NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II 

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NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II 

NURS 6560 Entire Course Weekly Discussions And Assignments

NURS 6560 Week 1: Scope of Practice of the Acute Care Advanced Practice Nurse in Perioperative Environments

With more 50 million surgical procedures performed annually (Centers for Disease Control and Prevention, 2015), advanced practice nurses must be prepared to practice in perioperative environments. Although the scope of practice may differ based on state laws and institutional regulations, all advanced practice nurses are an integral part of the multidisciplinary care team. From pre- to post-operation, they must coordinate patient care and communicate with patients, physicians, and family members.

This week, you examine the scope of practice for acute care advanced practice nurses in perioperative environments. You also explore the impact of scope of practice laws and regulations on clinical care.

Learning Objectives

By the end of this week, students will:

  • Analyze the scope of practice for acute care advanced practice nurses
  • Evaluate the impact of scope of practice on clinical care

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II

In this course, some Discussions will have two parts:

  • Part I will consist of a specific topic related to the week’s content.
  • Part II will consist of a pharmacology review of approximately 250 words. Please submit each posting separately but within the same Discussion thread.

You will be assessed on your posting and responses to both parts.

As medical care evolves, so does the role and scope of practice of the advanced practice nurse in acute care settings. When providing patient care, however, you, as an advanced practice nurse, must always ensure that you are working within the scope of practice outlined by your state’s laws and institution’s regulations. For this Discussion, you examine these laws and regulations and consider how they might affect your future clinical practice, consider the credentialing process for your area, and discuss negotiation techniques you may use in a job search.

To prepare:

    • Locate a collaborative practice agreement. Based on this agreement, consider the scope of practice of an advanced practice nurse in your state.
    • Locate and select at least two hospitals where you would be interested in working at once you obtain your licensure.
    • Locate the hospitals’ credentialing documents and investigate the scope of practice at each hospital.

Note: All hospitals do not have the same scope of practice even if they are located within the same city and state.

  • Consider how the laws and regulations of the state and hospitals might affect your practice with medical and surgical patients in acute care settings.
  • Think about how you would negotiate your first Advanced Practice role. Consider issues such as salary range, Continueing Medical Education (CME), license and DEA costs, insurance, hours, on call requirements, etc.

By Day 3

Post an explanation of the scope of practice of advanced practice nurses, as outlined in the collaborative practice agreement. Then, identify the two hospitals of interest that you selected. Based on the credentialing documents, explain the scope of practice for acute care advanced practice nurses at each hospital. Explain how this might affect your practice in terms of caring for medical and surgical patients in acute care settings (i.e., medical treatments, procedures you can perform, interpreting diagnostics, etc.). Finally, describe job negotiation considerations.

Note: To support your Discussion post, you must include references (with URL links) from the state and the hospitals you selected.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days who selected a different state or hospital from yours. Share additional insights or alternative perspectives.

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NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II

NURS 6560 Week 2: Pre- and Post-Operative Care

“A wide range of illnesses and injuries may require treatment that includes some type of surgical intervention. Surgery may be planned or unplanned, major or minor, invasive or noninvasive, and may involve any body part or system”

—Pamela Lynn (2008).

As this quotation suggests, advanced practice nurses must be able to provide pre- and post-operative care to patients with various illnesses and injuries. Consider a 17-year-old patient who is injured in a car accident. The patient has severe burns on her legs, and several toes on her right foot require amputation. Her injuries are affecting multiple body systems. As an advanced practice nurse, how might you stabilize and prepare this patient for surgery? What areas of care will be your focus as the patient recovers from surgery?

This week, you examine and discuss limitations and challenges of clinical practice. Then, as you explore the role of the advanced practice nurse in perioperative settings, you examine strategies for assessing, diagnosing, and treating patients in pre- and post-operative care.

