South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions

Week 1 – Assignment 2 Discussion

You are a family nurse practitioner working in a community health center. The patient you are about to see is a 3 month old natal female infant for a well-baby check. The child has just been adopted. The mother stays at home with the baby and the father works outside the home. They are covered by private health insurance through the father’s work. The parents own their own home in a suburban area, neither smoke, and they have one dog. Answer the following questions using course resources (texts) and two other evidence based sources (current guidelines and/or scholarly articles that are within a 3-5 year time frame).

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What are the components of a well-child check for this 3-month old infant?

Write an educational intervention plan for the parents. What are you going to teach the parents about their baby?

When completing a physical exam for this baby, what would be of particular focus and why?

Week 2 – South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions

SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template.

SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of patient identification from the SOAP note format. Provide a reference (s) for the differential diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time frame and come from a textbook, guideline,or currently published peer reviwed journal article.

Submission Details:

By Wednesday, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Include the reference number from eMedley in your document.

Submit your SOAP note into the discussion area below by Sunday, October 15, 2017 along with clinical insights about your case.

Respond to two peers with a substantial response that includes supportive references by Wednesday.

Week 3 – Assignment 1 Discussion

Assignment 1: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template.

SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of patient identification from the SOAP note format. Provide a reference (s) for the differential diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time frame and come from a textbook, guideline, or currently published peer reviewed journal article.

Submission Details:

By Wednesday, October 25, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

Include the reference number from eMedley in your document.

Submit your SOAP note into the discussion area below by Sunday, October 22, 2017 along with clinical insights about your case. South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions.

Respond to two peers with a substantial response that includes supportive references by Wednesday, October 25, 2017.

