Nursing Case Discussion Assignment Help ESSAY

Nursing Case Discussion Assignment Help

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Case Discussion Pulmonary – Part 1

Purpose

The purpose of this assignment is for students to:

1. Improve their ability to formulate diagnoses based on clinical presentation of patients

2. Improve their ability to understand and apply National Guidelines for the diagnosis and treatment of Pulmonary disorders

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Utilize healthcare delivery system resources in a fiscally responsible manner in the diagnosis and treatment of patients and families across the lifespan. (PO 5)

2. Develop management plans based on current scientific evidence and national guidelines. (PO 5)

3. Educate patients on treatment decisions (WO1)

4. Select an evidence-based article to support the plan of care for the case study patient. (WO2)

5. Analyze national guidelines and apply them to specific case study situations. (WO3)

6. Review appropriate antibiotic prescribing guidelines. (WO4)

Requirements:

Week 2: Case Discussion: Pulmonary Part One

Setting: A free medical clinic that provides health care for the under-insured.

Your next patient, Michelle G., age 40, is a regular of the clinic and the last patient of the day. The chart states she is here for recent episodes of shortness of breath.

You enter the room and Michelle G is dressed in work clothes, standing up looking at a health poster on the wall. You introduce yourself and ask her what brings her to the clinic today. “I think I may have a cold. I’ve been having a hard time breathing on and off lately.”

HPI: “I notice I’m short of breath mostly at work but by the time I get home feel fine. No episodes of shortness of breath on the weekends that I can recall. But a few hours back at work and I start to feel like I cannot catch my breath again. A few months ago this happened and it was so bad I left work and went to urgent care where they gave me a breathing treatment of some kind and sent me home on an antibiotic. I would like you to give me another antibiotic. She denies sputum. No new allergy triggers noted. She denies heartburn.

PMHx: Michelle G. reports her overall health as good.

Childhood/previous illnesses: eczema as a child

Chronic illnesses: Has seasonal allergies, spring is her worst season. Was seen by an allergy specialist ten years ago, Took allergy shots for five years with great results, now only takes Zyrtec when needed.

Surgeries: Cholecystectomy

Hospitalizations: childbirth x 3.

Immunizations: up-to-date on all vaccinations.

Allergies: Strawberries-Rash; erythromycin- severe GI upset.

Blood transfusions: none

Drinks alcohol socially, smoked 1 pack per week for 3 years in her 20’s. Denies illicit drug use.

Sleeps 6 to 7 hours a night. Exercises four to five days per week.

Current medications: Multivitamin, Zyrtec

Social History: Married, lives with husband and 3 children. Worked in advertising up until 18 months ago when she got laid off. In order to help with the household finances she took a job as a Baker’s assistant at an Artisan Bread Bakery. She arrives at 4 a.m. every morning to begin baking breads/pastries for the day.

Family History: Children are healthy- daughter currently has a sinus infection. Parents are deceased. Mother at age 80 from congestive heart failure. Father died at age 82 from lung cancer, diagnosed when metastasized to brain. PGM: died from unknown causes, PGF: Stroke at age 82. MGM: died at 83, had HTN, atherosclerosis and many heart attacks. PGF: died at 71 from complications of COPD.

PE: Height 5’10”, Weight 140 pounds

Vital signs : BP 130/70, T 98.0, P 75, R 18 Sao2 98% on RA

General: 40-year-old Caucasian female appears stated age in no apparent distress. Alert, oriented, and cooperative. Able to speak in full sentences and does not appear breathless. Skin: Skin warm, dry, and intact. Skin color is pale pink, no cyanosis or pallor.

HEENT: Head normo-cephalic. Hair thick and distribution even throughout scalp.

Eyes: Sclera clear. Conjunctiva: white, PERRLA, EOMs intact.

Ears: Tympanic membranes gray and intact with light reflex noted. Pinna and tragus non-tender

Nose: Nares patent with thin white exudate noted. Mucosa appears boggy and pale. Deviated septum noted. Sinuses non-tender to palpation.

Throat: Oropharynx pink, moist, no lesions or exudate. Tonsils 1+ bilaterally. Teeth in good repair, no cavities noted. Tongue smooth, pink, no lesions, protrudes in midline. Neck supple. No cervical lymphadenopathy or tenderness noted. Thyroid midline, small and firm without palpable masses.

