NSG 6001 History of Present Illness Discussion

NSG 6001 History of Present Illness Discussion

NSG 6001 History of Present Illness Discussion


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.

Tiffany Costley peer #1

  1. Discuss the history of present illness that you would take on this patient in preparation for the clinic visit. Include questions regarding Onset, Location, Duration, Characteristics, Aggravating Factors, Relieving Factors, Treatment, Severity (OLDCARTS).
  • The patient is a 60-year-old female with a past medical history of high cholesterol and hypertension. Patient presented to clinic with complaints of chest pain for three months. Ms. Johnston was asked about the onset of her chest pain; she states pain occurs with activity and at rest while watching tv. She also states that the pain subsides after three minutes. The patient described her pain as burning like sensation and occasional tingling in the middle of her chest. She states a 6 out of 10 pain intensity that does not radiate to her jaw, arms, or neck. When pain occurs, she is short of breath, but does not experience sweating, nausea, or vomiting. Ms. Johnston states that she tries to alleviate the pain through positioning, however, her pain seemed to be relieved by drinking cold water.
  1. Describe the physical examination and diagnostic tools to be used for Ms. Johnston. Are there any additional you would have liked to be included that were not?

Ms. Johnston’s assessment should include both subjective and objective date. This includes a full head to toe assessment. A complete vital sign, listening to heart and lung sounds through a stethoscope. Then palpating all major arteries such as bilateral carotid arteries, radial pulses, dorsalis pedis, and popliteal arteries (Toney-Butler & Unison-Pace, 2020). Patient’s jugular veins should also be examined for distention, as well as extremities checked for edema. Abdomen should also be examined through palpation as well auscultation. Ears, nose, throat, and eyes should be assessed for any abnormalities (Toney-Butler & Unison-Pace, 2020).

Additionally, patient should have a transthoracic echocardiogram done a CT coronary angiogram, and or a stress , if possible, before proceeding to a cardiac catheterization.

  1. What plan of care will Ms. Johnston be given at this visit; what is the patient education and follow-up?
  • Ms. Johnston should be referred to a cardiologist for further evaluation. However, because patient state chest pains a rest, it is best to send patient to the emergency room for a thorough cardiac evaluation. Patient has several risk factors that may lead to acute coronary syndrome. These include a family history of heart disease, age, obesity, hypertension, and high cholesterol levels.

Patient should be educated regarding lifestyle modifications such as

diet, exercise, and medication compliance to help reduce the recurrence of symptoms (Xian-liang et al., 2017). Patient should be prescribed antiplatelets medication such aspirin for daily maintenance. If she receives coronary stenting, Clopidogrel or Ticagrelor as well as statins for a proper maintenance for coronary syndrome must be prescribed.

Toney-Butler TJ, Unison-Pace WJ. Nursing Admission Assessment and Examination. Updated

(2020 Sep 2). In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2021 Jan-Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK493211/

Liu, X. L., Shi, Y., Willis, K., Wu, C. J. J., & Johnson, M. (2017). Health education for patients with acute coronary syndrome and type 2 diabetes mellitus: an umbrella review of systematic reviews and meta-analyses. BMJ Open7(10), e016857. https://doi.org/10.1136/bmjopen-2017-01685

Amber peer #2

  • Discuss the history of present illness that you would take on this patient in preparation for the clinic visit. Include questions regarding Onset, Location, Duration, Characteristics, Aggravating Factors, Relieving Factors, Treatment, Severity (OLDCARTS).

I would conduct a through history of Susan’s presenting symptoms. I would ask how long she has been having this chest pain, what brings it on and what makes it better, what is the description of the pain, point to where it is located, if it radiates to any other part of her body, how long the pain lasts at a time, if it causes shortness of breath, dizziness, passing out, diaphoresis, or palpitations, and what the pain scale is on a 0-10 rating.

  • Describe the physical examination and diagnostic tools to be used for Ms. Johnston. Are there any additional you would have liked to be included that were not?

During the physical examination I would include a full set of vitals and examine each body system with a focus on heart, lungs, abdomen, musculoskeletal, and vascular. Her vital signs show a BMI of 35.5 kg/m, blood pressure 136/82, and height/weight 5’6”/220lbs. These results are all concerning for cardiac complications. There is no tenderness to the chest wall, on auscultation, she has normal S1 and S2, lung sounds are normal with normal chest rise and fall, abdomen is nontender, obese, and soft with no organ enlargement, there is no edema in her extremities, and radial, carotid, and dorsalis pedis pulses are 2+ bilaterally with a regular rate. An ECG was ordered to examine any abnormalities in her heart rhythm, CBC, BMP, TSH, and fasting lipid panel were ordered to assess for hemoglobin, renal disease, electrolyte imbalances, kidney function, thyroid function, and hyperlipidemia. A positive stress examination led to admission to the hospital for a cardiac angiogram and placement of a stent in her LAD. I would not include any other diagnostic tests since they were able to determine Susan was having angina due to the 75% blockage in her left anterior descending.

  • What plan of care will Ms. Johnston be given at this visit; what is the patient education and follow-up?

At this current visit, Susan’s plan of care will be to reduce chest pain. She is being admitted to the hospital, so I would educate the patient to let their nurse know if she is having chest pain so they are able to treat her accordingly. At the follow up appointment after the cardiac catheterization, plan of care will be focused on medication management, weight loss, exercise, and dietary modification. Medication management and understanding why she takes each medicine will lead to increased compliance, reduce chances of clotting at the stent site, control blood pressure, and control lipids. Weight loss, exercise, and dietary changes will improve her health, decrease further cardiac and metabolic risks.

Lopes Write Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

NSG 6001 History of Present Illness Discussion
NSG 6001 History of Present Illness Discussion

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

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Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource