Many genitourinary (GU) disorders such as kidney disease begin developing during childhood and adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for pediatric patients, to identify potential signs and symptoms. Although some pediatric GU disorders require long-term treatment and management, other disorders such as bedwetting or urinary tract infections are more common and frequently require only minor interventions. In your role with pediatric patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following three case studies.

Case Study 1

You see a 3-year-old with a 2-day history of complaints of dysuria with frequent episodes of enuresis despite potty training about 7 months ago. She is afebrile and denies vomiting. Physical examination is normal. Dipstick voided urine analysis reveals: specific gravity 1.015, Protein 1+ non-hemolyzed blood, 1+ nitrites, 1+ leukocytes, and glucose-negative.

Case Study 2

Mark is a 15-year-old with complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago as a dull ache and has gradually worsened to where he can no longer stand without doubling over. He is afebrile and in marked pain. Physical exam is negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign.

Case Study 3

Maya is a 5-year-old who presents for a well-child visit. She is a healthy child with no complaints. Physical examination is normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood, leukocytes, and nitrites. Her blood pressure is normal, and she is at the 60th percentile for height and weight.

To prepare:

• Review “Genitourinary Disorders” in the Burns et al. text.
• Review and select one of the three provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder.

Reflect back over the past 8 weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #1, MSN Essential I, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

Program Outcome #1: Provide high quality, safe, patient-centered care grounded in holistic health principles. (holistic health & patient-centered care)

MSN Essential I: Background for Practice from Sciences and Humanities:

Recognizes that the master’s prepared nurse integrates scientific findings from nursing, biopsychosocial fields, genetics, public health, quality improvement, and organizational sciences for the continual improvement of nursing care across diverse settings.

Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

1. Critically analyzes data and evidence for improving advanced nursing practice.
2. Integrates knowledge from the humanities and sciences within the context of nursing science.
3. Translates research and other forms of knowledge to improve practice processes and outcomes.
4. Develops new practice approaches based on the integration of research, theory, and practice knowledg

                                    Hernandez Family Assessment

Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues. As you examine the Hernandez Family: Sessions 1-6 videos in this week’s Learning Resources, consider how you might assess and treat the client family.

                                                             Learning Objectives

Students will:

· Assess client families presenting for psychotherapy

To prepare:

· Review this week’s Learning Resources and reflect on the insights they provide on family assessment.

· View the Hernandez Family: Sessions 1-6 videos, and consider how you might assess the family in the case study.

Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources.

                                                                 The Assignment

Address in a comprehensive client assessment of the Hernandez family the following:

· Demographic information

· Presenting problem

· History or present illness

· Past psychiatric history

· Medical history

· Substance use history

· Developmental history

· Family psychiatric history

· Psychosocial history

· History of abuse and/or trauma

· Review of systems

· Physical assessment

· Mental status exam

· Differential diagnosis

· Case formulation

· Treatment plan

Note: Any item you are unable to address from the video should be marked “needs to be added to” as you would in an actual comprehensive client assessment

                                                               Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

• Chapter      12, “Family Therapy” (pp. 429–468)

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

• Chapter 3, “Basic Techniques of Family Therapy” (pp.      29–48)
• Chapter      4, “The Fundamental Concepts of Family Therapy” (pp. 49–68)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: It is highly recommended that you use this resource as a reference guide throughout the course. 

L’Abate, L. (2015). Highlights from 60 years of practice, research, and teaching in family therapy. American Journal of Family Therapy, 43(2), 180–196. doi:10.1080/01926187.2014.1002367

Mojta, C., Falconier, M. K., & Huebner, A. J. (2014). Fostering self-awareness in novice therapists using internal family systems therapy. American Journal of Family Therapy, 42(1), 67–78. doi:10.1080/01926187.2013.772870

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025

Papero, D. V. (2014). Assisting the two-person system: An approach based on the Bowen theory. Australian & New Zealand Journal of Family Therapy, 35(4), 386–397. doi:10.1002/anzf.1079.

                                                                         Required Media

Laureate Education (Producer). (2013a). Hernandez family> Sessions 1—6 [Video file]. Author: Baltimore, MD.

N.B: PLEASE ATTACH WITH THIS ASSIGNMENT IS THE 6 VIDEO TRANSCRIPT DOWNLOADED IN PDF FORMAT FOR THIS ASSIGNMENT SINCE THE VIDEO AND THE AUDIO IS NOT AVAILABLE AT THIS TIME, AND A SAMPLE FORMAT FOR THE ASSIGNMENT.

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Psychotherapy.net (Producer). (2006). Tools and techniques for family therapy. [Video file]. Mill Valley, CA: Author. 

N.B: PLEASE THIS SAMPLE IS JUST A FORMAT FOR ONLY HERNANDEZ CASE STUDY, BUT ASSIGNMENT IS TO WRITE ON HERNANDEZ FAMILY ASSESSMENT

    Details:

The first step of the EBP process is to develop a question from the nursing practice problem of interest.

Select a practice problem of interest to use as the focus of your research.

Start with the patient and identify the clinical problems or issues that arise from clinical care.

Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.

Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts. 

Suggestions for locating qualitative and quantitative research articles from credible sources:

1. Use a library database such as CINAHL Complete for your search.
2. Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

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 completi

  

Prepare a 10-minute presentation (10-15 slides, not including title or reference slide) on organizational culture and values.

Describe how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes.

Discuss how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem-solving.

Identify a specific instance from your own professional experience in which the values of the organization and the values of the individual nurses did or did not align. Describe the impact this had on nurse engagement and patient outcomes.

While GCU style format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using GCU documentation guidelines, which can be found in the GCU Style Guide, located in the Student Success Center.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.