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NRS 434 Shadow Health: Digital Clinical Experience Orientation

NRS 434 Shadow Health Digital Clinical Experience Orientation

When considering comparing physical assessments of a child versus an adult, the nurse must recognize that there are key differences between the two examinations. A physical assessment (PA) with an adult starts with assessing vitals, mood, hygiene, demeanor, and level of consciousness. The nurse has an opportunity to observe non-verbal forms of responses to questions to incorporate subjective and objective observations. Assessment of a child, however, relies heavily on objective observation from the patient and the parent’s input. The nurse must remain familiar with stages of development to better identify behavior outside of the norm and to properly educate the parent to know when to seek assistance upon noticing abnormalities. While both children and adults have targeted milestones, milestones among adults may vary depending on societal norms. Reaching milestones for children have a heavy dependence on their environment, family history, and cultural and traditional influences. The text mentions many factors to consider when assessing a child. One of which is nutrition. This aspect is often influenced by culture and family traditions. According to the CDC, more than 12 million children are obese (Falkner, 2018) and are at risk of co-morbidities such as heart disease, malnourishment despite being overweight, and chronic diseases. The nurse has an opportunity to provide patient education to the parent, with the child being a passive listener. In doing so, it is critical that the nurse put aside biases and present options and information as opposed to judgement (Falkner, 2018).

When involving the pediatric patient, therapeutic communication is key. The nurse will observe body language and pick up on ques in instances where the child may begin to withdraw or be uncomfortable. Allowing the child to participate in the assessment process may help them become more comfortable. Perhaps allow child to hold and use stethoscope, therapeutic touch and vivid interaction like asking the patient to say “aaaww”, positive reinforcement such as saying “good job”, and the use of comfort objects to demonstrating what will take place in the PA on a teddy bear are all methods that encourage engagement of a child patient.

Reference

 

Falkner, A. (2018). Grand Canyon University (E.D). Age-Appropriate Approach to Pediatric Health Care Assessment. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/2.

  • MG

Description:

Within the Shadow Health platform, complete the Digital Clinical Experience Orientation. Upon completion, submit the lab pass through the assignment dropbox.

You are not required to submit this assignment to LopesWrite.

Description

Objectives:

1. Apply evidence-based practice to health promotion for infants.
2. Examine environmental factors that increase risk to infant health.
3. Propose health promotion strategies for the infant

Description:

Read Chapter 1 in Health Assessment: Foundations for Effective Practice. Use the Appendix as needed to complete your assignments.

Unit III: Systems Assessment and Management of Disorders

Description:

Read “Unit III: Systems Assessment and Management of Disorders,” in the online eBook, Comprehensive Neonatal Nursing Care (5th ed.), edited by Kenner and Lott (2013), available through the GCU Library.

WHO Growth Standards Are Recommended for Use in the U.S. for Infants and Children 0 to 2 Years of Age
Description:

Review “WHO Growth Standards Are Recommended for Use in the U.S. for Infants and Children 0 to 2 Years of Age” (2010), located on the Centers for Disease Control and Prevention (CDC) website.

GCU Library Tutorial

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: NRS 434 Shadow Health: Digital Clinical Experience Orientation

Description:

View the GCU Library tutorial.

Optional: Breastfeeding

Description:

For additional information, the following is recommended:

“Breastfeeding,” located on the National Women’s Health Information Center website. Familiarize yourself with the reasons why breastfeeding is important and the resources that are available for patients.

Optional: Family History Resources

Description:

For additional information, the following is recommended:

“Family History Resources,” located on the Centers for Disease Control and Prevention (CDC) website.

Optional: Never Shake a Baby Educational Video

Description:

For additional information, the following is recommended:

“Never Shake a Baby Educational Video,” by warrenman4u (2008), located on the YouTube website. In particular, familiarize yourself with prevention of abuse.

Optional: 14 Diseases You Almost Forgot About Thanks to Vaccines

Description:

For additional information, the following is recommended:

Health Literacy Basics for Health Professionals

Description:

Watch “Health Literacy Basics for Health Professionals,” by VHC Primary Care (2014), located on the YouTube website.

A Comprehensive Newborn Examination: Part I. General, Head and Neck, Cardiopulmonary

Description:

Read “A Comprehensive Newborn Examination: Part I. General, Head and Neck, Cardiopulmonary,” by Lewis, from
American Family Physician (2014).

Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.

