Purpose

This week’s graded topics relate to the following Course Outcomes (COs).

• CO 1 – Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
• CO 4 – Utilize effective communication when performing a health assessment. (PO 3)

The Assignment

A 10-year-old child named Elizabeth is brought into the emergency department by her mother. The mother appears anxious but sits quietly next to her daughter in the waiting room. When called into the triage area, the mother gives a history of coming home from work to find Elizabeth sitting on the couch watching television. Elizabeth did not go to the door to greet her or look toward her when she said hello. The mother thought the daughter’s behavior was odd because she always greeted her at the door with a hug. As she approached Elizabeth, she noticed that she was clutching her right arm as if in pain. The mother asked what was wrong, but Elizabeth remained silent. Then she said “Nothing is wrong.” The father is sleeping upstairs. The mother gives a family history of having an alcoholic husband who usually drinks himself to sleep. She said he has abused Elizabeth physically and psychologically in the past, and she brought her to the emergency room because she fears he has hurt her. When Elizabeth is asked about the abuse she appears scared, insecure, and withdrawn.

1. What considerations should be made by the nurse, to provide a physically and emotionally safe environment for the interview and assessment of this client who has experienced domestic abuse?
2. In your response, include some special considerations that should be taken when interviewing a child.

  

Discussion: Assessing the Ears, Nose, and Throat

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes, but would probably perform a simple strep test.

In this Discussion, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

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 Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

Case 2: Focused Throat Exam
Lily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus over the past two weeks, Lily figured she shouldn’t take her three-day sore throat lightly. Your clinic has treated a few cases similar to Lily’s. All the patients reported decreased appetite, headaches, and pain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn’t sound congested.

To prepare:

With regard to the case study you were assigned:

· Review this week’s Learning Resources and consider the insights they provide.

· Consider what history would be necessary to collect from the patient.

· 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 5 possible conditions that may be considered in a differential diagnosis for the patient.

Write: 

an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. 

List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

After discussion with your mentor, name one financial aspect, one   quality aspect, and one clinical aspect that need to be taken into   account for developing the evidence-based practice project. Explain   how your proposal will directly and indirectly impact each of the aspects.

the capstone topic is handwashing in health care system

  

BOOK: Essential of Nursing Law and Ethics

by Susan J. Westrick and Katherine Dempski

Chapter 37 to 39 

· Choose only 1 Topic to write about:

ü Americans with Disability Acts

or

ü Employees with AIDS/HIV infections and Exposure to Bloodborne Pathogen

or

ü Impaired Nurses 

Please answer ONE of the following Discussion Questions. 

Please be certain to include the number of the DQ being answered and provide a well-developed and complete answer to receive credit. 

· DQ-1 How does the ADA affect nurse’s as employees?

or

· DQ-2 Should an HIV+ nurse or healthcare worker reveal to their employee their status? Please explain.

or

· DQ-3 What is an impaired nurse? What would you do if you encounter an impaired nurse while on-duty?

1. Write a summary (700 words minimum) about the topic answering the question.

2. You must write two replies to 2 class peers in different paper that the assignment # 1 (250-300words ) sustained with the proper references and make sure that the references that you use in your assignment are properly quoted in it.  

DIRECTION: 

1. The assignment in an APA format word document, Time New Roman 12 font 

2. It will be checked by Turnitin to verify originality.

3. The references used in the assignment must be quoted in the assignment. If it is not in quoted it will be considered plagiarism. 

4. A minimum of 3 evidence-based references besides the class textbook must be used and one of them must be from a gerontological nursing magazine. 

If you have any questions you can contact me via email.