Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research.  Be specific and provide examples.

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews Create a 6- to 7-slide PowerPoint presentation in which you do the following: · Identify and briefly describe your chosen clinical issue of interest. · Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest. · Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected. · Provide APA citations of the four peer-reviewed articles you selected. · Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.–

Excellent 81 (81%) – 90 (90%)Good 72 (72%) – 80 (80%)Fair 63 (63%) – 71 (71%)Poor 0 (0%) – 62 (62%)

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

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%)

Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%)Total Points: 100

 

Assignment Guidelines:

• This assignment must be in APA format.
• The assignment should be in paragraph form using complete sentences and avoiding bullet points and numbered list.
• Use a Level 1 heading to separate your sections (Page 47 of the APA Publication Manual).
• Title and reference pages do not count toward the total word or page count.
• Textbook and outside sources need to be referenced and cited in the paper.

Essays: (at least 300 words per prompt)

1. Kate is born with features that do not look quite normal. Her eyes are wide-set and slightly slanted. Her nose is short and flat, and she keeps her mouth slightly open. There is a straight crease across her palm, and her fifth digit is unusually short. The doctor tells her parents she has an inherited disorder. If you were the doctor what would you diagnosis Kate with? Discuss the etiology of Kate’s disorder? What is the biggest risk factor for this disorder? How can or will this disorder affect Kate? What test could have been completed to diagnosis this disorder before Kate’s birth?

2. Research one autosomal dominant disease, one autosomal recessive disease, and a sex-linked disease. For each disease discuss: 1. Etiology, 2. Signs and Symptoms, 3. Diagnosis, 4. Treatment and Prevention. Provide additional information from an outside source.

3. A 12-year-old child experiences high fever and chills. He also says that his heart feels like its pounding. Two weeks before these symptoms, the child fell off his bike and skinned his knee. This child also has a history of a heart murmur. What disease should be considered and what is the treatment? What congenital heart disease is associated with heart murmurs?

4. A 59-year-old male calls the paramedics after experiencing an episode of chest pain while shoveling snow. He describes his pain as a crushing, tight feeling that radiates to his left arm and jaw. What type(s) of heart disease is this patient experiencing (explain)? What diagnostic test would you expect the physician to order and why? What is the treatment?

PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:

1). ZERO (0) PLAGIARISM

2). ATLEAST 5 REFERENCES, NO MORE THAN 5 YEARS

3). PLEASE SEE THE FOLLOWING ATTACHED RUBRIC DETAILS and   the StrengthsFinder assessment Report   

Thank you.  

Do you believe you have the traits to be an effective leader? Perhaps you are already in a supervisory role, but as has been discussed previously, appointment does not guarantee leadership skills.

How can you evaluate your own leadership skills and behaviors? You can start by analyzing your performance in specific areas of leadership. In this Discussion, you will complete Gallup’s StrengthsFinder assessment. This assessment will identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success, and examine how the results relate to your leadership traits.

To Prepare:

Complete the StrengthsFinder assessment instrument, per the instructions found in this Module’s Learning Resources.

Please Note: This Assessment will take roughly 30 minutes to complete.

• Once you have completed your assessment, you will receive your “Top 5 Signature Themes of Talent” on your screen.
• Click the Download button below Signature Theme Report, and then print and save the report. We also encourage you to select the Apply tab to review action items.

NOTE: Please keep your report. You will need your results for future courses. 

• Reflect on the results of your Assessment, and consider how the results relate to your leadership traits.
• Download your Signature Theme Report to submit for this Discussion.

Post a brief description of your results from the StrengthsFinder assessment. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your StrengthsFinder assessment. Be specific. Note: Be sure to attach your Signature Theme Report to your Discussion post.

Requirements to Follow/grading rubric

To recognize the interrelationships of subjective data (physiological, psychosocial, cultural/spiritual values, and developmental) and objective data (physical examination findings) in planning and implementing nursing care.

To reflect on the interactive process that takes place between the nurse and an individual while conducting a health assessment and a physical examination.

