NSG 6001 Mr Barleys Health Condition Discussion

NSG 6001 Mr Barleys Health Condition Discussion

Sample Answer for NSG 6001 Mr Barleys Health Condition Discussion Included After Question

NSG 6001 Mr Barleys Health Condition Discussion


  • Respond to 2 peers using APA format please site all references
  • PEER #1 Suel
  • Discuss the Mr. Barley’s history that would be pertinent to his respiratory problem. Mr. Barley reports smoking one to two packs a day for 26 years and now has cut back on smoking to half a pack per day. In addition, he is a farmer who is exposed to chemicals and irritants.

Chief complaint: Productive ough and shortness of breath

HPI: 58-year-old farmer Caucasian male presents to clinic complaining of shortness of breath on exertion and productive cough with white phlegm mainly in the mornings for 2 weeks. Patient reports similar symptoms for the past two winters. Patient reports smoking 2 packs a day x 26 years and now has cut back to half a pack per day.

Social: 40 cigarette pack year, and drinks one beer every few days.

Family: Father died of a stroke at age of 70, mother is alive and suffers from HTN.

Past medical history: Tonsillectomy at 12 years of age.

  • Describe the physical exam and diagnostic tools to be used for Mr. Barley.

Common tools used in a physical exam were used such as:

Penlight: conjunctivae and sclerae are normal, PERRL, oropharynx is normal Sphygmomanometer: BP128/78 mmHg

Thermometer: 98.9 Fahrenheit

Stethoscope: Inspiratory crackles at the bases, and end-expiratory wheezing diffusely, Regular rate and rhythm. 2/6 systolic murmur loudest at the right upper sternal border (RUSB) with radiation to the left lower sternal border (LLSB), Bowel sounds normal

Hands: For manual exam- neck is supple without masses, lymphadenopathy, or thyromegaly. Laryngeal height measures 2 cm from sternal notch to the top of the thyroid cartilage upon full expiration. no hepatomegaly, no tenderness, 1+ pitting pretibial edema.

The physical exam for this patient focused on the classic findings of COPD which in the case study was listed as:

Increased anteroposterior (AP) diameter of the chest

Decreased diaphragmatic excursion

Wheezing (often end-expiratory)

Prolonged expiratory phase

Thorat, Salvi, and Kodgule (2017) state, “The most commonly used objective tool to diagnose asthma and COPD is spirometry.” This is the diagnostic tool used on Mr. Barley. However, spirometry may not be readily available in some rural areas or third world countries for several reasons including lack cost and lack of knowledge. Other tools used are pulmonary function test, and an x-ray which does not rule out COPD but may look for other diagnosis that may cause shortness of breath.

Are there any additional you would have liked to be included that were not?

The case study discussed possible tools available to assess lung status and how each served for the diagnosis of other diseases and not COPD, thus feeling content about the route opted for in the scenario. On the other hand, new studies are looking for possible ways to diagnose COPD early as not too much attention has been paid to the pathologic changes in the lungs of young adults with risk factors for COPD. Polverino et al. (2020) states, “In the postsurfactant era, where more young adults will be spirometrically diagnosed with COPD, patients should be classified not only on the basis of their airflow limitation, but also on lung abnormalities identified with safe, comprehensive imaging technologies that allow regular, longitudinal follow-up.” Lung MRI as a potential complementary diagnostic tool for early COPD is a tool that could deem effective in early diagnosis.

  • What plan of care will Mr. Barley be given at this visit, include drug therapy and treatments; what is the patient education and follow-up? According to the Global Initiative for Chronic Obstructive Lung disease, all symptomatic patients with COPD should be prescribed a short-acting bronchodilator and in this scenario, Albuterol is prescribed. However, as stated in the case study, “Smoking cessation is single-most important treatment strategy for COPD”. The patient education focuses on smoking cessation and provide patient with information about available smoking-cessation programs. Influenza and pneumococcal vaccines are recommended for adults with COPD to prevent exacerbations. Patient should return for regular check-ups and a follow up to perform another pulmonary function test in six months to a year is needed to determine how well patient is responding to treatment and if the disease is progressing. Follow ups will also monitor nutrition through body mass index (BMI), as good nutrition is especially important in COPD.


Thorat, Y. T., Salvi, S. S., & Kodgule, R. R. (2017). Peak flow meter with a questionnaire and mini-spirometer to help detect asthma and COPD in real-life clinical practice: a cross-sectional study. NPJ primary care respiratory medicine27(1), 1-7.

Polverino, F., Hysinger, E. B., Gupta, N., Willmering, M., Olin, T., Abman, S. H., & Woods, J. C. (2020). Lung MRI as a potential complementary diagnostic tool for early COPD. The American journal of medicine133(6), 757-760.

PEER #2 LorenaChief Complaint: Cough and SOB

HPI: Mr. Barley is 58-year-old male, smoker, who presents at the clinic with complaints of a 2-week productive cough progressively getting worse and shortness of breath on exertion. Symptoms are similar from the past 2 years around wintertime. Pt denies fever, chest pain, recent travel, TB, or recent chemical exposure.

Social History: Mr. Barley is a farmer, married for 35 years with whom he has 2 grown children. He is a smoker and has a 40-cigarette pack-year history. Pt drinks one beer every few days.

Family History: Father died at the age of 70 from a stroke; mother alive with history of hypertension; 2 healthy sisters.

Past Medical History: Denies any significant PMH.

Physical Exam:

Vital Signs: BP 128/78; P94 bpm; T; 98.9 F Wt.; Ht.; BMI.

Physical Assessment Findings:

HEENT: Normocephalic / atraumatic, conjunctivae and sclerae are normal, PERRL, oropharynx is normal.

Neck: Supple without masses, lymphadenopathy, or thyromegaly. Laryngeal height measures 2cm from sternal notch to the top of the thyroid cartilage upon full expiration.

Lungs: Increased AP diameter. Percussion is normal. Inspiratory crackles at the bases, and end-expiratory wheezing diffusely.

Heart: Regular rate and rhythm. 2/6 systolic murmur loudest at the right upper sternal border with radiation to the left lower sternal border.

Abdomen: Bowel sounds normal, no hepatomegaly, no tenderness.

Extremities/Pulses: +1 pitting pretibial edema.

Diagnostic Tools: Pulmonary Function Test (PFT), chest x-ray, and spirometry.

Are there any additional you would have liked to be included that were not? Arterial blood gas test to measure how well Mr. Barley’s lungs are bringing oxygen into his blood and removing carbon monoxide.

Plan of Care

Drug Therapy: Albuterol MDI PRN

Treatments: Smoking cessation and Immunizations (Influenza and Pneumococcal)

Patient Education: Instructions on how to use a meter dose inhaler with spacer; information of the benefits of smoking cessation; information on what is COPD, what to expect, and how to continue treatment. Also, warning signs regarding COPD exacerbation and when to seek help.

Follow-Up: Follow up to be scheduled in 6-12 months for another PFT and overall condition management.

A Sample Answer For the Assignment: NSG 6001 Mr Barleys Health Condition Discussion

Title: NSG 6001 Mr Barleys Health Condition Discussion

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NSG 6001 Mr Barleys Health Condition Discussion
NSG 6001 Mr Barleys Health Condition Discussion

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.

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.

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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