Name:	Pt. Encounter Number:
Date:	Age:	Sex:
SUBJECTIVE
CC: Reason given by the patient for seeking medical care “in quotes”
HPI: Describe the course of the patient’s illness, including when it began, character of symptoms, location where the symptoms began, aggravating or alleviating factors, pertinent positives and negatives, other related diseases, past illnesses, and surgeries or past diagnostic testing related to the present illness.
Medications: (List with reason for med )
PMH Allergies: Medication Intolerances: Chronic Illnesses/Major traumas Hospitalizations/Surgeries “Have you ever been told that you have diabetes, HTN, peptic ulcer disease, asthma, lung disease, heart disease, cancer, TB, thyroid problems, kidney problems, or psychiatric diagnosis?”
Family History Does your mother, father, or siblings have any medical or psychiatric illnesses? Is anyone diagnosed with: lung disease, heart disease, HTN, cancer, TB, DM, or kidney disease?
Social History Education level, occupational history, current living situation/partner/marital status, substance use/abuse, ETOH, tobacco, and marijuana. Safety status
ROS
General Weight change, fatigue, fever, chills, night sweats, and energy level	Cardiovascular Chest pain, palpitations, PND, orthopnea, and edema
Skin Delayed healing, rashes, bruising, bleeding or skin discolorations, and any changes in lesions or moles	Respiratory Cough, wheezing, hemoptysis, dyspnea, pneumonia hx, and TB
Eyes Corrective lenses, blurring, and visual changes of any kind	Gastrointestinal Abdominal pain, N/V/D, constipation, hepatitis, hemorrhoids, eating disorders, ulcers, and black, tarry stools
Ears Ear pain, hearing loss, ringing in ears, and discharge South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions	Genitourinary/Gynecological Urgency, frequency burning, change in color of urine. Contraception, sexual activity, STDs Female: last pap, breast, mammo, menstrual complaints, vaginal discharge, pregnancy hx Male: prostate, PSA, urinary complaints
Nose/Mouth/Throat Sinus problems, dysphagia, nose bleeds or discharge, dental disease, hoarseness, and throat pain	Musculoskeletal Back pain, joint swelling, stiffness or pain, fracture hx, and osteoporosis
Breast SBE, lumps, bumps, or changes South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions	Neurological Syncope, seizures, transient paralysis, weakness, paresthesias, and black-out spells
Heme/Lymph/Endo HIV status, bruising, blood transfusion hx, night sweats, swollen glands, increase thirst, increase hunger, and cold or heat intolerance	Psychiatric Depression, anxiety, sleeping difficulties, suicidal ideation/attempts, and previous dx
OBJECTIVE
Weight BMI	Temp	BP
Height	Pulse	Resp
General Appearance Healthy-appearing adult female in no acute distress. Alert and oriented; answers questions appropriately. Slightly somber affect at first and then brighter later.
Skin Skin is brown, warm, dry, clean, and intact. No rashes or lesions noted.
HEENT Head is normocephalic, atraumatic, and without lesions; hair evenly distributed. Eyes: PERRLA. EOMs intact. No conjunctival or scleral injection. Ears: Canals patent. Bilateral TMs pearly gray with positive light reflex; landmarks easily visualized. Nose: Nasal mucosa pink; normal turbinates. No septal deviation. Neck: Supple. Full ROM; no cervical lymphadenopathy; no occipital nodes. No thyromegaly or nodules. Oral mucosa, pink and moist. Pharynx is nonerythematous and without exudate. Teeth are in good repair.
Cardiovascular S1, S2 with regular rate and rhythm. No extra sounds, clicks, rubs, or murmurs. Capillary refills two seconds. Pulses 3+ throughout. No edema.
Respiratory Symmetric chest wall. Respirations regular and easy; lungs clear to auscultation bilaterally.
Gastrointestinal Abdomen obese; BS active in all the four quadrants. Abdomen soft, nontender. No hepatosplenomegaly.
Breast Breast is free from masses or tenderness, no discharge, no dimpling, wrinkling, or discoloration of the skin.
Genitourinary Bladder is nondistended; no CVA tenderness. External genitalia reveals coarse pubic hair in normal distribution; skin color is consistent with general pigmentation. No vulvar lesions noted. Well estrogenized. A small speculum was inserted; vaginal walls are pink and well rugated; no lesions noted. Cervix is pink and nulliparous. Scant clear to cloudy drainage present. On bimanual exam, cervix is firm. No CMT. Uterus is antevert and positioned behind a slightly distended bladder; no fullness, masses, or tenderness. No adnexal masses or tenderness. Ovaries are nonpalpable. (Male: Both testes are palpable, no masses or lesions, no hernia, and no uretheral discharge.) (Rectal as appropriate: No evidence of hemorrhoids, fissures, bleeding, or masses—Males: Prostrate is smooth, nontender, and free from nodules, is of normal size, and sphincter tone is firm).
Musculoskeletal Full ROM seen in all four extremities as the patient moved about the exam room.
Neurological Speech clear. Good tone. Posture erect. Balance stable; gait normal.
Psychiatric Alert and oriented. Dressed in clean slacks, shirt, and coat. Maintains eye contact. Speech is soft, though clear and of normal rate and cadence; answers questions appropriately.
Lab Tests Urinalysis—pending Urine culture—pending Wet prep—pending
Special Tests
Diagnosis
Include at least three differential diagnosis Final diagnosis Evidence for final diagnosis should be documented in your Subjective and Objective exams.
PLAN including education
Plan: Further testing Medication Education Nonmedication treatments Follow-up

Week 4 – Assignment 1 Discussion

Assignment 1: Grand Rounds

As a major project in this course, you will deliver a Grand Rounds presentation.

The health care topic for this presentation will be decided by your course faculty based on the results of the APEA Pre-Predictor Exam in Week 1. Your presentation will consist of a patient scenario that you experienced in your clinical setting. The format of your presentation can be Microsoft PowerPoint. APA format is also expected, and references should be cited. Include references at the bottom of the slides and a final reference list on the last slide.

Your goal is to:

• Provide a case study to go with the diagnosis.
• Utilize research articles or other materials to support your findings.
• Identify any practice barriers, issues, or problems (including cultural diversity and healthcare literacy).
• Discuss best practices for optimal outcomes.
• In addition to submitting your presentation, you will also be expected to lead a discussion throughout the week. You will want to keep the presentation interesting, professional, and focused to the topic.

When the week is over, you will update, revise, and complete your presentation on the basis of student comments and instructor feedback.

In Week 1, the instructor will divide the class into groups and assign you a week in which you will be expected to present your case. Some of you will present in Week 4, some will present in Week 7, and the remainder will present in Week 9.

Those who are not presenting in a given week are responsible for participating in at least two presentations.

For additional details, please see the Grand Rounds assignment page in the week in which you are assigned to present.

South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions Submission Details:

Name your document SU_NSG6440_W4_A1_LastName_FirstInitial.doc.

Week 5 -Assignment 1 Discussion

Assignment 1: Discussion

As a family nurse practitioner, you are working in a rural health clinic. You are evaluating a 16-year-old adolescent patient who comes in complaining of having difficulty concentrating in school. On exam, you also note that the patient is very thin and frail in appearance and is asking you for diet pills.

• What are some initial areas for concern? What screening tools can help lead you closer to your diagnosis?
• Describe 1 health promotion strategy you can discuss with the patient.
• Be sure to address the following in your plan of care: pharmacological and non-pharmacological (OTC) interventions, labs, follow-up, teaching, and referral/s.
• Your work should integrate course resources (text/s) as well as a minimum of two (2) other evidence-based guidelines and/or articles published within 3–5 years.

Submission Details:

Name your document SU_NSG6440_W5_A1_LastName_FirstInitial.doc.

Submit by Saturday.

Week 6 -Assignment 1 Discussion

South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions Assignment 1: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template.

SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of patient identification from the SOAP note format. Provide a reference (s) for the differential diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time frame and come from a textbook, guideline, or currently published peer reviewed journal article.

Submission Details:

• By Wednesday, November 15, 2017, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.
• Include the reference number from eMedley in your document.

Submit your SOAP note into the discussion area below by Sunday, November 12, 2017 along with clinical insights about your case.

Respond to two peers with a substantial response that includes supportive references by Wednesday, November 15, 2017.

Week 7 -Assignment 1 Discussion

Assignment 1: Grand Rounds

As a major project in this course, you will deliver a Grand Rounds presentation.

The health care topic for this presentation will be decided by your course faculty based on the results of the APEA Pre-Predictor Exam in Week 1. Your presentation will consist of a patient scenario that you experienced in your clinical setting. The format of your presentation can be Microsoft PowerPoint. APA format is also expected, and references should be cited. Include references at the bottom of the slides and a final reference list on the last slide.

Your goal is to:

• Provide a case study to go with the diagnosis.
• Utilize research articles or other materials to support your findings.
• Identify any practice barriers, issues, or problems (including cultural diversity and healthcare literacy).
• Discuss best practices for optimal outcomes.

In addition to submitting your presentation, you will also be expected to lead a discussion throughout the week. You will want to keep the presentation interesting, professional, and focused to the topic.

When the week is over, you will update, revise, and complete your presentation on the basis of student comments and instructor feedback.

In Week 1, the instructor will divide the class into groups and assign you a week in which you will be expected to present your case. Some of you will present in Week 4, some will present in Week 7, and the remainder will present in Week 9.

Those who are not presenting in a given week are responsible for participating in at least two presentations.

For additional details, please see the Grand Rounds assignment page in the week in which you are assigned to present.

Submission Details:

Name your document SU_NSG6440_W7_A1_LastName_FirstInitial.doc.

Submit by Saturday.

Week 8 – Assignment 1 Discussion

South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions Assignment 1: SOAP Note

Each week, you are required to enter your patient encounters into eMedley. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using the SOAP Note template.

SOAP Note: Choose one patient from an area of weakness identified from the Week 1 Pre-Predictor Exam and submit a SOAP note of this patient. Remember to remove all forms of patient identification from the SOAP note format. Provide a reference (s) for the differential diagnosis and treatment plan in APA format. The reference should be within a 3-5 year time frame and come from a textbook, guideline, or currently published peer reviewed journal article.

Submission Details:

By Wednesday, enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.

• Include the reference number from eMedley in your document.
• Submit your SOAP note into the discussion area below by Sunday, November 26, 2017 along with clinical insights about your case.

Respond to two peers with a substantial response that includes supportive references by Wednesday, November 29, 2017.

Week 9 -Assignment 1 Discussion

Assignment 1: Grand Rounds

This week continues the Grand Rounds presentations as assigned by the instructor.

Those who are not presenting this week are responsible for participating in at least two presentations.

Keep in mind the following guidelines while taking part in this assignment:

• For those who are presenting, post your presentation to this Discussion Area by Saturday, December 2, 2017. Begin facilitating the discussion and continue to lead it throughout the week.
• For those who are participants this week, begin participating on Saturday, December 2, 2017, and continue until the end of the week.

For the presenters:

The Grand Rounds presentation should consist of a patient scenario that you experienced in your clinical setting or a diagnosis that has been covered within the course material prior to this week. This may be presented in Microsoft PowerPoint or Microsoft Word format

Your goal is to:

• Provide a case study to go with the diagnosis.
• Utilize research articles or other materials to support your findings.
• Identify any practice barriers, issues, or problems (including cultural diversity and healthcare literacy).
• Discuss best practices for optimal outcomes.
• In addition to submitting your presentation, you will also need to lead a discussion. Here are some guidelines:
• To prepare for your presentation, rehearse the key points and findings of your research and think about points you can make to initiate the discussion and keep it going.
• Develop questions you can ask to initiate the discussion and keep it going.

As you approach the end of the discussion period, ask participants to:

• Summarize the discussion.
• Draw conclusions from the collective group discussion.
• Keep the presentation interesting, professional, and focused to the topic. APA format is expected and references should be cited. If you are presenting on Microsoft PowerPoint, include references at the bottom of the slide(s) and a final reference list on the last slide.
• When the week is over, update/revise/complete your presentation based on students’ comments and instructor’s feedback.

For the participants:

• Those who are not assigned to present this week should review at least two presentations and participate in the discussion. Here are some guidelines for participation:
• Prepare for the discussion by reading the presenter’s submission.
• Keep your participation at the level of critical thinking—analyzing, synthesizing, and evaluation. Make connections between what you are learning in this course and what you already know.
• Make comparisons, note contrasts, and challenge points of view. Interact with both presenters and other students.
• Add to the experience what you might have read about the topic or experienced personally.

Be prepared to substantiate your points of view.

At the end of the week, be prepared to summarize or draw conclusions from the presentation experience.

Week 10 – Assignment 1 Discussion

Assignment 1: Evidence-Based Clinical Intervention

By Friday, submit your Evidence-Based Clinical Intervention to the Discussion Area.

Your Evidence-Based Clinical Intervention should be submitted in a Microsoft Word document following APA style and should include the following:

The medical problem/diagnosis/disease.

Typical presenting signs and symptoms including:

• Onset, Characteristics, Location, Radiation, Timing, Setting, Aggravating factors, Alleviating factors, Associated symptoms, Course since onset, Usual age group affected
• Concomitant disease states associated with the diagnosis

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• The pathophysiology of the problem.
• Three differential diagnoses and the usual presenting signs and symptoms in priority sequence with rationales.
• Reference to at least two current journal articles that show evidence-based practice as how to best treat this disorder related to the primary differential.
• The expected outcomes of the intervention.
• Algorithms if available.
• A typical clinical note in SOAP format.

Respond to at least two of your classmates’ Evidence-Based Clinical Interventions using the lessons and vocabulary found in the reading. Support your answers with examples and research. Your responses should clarify your understanding of the topic. They should be your own, original, and free from plagiarism. Follow the APA format for writing style, spelling and grammar, and citation of sources.

Week 10 -Assignment 2 Discussion

South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions Assignment 2: Reflection

By Saturday, reflect on the course and what you have learned over the last ten weeks. Write up a brief summary of how you meet each course objective. Include examples from both the course and practicum experiences.

Post your response to the Discussion Area by Saturday, 2017. Include references to support your work. Respond to at least two of your peers providing substantial feedback supported with references. South NSG6440 – Practicum IV: Family Health – Primary Care – Weekly discussions.