N305 Week 1 Discussion Exploring the Nurse’s Role in Health Assessment

This week’s graded topics relate to the following Course Outcomes (COs).

CO 1 – Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)

CO 5 – Explore the professional responsibilities involved in conducting a comprehensive health assessment and provide appropriate documentation. (PO 6)

Discussion

The nursing process is utilized in a variety of nursing roles and health care settings. Whether you are working in direct patient care, telehealth, or in a leadership role – the basic model is the same! Take this opportunity to share how the nursing process is utilized in your own practice settings! Hint: Your assigned readings will be helpful in formulating your answers.

Please answer the following question in your initial post:

Describe how you apply the first step (assessment) of the nursing process in your current practice setting. If you are not currently practicing as an RN, you may use an example from a prior clinical or work experience. Include the following information:

Briefly describe your practice setting and the typical patient population.

Provide examples of key subjective and objective data points you collect.

Describe how you document your findings. Is there technology involved?

Describe your process of data analysis. What is the end result of this process? (i.e., Do you formulate nursing diagnoses and care plans, collaborate with others and/or make referrals?)

Discussion Questions (DQ)
• Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

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Weekly Participation
• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
• I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
• As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

LopesWrite Policy
• For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
• Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
• Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
• Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
• The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
• Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
• If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
• I do not accept assignments that are two or more weeks late unless we have worked out an extension.
• As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
• Communication is so very important. There are multiple ways to communicate with me:
o Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
o Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Check Out Also: NR 536- Week 8 Assignment Self-Assessment of NLN Nurse Educator Core Competencies

Complete each item below:

Complete each item below:

Situation

A 19-year old female, Amka Oxendine is brought to the ED by the EMS for acetaminophen ingestion complaining of nausea and abdominal pain. EMS reported ingestion of 15 (500mg) extra strength acetaminophen pills for suicidal ideation (SI) following a phone conversation with her boyfriend. Amka Oxendine however denies ETOH, illicit/recreational drug use and abuse, or abuse of other prescription drugs. She further denies use of other OTC or herbal medications. She called the EMS 4 hours later complaining of abdominal pain and nausea but denied upper/lower GI bleeding, vomiting, or palpitations. Latest laboratory findings revealed a serum acetaminophen was 150 mcg/mL. Other laboratory findings were within normal limits (WNL). Provider initiated IV in LAC NAC and suicide precautions. Today, patient denies nausea, vomiting, abdominal pain, chest pain/discomfort, difficulty breathing, palpitations, or shortness of breath) (SOB). She reports feeling stressed, lonely, and overwhelmed. She also reports a family history of depression (father) and anxiety (father and mother).

Background

Patients was diagnosed with MDD (major depressive disorder) at 15-years old during her high school years. She has been on daily fluoxetine (Prozac) 20mg PO since she was 16-years old. She had her last fluoxetine dose yesterday in the morning. She is presently attending psychotherapy which she reports being effective. Her social life reveals that she is currently stressed in college where she has no friends, she is failing in her academics, and her boyfriend recently broke up with her. She has previously attempted suicide. She also reports occasional loss of appetite, excess or less sleep, and wanting to be left alone most of the time. She however denies fever, intentional/unintentional weight loss, or anxiety.

Assessment

Patient is AOX4. She exhibits no signs of cardiovascular or respiratory distress. IV site and surrounding left antecubital arm has erythema, skin is warn, pale, and diaphoretic, there is multiple scarring on medial thigh bilaterally.

Vital Signs: Blood Pressure (BP)-116/74mmHg, Pulse-66bpm, RR-12cycles/min, SPO2-96%, Code status- Full code.

Recommendation

Administration of Diphenhydramine 50 mg as prescribed & PRN for urticaria
Obtain 1:1 sitter for SI precautions
Discuss with the patient considerations of involvement of her family for psychosocial support and part of the coping strategy
Considering that this patient is at high risk of suicide and recurring depression based on her medical history and age, recommend an appropriate community support group.
Recommend increased dosing of current antidepressant for optimal outcome

If Ms. Oxendine resided in your community, would appropriate services be available for her? List two specific community resources in your area that would benefit Ms. Oxendine. Provide the names and website addresses (URL).

Aurora Behavioral Health which can be accessed via https://www.aurorasandiego.com/programs/san-diego-outpatient-services
Suicide Prevention Lifeline: 1-800-273-8255 (1-800-273-TALK)
In a one paragraph response, what findings in your iHuman assessment led you to select these two community resources for Ms. Oxendine? What services do they provide?

Patient Amka Oxendine’s history indicates that she has an underlying diagnosis of MDD (major depressive disorder) with multiple suicide attempts. Therefore, she would benefit immensely from an intense outpatient program that includes both behavioral and psychopharmacological services. Evidence from currently existing literature indicates that suicide attempts result from maladaptive behavior, cognition, and affective responses to stressors (Oud et al., 2019). The same factors predispose adolescents to depressive episodes. Cognitive behavioral therapy (CBT) is a psychotherapeutic intervention provided by Aurora Behavioral Health to address skill deficits cognitive and behavioral components. The former addresses deficits in interpersonal relations and coping skills. The latter addresses deficits in cognitive distortions, and automatic thoughts to promote emotion regulation and supportive relationships. The suicidal prevention lifeline resource will be helpful in reaching out for help during a suicidal crisis or when she feels suicidal.

In a one paragraph response, do you feel there are adequate resources available for patients suffering from mental health concerns and/or addiction residing in your area? Why or why not?

Initially, the COVID-19 epidemic had restricted that availability of most mental healt resources in my community to online/virtual, which inconvinienced both providers and patients to an extent. Patients felt lonely and secluded in omes but not anymore. Currently, such concerns are a non-issue as the environment has normalized. Therefore, I feel that there are adequate resources for mental health/addiction in my community.

References

Oud, M., De Winter, L., Vermeulen-Smit, E., Bodden, D., Nauta, M., Stone, L.,& Stikkelbroek, Y. (2019). Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis. European psychiatry, 57, 33-45.