• Complete the ShadowHealth© Musculoskeletal and Neurological assignments

Professional Development

• Write a 500-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
  • What;
  • went well in your assessment?
  • did not go so well? What will you change for your next assessment?
  • findings did you uncover?
  •  questions yielded the most information? Why do you think these were effective?
  • diagnostic tests would you order based on your findings?
  • differential diagnoses are you currently considering?
  •  patient teaching were you able to complete? What additional patient teaching is needed?
  • Would you prescribe any medications at this point? Why or why not? If so, what?
  • How did your assessment demonstrate sound critical thinking and clinical decision making?

Instructions: Response must be at least 510 words, written in current APA format with at least two academic references cited. References must be within the last five years. Response must extend, refute/correct, or add additional nuance.

J.R. is a 36-year-old white, middle-class woman who has been sexually active with one partner for the past 2 years. She and her partner have no history of STIs, but her partner has a history of fever blisters. She reports genital pain, genital vesicles and ulcers, and fever and malaise for the last 3 days. Examination reveals adenopathy and vaginal and cervical lesions.

1. What drug therapy would you prescribe? Why?
2. What are the parameters for monitoring the success of the therapy?
3. Discuss specific education for J.R. based on the diagnosis and prescribed therapy.

Assignment Content

1. Managing risk and ensuring quality requires skillful resource management. Resource management enables a leader to operate from a position of ability and planning rather than managing reactions to crises. Resource management also lends itself to creative team building and the diffusion of change.To prepare for your monthly meeting with your team, you have developed a presentation called Managing Quality and Risk. You would also like to use the time to address increasing stress and rush during transitions with patients and shifts. You have decided to create another section in the presentation called Identifying Waste.

   For this assessment, you will create a Microsoft PowerPoint® presentation incorporating the details of both sections of the assessment. Interpersonal communication skills are integral to presentation of organized ideas and change.

   Create a 14- to 20-slide PowerPoint® presentation that includes the following:
   Managing Quality and Risk
   Consider how managing quality often means addressing small issues to prevent them from escalating into ethical, legal, or fiscal risks for the organization. Keep in mind, you are adding to your presentation with the goal of showing your chief nursing officer how you plan to address the topic you select from the list below.

2. Mitigating bullying and lateral violence

4. Select one of the following topics:
   • Mitigating bullying and lateral violence
   • Managing conflict
   • Using power to influence elevations for value and safety
   • Valuing diversity
   • Identifying Waste and Resource Management
     Think about the clinical environment where you work or one in which you previously worked.
     Identify opportunities for waste reduction. Consider the following:
   • Setting: administrative, operational, clinical
   • Efficiency
   • Value to patient
   • Value to quality and safety in nursing practice
   • Develop a plan to carry out your suggestions as a nurse leader on your floor. Consider:
   • Available resources: time, budget, space, industry collateral, personnel
   • Employee engagement
   • Change management principles
   • Team dynamics
   • Communication strategies
   • Suggest process changes to improve the situation as if you are communicating to frontline staff and nurse leaders and explaining your findings.Format your PowerPoint® presentation to ensure the slides only contain essential information and as little text as possible. Do not design a slide made up of long bullet points. Include detailed speaker notes for each slide of your presentation. Your speaker notes convey the details you would give if you were presenting.

     Review the Create Speaker Notes page on Microsoft® for more help.

Discussion 1
Tom, a 26-year-old runner, came into the office today complaining of constant pain in the right ankle. While running his usual route, he accidentally stepped on a branch lying in his path, twisting his ankle inward.

He;

denies hearing a “pop.” He was able to walk, or limp, the remaining ¼ mile back to his home, where he immediately elevated and iced the ankle for 30 minutes.

took two acetaminophen 325 mg, showered and dressed for work, and drove to his place of employment. He continued to experience significant pain in the ankle, worse when walking. His foot became swollen. Since his job in a sporting goods store requires that he be on his feet most of the day, he was unable to continue his normal workday, and made a same-day appointment to be seen. He has no chronic diseases, takes no medication, and denies recent use of NSAIDs, as aspirin and ibuprofen cause him to have gastritis.

sprained the ankle last year, but was able to manage that injury at home.

Assessment
A 26-year-old, otherwise healthy male presents limping into the examination room, holding his right shoe in his hand. He grimaces with partial weight-bearing of the affected foot. He has local ecchymosis and 1+ edema over the anterolateral ligaments of the right ankle. Capillary refill, pulses, and sensation of the foot and toes are intact. There is no lateral or anterior instability of the joint or tendons. X-ray of the ankle and foot are negative for fracture or dislocation. He has a grade I lateral ankle sprain.

What pain relieving medications would you prescribe? Defend your choice.
How would you prescribe them?
What side effects should you educate the patient about?
Does the age of the patient influence what your choice?
Discussion Question 2
What;

organs are damaged mostly by taking NSAIDS?

patient education would you provide to someone taking NSAIDS? What organ is damaged by taking too much aspirin?

patient education should you provide to a patient taking Aspirin? List 3 diagnosis for which you would administer NSAIDS. List 3 diagnosis for which you would administer Aspirin. What labs or diagnostic tests would you perform for a patient who has consumed too much Aspirin and NSAIDS. Your response should be at least 350 words.

Gynecologic Health

Select a patient that you examined as a nurse practitioner student during the last three weeks of clinical on OB/GYN Issue. With this patient in mind, address the following in a SOAP Note 1 OR 2 PAGES :

Subjective: What details did the patient provide regarding her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters for this patient , as well as a rationale for this treatment and management plan.

Very Important:  Reflection notes: What would you do differently in a similar patient evaluation?

Reference

Gagan, M. J. (2009). The SOAP format enhances communication. Kai Tiaki Nursing New Zealand, 15(5), 15.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.

Chapter 6, “Care of the Well Woman Across the Life Span” ,“Care of the Woman Interested in Barrier Methods of Birth Control” (pp. 275–278)

Chapter 7, “Care of the Woman with Reproductive Health Problems”

“Care of the Woman with Dysmenorrhea” (pp. 366–368)

“Care of the Woman with Premenstrual Symptoms, Syndrome (PMS), or Dysphoric Disorder (PMDD)” (pp. 414–418)