Learning Objectives

By the end of this week, students will:

  • Analyze limitations and challenges of clinical practice
  • Evaluate pre- and post-operative care patients
  • Develop differential diagnoses for pre- and post-operative care patients
  • Develop treatment plans for pre- and post-operative care patients

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II 

From providing ongoing assessments to monitoring for complications and facilitating recovery, advanced practice nurses who care for patients in perioperative environments experience a unique set of limitations and challenges. Reflecting on your experiences in this complex and critical environment will help you develop your professional competency and prepare you for your future role as an advanced practice nurse. In this week’s Discussion, you consider limitations and challenges of clinical practice in perioperative care settings.

To prepare:

  • Reflect on this week’s clinical experiences.
  • Consider one limitation or challenge you encountered.
  • Think about how you overcame this limitation or challenge and how this might affect your future practice in pre- and post-operative care settings.

By Day 3

Post a description of at least one limitation or challenge you encountered during your clinical experience this week. Explain how you overcame this limitation or challenge and how this might affect your future practice.

Note: If you refer to a patient in your Discussions or Assignments, be sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

Read a selection of your colleagues’ responses.

By Day 6

Respond to two colleagues by sharing additional insights or alternative perspectives.

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II 

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients

The perioperative period is critical for surgical patients. Whether patients require fluid and electrolyte management, pain management, or treatment for infections or surgical complications, advanced practice nurses must be able to provide safe and effective care. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat patients who require pre- and post-operative care.

To prepare:

  • Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients in pre- and post-operative care.
  • Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions to consider in a differential diagnosis for the patient.
  • Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for each patient that includes health promotion and patient education strategies for pre- and post-operative care patients.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. As you interact with this week’s i-Human patients, complete the assigned case studies. For guidance on using i-Human, refer to the i-Human Patients Case Player Student Manual in the Week 2 Learning Resources.

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NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II

NURS 6560 Week 3: Assessment and Care of Patients With Conditions of the Head, Neck, Esophagus, and Diaphragm

Health conditions involving the head, neck, esophagus, and diaphragm can disrupt patients’ daily lives, making surgical interventions necessary. Consider Janice Savage-Martin, who frequently experienced impaired breathing, congestion, and headaches. These symptoms and the pain associated with them put a strain on her normal routine and ability to work. After being diagnosed with turbinates and a deviated septum, providers recommended surgery to shrink the blood vessels in the turbinates. Like many surgical patients, however, Janice was concerned that her recovery would be painful and might lead to further health complications (Methodist Health System, 2015). As an advanced practice nurse who cares for surgical patients like Janice, you will play significant role in educating patients, easing concerns, and providing evidence-based care.

This week, as you explore the pre- and post-operative care of patients with conditions related to the head, neck, esophagus, and diaphragm, you examine strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

  • Evaluate medical and surgical patients with conditions related to the head, neck, esophagus, and diaphragm
  • Develop differential diagnoses for medical and surgical patients with conditions related to the head, neck, esophagus, and diaphragm
  • Develop treatment plans for medical and surgical patients with conditions related to the head, neck, esophagus, and diaphragm

There are many common health conditions associated with the head, neck, esophagus, and diaphragm. Although these conditions and their related symptoms usually are managed easily, a delay in treatment can result in sensory debility such as hearing loss or sight loss. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with health conditions related to the head, neck, esophagus, and diaphragm.

To prepare:

  • Review this week’s Learning Resources. With the head, neck, esophagus, and diaphragm in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.
  • Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions to consider in a differential diagnosis for the patient.
  • Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with conditions related to the head, neck, esophagus, and diaphragm.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Patients Case Player Student Manual in the Week 2 Learning Resources.

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II

Assignment 2: Fitzgerald Health Education Associates (FHEA) AGPCNP 150 University Exit Comprehensive Exam

The Fitzgerald Health Education Associates (FHEA) AGACNP 150 University Exit Comprehensive Exam is a learning activity used to guide your preparation for your national certification exams. The results of the exam will help you understand how well prepared you are for your national certification exams and the areas in which you need to further prepare.

In Weeks 1 or 2 of this course, you should have received an email from Fitzgerald Health Education Associates (FHEA) explaining how to access the Fitzgerald Health Education Associates (FHEA) AGACNP 150 University Exit Comprehensive Exam. Please follow the directions FHEA provided and complete the exam.

This exam is worth 10% of your overall course grade. You must complete the exam by Day 7 of Week 3 to receive a grade for this exam.

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NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II 

NURS 6560 Week 4: Assessment and Care of Patients With Cardiovascular Conditions

After experiencing severe chest pain and shortness of breath, Edward Richardson underwent surgery for coronary artery disease. Before surgery, he felt anxious and had trouble sleeping, as do many surgical patients with cardiovascular conditions. To relieve his concerns, his health care providers developed a pre-operative care plan that included breathing and relaxation exercises. To ensure a full recovery, his post-operative care plan included changes to his diet, exercise, and lifestyle (Northwestern Medicine, 2014). As an advanced practice nurse who cares for surgical patients like Edward, you must assess patient needs and provide individualized care plans to patients throughout the perioperative period.

This week, as you study the pre- and post-operative care of patients with cardiovascular conditions, you examine strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

  • Evaluate medical and surgical patients with cardiac conditions
  • Develop differential diagnoses for medical and surgical patients with cardiac conditions
  • Develop treatment plans for medical and surgical patients with cardiac conditions

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II

Many cardiac disorders such as myocardial infarctions are a common problem in the acute care setting. Thus it is essential for you, as the advanced practice nurse caring for acute patients, to identify potential signs and symptoms of complications. Although some cardiac disorders require outpatient treatment and management, other procedures such as CABGs or valve replacements are more common and frequently require major interventions. In your role with acute cardiac patients, you must evaluate symptoms and determine how to treat patients. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies.

Case Study 1

Tom is 56-year-old African American male who presented to the ED with chest pain radiating to his back. The pain has been continuous for 1 hour. The patient complains of shortness of breath. The pain has not been relieved with rest. The patient’s vitals are: 99.1-98-18-198/110. The patient’s cardiac enzymes are negative. Labs results are as follows:

  • Na 134
  • K 4.1
  • Cr 1.8
  • BUN 42
  • Glucose 248
  • WBC 13.1
  • Hbg 14.1
  • Hct 44.2
  • Plt 236
  • EKG sinus rhythm no ekg changes

Case Study 2

Liz is a 79-year-old female with a history of aortic stenosis and hypertension. The patient underwent elective aortic valve replacement yesterday. This AM during rounds, the patient is sitting up in the chair. Vital signs: 99.4-54-20-85/50. Pa 29/13, CVP10. Urine output 20 ml/hr for the last 3 hours. Cardiac output 3.9, cardiac index 1.8. Patient’s preop ef was 50%. Labs are as follows:

  • K 4.0
  • Cr 1.5
  • BUN 42
  • Hgb 9.8
  • Hct 29.1
  • Plt 138
  • Postoperative chest X-ray normal

Case Study 3

Arvid is a 69-year-old male you are seeing in CCU 1 hour after he had a CABG × 4. The patient is intubated. VS: 97.1-78-14-90/50. PA 30/13, CVP 12. ABG 7.21-49-98-19.6-99%- -6 base deficit. Mixed venous O2 sat 68. Hgb 10.2, Hct 32.1. The patient is sedated. Vent settings FiO2 50%, IMV 12, PEEP 5, tidal volume 550.

To prepare:

  • Review and select 1 of the 3 case studies provided. Analyze the patient information.
  • Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
  • Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
  • Consider strategies for educating patients and families on the treatment and management of the cardiac disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the cardiac disorder.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours.