Lungs: Lungs clear to auscultation bilaterally. Respirations unlabored. Slight wheezing noted inspiration and on forced expiration. Wheezing does not clear with forced cough.

CV: Heart S1 and S2 noted, RRR, no murmurs noted, no displaced PMI. Peripheral pulses equal bilaterally, no peripheral edema

Abdomen: Abdomen round, soft, with bowel sounds noted in all four quadrants. No organo-megaly noted.

Diagnostic Testing:

Review of the patient’s EMR reveals an old CXR from last winter when she had Bronchitis.

CXR Report: 11/7/2016

This is a PA and lateral chest radiograph on Ms. Michelle X, performed on 11/7/16. Clinical information: low grade fever, productive cough, malaise.

Findings: Cardio-mediastinal silhouette is normal. B/L lung fields are clear. There are no effusions. The bony thorax appears normal. No opacities or fluid. Diaphragm normal.

Impression: Normal chest radiograph without pathology.

Click here to view CXR (Links to an external site.) (Links to an external site.)

You suspect an obstructive/restrictive process and order Pulmonary Function Testing

Pre-Bronchodilator Challenge- FEV1/FVC 60%, FVC decreased

Post Bronchodilator Challenge- FEV1/FVC 75%

Discussion Questions Part One:

1. What is your primary diagnosis for Michelle given the pattern of occurrence of symptoms, exam results, and recent history? Include the rationale and a reference for your diagnoses.

2. What is your first-line treatment plan for Michelle including medications, labs, education, referrals, and follow-up? Identify the drug class of each medication you prescribe and exactly what symptom it is targeted to address.

3. Address Michelle’s request for an antibiotic.

**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.

DISCUSSION CONTENT

Category

Points

Description

Organization

Discussion post presented in a logical, meaningful, and understandable sequence. Headings reflect separation of criterion outlined in assignment guidelines.

**Direct quote should not exceed 15 words & must add substantively to the discussion

APA/Grammar/Spelling

Discussion post has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post.

* APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

16%

Total FORMAT Points= 10 pts

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeDiscussion Content Possible Points = 90 Points

Application of Course Knowledge Post contributes unique perspectives/insights applicable to the identified diseases. Original dialogue is used with little or zero direct quotes. Demonstrates course knowledge by thorough, detailed, thoughtful, evidence-based discussion of similarities and differences between assigned diseases in reference to: • Presentation (demographics, onset of symptoms, associated risk factors) • Pathophysiology (knowledge demonstrated in original dialogue) • Assessment (physical assessment, diagnostic testing) • Diagnosis • Treatment *Note listing the components of each disease separately without reflecting on them in relation to each other does not demonstrate course knowledge.

50 pts

Excellent

Post contributes unique perspectives/insights applicable to the identified diseases. Post includes original dialogue with little or zero direct quotes. Demonstrates course knowledge by thorough, detailed, thoughtful, evidence-based discussion of similarities and differences between assigned diseases in reference to: • Presentation (demographics, onset of symptoms, associated risk factors) • Pathophysiology (knowledge demonstrated in original dialogue) • Assessment (physical assessment, diagnostic testing) • Diagnosis • Treatment (Using National Guidelines) *Note listing the components of each disease separately without reflecting on them in relation to each other does not demonstrate course knowledge.

45 pts

V. Good

Post contributes unique perspectives or insights and original dialogue with little or no direct quotes, but lacks some applicability/specificity to the assigned diseases in one assigned area. Some areas not compared and contrasted.

41 pts

Satisfactory

Post has limited comparison/contrast perspective, insights and/or applicability to assigned disease in more than one assigned area.

25 pts

Needs Improvement

Post has limited comparison/contrast perspective, insights and/or applicability to assigned disease OR Post lacks fundamental understanding of disease components (presentation, assessment, pathophysiology, diagnosis or treatment) OR The majority of the post is direct quotes without reflection that demonstrates understanding of quoted content.

0 pts

Unsatisfactory

Wrong assignment submitted OR Post offer no insight, no original dialogue or application to the assigned diseases.

50 pts

This criterion is linked to a Learning OutcomeSupport from Evidence-Based Practice

Discussion post supported by evidence from appropriate sources published within the last five years. Content of journal articles represents a logical link between the article content and the case study information. In-text citations and full references are provided.

