventable or manageable. Addressing the modifiable risk factors and adopting healthier lifestyle habits early in life can dramatically reduce the risk of developing cardiovascular conditions. The advanced practice nurse plays an important role in educating and advising their patients about ways to reduce modifiable risk factors, as well as encouraging and supporting their efforts.

However, if cardiovascular conditions are left unmanaged, patients may suffer from serious complications. When evaluating patients, it is important to consider individual patient factors and behaviors that might increase patient risk of conditions, such as hypertension. There are also other conditions that require advanced practice nurses to use appropriate and critical thinking to correctly diagnose cardiovascular or other vascular-related conditions. For this reason, as the advanced practice nurse caring for patients, it is critical that you immediately identify signs and symptoms of blood clots and other cardiovascular conditions.

For this week, you will analyze an i-Human simulation case study about an adult patient with a cardiovascular condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Learning Objectives

Students will:

Formulate differential diagnoses for adult patients with cardiovascular conditions

Analyze pattern recognition in adult patient diagnoses

Analyze the role of patient information in differential diagnosis

Evaluate pharmacologic and non-pharmacologic treatment options for adult patients

Create an appropriate treatment plan that includes health education and follow-up care

Learning Resources

Required Readings
 (click to expand/reduce)

Required Media
(click to expand/reduce)

Assignment: i-Human Case Study: Evaluating and Managing Cardiovascular Conditions

Because cardiovascular conditions are preventable and manageable, it is important that the advanced practice nurse use both their understanding of the cardiovascular system and the impact of patient factors and behaviors that might increase patient risk of such conditions. This critical information can guide you in immediately identifying signs and symptoms that can inform differential diagnoses and lead to identification of appropriate treatment options and a treatment plan.

Photo Credit: yodiyim / Adobe Stock

For this Case Study Assignment, you will analyze an i-Human simulation case study about an adult patient with a cardiovascular condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

To prepare:

Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with cardiovascular conditions.

Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.

Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.

Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.

Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with cardiovascular conditions.

Assignment

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the 
i-Human Graduate Programs Help 
link within the i-Human platform.

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By Day 7

Complete
 and 
submit
 your Assignment in i-Human.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.

Click the 
Week 4 Assignment Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 4 Assignment 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
 button to complete your submission.

Grading Criteria

To access your rubric:

Week 4 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment draft and review the originality report NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Submit Your Assignment by Day 7

To participate in this Assignment:

Week 4 Assignment

What’s Coming Up in Week 5?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will complete the next Knowledge Check which covers the topics from Weeks 4 and 5 of Module 2. Refer to the Week 5 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly.

Week 5: Evaluation and Management of Respiratory Conditions

Respiratory conditions can often be well managed when properly diagnosed and treated. Despite the existence of effective pharmacological treatments, lack of patient adherence to those treatments can negatively affect patient outcomes. As an advanced practice nurse, you play a critical role in the management of respiratory conditions, including providing education to patients about treatment options and their potential side effects and helping them weigh the benefits and risks. You must know when to treat, when to order diagnostics, and when to refer for specialized care. Failure to implement the appropriate actions can negatively impact the diagnosis and treatment of a patient, including the possible loss of their life.

For this week, you will complete a Knowledge Check assessment covering the Module 2 topics examined in Weeks 4 and 5.

Learning Objective

Students will:

Identify key terms, concepts, and principles related to the primary care of adults across the lifespan (KC)

Learning Resources

Required Readings
 (click to expand/reduce)

Required Media
(click to expand/reduce)

Knowledge Check: Module 2: Cardiovascular and Respiratory Conditions

In this exercise, you will complete a 10-question Knowledge Check to gauge your understanding of this module’s content. Please note that this is a formative practice to help you better prepare for your Midterm and Final Exam as well as your NP certification exam. The questions in this Knowledge Check are related to the topics from Weeks 4 and 5. Topics include:

acute bronchitis

asthma

chronic obstructive pulmonary disease (COPD)

other respiratory conditions

myocardial infarction (MI)

hypertension (HTN)

thrombotic events

Photo Credit: [ismagilov]/[iStock / Getty Images Plus]/Getty Images

It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

By Day 7

Complete
 and 
submit
 your Knowledge Check.

Submission Information

Submit Your Knowledge Check by Day 7

To submit your Knowledge Check:

Week 5 Knowledge Check NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course

What’s Coming Up in Module 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 3, you will examine the evaluation and management of gastrointestinal conditions in Week 6, genitourinary and endocrine conditions in Week 7, and hematologic conditions in Week 8. In Weeks 7 and 8, you will also analyze an i-Human simulation case study about an adult patient presenting a condition and consider how to assess, diagnose, and treat the patient.

Week 6 Midterm Exam

In Week 6, you will not participate in a Discussion or complete an Assignment; however, you will take a Midterm Exam. Please, take this time to review the topics and resources covered in Weeks 1–6 to prepare for your exam. Plan your time accordingly.

Photo Credit: [triloks]/[E+]/Getty Images

Week 8 Knowledge Check

Photo Credit: ARTQU / iStock / Getty Images Plus / Getty Images

In Week 8, you will complete the next Knowledge Check, which covers the topics from Weeks 6, 7, and 8 of Module 3. Refer to the Week 8 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.Week 6: Evaluation and Management of Gastrointestinal Conditions

Diagnosis of gastrointestinal conditions often begins with assessing the gastrointestinal tract. If it appears normal, but is not working correctly, the condition can often be a manifestation of an issue with the patient’s exercise regimen, diet, and/or medications. Other times, the gastrointestinal tract appears abnormal, does not work correctly, and may necessitate surgery to remove or repair the source of the manifestation. Patients with gastrointestinal conditions face many daily challenges as they adhere to treatment and management plans. For example, for some, it impacts their social life due to the potential complications related to the medications or diet restrictions that may be part of the treatment plan. They may feel that they are unable to tell others about the adverse effects, such as intense pain, nausea, bowel obstructions, dehydration, fatigue, and depression. As the advanced practice nurse, you must not only evaluate and treat patients experiencing these challenges but also help them to develop management plans that will minimize daily challenges related to their conditions.

For this week, you will not participate in a Discussion or complete an Assignment; however, you will examine the evaluation and management of gastrointestinal conditions through the variety of Learning Resources available to you. Additionally, you will complete and submit the Midterm Exam. Take this time to review the topics and resources covered in Weeks 1–6 and prepare for your exam. Plan your time accordingly NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course.

Learning Objective

Students will:

Synthesize key terms, concepts, and principles related to the primary care of adults across the lifespan

Learning Resources

Required Readings
 (click to expand/reduce)

Required Media
(click to expand/reduce)

Midterm Exam

This 100-question exam is a test of your knowledge in preparation for your certification exam. 
No outside resources,
 including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to 
comply with Walden University’s Code of Conduct
.

This exam will be on topics covered in Weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 150 minutes for completion.

Photo Credit: [triloks]/[E+]/Getty Images

By Day 7

Submit
 your Midterm Exam.

Submission Information

Submit Your Exam by Day 7

To submit your Exam:

Week 6 Midterm Exam

What’s Coming Up in Week 7?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will analyze an i-Human simulation case study about an adult patient with a gastrointestinal condition. Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient.

To go to the next week:

Week 7 NRNP – 6531 Adv Practice Care of Adults Across the Lifespan full course