  • Describe how a patient factor such as age, gender, ethnicity or culture might affect the diagnosis, management, and follow-up care of patients with the cardiac disorders your colleagues discussed.
  • Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.​

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NURS 6560 Week 5: Assessment and Care of Patients With Respiratory Conditions and Shock

Greg Andrews was hospitalized for extreme nausea, which he attributed to possible food poisoning. Although he was discharged after a few hours, his condition worsened the following day. After being rushed back to the hospital, he quickly fell into a 3-week coma. Tests revealed that the cause of Greg’s nausea was actually pneumonia that had progressed to sepsis. As his organs began to shut down from the sepsis, blood flow to his extremities decreased, requiring the amputation of his limbs. Although Greg’s prognosis was grim, he managed to recover from his illness after a long-term stay in acute care (UC Health Media Room, 2013). As his case demonstrates, the condition of pulmonary and shock patients can change rapidly over a short time period, and patients sometimes must undergo surgical procedures. As an advanced practice nurse who cares for patients before, during, and after surgery, you must understand how to stabilize and support patients throughout all phases of their care.

This week, as you examine the pre- and post-operative care of patients with conditions respiratory conditions and shock, you explore strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

  • Evaluate medical and surgical patients with respiratory conditions
  • Develop differential diagnoses for medical and surgical patients with respiratory conditions
  • Develop treatment plans for medical and surgical patients with respiratory conditions

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II 

In your role as the advanced practice nurse, it is critical that you be able to identify even the earliest signs of health conditions related to pulmonary issues and shock. Although these conditions often are triggered by common infections and environmental factors, they can progress quickly to life-threatening circumstances. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with health conditions related to pulmonary issues and shock.

To prepare:

  • Review this week’s Learning Resources. With respiratory conditions and shock in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.
  • Review this week’s i-Human study. Based on the patient information provided, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about each patient’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions to consider in a differential diagnosis for the patient.
  • Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with respiratory conditions and shock.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Rubrici-Human Patients Case Player Student Manual in the Week 2 Learning Resources.

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NURS 6560 Week 6: Assessment and Care of Patients with Conditions of the Acute Abdomen, Stomach/Duodenum, and Appendix

Jordan Lemke woke up one morning with a fever and severe abdominal pain on his right side. Concerned, Jordan’s parents rushed him to the hospital, where blood tests and a CT scan were ordered. Providers quickly diagnosed Jordan with a ruptured appendix and immediately scheduled him for surgery (Aspirus Medford Hospital, 2014). Like many patients with conditions related to the acute abdomen, stomach/duodenum, and appendix, Jordan benefited from the prompt response of his health care team. The immediate care needs of these disorders require that you, as the advanced practice nurse, be able quickly to identify the various presentations, signs, and symptoms.

This week, as you study the pre- and post-operative care of patients with acute abdominal, stomach/duodenal, and appendicular disorders, you examine strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

  • Evaluate medical and surgical patients with conditions of the acute abdomen, stomach/duodenum, and appendix
  • Develop differential diagnoses for medical and surgical patients with conditions of the acute abdomen, stomach/duodenum, and appendix
  • Develop treatment plans for medical and surgical patients with conditions of the acute abdomen, stomach/duodenum, and appendix
  • Assess patient evaluation, diagnosis, and treatment in acute medical and surgical settings

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II 

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Acute Abdomen, Stomach/Duodenum, and Appendix

Acute abdominal, stomach/duodenal, and appendicular disorders require a high level of care, because many are life-threatening. To ensure that you immediately recognize classic signs and symptoms of these disorders, it is critical that you have strong assessment and diagnostic skills. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with health conditions related to the acute abdomen, stomach/duodenum, and appendix.

