Assessment Of The Musculoskeletal System And Pain

  • CO1 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)
  • CO2 Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)
  • CO3 Utilize effective communication when performing a health assessment. (PO 3)

Fred is an 83-year-old male who is being admitted to the medical-surgical unit status post fall. He is alert and oriented and reports that while visiting a local casino with his wife Margaret earlier this evening, he tripped over a curb and fell landing on his right side. After receiving morphine in the emergency room prior to transfer to your unit, Fred is rating his pain at 6/10. He has multiple bruises from his jawbone to his knee as well as a slight rotation of his right leg.

Past medical history includes: myocardial infarction (MI) x 2, peripheral vascular disease (PVD) with bilateral iliac stents, non-insulin-dependent diabetes mellitus (NIDDM), sleep apnea, and degenerative joint disease.

Medications include: aspirin, Plavix, Lopressor, Lisinopril, and Metformin.

After reviewing the above scenario please answer the following questions.

  1. Based on the information provided, how will you prioritize your care, what assessments will you include and in what order? Please provide rationale for your response.
  2. Considering this patient’s age, injury, past medical history, and list of current medications, what, if any, concerns do you have related to his potential need for surgery?
  3. Should surgery to repair his right femur be required; what type of clearance and pre-op orders would you anticipate receiving related to his diet, meds, lab work, and so on?

STOPPED IN HIS TRACKS

CLASS: I am certain that most of you have encountered a patient like Fred.  They are vibrant and engaged elderly people who suffer a fall and sustain what can be life threatening injuries.  His situation is complicated by his age (the condition of his vital organs and musculoskeletal system), his previous medical history and his current medication regimen.   Be sure to consider each of these complications as you create your plan for his nursing care.  

References:

Chamberlain College of Nursing (2019) NR305 RN Health Assessment.Week 7 lesson Downers Grove, IL Online Publication

 
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Assessment Of The Neurological System 19097687

CO1 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)

CO2 Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)

CO3 Utilize effective communication when performing a health assessment. (PO 3)

Randy Adams is a 38-year-old male patient of Dr. Joseph Reynolds who was admitted yesterday morning for 24-hour observation for mild concussion following a motor vehicle accident. Randy lost consciousness during the accident and was very confused when he arrived in the ER after EMS transport. He is an Iraq war veteran and he seemed to think after the accident that this all happened in Iraq. Dr. Reynolds is concerned that Randy has some residual problems from a couple of explosive incidents that occurred while he was in Iraq. The physician is unsure whether Randy’s current symptoms are from the car accident or from prior injuries so he has referred him for consultations to both a neurologist and to a behavioral health specialist.

 Based on the above please discuss the following.

Pathophysiology of concussive injuries and treatment

Neurological assessment tools used in your current practice setting (if not presently working, please describe one used during prior employment or schooling)

Current best practices associated with post-traumatic stress disorder (PTSD)

Nursing interventions you would include in this patient’s plan of care

 
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Assessment Report For Proposed Researched Projects Qn 8 Pages By 16th April

Check the attached document for details.  DO NOT PLAGIARIZE, WRITE WELL, GOOD GRAMMAR IS A PLUS, REFERENCE WELL.

 
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Assessment Three Class One

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Assessment Two Class One

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Assessment1class6

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Assessment1class4 19315101

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Assessment2 19287387

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Assessment2 Determining The Credibility Of Evidence And Resourc

Develop a 2-4-page scholarly paper in which you describe a quality or safety issue, or a chosen diagnosis, and then identify and analyze credible evidence that could be used as the basis for applying EBP to the issue.

The goal of using evidence-based research findings is to enhance safety and quality of patient care and ensure optimal outcomes are achieved. It is not uncommon to hear a nurse say, “why change it as we’ve always done it this way.” However, this is no longer acceptable in today’s practice environment. The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided. As the profession of nursing continues to evolve and engage in health care transformation, baccalaureate-prepared nurses are expanding taking on leadership roles that include incorporating EBPs. To be able to do this, the nurse needs to understand the criteria and makes a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into health care settings.

It would be an excellent choice to complete the Vila Health Determining the Credibility of Evidence activity prior to developing the report. The activity is a media simulation that offers an opportunity to review a scenario and work on determining the credibility of presented evidence. These skills will be necessary to complete Assessment 2 successfully. This media simulation is one potential source of context on which to base your assessment submission. This will take just a few minutes of your time and is not graded.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision. 
    • Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.
    • Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis.
  • Competency 3: Apply an evidence-based practice model to address a practice issue. 
    • Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis.
  • Competency 4: Plan care based on the best available evidence. 
    • Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.
  • Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence. 
    • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.

Scenario

For this assessment, you may choose from the following options as the context for the quality or safety issue or chosen diagnosis for researching and completing this assessment:

  • The specific diagnosis you identified in your previous assessment.
  • The simulation Vila Health: Determining the Credibility of Evidence.
  • A personal practice experience in which a sentinel event occurred.

Instructions

The purpose of this analysis is to better understand what constitutes credibility of journal articles as well as websites. The role of the baccalaureate-prepared nurse in incorporating evidence-based research continues to growth in clinical practice. As quality improvement (QI) measures to reduce safety risks continue to be emphasized, the need for evidence-based models and evidence-based templates is growing. This type of systematic approach to incorporating evidence-based findings allows nurses to make clinical and operational decisions based upon the best available evidence. When the most up-to-date evidence-based findings are utilized, patient-centered care improves outcomes and enhances the patient experience.

For this assessment:

  • Explain the criteria that should be used when determining the credibility of journal articles as well as websites.
  • Support your explanations with references to the literature or research articles that describe criteria that should be used to determine credibility. 
    • Your identification and determination of credibility should be done within the context of your chosen scenario for this assessment. For example, if you choose to use the provided Vila Health scenario, your initial identification of resources should be of resources that will best help address the presented issue. However, if you are locating resources to help provide evidence-based care for the diagnosis you identified in the first assessment, you may want to begin your literature and evidence search from the databases that identified. Any of the three scenario options are acceptable. So, pick the one that most interests you.

Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.

  • Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.
  • Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.
  • Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis. 
    • This is where you are selecting the specific resources to help address the issue in your chosen scenario. 
  • Explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis.
  • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Submission Requirements

Your assessment should meet the following requirements:

  • Length of submission: 2–4-page scholarly paper, this does not include the APA-formatted title page and reference list.
  • Number of references: Cite 3–5 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than five years old.
  • APA formatting: References and citations are formatted according to current APA style.
 
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