Chapter: 20 Anus,Rectum,Prostate 

While you are examining a 1-year-old girl, the mother mentions how eager she is to begin toilet training her child. How should you respond? When is it best to begin toilet training? 

What do the rectum and anus form?

Control of the external anal sphincter is gradually achieved at what age?

Differentiate between internal and external hemorrhoids.

You are observing an examiner take the history of a 70-year-old man as part of the musculoskeletal examination. You notice that the examiner asks the patient about exercise habits in his early years. Is this a relevant question to ask this patient? Why or why not?

A young woman is concerned about a 1-cm difference in the length of her legs. What is the best response to give this patient?  

A 3-year-old boy has had anal itching that becomes worse at night. What do these symptoms indicate?

You are assessing a pregnant woman who has had a fourth-degree perineal laceration. Why is it necessary to assess this patient’s anal sphincter function? 

You are about to perform a rectal examination of an older adult. What is the suggested position for this patient? 

What is a clue to the diagnosis of Hirschsprung disease?

What do persistent, pencil-like stools suggest?

Distinguish between the stool of a formula-fed baby and a breastfed baby.

Create a chart or two-column list that compares the risk factors for colorectal cancer with those for prostatic cancer.

What are the risk factors for colorectal cancer?

What are the risk factors for prostate cancer?

What symptoms are associated with BPH?

JF is a 42-year-old patient who presents for an annual examination, but he complains that he has had a fever for the past few days and recently some “urinary symptoms.”

1- Describe the best method for a rectal examination during the physical assessment

2- What additional past medical history questions would you ask of JF since you suspect prostatitis?

3- During the rectal examination of JF with acute prostatitis, what findings would expect on physical examination? .

A, Correct procedure for introducing finger into rectum. Press pad of finger against the anal opening. B, As external sphincter relaxes, slip the fingertip into the anal canal. Note that patient is in the hips-flexed position.

 

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Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

1. Describe the contemporary issue and explain what external stressors are associated with this issue.
2. Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.
3. Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented. 

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. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

ebook link-  https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/3 

 

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A 60-year-old man is brought to the ER by ambulance because of slurred speech and left side weakness. His wife states they went to bed at 11pm and woke up at 5am when she noticed his symptoms. He is right handed with a history of coronary artery disease, hypertension, and hypercholesterolemia and a heart attack at age 50. He currently is unable to move his left arm and leg. He had an episode of amaurosis fugux (blindness)in his right eye one month ago that lasted for 5 minutes. Around 3 months ago his wife states he had bilateral pain in his legs while they were on a walk that lasted about 15 minutes. He is taking a baby aspirin a day an ACE inhibitor, and statin as well. He does have a history of alcohol use and smoking in the past but stopped after his heart attack. His blood pressure is 195/118 Pulse 106, Respiratory rate 18, Temperature 99.8, o2 sat is 97% on room air. Although his pupils are equal and reactive, and the ocular movements are intact, he is unable to turn his eyes voluntarily toward the left side. The neck is supple, there is no jugular vein distension, and there are no bruits. The lungs are clear heart sounds regular without murmurs, and abdomen is normal. The limbs are not well perfused distally. The neurologic examination reveals that he is alert and oriented, although he does not recognize he is sick. He shows loss of awareness and attention with respect to objects or stimuli on his left side. He has mild dysarthria but, his speech is fluent, and he understands and follows commands very well. There is mild weakness on the left side of the face and left sided homonymous hemaianopsia, but there is no nystagmus or ptosis, and no tongue or uvula deviation. He is not able to move his left arm and leg, has hyperreflexia, and the left great toe is upgoing.

• What are two questions you would ask this patient?
• Identify the subjective data for this patient.
• Identify the objective data for this patient.
• What is the likely diagnosis?

Your response should include evidence of review of the course material, websites, and literature through proper citations using APA format.

 

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AP Role

How well do you know your future role in advance practice?

The elevator door opens; you step on and find yourself face to face with a known skeptical colleague, who inquires “what are you doing in your profession”? It’s your chance to share, define and possible persuade this person about your chosen role of nursing in advance practice. You have 10 floors, roughly 90 seconds to make an impression. Draft an “Elevator Speech” (approximately 300 words) reflecting the conversation about your future role in your program of study.  In three detailed paragraphs, address why you have chosen this role (your passion) and define steps to ascertain the role including certification criteria and how the role will impact patient outcomes (how you will make a difference).

Support your work with evidence based research. For example, in conversation you tell the person A recent study by Taylor in 2016 showed that NPs were efficient as MDs at treating primary care problems. (Reference at the end) Respond to at least two of your cohorts, faculty and continue the dialogue with those that responded to your initial post. Use references in your responses.

 

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 For your portfolio contribution, please consider how you have developed the knowledge, skills, and attitudes that enable your achievement of the bachelor’s/master’s level nursing competency/ies listed in the syllabus. Then write a minimum of 1000 words describing how this course has helped you achieve these outcomes. Finally, chose one assignment that you feel represents your best learning in the course. Take a few minutes to revise it, according to comments from your professor. Combine these into one document. 

 

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