Rubric

NR304 RUA: Health History and Physical Assessment Guidelines (Sept20)

NR304 RUA: Health History and Physical Assessment Guidelines (Sept20)

Criteria Ratings Pts

This criterion is linked to a Learning OutcomeHealth History: Subjective Data

Required criteria

1. Demographic data

2. Reason for care (why they are in the facility)

3. Present illness (PQRST of current illness)

4. Perception of health

5. Past medical history (including medications, allergies, and vaccinations and immunizations)

6. Family medical history

7. Review of systems

8. Developmental considerations

9. Cultural considerations

10. Psychosocial considerations

11. Presence or absence of collaborative resources (community, family, groups, and healthcare system)

30.0 pts

Highest Level of Performance

Includes 11 requirements for section.

28.0 pts

High Level of Performance

Includes 9-10 requirements for section.

23.0 pts

Satisfactory Performance

Includes 5-8 requirements for section.

15.5 pts

Unsatisfactory Performance

Includes 1-4 requirements for section.

0.0 pts

Not Present

No requirements for this section presented.

30.0 pts

This criterion is linked to a Learning OutcomePhysical Examination: Objective Data

Required criteria

1. From NR302:

o HEENT (head, eyes, ears, nose, and throat)

o Neck (including thyroid and lymph chains)

o Respiratory system

o Cardiovascular system

2. From NR304:

o Neurological system

o Gastrointestinal system

o Musculoskeletal system

o Peripheral vascular system

30.0 pts

Highest Level of Performance

Includes 8 requirements for section.

28.0 pts

High Level of Performance

Includes 7 requirements for section.

23.0 pts

Satisfactory Performance

Includes 4-6 requirements for section.

15.5 pts

Unsatisfactory Performance

Includes 1-3 requirements for section.

0.0 pts

Not Present

No requirements for this section presented.

30.0 pts

This criterion is linked to a Learning OutcomeNeeds Assessment

Required criteria

1. Based on the health history and physical examination findings, determine at least two health education needs for the individual. Remember, you may identify an educational topic that is focused on wellness.

2. Support the identified health teaching needs selected with evidence from two current, peer-reviewed journal articles.

3. Discuss how the interrelationships of physiological, developmental, cultural, and psychosocial considerations will influence, assist, or become barriers to the effectiveness of the proposed health education.

4. Describe how the individual’s strengths (personal, family, and friends) and collaborative resources (clinical, community, and health and wellness resources) effect proposed teaching.

20.0 pts

Highest Level of Performance

Includes 4 requirements for section.

18.0 pts

High Level of Performance

Includes 3 requirements for section.

15.0 pts

Satisfactory Performance

Includes 2 requirements for section.

7.5 pts

Unsatisfactory Performance

Includes 1 requirement for section.

0.0 pts

Not Present

No requirements for this section presented.

20.0 pts

This criterion is linked to a Learning OutcomeReflection

Required criteria

1. Describe the interaction in its entirety: include the environment, your approach to the individual, time of day, and other features relevant to therapeutic communication and to the interview process.

2. How did your interaction compare to what you have learned?

3. What went well?

4. What barriers to communication did you experience?

5. How did you overcome them?

6. What will you do to overcome them in the future?

7. Were there unanticipated challenges to the interview?

8. Was there information you wished you had obtained?

9. How will you alter your approach next time?

10.0 pts

Highest Level of Performance

Includes 9 requirements for section.

9.0 pts

High Level of Performance

Includes 7-8 requirements for section.

8.0 pts

Satisfactory Performance

Includes 5-6 requirements for section.

4.0 pts

Unsatisfactory Performance

Includes 1-4 requirements for section.

0.0 pts

Not Present

No requirements for this section presented.