To prepare:

  • Review this week’s Learning Resources. With acute abdominal, stomach/duodenal, and appendicular disorders in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.
  • Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions to consider in a differential diagnosis for the patient.
  • Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with abdominal conditions.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Patients Case Player Student Manual in the Week 2 Learning Resources

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NURS 6560 Week 7: Assessment and Care of Patients With Conditions of the Liver/Biliary Tract, Pancreas, and Spleen

Conditions related to the liver/biliary tract, pancreas, and spleen frequently are chronic in nature and difficult to diagnose. Although many of these conditions are manageable once diagnosed, they often have a tremendous impact on quality of life for patients. With chronic conditions such as these accounting for 81% of hospital admissions (Partnership to Fight Chronic Disease, n.d.), it is essential that you have a strong foundation in the various presentations and symptoms.

This week, as you examine the pre- and post-operative care of patients with conditions related to the liver/biliary tract, pancreas, and spleen, you explore strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

  • Evaluate medical and surgical patients with conditions of the liver/biliary track, pancreas, and spleen
  • Develop differential diagnoses for medical and surgical patients with conditions of the liver/biliary track, pancreas, and spleen
  • Develop treatment plans for medical and surgical patients with conditions of the liver/biliary track, pancreas, and spleen

The liver/biliary tract, pancreas, and spleen often are associated with chronic conditions, which may result in long-term symptoms for patients. Whereas some of these symptoms may be connected easily to a particular condition, many symptoms are associated with multiple conditions, making an immediate diagnosis challenging. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with health conditions related to the liver/biliary tract, pancreas, and spleen.

To prepare:

  • Review this week’s Learning Resources. With the liver/biliary track, pancreas, and spleen in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.
  • Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions to consider in a differential diagnosis for the patient.
  • Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with conditions of the liver/biliary tract, pancreas, and spleen.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Patients Case Player Student Manual in the Week 2 Learning Resources.

By Day 7

This Assignment is due.

Assignment 2: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover the following topics:

  • Conditions of the Acute Abdomen, Stomach/Duodenum, and Appendix
  • Conditions of the Liver/Biliary Tract, Pancreas, and Spleen
  • Conditions of the Intestines, Hernias, and Abdominal Wall Lesions

These questions are intended to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

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NURS 6560 Week 8: Assessment and Care of Patients With Conditions of the Intestines, Hernias, and Abdominal Wall Lesions

After experiencing issues with bowel movements, Terri Gillmore went to the hospital where she was diagnosed with a perforated appendix. Her condition, worsened over time and pain medications did not alleviate her symptoms. Additional diagnostic testing revealed that the actual cause of Terri’s symptoms was Crohn’s disease, which was so severe that providers recommended surgery (University of Maryland Medical Center, 2013). As Terri’s case demonstrates, abdominal conditions can be challenging to diagnose, causing distress and pain for patients. Thus it is essential for you not only to know which diagnostic tests to order and when to order them, but also to be aware of when it is appropriate to consult with specialists and other professionals on your multidisciplinary team.

This week, as you study the pre- and post-operative care of patients with conditions related to intestines, hernias, and abdominal wall lesions, you examine strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

  • Evaluate medical and surgical patients with conditions of the intestines, hernias, and abdominal wall lesions
  • Develop differential diagnoses for medical and surgical patients with conditions of the intestines, hernias, and abdominal wall lesions
  • Develop treatment plans for medical and surgical patients with conditions of the intestines, hernias, and abdominal wall lesions

Conditions associated with the intestines, hernias, and abdominal wall lesions typically are the result of work environment factors, genetics, or infection. Patients who present with these conditions need extensive diagnostic tests and often require referral to a specialist. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with health conditions related to the intestines, hernias, and abdominal wall lesions.

To prepare:

  • Review this week’s Learning Resources. With the intestines, hernias, and abdominal wall lesions in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.
  • Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions to consider in a differential diagnosis for the patient.
  • Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with conditions of the intestines, hernias, and abdominal wall lesions.

To complete:

As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Patients Case Player Student Manual in the Week 2 Learning Resources.

