Sample Answer for NRS 434 Assignment: Shadow Health: Conversation Concept Lab Included After Question
NRS 434 Assignment Shadow Health Conversation Concept Lab
Description:
Within the Shadow Health platform, complete the Conversation Concept Lab. The estimated average time to complete this assignment is 40 minutes. Please note, this is an average time. Some students may need longer.
This clinical experience is a conversation concept lab. Students have one opportunity to complete this graded assignment. Upon completion, submit the lab pass through the assignment dropbox. Students will receive full points for successful completion of this assignment. A proficiency score is not provided.
Please review the assignment in the Health Assessment Student Handbook in Shadow Health prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Description
Objectives:
1. Utilize the nursing process in completing a comprehensive health history.
2. Examine factors that contribute to risk-taking behavior in adolescents.
3. Discuss support options for adolescents encountering external stressors.
4. Evaluate the issues associated with adolescent pregnancy
Health Assessment: Foundations for Effective Practice
Description:
Read Chapter 3 in Health Assessment: Foundations for Effective Practice.Use the Appendix as needed to complete your assignments.
Purpose of the Systematic Physical Assessment in Everyday Practice: Critique of a Sacred Cow
Description:
Read “Purpose of the Systematic Physical Assessment in Everyday Practice: Critique of a ‘Sacred Cow,'” by Zambas, from Journal of Nursing Education (2010).
How to Improve Your Sexual Health History-Taking Skills
Description:
Read “How to Improve Your Sexual Health History-Taking Skills,” by French, from Practice Nurse (2010).
Optional: Making the Most of the Adolescent Male Health Visit: Part 1: History and Anticipatory Guidance
Description:
For additional information, the following is recommended:
“Making the Most of the Adolescent Male Health Visit: Part 1: History and Anticipatory Guidance,” by Marcell and Bell, from Contemporary Pediatrics (2006).
Respiratory Assessment
Description:
Read “Respiratory Assessment,” by Simpson, from British Journal of Nursing (2006).
Sexually Transmitted Diseases
Description:
View Sexually Transmitted Diseases page of the Medscape website. You will need to create a free account in order to access this material.
Affordable Care Act
Description:
View the Affordable Care Act page of the Medscape website. You will need to create a free account in order to access this material.
Break the Silence: Stop the Violence
Description:
View the video “Break the Silence: Stop the Violence,” by the Centers for Disease Control and Prevention (CDC), located on CDC website. Familiarize yourself on prevention of interpersonal abuse
A Sample Answer For the Assignment: NRS 434 Assignment: Shadow Health: Conversation Concept Lab
Title: NRS 434 Assignment: Shadow Health: Conversation Concept Lab
Identifying Data and Reliability
Ms. Jones is a pleasant, 28-year-old African American single woman who presents for a pre-employment physical. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Speech is clear and coherent. She maintains eye contact throughout the interview
General Survey
Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. She is well-nourished, well-developed, and dressed appropriately with good hygiene.
Reason for Visit
“I came in because I’m required to have a recent physical exam for the health insurance at my new job.”
History of Present Illness
Ms. Jones reports that she recently obtained employment at Smith, Stevens, Stewart, Silver & Company. She needs to obtain a pre-employment physical prior to initiating employment. Today she denies any acute concerns. Her last healthcare visit was 4 months ago, when she received her annual gynecological exam at Shadow Health General Clinic. Ms. Jones states that the gynecologist diagnosed her with polycystic ovarian syndrome and prescribed oral contraceptives at that visit, which she is tolerating well. She has type 2 diabetes, which she is controlling with diet, exercise, and metformin, which she just started 5 months ago. She has no medication side effects at this time. She states that she feels healthy, is taking better care of herself than in the past, and is looking forward to beginning the new job.
Medications
• Metformin, 850 mg PO BID (last use: this morning) • Drospirenone and ethinyl estradiol PO QD (last use: this morning) • Albuterol 90 mcg/spray MDI 1-3 puffs Q4H prn (last use: yesterday) • Acetaminophen 500-1000 mg PO prn (headaches) • Ibuprofen 600 mg PO TID prn (menstrual cramps: last taken 6 weeks ago
Allergies
Penicillin: rash • Denies food and latex allergies • Allergic to cats and dust. When she is exposed to allergens she states that she has runny nose, itchy and swollen eyes, and increased asthma symptoms.