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Physical assessment of the child and that of an adult is done similarly yet differently. The act of auscultation, palpation, taking the vital signs to get the objective data are done the same but the normal range limits are different. For example, the healthy adult blood pressure normal range is from 90/60 mmHg – 120/80 mmHg, pulse rate 60-100 beats per minute and temperature of 97.8 ‘F to 98.6″F whereas to a 1-11-year-old child has a heart rate of 70-120 bpm, blood pressure of 90-110 systolic and 55-75 diastolic.

In using Erikson’s theory, an adult’s stage of development is focused on the fear of loneliness if there is no long-lasting relationship and adult contemplates their contribution to society with their achievements or lack of, and for a school-aged child, the focus is more on establishing trust and self-esteem (Grand Canyon University, 2018).

Communication and approach with these two different age groups also differ. A caring and comfortable environment is needed for a school-aged child in order to extend their trust from their parents to the healthcare provider. The questions are also formulated so that the child is able to answer. Whereas for the adult, a more factual and straightforward questioning is done. Utilizing the evidence-based practice tools provided to the health care team, a thorough and effective assessment is done to promote health and have an effective nursing process.

References:

 

Grand Canyon University (Ed). (2018). Health assessment: Foundations for effective practice. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/

 

Medline Plus. Retrieved from: Vital signs: MedlinePlus Medical Encyclopedia

 

C.S.Mott Children’s Hospital .Retrieved from: Vital Signs in Children | CS Mott ChilVital Signs in Children | CS Mott Children’s Hospital | Michigan Medicinedren’s Hospital | Michigan Medicine

SO

Stanley Ogbo

Posted Date

Feb 5, 2022, 11:56 PM

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Replies to Rizalina Orencia

Stanley Ogbo

College Name, Grand Canyon University

Course Number: NRS-434VN

Topic 2 DQ 2

Dr. Lily Polsky

4 February 2022.

Introduction

Child development assessment is defined as a process of getting data about their growth and development. The Nurse aims at getting a record growth in all areas while collecting the information. The data being collected include language, cognitive and social-emotional and approaches to learning. Child assessments is important in ascertaining children with special needs that may require extra support (Kaufman, 2018).

Comparing physical assessments of a child to an adult

Obtaining data is different at each age because human needs vary with age. In addition, the mode of assessment used is dynamic. For example, piece of information is obtained from the parent or care giver in a 5-year-old compared to the nineteen-year-old that can express themselves coherently. The Nurse uses Observation as one of the techniques used in the assessment. Here, the care provider interacts with the child and concludes based on their conduct. The other methods include standard test, portfolios, care provider ratings and parent ratings. However, all methods are best applicable for different ages. There is need to modify the techniques in some situation. For example, reading out questions on a standardized test for a five-year-old and writing out the answers for them. However, when the same approach is used on a twelve-year-old, they are left to read, interpret, and even answer the questions on the test with minimal assistance,

Communication strategies a nurse would use to encourage engagement

Nine-year-old Ben was born at 37 weeks with 2600grams via safe vaginal delivery and was admitted for 2 weeks due to birth asphyxia. He had gained 300grams on discharge. He was breastfed exclusively for the first 6 months and was weaned with different soft foods. He could roll over at 4 months and began sitting at 6. He was hospitalized for severe malnutrition for a month while he was 9 months old. This delayed his milestone and he only crawled when he was 16 months. He could say four-letter words at 6 months and could say complete simple sentences at 24 months. He has good relationship with his family members. He started school at 4 years, is obedient, has average performance, loved by teacher and friends at school. Ben fits into the 4th stage of Erikson developmental theory, known as Industry vs. Inferiority. The basic virtue at this stage is competency (Cherry, 2018). Based on Erikson`s theory, the nurse should focus on his ability to read, do simple sums, and write. The assessor will obtain information on Ben`s friends and this assessment done with he is with his friends. The friends he does not like will make him feel inferior.

Conclusion

Child development assessment is important because it provides opportunity for the care provider to establish any special needs that the child may require. Moreover, the assessment provides a ground where both the care provider and the parents can provide support for the child. However, the needs of the child change with time and hence the mechanisms used in assessing as well as the results (Kaufman, 2018).

 

 

References

Cherry, K. (2018). Erik Erikson`s Stages of Psychosocial Development. Retrieved June 5, 2018.

Kaufman, A. S. (2018). Contemporary intellectual assessment: Theories, tests, and issues. Guilford Publications.

