Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.

Photo Credit: Getty Images/Science Photo Library RF

To Prepare

• Review the interactive media piece assigned by your Instructor. 
• Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
• Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
• You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

By Day 7 of Week 8

Write a 1- to 2-page summary paper that addresses the following:

• Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
• Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
• What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
• Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

This week’s assignment is a written piece that will be not be due until Week 8!!!  

The assignment is based on decision tree interactive media under resources in Week 6.   

I have selected the Alzheimer’s Disease for our focus.   

To Prepare 

• Review the interactive media piece for Alzheimer’s Disease.   
• Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece. 
• Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned. 
• You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment. 

By Day 7 of Week 8 

• Write a 1- to 2-page summary paper that addresses the following: 
• Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. 
• Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources. 
• What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources. 
• Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples. 

three sources for this assignment

 

Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses. As a PMHNP, you will be faced with varying rates that may be different than other health care providers you may work with.

In this Practicum Journal Assignment, you will analyze reimbursement rates for mental health treatments you will likely use in your practice and compare those rates to other provider rates.

Learning Objectives

Students will:

• Analyze reimbursement rates for mental health treatments

To prepare for this Practicum Journal:

• Research reimbursement rates for various treatment modalities.
• Compare NP rates to other provider rates.

For this Practicum Journal:

Complete the Reimbursement Rate Template in your Learning Resources using the five types of services you are likely to use in your practice.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1 Describe the clinical manifestations present in Mrs. J.

2 Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.

3 Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

4 Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.

5 Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.

6 Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.

7 Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

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

 

Week 7: NR700 Reflection on Learning

Re-submit Assignment

• Due Feb 21 by 11:59pm
• Points 100
• Submitting a text entry box or a website url

Purpose

The purpose of this activity is to deepen learning through reflective inquiry. This activity will allow for expansion in self-awareness, identification of knowledge gaps, and assessment of learning goals.

Course outcomes: This assessment enables the student to meet the following course outcomes:

1. Explore the DNP role and advanced practice issues within collaborative teams across diverse healthcare systems. (PO 1, 6, 8, 9)
2. Examine nursing ways of knowing and the development of nursing science. (PO 3, 5, 9)
3. Analyze the concepts and principles used in theory development in nursing. (PO 3, 5. 9)
4. Differentiate research, quality improvement, and evidence based practice as it relates to the role of the DNP. (PO 3, 5, 6)
5. Demonstrate evidence search techniques to support translation science (PO 3, 5)
6. Critically appraise level and quality of evidence (PO 3, 5)
7. Translate evidence at the microsystem, mesosystem, and macrosystem levels of healthcare systems (PO 2, 3, 4, 5, 6, 9)

Due date: Sunday 11:59 p.m. MT at the end of Week 7. The Late Assignment Policy applies to this assignment.

Total points possible: 100 points

Preparing the Assignment

Follow these guidelines when completing each component of this assignment. Contact your course faculty if you have questions. It is each student’s responsibility to save and maintain all artifacts required in the e-Portfolio (Links to an external site.).

1. Write a brief 1-2 paragraph weekly reflection addressing the questions posed in the Reflect section of each weekly module. Edit your ePorfolio Reflection to include each weekly reflection.
2. Include the following sections in your ePorfolio Reflection.Week 1
   • What were the most important concepts you learned in week 1?
   • Why are these concepts important?
   • How will they prepare you for your future role as a DNP-prepared nurse?
   • In what ways do you feel prepared for your new role? In what ways do you feel unprepared?
   • Week 2
   • Provide one specific example of how you achieved the weekly objectives.
   • What do you value most about your learning this week?
   • What else do you need to explore to further grow as a DNP practice scholar?
   • Week 3
   • Provide one specific example of how you achieved the weekly objectives.
   • What personal values, if any, were challenged this week?
   • What values can you reaffirm or want to reconsider after this learning?
   • Week 4
   • Provide one specific example of how you achieved the weekly objectives.
   • What concepts, theories, models, tools, techniques, and resources in this week did you find most valuable?
   • What issues had you not considered before?
   • Week 5
   • Provide one specific example of how you achieved the weekly objectives.
   • How might you use this information in your future role as a DNP practice scholar?
   • What topics, if any, had you not considered before?
   • Week 6
   • Provide one specific example of how you achieved the weekly objectives.
   • What knowledge do you still need to demonstrate competency in the weekly concepts?
   • What skills do you need to continue developing to apply these concepts?
   • Week 7
   • Provide one specific example of how you achieved the weekly objectives.
   • What are the core values and best practices that define the roles of the DNP practice scholar?
   • How will this knowledge improve your effectiveness as a DNP practice scholar?
   • What skills do you need to implement these best practices and how will you develop them?
   • Writing Organization and Mechanics
   • Grammar and mechanics are free of errors.