Medical History
Asthma diagnosed at age 2 1/2. She uses her albuterol inhaler when she experiences exacerbations, such as around dust or cats. Her last asthma exacerbation was yesterday, which she resolved with her inhaler. She was last hospitalized for asthma in high school. Never intubated. Type 2 diabetes, diagnosed at age 24. She began metformin 5 months ago and initially had some gastrointestinal side effects which have since dissipated. She monitors her blood sugar once daily in the morning with average readings being around 90. She has a history of hypertension which normalized when she initiated diet and exercise. No surgeries. OB/GYN: Menarche, age 11. First sexual encounter at age 18, sex with men, identifies as heterosexual. Never pregnant. Last menstrual period 2 weeks ago. Diagnosed with PCOS four months ago. For the past four months (after initiating Yaz) cycles regular (every 4 weeks) with moderate bleeding lasting 5 days. Has new male relationship, sexual contact not initiated. She plans to use condoms with sexual activity. Tested negative for HIV/AIDS and STIs four months ago.
Health Maintenance
Last Pap smear 4 months ago. Last eye exam three months ago. Last dental exam five months ago. PPD (negative) ~2 years ago. Immunizations: Tetanus booster was received within the past year, influenza is not current, and human papillomavirus has been received. She reports that she believes she is up to date on childhood vaccines and received the meningococcal vaccine for college. Safety: Has smoke detectors in the home, wears seatbelt in car, and does not ride a bike. Uses sunscreen. Guns, having belonged to her dad, are in the home, locked in parent’s room.
Family History
• Mother: age 50, hypertension, elevated cholesterol • Father: deceased in car accident one year ago at age 58, hypertension, high cholesterol, and type 2 diabetes • Brother (Michael, 25): overweight • Sister (Britney, 14): asthma • Maternal grandmother: died at age 73 of a stroke, history of hypertension, high cholesterol • Maternal grandfather: died at age 78 of a stroke, history of hypertension, high cholesterol • Paternal grandmother: still living, age 82, hypertension • Paternal grandfather: died at age 65 of colon cancer, history of type 2 diabetes • Paternal uncle: alcoholism • Negative for mental illness, other cancers, sudden death, kidney disease, sickle cell anemia, thyroid problems
Social History
Never married, no children. Lived independently since age 19, currently lives with mother and sister in a single family home, but will move into own apartment in one month. Will begin her new position in two weeks at Smith, Stevens, Stewart, Silver, & Company. She enjoys spending time with friends, reading, attending Bible study, volunteering in her church, and dancing. Tina is active in her church and describes a strong family and social support system. She states that family and church help her cope with stress. No tobacco. Cannabis use from age 15 to age 21. Reports no use of cocaine, methamphetamines, and heroin. Uses alcohol when “out with friends, 2-3 times per month,” reports drinking no more than 3 drinks per episode. Typical breakfast is frozen fruit smoothie with unsweetened yogurt, lunch is vegetables with brown rice or sandwich on wheat bread or low-fat pita, dinner is roasted vegetables and a protein, snack is carrot sticks or an apple. Denies coffee intake, but does consume 1-2 diet sodas per day. No recent foreign travel. No pets. Participates in mild to moderate exercise four to five times per week consisting of walking, yoga, or swimming.
Mental Health History
Reports decreased stress and improved coping abilities have improved previous sleep difficulties. Denies current feelings of depression, anxiety, or thoughts of suicide. Alert and oriented to person, place, and time. Well-groomed, easily engages in conversation and is cooperative. Mood is pleasant. No tics or facial fasciculation. Speech is fluent, words are clear.
Review of Systems – General
No recent or frequent illness, fatigue, fevers, chills, or night sweats. States recent 10-pound weight loss due to diet change and exercise increase.
HEENT
Subjective
Reports no current headache and no history of head injury or acute visual changes. Reports no eye pain, itchy eyes, redness, or dry eyes. Wears corrective lenses. Last visit to optometrist 3 months ago. Reports no general ear problems, no change in hearing, ear pain, or discharge. Reports no change in sense of smell, sneezing, epistaxis, sinus pain or pressure, or rhinorrhea. Reports no general mouth problems, changes in taste, dry mouth, pain, sores, issues with gum, tongue, or jaw. No current dental concerns, last dental visit was 5 months ago. Reports no difficulty swallowing, sore throat, voice changes, or swollen nodes.