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NURS 6560 Week 9: Assessment and Care of Patients With Adrenal and Urogynecologic Conditions

From severe abdominal pain to urinary frequency, urinary incontinence, sexual health issues, and the overproduction of hormones, adrenal and urogynecologic symptoms often cause frustration and embarrassment for patients. These feelings might cause patients to hold back information, making assessment and diagnosis of adrenal and urogynecologic conditions challenging. Because patients may require surgery to minimize the impact of these conditions on their daily lives, it is essential that you establish trust with patients and carefully ask questions to quantify complaints appropriately.

This week, as you examine the pre- and post-operative care of patients with adrenals and urogynecology conditions, you explore strategies for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

  • Evaluate medical and surgical patients with adrenal and urogynecologic conditions
  • Develop differential diagnoses for medical and surgical patients with adrenal and urogynecologic conditions
  • Develop treatment plans for medical and surgical patients with adrenal and urogynecologic conditions

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II

Many genitourinary (GU) disorders such as kidney disease start developing during adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for adolescent patients, to identify potential signs and symptoms. Although some adolescent GU disorders require long-term treatment and management, other disorders such as urinary tract infections are more common and frequently require only minor interventions. In your role with adolescent patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies.

Case Study 1

Alicia is an 18-year-old female who is brought into urgent care by her mother. She is complaining of dizziness. She recently started to lift weights for softball season. She has been healthy up to this point. Vitals are: temp 101.9°F, HR 120, RR 24, BP 90/54. She has lower extremity edema and decreased skin turgor. She states that her shoulders, thighs, and lower back hurt. She is having trouble moving her arms and legs. She also complains of vague abdominal pain, with nausea and vomiting. Labs came back with CK 10,000, uric acid 40 mg/dl, WBC 14.3, BUN:creatinine ratio 6:1, K 5.8. Urinalysis shows a presence of myoglobin of more than 25.

Case Study 2

Mark is a 15-year-old male with a complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago as a dull ache and gradually has worsened such that he can no longer stand without doubling over. He is afebrile and in marked pain. Physical exam results are negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign.

Case Study 3

Maya is a 16-year-old female who presents to the ER for urinary pain. She is a healthy adolescent with complaints of lower abdominal pain, low back pain, and burning with urination. She had a fever of 102°F at home. Physical examination results are normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood. Leukocytes are moderate and nitrites, moderate. Her blood pressure is normal, and she is at the 60th percentile for height and weight. Vitals are: temp 103.1°F, HR 116, RR 18, BP 100/58. P Ox is 98% (Johns Hopkins Children’s Center, 2010).

To prepare:

  • Review and select 1 of the 3 provided case studies. Analyze the patient information.
  • Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
  • Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
  • Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours.

  • Describe how culture might affect the diagnosis, management, and follow-up care of patients with the genitourinary disorders your colleagues discussed.
  • Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.​

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NURS 6560 Week 10: Assessment and Care of Patients with Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery

Jill Joyce experienced years of back pain that prevented her from completing even the most basic tasks. Bulging discs and degenerative changes in her spine were affecting nerve function, which caused pain that could be alleviated only with surgery (Healthy Life, 2008). Like Jill’s back pain, many conditions related to neurology, orthopedics, and plastic/reconstructive surgery may affect patients’ function and mobility. In your role as advanced practice nurse, you must not only diagnose and treat these patients but also help them manage changes in their function and mobility.

Learning Objectives

By the end of this week, students will:

  • Evaluate medical and surgical patients with conditions related to neurology, orthopedics, and plastic/reconstructive surgery
  • Develop differential diagnoses for medical and surgical patients with conditions related to neurology, orthopedics, and plastic/reconstructive surgery
  • Develop treatment plans for medical and surgical patients with conditions related to neurology, orthopedics, and plastic/reconstructive surgery

NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II

This week, you study neurologic and orthopedic conditions with plastic surgery considerations. Both neurologic and orthopedic conditions are seen in the trauma areas of the hospital. These conditions encompass cardiovascular, pulmonary, and metabolic aspects of care in the ICU. For this Discussion, focus on adolescent patients, and consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies.