A Comprehensive Newborn Examination: Part II. Skin, Trunk, Extremities, Neurologic

Description:

Read “A Comprehensive Newborn Examination: Part II. Skin, Trunk, Extremities, Neurologic,” by Lewis, from
American Family Physician (2014).

Loom

Description:

Utilize Loom to complete the topic assignment. Refer to the resource, “Loom,” located in the Student Success Center, for additional guidance on recording your presentation.

Experience Overview

Student Performance Index Score: 2.0 of 2.0 (100.0%)

Tina Jones.

Time

Shadow Health: Digital Clinical Experience Orientation

19 minutes spent interacting with patient
10 minutes spent in post-exam activities
29 minutes total spent in assignment

Examination

No interview questions were asked
1 empathetic statement made
1 educational statement made
13 tool and tests conducted

Documentation

No documentation was written

Transcript

Started: Dec 06, 2019 | Total Time:19 min
Your Avatar.
hello, my name is Chinwe, and I am here to interview and examine you.

Greet
12/06/19 9:59 AM MST

Tina Jones.
Hey.
Your Avatar.
Treating high cholesterol helps lower your risk of stroke.

Educate
12/06/19 10:01 AM MST

Tina Jones.
Thanks for telling me.
Your Avatar.
It sounds like that was a challenging time for you.

Empathize
12/06/19 10:03 AM MST

Tina Jones.
Thanks.
Your Avatar.
Examined right eye.

Exam Action
12/06/19 10:06 AM MST

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Examined left eye.

Exam Action
12/06/19 10:06 AM MST

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Percussed posterior left upper chest wall

Exam Action
12/06/19 10:08 AM MST

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Percussed posterior right upper chest wall

Exam Action
12/06/19 10:08 AM MST

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Percussed posterior left middle chest wall

Exam Action
12/06/19 10:08 AM MST

Your Avatar.
Percussed posterior right middle chest wall

Exam Action
12/06/19 10:08 AM MST

Your Avatar.
Percussed posterior left lower chest wall

Exam Action
12/06/19 10:08 AM MST

Your Avatar.
Percussed posterior left lower chest wall

Exam Action
12/06/19 10:08 AM MST

Your Avatar.
Percussed posterior left lower chest wall

Exam Action
12/06/19 10:08 AM MST

Your Avatar.
Percussed posterior right lower chest wall

Exam Action
12/06/19 10:08 AM MST

Your Avatar.
Percussed posterior right lower chest wall

Exam Action
12/06/19 10:08 AM MST

Your Avatar.
Percussed posterior right lower chest wall

Exam Action
12/06/19 10:08 AM MST

Your Avatar.
CompletedOrientation

Objective Data Collection: 2 of 2 (100%)

  • Correct
  • Partially correct
  • Incorrect
  • Missed
Inspected pupils
1 of 1 point
Observations With Penlight (1/1 point)
  • No visible abnormal findings (PERRL)
  • Unequal
  • Irregular
  • Miosis
  • Mydriasis
  • Non-reactive to light
Percussed chest wall
1 of 1 point
Observations (1/2 point)
  • All areas resonant
  • Some areas dull, some resonant
Location (1/2 point)
  • No areas of dullness
  • Dullness, anterior right upper lobe
  • Dullness, anterior right lower lobe
  • Dullness, anterior left upper lobe
  • Dullness, anterior left lower lobe
  • Dullness, posterior right upper lobe
  • Dullness, posterior right lower lobe
  • Dullness, posterior left upper lobe
  • Dullness, posterior left lower lobe

Hallway Interaction Activity Time: 2 min

Diana, your Preceptor

Diana
Your Preceptor

Hi there! How would you like to improve your interprofessional communication skills within the DCE?

This is your avatar.

This is you.

Ask open-ended questions

Multiple Choice Question Activity Time: 1 min

Select the right answer from the available choices.

Correct:We are here to support you as you develop your clinical reasoning and therapeutic communication skills. If at any time you have questions or concerns, please contact us! There is a direct link to our Help Desk in the upper right hand corner of your screen.
  • Wrong Answer
  • Right Answer (Correct Response)
  • Wrong Answer
  • Wrong Answer

Open Text Question Activity Time: 4 min

Please describe what you look forward to most in your upcoming activities within the DCE.

Student Response: Learn how to properly interview and examine a patient.

Model Note: There are many opportunities to learn and practice your clinical skills within the DCE, and we hope you are looking forward to all of them!

Reflection Prompt Activity Time: 3 min

How do you think the DCE can help you improve your clinical reasoning skills?

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