Objective
Head is normocephalic, atraumatic. Bilateral eyes with equal hair distribution on lashes and eyebrows, lids without lesions, no ptosis or edema. Conjunctiva pink, no lesions, white sclera. PERRLA bilaterally. EOMs intact bilaterally, no nystagmus. Mild retinopathic changes on right. Left fundus with sharp disc margins, no hemorrhages. Snellen: 20/20 right eye, 20/20 left eye with corrective lenses. TMs intact and pearly gray bilaterally, positive light reflex. Whispered words heard bilaterally. Frontal and maxillary sinuses nontender to palpation. Nasal mucosa moist and pink, septum midline. Oral mucosa moist without ulcerations or lesions, uvula rises midline on phonation. Gag reflex intact. Dentition without evidence of caries or infection. Tonsils 2+ bilaterally. Thyroid smooth without nodules, no goiter. No lymphadenopathy.
Respiratory
Subjective
Reports no shortness of breath, wheezing, chest pain, dyspnea, or cough.
Objective
Chest is symmetric with respiration, clear to auscultation bilaterally without cough or wheeze. Resonant to percussion throughout. In office spirometry: FVC 3.91 L, FEV1/FVC ratio 80.56%.
Cardiovascular
Subjective
Reports no palpitations, tachycardia, easy bruising, or edema.
Objective
Heart rate is regular, S1, S2, without murmurs, gallops, or rubs. Bilateral carotids equal bilaterally without bruit. PMI at the midclavicular line, 5th intercostal space, no heaves or lifts. Bilateral peripheral pulses equal bilaterally, capillary refill less than 3 seconds. No peripheral edema.
Abdominal
Subjective
Gastrointestinal: Reports no nausea, vomiting, pain, constipation, diarrhea, or excessive flatulence. No food intolerances. Genitourinary: Reports no dysuria, nocturia, polyuria, hematuria, flank pain, vaginal discharge or itching.
Objective
Abdomen protuberant, symmetric, no visible masses, scars, or lesions, coarse hair from pubis to umbilicus. Bowel sounds are normoactive in all four quadrants. Tympanic throughout to percussion. No tenderness or guarding to palpation. No organomegaly. No CVA tenderness.
Musculoskeletal
Subjective
Reports no muscle pain, joint pain, muscle weakness, or swelling.
Objective
Bilateral upper and lower extremities without swelling, masses, or deformity and with full range of motion. No pain with movement.
Neurological
Subjective
Reports no dizziness, light-headedness, tingling, loss of coordination or sensation, seizures, or sense of disequilibrium.
Objective
Strength 5/5 bilateral upper and lower extremities. Normal graphesthesia, stereognosis, and rapid alternating movements bilaterally. Tests of cerebellar function normal. DTRs 2+ and equal bilaterally in upper and lower extremities. Decreased sensation to monofilament in bilateral plantar surfaces.
Skin, Hair & Nails
Subjective
Reports improved acne due to oral contraceptives. Skin on neck has stopped darkening and facial and body hair has improved. She reports a few moles but no other hair or nail changes.
Objective
Scattered pustules on face and facial hair on upper lip, acanthosis nigricans on posterior neck.
NRS 434 Assignment Shadow Health Conversation Concept Lab Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
|
Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
|
Presentation of information was minimally demonstrated in all of the following elements:
|
Presentation of information is unsatisfactory in one of the following elements:
|
Presentation of information is unsatisfactory in two of the following elements:
|
Presentation of information is unsatisfactory in three or more of the following elements
|
| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
|
Presentation of information was minimally demonstrated in the all of the following elements:
|
Presentation of information is unsatisfactory in one of the following elements:
|
Presentation of information is unsatisfactory in two of the following elements:
|
Presentation of information is unsatisfactory in three of the following elements
|
| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
|
Demonstrated 3 of the following:
|
Demonstrated 2 of the following:
|
Demonstrated 1 or less of the following:
|
||
| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
|
Failed to demonstrate the following:
|
||||
| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |