NUR643E Advanced Health Assessment for Nurse Educators.

Nurses are aware that spiritual care is an integral component of holistic nursing care. However, as highlighted by Martins, Romeiro & Caldeira (2017), it is rarely prioritized as other dimensions of care which qualifies it as a reason for omission of care. The most preferred strategy to handle information in this patient’s scenario is to explain confidentiality to the patient using an informed consent, explain about the duty to protect, and how self-harm can lead to mandated reporting such as significant health risk (large and deep infected wounds) and developing suicidal ideations.NUR643E Advanced Health Assessment for Nurse Educators.

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The best way to incorporate the author’s worldview in providing quality care is by conceptualizing the scenario from an individual perspective and bridging a partnership by offering self, and any available resources that can be used to plan and chart the most appropriate path of care. Therefore, the author will utilize her education, caring presence, and experience to interpret the patient’s point of view, and integrate with her perspective, knowledge reservoir, and resources.NUR643E Advanced Health Assessment for Nurse Educators.

The major elements to accurately obtaining the necessary information for effective treatment include: performing a spiritual assessment on the patient using intentional questions that focus on her spirituality, faith practices, and beliefs and determining how to utilize this information (Hodge, 2015). A spiritual assessment will help to gather, analyze, and synthesize information about the patient’s Christian worldview into a framework that provides a basis for health-related decisions. According to Pfeiffer (2018), another requirement is seeing the entire scenario from the patient’s perspective as this will help to develop an individualized care plan that addresses the patient’s needs and does not truncate the relationship of respect and trust.NUR643E Advanced Health Assessment for Nurse Educators.

Week 2 Quiz

•Which of the following changes are expected in vision as part of the normal aging process?

•Cataracts

•Glaucoma

•Macular Degeneration

•Blurring of near vision

•A light is pointed at a patient’s pupil, which contracts. It is also noted that the other pupil contracts as well, though it is not exposed to bright light. Which of the following terms describes this latter phenomenon?NUR643E Advanced Health Assessment for Nurse Educators.

•Direct reaction

•Consensual reaction

•Near reaction

•Accommodation

•A patient complains of knee pain on your arrival in the room. What should your first sentence be after greeting the patient?

•How much pain are you having?

•Have you injured this knee in the past?

•When did this first occur?

•Could you please describe what happened?

•Mrs. T. presents for her regular visit to the clinic. She is on your schedule because her regular provider is on vacation and she wanted to be seen. You have heard about her many times from your colleague and are aware that she is a very talkative person. Which of the following is a helpful technique to improve the quality of the interview for both the provider and the patient?NUR643E Advanced Health Assessment for Nurse Educators.

•Allow the patient to speak uninterrupted for the duration of the appointment.

•Briefly summarize what you heard from the patient in the first 5 minutes and then try to have her focus on one aspect of what she told you.

•Set the time limit at the beginning of the interview and stick with it, no matter what occurs in the course of the interview.

•Allow your impatience to show so that the patient picks up on your nonverbal cue that the appointment needs to end.

•The following information is recorded in the health history: “The patient has had abdominal pain for 1 week. The pain lasts for 30 minutes at a time; it comes and goes. The severity is 7 to 9 on a scale of 1 to 10. It is accompanied by nausea and vomiting. It is located in the mid-epigastric area.” To which of these categories does it belong?NUR643E Advanced Health Assessment for Nurse Educators.

•Chief complaint

•Present illness

•Personal and social history

• Review of systems

•Is the following information subjective or objective?

Mr. M. has a respiratory rate of 32 and a pulse rate of 120.

•Subjective

•Objective

•A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is true?

•She obtains a 20% correct score at 100 feet.

•She can accurately name 20% of the letters at 20 feet.

•She can see at 20 feet what a normal person could see at 100 feet.

•She can see at 100 feet what a normal person could see at 20 feet.

•Ms. Whiting is a 68-year-old who presents in for her usual follow-up visit. You notice a few flat, red, and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere else. She doesn’t mention them. They are tender when you examine them. What should you do?NUR643E Advanced Health Assessment for Nurse Educators.

•Conclude that these are lesions she has had for a long time.

•Wait for her to mention them before asking further questions.

•Ask how she acquired them.

•Conduct the visit as usual for the patient.

•Mrs. R. is a 92-year-old retired teacher who presents to your clinic accompanied by her daughter. You ask Mrs. R. why she came to your clinic today. She looks at her daughter and doesn’t say anything in response to your question. This is an example of which type of challenging patient?

•Talkative patient

•Angry patient

•Silent patient

•Hearing-impaired patient

•You have just asked a patient how he feels about his emphysema. He becomes silent, folds his arms across his chest, leans back in his chair, and then replies, “It is what it is.” How should you respond?NUR643E Advanced Health Assessment for Nurse Educators.

• “You seem bothered by this question.”

• “Next, I would like to talk with you about your smoking habit.”

•“Okay, let’s move on to your other problems.”

• “You have adopted a practical attitude toward your problem.”

NUR643E Advanced Health Assessment for Nurse Educators

Week 1 Discussion

DQ1 You are
working with a nursing student who is introducing herself to a Native American
patient to establish rapport. The nursing student is trying to make eye contact
and puts her hand on the shoulder of the patient to get his attention. What
situation could arise with this approach?
How would you handle this situation? Defend rationale with references.

DQ2 While
completing a health assessment, you notice that there are indications that the
patient may have been cutting herself. You inquire about the marks and she
indicates that she scratched her wrist when she tried to break her fall. How do
you handle this information? How can you incorporate your Christian worldview
to help in providing quality care? What are the key elements to accurately
obtaining the needed information for effective treatment?

NUR643E Advanced Health Assessment for Nurse Educators

Week 2 Discussion

DQ1 As an
instructor, you are working with a nursing student in the second year of a
4-year nursing program. The student does not perform an ear exam correctly. How
would you explain the appropriate technique to examine the ears?

DQ2 You are
working the triage desk of the ED. A client presents with sudden loss of vision
of the right eye after a head collision during a volleyball game. What would
your assessment include? What could be initial problems and would they warrant
emergent intervention?

NUR643E Advanced Health Assessment for Nurse Educators

Week 3 Discussion

DQ1 Select
one pulmonary, cardiac, peripheral vascular, or lymphatic system disorder.
Discuss the clinical characteristics and identify the appropriate laboratory,
imaging, and other diagnostic and screening tools that apply to this disorder.
Explain why these tests or tools were chosen as appropriate to the conditions.
Select different topics from that of your classmates.NUR643E Advanced Health Assessment for Nurse Educators.

DQ2 You are
called to the bedside of a critical patient as a rapid response team member.
Upon initial inspection the patient is cyanotic, has labored breathing, and is
not responding well. Develop an SBAR (situation, background, assessment,
recommendation) for this patient. Use references to substantiate your approach
to this clinical scenario.

NUR643E Advanced Health Assessment for Nurse Educators

Week 4 Discussion

DQ1 As an
instructor, you are working with a nursing student to develop a problem-focused
exam involving the musculoskeletal system and extremities. Formulate potential questions to support the
student in soliciting specific information about the patient related to past
history, drugs that may adversely affect the musculoskeletal system, family. NUR643E Advanced Health Assessment for Nurse Educators.
history, psychosocial profile, and provide rationale.

DQ2 The
goal of a complete musculoskeletal assessment is to detect risk factors,
potential problems, or musculoskeletal dysfunction early and then to plan appropriate
interventions, including teaching health promotion and disease prevention, and
implementing treatment measures. By doing so, you can play a signi?cant role in
preventing pain and dysfunction in your patients. Describe a plan to provide patient teaching
that incorporates health promotion and disease prevention. Provide rationale.

NUR643E Advanced Health Assessment for Nurse Educators

Week 5 Discussion

DQ1 Differentiate
between the appearances of skin lesions in relation to cancerous versus noncancerous.NUR643E Advanced Health Assessment for Nurse Educators.

DQ2 A
patient presents with abdominal discomfort to the point of being in the fetal
position. What questions need to be asked of this patient? What examination
techniques would you perform for this patient?

NUR643E Advanced Health Assessment for Nurse Educators

Week 6 Discussion

DQ1 A
patient is experiencing delirium after the initiation of a new medication. What
are questions you want answered as well as physical findings would you be
looking for?NUR643E Advanced Health Assessment for Nurse Educators.

DQ2 Choose
a special population and detail the approach to history taking and physical
examination with the patient and/or family member.

NUR643E Advanced Health Assessment for Nurse Educators

Week 7 Discussion

DQ1 A
patient presents with heaviness in their chest and diaphoretic. What steps will
you take in providing a proper assessment?

DQ2A patient
calls out on the call system and requests pain medication. We know that a
patient is to rate their pain on a scale. If the pain is unrelated to the
admission diagnosis, what steps will you take in providing a proper assessment?NUR643E Advanced Health Assessment for Nurse Educators.

NUR643E Advanced Health Assessment for Nurse Educators

Week 8 Discussion

DQ1 You
walk into a patient’s room and find him unconscious because he does not greet
you when you walk in. What are some of your initial assessment techniques that
need to be employed and why?NUR643E Advanced Health Assessment for Nurse Educators.

DQ2 You
just reviewed the morning laboratory report for a patient in critical care. You
noted that the potassium level is 6.5 mEq/L. What are areas you need to be
assessing the patient to monitor for complications from hyperkalemia? Explain
your approach in a head to toe assessment.

NUR643E Advanced Health Assessment for Nurse Educators

Week 1 Assignment

Health
Assessment Topic Reflection 1

Complete a
250?word reflection of what you learned during this topic. Include the
following in your reflection:NUR643E Advanced Health Assessment for Nurse Educators.

Think about
an experience you’ve encountered when viewing or completing the particular
assessment.

Discuss
difficulties that could potentially arise or specific questions related to completing
this type of assessment.

Include
illustrative examples of potential strategies used to overcome the difficulties
encountered when completing (the particular) assessment.

Describe
how the Christian worldview and compassion for all plays a role in this type of
assessment.

APA style
is not required, but solid academic writing is expected.

This
assignment uses a rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for successful completion.NUR643E Advanced Health Assessment for Nurse Educators.

You are not
required to submit this assignment to LopesWrite.

NUR643E Advanced Health Assessment for Nurse Educators

Week 2 Assignment

Health
Assessment Topic Reflection 2

Complete a
250?word reflection of what you have learned during this topic. Include the
following in your reflection:

Think about
an experience you’ve encountered when viewing or completing the particular
assessment.

Discuss
difficulties that could potentially arise or specific questions related to
completing this type of assessment.

Include
illustrative examples of potential strategies used to overcome the difficulties
encountered when completing (the particular) assessment.

Describe
how the Christian worldview and compassion for all plays a role in this type of
assessment.

APA style
is not required, but solid academic writing is expected.

This
assignment uses a rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for successful completion.NUR643E Advanced Health Assessment for Nurse Educators.

You are not
required to submit this assignment to LopesWrite.

NUR643E Advanced Health Assessment for Nurse Educators

Week 3 Assignment

Health
Assessment Topic Reflection 3

Complete a
250?word reflection of what you have learned during this topic. Include the
following in your reflection:

Think about
an experience you’ve encountered when viewing or completing the particular
assessment.

Discuss
difficulties that could potentially arise or specific questions related to
completing this type of assessment.

Include
illustrative examples of potential strategies used to overcome the difficulties
encountered when completing (the particular) assessment.

Describe
how the Christian worldview and compassion for all plays a role in this type of
assessment.

APA style
is not required, but solid academic writing is expected.

This
assignment uses a rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for successful completion.NUR643E Advanced Health Assessment for Nurse Educators.

You are not
required to submit this assignment to LopesWrite.

NUR643E Advanced Health Assessment for Nurse Educators

Week 4 Assignment

Health
Assessment Topic Reflection 4

Complete a
250?word reflection of what you have learned during this topic. Include the
following in your reflection:

Think about
an experience you’ve encountered when viewing or completing the particular
assessment.

Discuss
difficulties that could potentially arise or specific questions related to
completing this type of assessment.

Include
illustrative examples of potential strategies used to overcome the difficulties
encountered when completing (the particular) assessment.

Describe
how the Christian worldview and compassion for all plays a role in this type of
assessment.

APA style
is not required, but solid academic writing is expected.

This
assignment uses a rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for successful completion.NUR643E Advanced Health Assessment for Nurse Educators.

You are not
required to submit this assignment to LopesWrite.

NUR643E Advanced Health Assessment for Nurse Educators

Week 5 Assignment

Health
Assessment Topic Reflection 5

Complete a
250?word reflection of what you have learned during this topic. Include the
following in your reflection:

Think about
an experience you’ve encountered when viewing or completing the particular
assessment.

Discuss
difficulties that could potentially arise or specific questions related to
completing this type of assessment.

Include
illustrative examples of potential strategies used to overcome the difficulties
encountered when completing (the particular) assessment.

Describe
how the Christian worldview and compassion for all plays a role in this type of
assessment.

APA style
is not required, but solid academic writing is expected.

This
assignment uses a rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for successful completion.NUR643E Advanced Health Assessment for Nurse Educators.

You are not
required to submit this assignment to LopesWrite.

NUR643E Advanced Health Assessment for Nurse Educators

Week 2 Assignment

SBAR

Choose an
experience from your nursing practice. Using the “SBAR” template,
explain the situation in detail, followed with background information. Then
explain your immediate assessment and recommendations you have for the
provider.

Include the
following in the “SBAR” template:

Be sure to
include three or four evidence?based references, not older than 5 years.

When giving
your recommendation discuss how you would educate the client using
evidence?based research and guidelines. How would you deliver your
recommendation in various learning environments?NUR643E Advanced Health Assessment for Nurse Educators.

APA style
is not required, but solid academic writing is expected.

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

You are not
required to submit this assignment to LopesWrite.

NUR643E Advanced Health Assessment for Nurse Educators

Week 2 Quiz

•Which of
the following changes are expected in vision as part of the normal aging
process?

•Cataracts

•Glaucoma

•Macular
Degeneration

•Blurring
of near vision

•A light is
pointed at a patient’s pupil, which contracts. It is also noted that the other
pupil contracts as well, though it is not exposed to bright light. Which of the
following terms describes this latter phenomenon?

•Direct
reaction

•Consensual
reaction

•Near
reaction

•Accommodation

•A patient
complains of knee pain on your arrival in the room. What should your first sentence
be after greeting the patient?

•How much
pain are you having?

•Have you
injured this knee in the past?

•When did
this first occur?

•Could you
please describe what happened?

•Mrs. T.
presents for her regular visit to the clinic. She is on your schedule because
her regular provider is on vacation and she wanted to be seen. You have heard
about her many times from your colleague and are aware that she is a very
talkative person. Which of the following is a helpful technique to improve the
quality of the interview for both the provider and the patient?NUR643E Advanced Health Assessment for Nurse Educators.

•Allow the
patient to speak uninterrupted for the duration of the appointment.

•Briefly
summarize what you heard from the patient in the first 5 minutes and then try
to have her focus on one aspect of what she told you.

•Set the
time limit at the beginning of the interview and stick with it, no matter what
occurs in the course of the interview.

•Allow your
impatience to show so that the patient picks up on your nonverbal cue that the
appointment needs to end.

•The
following information is recorded in the health history: “The patient has had
abdominal pain for 1 week. The pain lasts for 30 minutes at a time; it comes
and goes. The severity is 7 to 9 on a scale of 1 to 10. It is accompanied by
nausea and vomiting. It is located in the mid-epigastric area.” To which of
these categories does it belong?NUR643E Advanced Health Assessment for Nurse Educators.

•Chief
complaint

•Present
illness

•Personal
and social history

• Review of
systems

•Is the
following information subjective or objective?

Mr. M. has
a respiratory rate of 32 and a pulse rate of 120.

•Subjective

•Objective

•A patient
is assigned a visual acuity of 20/100 in her left eye. Which of the following
is true?

•She
obtains a 20% correct score at 100 feet.

•She can
accurately name 20% of the letters at 20 feet.

•She can
see at 20 feet what a normal person could see at 100 feet.

•She can
see at 100 feet what a normal person could see at 20 feet.

•Ms.
Whiting is a 68-year-old who presents in for her usual follow-up visit. You
notice a few flat, red, and purple lesions, about 6 centimeters in diameter, on
the ulnar aspect of her forearms but nowhere else. She doesn’t mention them.
They are tender when you examine them. What should you do?

•Conclude
that these are lesions she has had for a long time.

•Wait for
her to mention them before asking further questions.

•Ask how
she acquired them.

•Conduct
the visit as usual for the patient.

•Mrs. R. is
a 92-year-old retired teacher who presents to your clinic accompanied by her
daughter. You ask Mrs. R. why she came to your clinic today. She looks at her
daughter and doesn’t say anything in response to your question. This is an
example of which type of challenging patient?NUR643E Advanced Health Assessment for Nurse Educators.

•Talkative
patient

•Angry
patient

•Silent
patient

•Hearing-impaired
patient

•You have
just asked a patient how he feels about his emphysema. He becomes silent, folds
his arms across his chest, leans back in his chair, and then replies, “It is
what it is.” How should you respond?

• “You seem
bothered by this question.”

• “Next, I
would like to talk with you about your smoking habit.”

•“Okay,
let’s move on to your other problems.”

• “You have
adopted a practical attitude toward your problem.”

NUR643E Advanced Health Assessment for Nurse Educators

Week 5 Midterm Quiz

• Adam is a very successful 15-year-old
student and athlete. His mother brings him in today because he no longer
studies, works out, or sees his friends. This has gone on for a month and a
half. When you speak with him alone in the room, he states it “would be better
if I was not here.” What would you do next?NUR643E Advanced Health Assessment for Nurse Educators.

•Tell him
that he has a very promising career in anything he chooses and soon he will
feel better.

•Tell him
that he needs an antidepressant and it will take about 4 weeks to work.

•Speak with
his mother about getting him together more with his friends.

•Assess his
suicide risk.

•Mr. Chin
is an 82-year-old man who presents to your office for a routine check. On
examination, you notice a somewhat high-pitched murmur in the second right
intercostal space during systole. It does not radiate and the rest of his
examination is normal for his age. Which is true of the most likely cause of
this murmur?NUR643E Advanced Health Assessment for Nurse Educators.

•It often
increases carotid upstroke.

•It carries
with it increased risk for cardiovascular disease.

•It is
usually accompanied by an S3 gallop.

•It is
found in 10% of otherwise normal elderly patients.

•Mrs.
Fletcher complains of numbness of her right hand. On examination, sensation of
the volar aspect of the web of the thumb and index finger and the pulp of the
middle finger are normal. The pulp of the index finger has decreased sensation.
Which of the following is affected?

•Median
nerve

•Ulnar
nerve

•Radial
nerve

•You are
assessing a patient for peripheral vascular disease in the arms, secondary to a
complaint of increased weakness and a history of coronary artery disease and
diabetes. You assess the brachial and radial pulses and note that they are
bounding. What does that translate to on a scale of 0 to 3?NUR643E Advanced Health Assessment for Nurse Educators.

•0

•3+

•2+

•1+

•A
70-year-old retired auto mechanic presents to your office because his neighbor
is concerned about his memory. The patient himself admits to misplacing his
keys more often and forgets what he is supposed to buy from the grocery store
and where he has parked the car. He denies getting lost in familiar places.
Upon further questioning, he states that his wife of 40 years died 8 months
ago; his three children live in three different states; and he has limited his
activities because the people he interacted with were “his wife’s friends, not
his.” He drinks a six-pack of beer daily; he does not smoke or use illicit
drugs. You perform a mini-mental state examination and obtain a total score of
24 out of 28. Based on this information, what is the most likely condition?NUR643E Advanced Health Assessment for Nurse Educators.

•Benign
forgetfulness

•Dementia

•Meningitis

•Depression

•You are screening
people at the mall as part of a health fair. The first person who presents for
screening has a blood pressure of 132/85. How would you categorize this?

•Normal

•Prehypertension

•Stage 1
hypertension

•Stage 2
hypertension

•A
17-year-old high school senior presents to your clinic in acute respiratory
distress. Between shallow breaths, he states he was at home finishing his
homework when he suddenly began having right-sided chest pain and severe
shortness of breath. He denies any recent traumas or illnesses. His past
medical history is unremarkable. He doesn’t smoke but drinks several beers on
the weekend. He has tried marijuana several times but denies any other illegal
drugs. He is an honors student and is on the basketball team. His parents are both
in good health. He denies any recent weight gain, weight loss, fever, or night
sweats. On examination you see a tall, thin young man in obvious distress. He
is diaphoretic and is breathing at a rate of 35 breaths per minute. On
auscultation, you hear no breath sounds on the right side of his superior chest
wall. On percussion, he is hyperresonant over the right upper lobe. With
palpation, he has absent fremitus over the right upper lobe.

What
disorder of the thorax or lung best describes his symptoms?

•Spontaneous
pneumothorax

•Chronic
obstructive pulmonary disease (COPD)

•Asthma

•Pneumonia

•When
assessing the lung fields, what does the technique of percussion look for?NUR643E Advanced Health Assessment for Nurse Educators.

•Consolidation

•Rales

•Wheezing

•Rhonchi

•Which of
the following events occurs at the start of diastole?

•Closure of
the tricuspid valve

•Opening of
the pulmonic valve

•Closure of
the aortic valve

•Production
of the first heart sound (S1)

•A pregnant
woman finally pres

NUR643E Advanced Health Assessment for Nurse Educators.