Assignment: Family Nurse Practitioner

Assignment: Family Nurse Practitioner

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Week 1 discussion

Discussion Questions

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, post a response to one question in the Discussion Area by the due date assigned. You may respond to your classmates’ postings for either question.

To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

You are a Family Nurse Practitioner working in a community health center. You are seeing a 14-year-old adolescent patent for an annual visit. The patient’s mother is also present during the visit and notes that the patient’s grades in school have been declining. Her son is also hanging out with a group of kids that she has concerns about. The mother has concerns for what is going on with her son. 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).

What are the components of an annual exam for an adolescent patient?

Is the mother required to be present during your exam?

Describe 1 health promotion idea that you would discuss with your middle adolescence patient. Why is this idea important?

What are some screening tools that might be of importance in this situation? (hint: do you suspect drug or alcohol abuse here?)

Week 2 discussion

A fifteen-year-old female presents to your clinic complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately, she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema, and her father has high blood pressure. She is the only child. She denies smoking and illegal drug use. On examination, she is in no acute distress and her vital signs are: T 98.6, BP 120/80, pulse 80, and respirations 20. Her head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is decreased air movement and high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.

What is the chief complaint?

Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?

What treatment plan would you consider utilizing current evidence based practice guidelines?

Week 3 discussion

In week 3 you learned about other common adolescent health conditions. Review the following case study and answer the following questions:

An 18 year old white female presents to your clinic today with a 2 week history of intermittent abdominal pain. She also is positive for periodic cramping and diarrhea as well as low grade fever. She also notes reduced appetite. She notes that She admits smoking ½ PPD for the last 2 years. Denies any illegal drug or alcohol use. Does note a positive history of Crohn’s Disease. Based on the information provided answer the following questions:

What are the top 3 differentials you would consider with the presumptive final diagnosis listed first?

What focused physical exam findings would be beneficial to know?

What diagnostic testing needs completed if any to confirm diagnosis?

Using evidence based treatment guidelines note a treatment plan.

Week 4 discussion

Discussion

This week’s content addressed common chronic diseases. Please review the case study below and answer the following questions:

A sixty-year-old baker presents to your clinic, complaining of increasing shortness of breath and nonproductive cough over the last month. She feels like she can’t do as much activity as she used to do without becoming tired. She even has to sleep upright in her recliner at night to be able to breathe comfortably. She denies any chest pain, nausea, or sweating. Her past medical history is significant for high blood pressure and coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is married and is retiring from the local bakery soon. She denies any tobacco, alcohol, or drug use. Her mother died of a stroke, and her father died from prostate cancer. She denies any recent upper respiratory illness, and she has had no other symptoms. On examination, she is in no acute distress. Her blood pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory rate is 16. With auscultation, she has distant air sounds and she has late inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2 are distant and an S3 is heard over the apex.

What is the chief complaint?

Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?

What treatment plan would you consider utilizing current evidence based practice guidelines?