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Module 1 discussion

DQ1 Clinical Reasoning: Assessing Your Skill

This activity gives you the opportunity to become familiar with the Digital Clinical Experience (DCE) and interact with Tina Jones. You will be using her and other avatars throughout the course to refine your ability to conduct a comprehensive health history and physical examination, and develop your clinical reasoning skills.

You must complete your Digital Clinical Experience (DCE) Orientation in Shadow Health before you begin this or any assignment in Shadow Health.

Respond to the following:

Question 1: Discuss clinical reasoning and describe the process through which a clinician’s clinical reasoning develops over time. How does the APN use this clinical reasoning to develop a hypothesis and establish a working diagnosis?

Question 2: Discuss what have you learned about yourself during your interaction with Tina. What have you learned about your skill level? What do you see as your goals for this course?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

DQ2 Clinical Reasoning: Mental Health

For this discussion, you will use the scenario of Ms. Ruiz, covered in the module notes, to answer your questions.

Respond to the following:

Question 1: What questions should you ask Ms. Ruiz? What are your concerns for her? What kind of services would you need to establish for her follow-up care? What other members of the healthcare team would you work with in establishing a plan of care? Identify interventions, including health promotion activities that you would recommend. How would you treat her “sleep” issue?

Question 2: What impact may Ms. Ruiz’s social situation and culture have on this scenario?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Module 2 discussion

DQ1 Clinical Reasoning: Skin Lesions

For this discussion, you will use the scenario of Mrs. Wright, found in the module notes, to answer the questions. This discussion provides an opportunity for you to explore the skin and lesions of the skin.

Respond to the following:

Question 1: What should your level of concern be for lesions that occur in this area of the face? How should you address this issue and what should be your priority for this patient, who has shingles on her face?

Question 2: What other questions are pertinent in determining how to treat this patient? What should your treatment plan be? What other members of the healthcare team would you work with in establishing a plan of care?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

DQ2 Clinical Reasoning: Head and Neck

For this discussion, you will use the scenario of Ms. Blackfoot, found in the module notes, to answer the questions. This discussion provides an opportunity for you to explore the head and neck.

Respond to the following:

Question 1: What other questions regarding Ms. Blackfoot’s health history should you ask or be concerned about? What other systems should you include in your examination?

Question 2: What would be your presumptive initial diagnosis? Discuss the clinical reasoning that led you to this conclusion. What other diagnosis should you include in your differential diagnosis? What other members of the healthcare team would you work with in establishing a plan of care?

Question 3: Discuss the cultural implications of this woman’s diagnosis. What things should you be cognizant of when engaging in a conversation with the patient concerning her diagnosis and treatment?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Module 3 discussion

DQ1 Clinical Reasoning: Heart and Lungs

Respond to the following:

Question 1: What would be part of your work up for this patient? Based on his immigrant status, what would concern you regarding the etiology of the disease process? What are the co-morbidities that would be concerning for this diagnosis in an immigrant patient of Mexican descent?

Question 2: What is the role of the APN in treating a Hispanic patient with heart failure? What other members of the healthcare team would you work with in establishing a plan of care for Mr. Rodriguez? How do you provide culturally competent care for this patient? What barriers are there for this patient in receiving the care that is needed? What are the social determinants of health in this population?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

DQ2 Clinical Reasoning: Coronary Heart Disease

Respond to the following:

Question 1: Mr. Foster, the DCE patient, is a Caucasian male. How does race affect the risk factors for coronary heart disease (CHD)? Given the diagnosis of CHD, what would you expect to uncover when you perform an examination of Mr. Foster’s peripheral vascular system and why? What other members of the healthcare team would you work with in establishing a plan of care for Mr. Foster?

Question 2: Consider how a woman may present with coronary heart disease (CHD). How might symptoms, diagnosis, and disease trajectory differ between men and women?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Module 4 discussion

DQ1 Clinical Reasoning: The Abdomen

Respond to the following:

Question 1: What questions are necessary to ask during the work up of Ms. Patterson? Explain your rationale for asking these questions.

Question 2: What tests should you include once you have a working diagnosis of Acute Pancreatitis? Provide a rationale for these tests. What other members of the healthcare team would you work with in establishing a plan of care for Ms. Patterson?

Question 3: After all testing is complete, Ms. Patterson is found to have blockage of the ducts. Discuss the interventions necessary for management of the blockage.

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

DQ2 Clinical Reasoning: The Breast and GU System

Respond to the following:

Question 1: What would be your first concern for this patient? Provide a rationale for this answer. Describe the steps you would take when working up the breast mass. Discuss what other areas you would seek further information from Ms. Berger.

Question 2: Discuss the types of counseling you would consider given the possible outcomes. Provide a rationale for this answer. Identify other members of the healthcare team you would involve in developing a plan of care for Ms. Berger.

Question 3: Describe the risk factors for breast cancer. Discuss health promotion activities you would advocate for your female patients related to the breast and genitourinary (GU) system.

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Module 5 discussion

DQ1 Clinical Reasoning: Male Genitourinary System

Respond to the following:

Question 1: What other questions should you ask of Mr. Lange that are pertinent to this issue? What should be included in a physical exam of a 60 year-old male for this specific exam?

Question 2: What is the recommended work up for a patient you suspect has benign prostate hypertrophy (BPH)? What complications can develop from bladder outlet obstruction due to BPH?

Question 3: Briefly describe three (3) treatment options for Mr. Lange. What other members of the healthcare team would you work with in establishing a plan of care for Mr. Lange? Additionally, please include health promotion activities that would be culturally appropriate for him and provide a rationale for your choices.

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

DQ2 Clinical Reasoning: Musculoskeletal System

Respond to the following:

Question 1: Based on the information provided in the case study, what would you consider to be the essential questions to ask Ms. Lee?

Question 2: Based upon your evaluation, you feel that Ms. Lee may have rheumatoid arthritis. If that were the case, what would your examination reveal? List the tests that should be included in Ms. Lee’s work up.

Question 3: What treatment recommendations would you suggest for Ms. Lee if she is diagnosed with rheumatoid arthritis? Please include health promotion activities that would be culturally appropriate for her and provide a rationale for your choices. What kind of practitioner would you recommend as a primary care provider for Ms. Lee?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Module 6 discussion

DQ1 Clinical Reasoning: Neurological System

Respond to the following:

Question 1: What other questions would you ask Ms. Barthel? What specific exams would you perform on Ms. Barthel?

Question 2: You believe Ms. Barthel has multiple sclerosis (MS). Discuss what you know about the diagnosis of this disease. What tests and specialist(s) would you recommend her seeing?

Question 3: Describe your concerns about Ms. Barthel’s health and safety. What kinds of health promotion activities would you suggest for Ms. Barthel?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

DQ2 Clinical Reasoning: Putting it All Together

Respond to the following:

Question 1: What would you do prior to conducting a comprehensive assessment? What things would you organize and what would be your first priority?

Question 2: What have you learned about health assessment and physical assessment during the course of this semester? What were your “aha” moments?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Module 7 discussion

DQ1 Clinical Reasoning: Pediatrics

Respond to the following:

Question 1: How would you organize this visit and what would be your first priority? What should you know about Cystic Fibrosis as a primary care provider?

Question 2: You make a diagnosis of poison ivy, but you decide to draw Measles titer on Jason, out of caution. What should you discuss next with Jason and Ms. Reynolds? What activities would you suggest to promote Jason’s health?

Question 3: Should you consider speaking with Ms. Reynolds during the visit about her possible pregnancy? Discuss the heredity component of cystic fibrosis. What diagram is used to describe dominant and recessive traits?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

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DQ2 Clinical Reasoning: Older Adult

Respond to the following:

Question 1: You are the Nurse Practitioner Hospitalist and you are asked to admit Ms. Winchester to the hospitalist service. What are your concerns regarding the treatment of this patient with Parkinson’s Disease (PD) and mild cognitive impairment (MCI)? How should she be managed in the hospital? What preoperative test(s) should you order for this patient?

Question 2: There are several things that could be causing Ms. Winchester’s acute confused state prior to her fall. What studies should be ordered to rule out another cause of her confusion (other than the fall)?

Question 3: What would you include in your postoperative plan if Ms. Winchester’s surgery goes well? Include her family in this plan.

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Module 8 discussion

Cultural and Spiritual Competence

Respond to the following:

Question 1: What implications does culture have for the care of Ms. Gandhi? Describe the spiritual concerns you’ve identified.

Question 2: What cultural factors do you believe may contribute to Ms. Gandhi’s overall health? How would you address her physical needs in a culturally competent way? How would you address her spiritual needs? What would be different if Ms. Gandhi was a Muslim? Or if she was male rather than female?

Question 3: Given the limited time allotted, how would you prioritize this visit? What would you address first, second, etc.?

You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.

Submission Instructions

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

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