Assessing Neurological Symptoms

Discussion: Assessing Neurological Symptoms

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Case 1: Headaches

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

Case 2: Numbness and Pain

A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.

Case 3: Drooping of Face

A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.

To prepare:

With regard to the case study you were assigned:

  • Review this week’s Learning Resources, and consider the insights they provide about the case study.
  • Consider what history would be necessary to collect from the patient in the case study you were assigned.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
  • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 9”) with “Review of Case Study ___.” Fill in the blank with the number of the case study you were assigned.

By Day 3

Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

Submission and Grading Information
Grading Criteria

To access your rubric:

Week 9 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 9 Discussion

 
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Assessing A Healthcare Program/Policy Evaluation

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

  • Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
  • Select an existing healthcare program or policy evaluation or choose one of interest to you and get approval to use it from your Instructor.
  • Review the healthcare program or policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

  • Describe the healthcare program or policy outcomes.
  • How was the success of the program or policy measured?
  • How many people were reached by the program or policy selected?
  • How much of an impact was realized with the program or policy selected?
  • At what point in program implementation was the program or policy evaluation conducted?
  • What data was used to conduct the program or policy evaluation?
  • What specific information on unintended consequences was identified?
  • What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
  • Did the program or policy meet the original intent and objectives? Why or why not?
  • Would you recommend implementing this program or policy in your place of work? Why or why not?
  • Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.
 
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SOAP Note Assignment

SOAP Note Assignment

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

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

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

Download the access codes.

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

Format

  • Your care plan should be formatted as a Microsoft Word document. Follow the current APA edition style. Your paper should be no longer than 3-4 pages excluding the title and the references and in 12pt font.
  • Name your document: SU_NSG6001_W4A2_LastName_FirstInitial.doc.
  • Submit your document to the Submissions Area by the due date assigned.

Here is what my professor said about last paper 

reviewed the submission on 4/16/19 did not identify which diagnosis applies to the  patient, 

what antibiotics would be ordered,

need to expand on health teaching

i lost 40 points….

 Assessment: (Include at least 3 priority diagnosis with ICD-10 codes. Please place in order of priority.) 

  • SUO_NG6001_GU_Clinical_Case_Nursing_5_week.pdf
  • SU_NSG6001_W4A2_PAND
 
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Legal And Ethical Conduct

Legal and Ethical Conduct

Legal and Ethical Conduct

As emphasized in this week’s media presentation, all nurses need to be familiar with the laws and regulations that govern their practice: their state’s Nurse Practice Act, ANA’s Nursing: Scope and Standards of Practice, specialty group standards of practice, etc. In addition, basic ethical principles guide nurses’ decision-making process every day. ANA’s Code of Ethics and ANA’s Social Policy Statement are two important documents that outline nurses’ ethical responsibilities to their patients, themselves, and their profession. This said, there is a dilemma: The laws are not always compatible with the ethical positions nurses sometimes take. This week’s Discussion focuses on such a dilemma.

To prepare:

  • Review this week’s Learning Resources, focusing on the information in the media presentation about the relationship between the law and ethics.
  • Consider the ethical responsibility of nurses in ensuring patient autonomy, beneficence, non-malfeasance, and justice.
  • Read the following scenario: 



    Lena is a community health care nurse who works exclusively with HIV-positive and AIDS patients. As a part of her job, she evaluates new cases and reviews confidential information about these patients. In the course of one of these reviews, Lena learns that her sister’s boyfriend has tested HIV positive. Lena would like to protect her sister from harm and begins to consider how her sister can find out about her boyfriend’s health status.
  • Consult at least two resources to help you establish Lena’s legal and ethical position. These resources might include your state’s Nurse Practice Act (I LIVE IN CALIFORNIA), the ANA’s Code of Ethics, ANA’s Nursing: Scope and Standards of Practice, and internal or external standards of care.
  • Consider what action you would take if you were Lena and why.
  • Determine whether the law and the ANA’s standards support or conflict with that action.

Post by Day 3 a description of the actions you would take in this situation, and why. Justify these actions by referencing appropriate laws, ethical standards, and professional guidelines.

Required Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Readings
  • Milstead, J. A. (2013). Health policy and politics: A nurse’s guide (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.
    • Chapter 4, “Government Regulation: Parallel and Powerful” (pp. 73–109)



      This chapter explains the major concepts of the regulation of health professionals, with emphasis on advanced practice nurses (APN) and the process of licensure and credentialing.
  • ANA’s Foundation of Nursing Package– (Access this resource from the Walden Library databases through your NURS 6050 Course Readings List)
    • Guide to the Code of Ethics: Interpretation and Application



      This guide details the history, purpose and theory, application, and case studies of this must-have Code of Ethics.
    • Nursing Social Policy Statement



      The Nursing Social Policy Statement provides an understanding of the social framework and obligations of the nursing profession.
    • Nursing: Scope & Standards of Practice



      This book contains several national standards of practice that can be used to inform the decision-making process, development, implementation, and evaluation of several functions and aspects of advanced practice nursing.
  • Gallagher, T. H. (2009). A 62-year-old woman with skin cancer who experienced wrong-site surgery: Review of medical error. JAMA: Journal of the American Medical Association, 302(6), 669–677. 

    Retrieved from the Walden Library databases. 



    The article showcases the different sides of medical error, from a 62-year-old patient who suffered and the components of the medical error’s impact and aftermath.
  • Reinhardt, U. E. (2010, Jan 30). Repercussions of simplicity. New York Times, p. A14. 

    Retrieved from the Walden Library databases.



    This article determines that the government should take low-income families into account when determining mandatory health insurance because many Americans choose to go without insurance despite preexisting conditions presumably no longer being an issue.
  • Board on Health Care Services. (2007). Preventing medication errors: Quality Chasm Series. Washington, DC: The National Academies Press. Retrieved from http://www.nap.edu/openbook.php?record_id=11623&page=43
    • Part 1, “Understanding the Causes and Costs of Medication Errors” (pp. 43–49)
  • This article discusses the multilayered nature of medication error as a system of failures due to individual behaviors and conditions.

NOTE: 1 1/2 TO 2 PAGES; Consult at least two resources to help you establish Lena’s legal and ethical position.

 
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