Case Study 1

A 17-year-old male was celebrating his birthday with friends and alcohol. At one point he jumped into the hotel pool three stories below, hitting the side of the pool with his chest. EMS arrived and packaged him with spinal support. He arrives in the ER with breathing difficulty, chest pain, GCS 10, and O2 sat of 94%. You do initial assessment in the first 10 minutes and find that his chest is asymmetric for breathing and contusions are noted all over his chest. His CXR shows multiple rib fractures on both sides and pulmonary contusions. His cervical spine is stable in a collar. His thoracic and lumbar films are negative for fractures. In the next hours, what are your priorities, and what plan would you have for this patient as he moves to the ICU? At what stage of development is he, and how does that affect his care?

Case Study 2

A 13-year-old female restrained passenger of a vehicle was involved in an MVA at 60 mph on the highway. The vehicle experienced a frontal impact. The patient arrived in the ER with closed fractures of the left tibia and fibula with angulation, dislocation of the right ankle, multiple pelvic fractures, and femur fracture on the left side. Her BP is 92/54 with pulse of 130. What is your plan for this patient, and what are the considerations to prevent further morbidity? At what stage of development is she, and how does that impact her care?

Case Study 3

A 19-year-old male private in the U.S. Air Force was driving with friends when they dared him to “surf the car.” He fell off the roof of the car while it was moving at a speed of approximately 40 mph. He landed face first. He is now in the ICU with a closed head injury. His intracranial pressure is elevated, and his pupillary response is slowing. At this time, what medications do you recommend, and what other medical treatments do you recommend? In addition, after the acute situation is controlled and the patient awakens, what medication do you use for his agitation?

To prepare:

  • Review and select 1 of the 3 provided case studies. Analyze the patient information.
  • Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
  • Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
  • Consider strategies for educating patients and families on the treatment and management of the trauma care.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of neurologic and orthopedic conditions.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours.

  • Describe how culture might affect the diagnosis, management, and follow-up care of patients with the neurological, orthopedic, or plastics disorders your colleagues discussed.
  • Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.​

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NURS 6560 Week 11: Assessment and Care of Patients With Oncologic Conditions, Organ Transplants, and Medical Ethical Considerations

“In today’s health care settings, there are many opportunities for the [nurse] to share expertise, experience, and knowledge in addressing situations in which there are ethical decisions and moral agency and advocacy implications.”

—Janet G. Whetstone Foster & Suzanne S. Prevost (2012, p. 16)

Oncology and organ transplant patients often present with complex health conditions. The complexity of these conditions will require you, as the advanced practice nurse, to address various medical ethical considerations. As patients and their families face difficult healthcare decisions, you will be trusted to make decisions for their well-being. For these reasons, it is critical that ethical behavior drive your nursing practice.

This week, you discuss medical ethical considerations in acute care settings. Then, as you study the pre- and post-operative care of patients with oncology conditions and organ transplants, you examine special considerations for assessment, diagnosis, and treatment.

Learning Objectives

By the end of this week, students will:

  • Assess patient evaluation, diagnosis, and treatment in acute medical and surgical settings

Assignment: Final Practicum Evaluation

By Day 7

Submit your Final Practicum Evaluation to Meditrek.

Exam: Final Exam

This exam will cover topics related to assessing, diagnosing, and treating the following in pre- and post-operative care patients:

  • General pre- and post-operative care
  • Head, neck, esophagus, and diaphragm
  • Cardiology
  • Respiratory conditions and shock
  • Acute abdomen, stomach/duodenum, and appendix
  • Liver/biliary tract, pancreas, and spleen
  • Intestines, hernias, and abdominal wall lesions
  • Adrenal and urogynecologic conditions
  • Neurologic and orthopedic conditions and plastic/reconstructive surgery
  • Oncologic conditions, organ transplants, and medical ethical considerations

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