10.0 pts

This criterion is linked to a Learning OutcomeStyle and Organization

Required criteria

1. Writing reflects synthesis of information from prior learning applied to completion of the assignment.

2. Grammar and mechanics are free of errors.

3. Able to verbalize thoughts and reasoning clearly.

4. Use appropriate resources and ideas to support topic.

5. Adheres to APA recommendations for title page, running head, headings, in-text citations, and reference page.

6. HIPAA protocols followed.

10.0 pts

Highest Level of Performance

Includes 6 requirements for section.

9.0 pts

High Level of Performance

Includes 5 requirements for section.

8.0 pts

Satisfactory Performance

Includes 4 requirements for section.

4.0 pts

Unsatisfactory Performance

Includes 1-3 requirements for section.

0.0 pts

Not Present

No requirements for this section presente

See page 16 and 17 of attached document. Assignment labeled Genomics part 1

 Patient Genetic and Genomics Interview and Education Part 1

 To assess a patient’s genetic risk, you must understand the relationship of genetics and genomics to health, prevention, screening, treatment, and monitoring. E This is a two-part assignment whose purpose is to help you develop your abilities to apply genetics and genomic information while providing patient care. Purpose: Use a constructed genetic pedigree from collected family history information to identify a risk profile and develop a plan of care, including patient education and referral. Before you start this project go and register for the G3C (Global Genetics and Genomics Community) learning portal https://www.genomicscases.net/en/. The site is free and has interactive cases that demonstrate how genetic and genomics link to health and illness. Throughout each patient scenario, there are links to resources and supplemental educational activities to expand upon genetic/genomic learning concepts. At the end of each patient encounter, learners are prompted to make a recommendation to their “patient” and are assessed across multiple domains such as risk assessment, family history, and patient medical history. There are 17 cases, and you can get CEs for the activities. Part 1: a. Choose one case in the https://www.genomicscases.net/en/ and complete the activity, please submit the report given at the end of the activity. b. Select a patient that you can interview virtually. Set up a time and quiet time, go over with the patient about confidentiality, and explain that no identifiable information will be used in this assignment. c. Go to the Center for Disease Control “My Family Health Portrait: A tool from the Surgeon General at https://phgkb.cdc.gov/FHH/html/index.html d. Collect a client’s personal and three-generation family health history to assess for genomic factors that impact the client’s health ( Save the created Family Health History, please, use fictitious names, but keep the rest of the information accurate). e. Identify genetic and genomic factors within collected history and that contribute to illness and/or health risk. f. Identify issues in this patient-related to each of the following: Financial/Socioeconomics, Cultural, Religious, and Lifestyle. g. Identify ethical/legal concepts related to this patient. Include concepts Genetics/Genomics Nursing Practice. 17 h. Identify the major challenge with this patient and identified possible strategies to overcome this challenge i. Report your findings in a three-page report including the three-generation Map using APA guidelines 

Grading Rubric Rating Criteria Needs Improvement 10 points Proficient 15 points Exceptional 20 points Pedigree Construction Student included most data from family members but is missing data from some individuals. Trait of interest is clearly diagramed in the pedigree. Student included 3 or more generations using standardized symbols and terminology OR the U.S. Surgeon General’s My Family Health Portrait Tool. Student included 3 or more generations using standardized symbols and terminology OR the U.S. Surgeon General’s My Family Health Portrait Tool. Pedigree Analysis Analysis of the pedigree is incomplete, inaccurate, and/or does not address relevant genomic factors that impact the client’s health. Analysis of the pedigree is complete, accurate, AND addresses relevant genomic factors that impact the client’s health. Analysis of the pedigree is comprehensive, accurate, AND addresses relevant genomic factors that impact the client’s health. Pedigree identification of health risk Identifies some risk factors but fails to make connections. Identifies partially potential health risk factors for this patient. Identifies potentially significant health risk for this patient. Pedigree identification of environmental and cultural factor as risk fa tors. Completes a risk analysis of the environmental and cultural factors but misses two or more components. Completes a risk analysis of the environmental and cultural factors but misses one component. Completes a thorough risk analysis for the identified patient based on their pedigree, culture, environmental exposure and life style.