20 pts

Excellent

Discussion post fully supported by evidence from appropriate sources published within the last five years including National Guidelines. Content of journal articles represents a logical link between the article content and the assigned topics/case study information. In-text citations and complete references are provided.

18 pts

V. Good

Discussion post is partially supported by evidence from appropriate sources published within the last five years. In-text citations and complete references are provided. Evidence-based reference(s) used but may not fully demonstrate National guidelines or fully support treatment recommendations.

16 pts

Satisfactory

Discussion post is supported by evidence from appropriate resources however National Guidelines are not referenced in regard to diagnostic testing and treatment planning OR Journal articles do not represent logical link between the article content and assigned topics/ case study.

10 pts

Needs Improvement

Sources may not be scholarly in nature or may be older than five years. In-text citations and/or full references may be incomplete or missing.

0 pts

Unsatisfactory

Discussion post contains no evidence-based practice reference or citation. *Students should note that factitious sources, sources that are clearly not read by the student and used, or sources that have incorrect dates will result in an automatic ZERO for this section for the week.

20 pts

This criterion is linked to a Learning OutcomeInteractive Dialogue

Presents diseases together and responds substantively to at least one peer including evidence from appropriate sources, and all direct faculty questions posted. Substantive posts contribute new, novel perspectives to the discussion using original dialogue (not quotes from sources)

20 pts

Excellent

Presents diseases together and responds substantively to at least one peer including evidence from appropriate sources, and all direct faculty questions posted. **Substantive posts contribute new, novel perspectives to the discussion using original dialogue (not quotes from sources).

18 pts

V. Good

Presents diseases together and responds substantively to at least one peer. Does include evidence from appropriate sources. Responds to some direct faculty questions.

16 pts

Satisfactory

Responds to a student peer and/or faculty, but the nature of the response is not original dialogue or lacks fundamental understanding of concepts discussed. Includes some evidence from appropriate sources.

10 pts

Needs Improvement

Responds to a student peer and/or faculty questions but the post doesn’t include original dialogue, perspectives or conversation. Does not include evidence from appropriate sources.

0 pts

Unsatisfactory

Does not respond to at least one peer and/or does not respond to faculty questions posted by Sunday. *A zero may be assessed here for not responding to questions posed by faculty.

20 pts

This criterion is linked to a Learning OutcomeDiscussion Format Possible Points = 10 Points

Organization Discussion post presented in a logical, meaningful, and understandable sequence. Headings reflect separation of criterion outlined in assignment guidelines.

5 pts

Excellent

Discussion post presented in a logical, meaningful, and understandable sequence. Organization of topics and transitions among ideas lends clarity to the discussion. Headings and paragraph spacing are used logically and contribute to evidence of the assigned diseases being compared and contrasted.

4 pts

V. Good

Discussion post presented in a logical, meaningful, and understandable sequence, However minimal transitions, headings and spacing used to organize thoughts.

3 pts

Satisfactory

May be unclear or difficult to follow in places. Headings, paragraphs and spacing absent.

2 pts

Needs Improvement

May be unclear or difficult to follow in places. Weak linkages between assigned diseases.

0 pts

Unsatisfactory

Assigned diseases are discussed separately and not linked through organization of thoughts, paragraph, spacing or headings.

5 pts

This criterion is linked to a Learning OutcomeAPA/Grammar/Spelling

(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

5 pts

Excellent

Zero errors in grammar/spelling. Strong ability to communicate thoughts and ideas concisely. Headings and paragraph spacing are used logically and contribute to evidence of the assigned diseases being compared and contrasted.

4 pts

V. Good

Zero to 2 errors in grammar/spelling but no effect on ability to communicate thoughts and ideas.

3 pts

Satisfactory

3-6 errors in grammar/spelling with no effect on ability to communicate thoughts and ideas.

2 pts

Needs Improvement

>6 errors in grammar/spelling which contributes somewhat to effectiveness of ability to communicate thoughts and ideas.

0 pts

Unsatisfactory

Errors in grammar contribute to a fundamental lack of understanding of information presented.

5 pts

This criterion is linked to a Learning OutcomeParticipation

Discussion late penalty deductions A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday at 1159pm MT, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0)

0 pts

Minus Points

0 pts

Minus Points

0 pts

Nursing Case Discussion Assignment Help ESSAY

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