Discuss three ways of creating an environment that provides psychological comfort for both patient and practitioner when conducting an examination and assessment of the Genitourinary system.

Create a flowchart outlining the process you would take from determining the problem to finding a solution.
February 19, 2020
2. What do nurses have in common among all of the levels of education? What are the major differences? 3.How does level of education change the role of the professional nurse?
February 19, 2020

Discuss three ways of creating an environment that provides psychological comfort for both patient and practitioner when conducting an examination and assessment of the Genitourinary system.

DQ 1 Healthy People Initiative (graded) As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic woman who is in her second year of nursing school. She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. After doing her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. She is married with two school-age children. She is in class a total of 15 hours per week, plus 12 hours of labs and clinical. She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children. She states that she is lucky to get six hours of sleep per night, but that is okay with her. She lives one hour from campus and commutes each day. Using.healthypeople.gov/”>Healthy People 2020and your text as a guide: What additional information would you like to gather from Maria? What are Maria’s real and potential health risks? Why is Maria’s culture important when obtaining the health assessment? Pick one of Maria’s health risks. Would you classify Maria’s problem as first-level priority, second-level priority, third-level priority, or a collaborative problem? What would be one reasonable short-term goal for this risk? DQ2 Cultural Bias (graded) Understanding cultural phenomena is essential to the completion of an accurate and holistic health assessment. Please review a cultural group from Table 2-3 (p. 20) from your text and describe the cultural differences pertinent to that group (you may have to do some additional searching). Remember, the table may not include all cultural groups. Let’s try to include all the countries within the groups listed in the discussion, so please do not choose a group that has already been done. To expedite this, please use the group name in the title of your post. Devry NR305 Week 2 Discussion DQ 1 & DQ 2 Latest 2016 March DQ 1 Pain Assessment: The Fifth Vital Sign (graded) John, a 46-year-old African American male presents for admission to your hospital for hemi colectomy for colon polyps. He is complaining of chronic back pain. Patient is on disability from work-related injury. History of two previous back surgeries with relief of numbness in RLE, but pain has not been relieved. His current medications include Methadone, Neurontin, and Norco. John states he takes Tylenol PM every night in addition to his prescribed medications. John is a smoker and smokes 1 PPD. John confides in you that he is considering a spinal cord stimulator for the chronic pain. What risk factors does John have for risk of opioid withdrawal during this hospitalization? Is there a stigma connected to being disabled and/or methadone? Does the nurse need to be concerned about acetaminophen use? What are the differences in acute and chronic pain? DQ 2 Nutritional Assessment (graded) Red Yoder is an 80-year-old farmer who lives alone in the farmhouse where he grew up. It is located 20 miles outside of town. Red has been a widower for 10 years. Red rarely cooks for himself and mainly eats packaged or processed foods. His son, Jon, manages the farm now, but Red is still involved in the decision making. Red’s current medical problems include insulin-dependent diabetes complicated by an open foot wound. He also has some incontinence and difficulty sleeping. Red is awaiting a visit from the home health nurses. He relates that he has an open wound on his big toe that developed after walking in a new pair of shoes. When his daughter-in-law, Judy, saw the wound, she called the family doctor, who suggested a visit by the wound care nurse, who works with the home health agency. Red agreed as long as his VA benefits cover the costs. Red is aware that his son and daughter-in-law have concerns about him living alone, but Red insists that while he needs a little help from Jon and Judy at times, he is still capable of caring for himself. What are Red’s strengths? What are your concerns for this patient? What is the cause of your concern? What information do you need? What are you going to do about it? What is Red experiencing? Devry NR305 Week 3 Discussion DQ 1 & DQ 2 Latest 2016 March DQ 1 General Survey and Health History (graded) Casey is a 17-year-old high school student admitted to the ER with a compound fracture of the left leg obtained when falling at the local skateboard park while practicing for a national competition. He has never been hospitalized before. His mother has been notified and is on her way. The EMTs gave him morphine and he reports his pain level as “okay.” What part of the interview and examination can be done prior to his mother’s arrival? As you enter the room for the first time, what should you observe as part of the general survey? As you complete his history, what areas are especially important? What are the important developmental considerations for Casey? DQ 2 The Older Adult (graded) As you recall, our older patient, Red Yoder, with whom you met in Week 2, is preparing for discharge from the hospital since his wound required intravenous antibiotics and wound care. Jon (Red’s son) thinks that Red should move in with him for now, but Red is sure he is able to care for himself and insists that his confusion was due to the fact that he did not have his glasses or hearing aids for the last week. You have identified discharge teaching needs for him. This morning, however, in report the night nurse has shared “Patient is alert and oriented; vital signs stable. Fasting blood sugar this morning is 118. Red had his usual night of sleep. He was up several times to go to the bathroom. Since his catheter was removed yesterday, he has urgency incontinence. He is able to ambulate to the bathroom, but he is weak.” You administer his AM medications and note that he has some difficulty grasping the water cup and needs assistance holding it. Mr. Yoder states he needs to go to the bathroom and when you assist him up to his feet, he seems a bit unsteady. He takes several steps and tells you he needs to sit down. How much, if any, functional decline has occurred while Red was hospitalized and how will this affect his recovery? What are the risks and benefits of Red living with Jon and Judy? What are the risks or benefits of Red living at home after discharge? If services are in place, would it be considered a safe discharge? Considering all aspects of aging, what are the best and appropriate options for Red at this time? Devry NR305 Week 4 Discussion DQ 1 & DQ 2 Latest 2016 March DQ 1 Assessment of the Skin (graded) William Smaile is a 65-year-old man who presents to his general practitioner’s office with complaint of right forearm swelling, redness, and pain. He was recently discharged from the hospital where he had been receiving intravenous antibiotics for a respiratory infection. Subjective Data Pain level is a 5/10 location = right forearm, aching Retired foreman at a local industrial plant Objective Data Vital signs: BP 150/68, T 37 degrees Centigrade, P 80, R 16 Swelling and reddened right forearm, warm to touch + pulses, brachial and radial (R) +2 capillary refill fingers right hand What other assessments should be included for this patient? From your readings, what is the most probable cause of the swelling? What is your nursing diagnosis? What would be included in the nursing care plan? What interventions might be included in the plan of care for this patient? DQ 2 Assessment of the Head, Neck, and Regional Lymphatics (graded) Describe the characteristics of the lymph nodes associated with the disease states listed below: (Choose one.) Acute infection Chronic inflammation Cancer Devry NR305 Week 5 Discussion DQ 1 & DQ 2 Latest 2016 March DQ 1 Assessment of the Abdomen (graded) Kevin Valeri is a 64-year-old man who presents to the gastroenterologist’s office with constipation and abdominal bloating. Subjective Data Pain level is a 4/10 location = right lower abdomen Retired Engineer States he has been going to the bathroom with the help of laxatives, but not having regular movements Appetite is decreased, some nausea PMH: depression, anxiety, chronic constipation Objective Data Vital signs: T 37 degrees Centigrade, P 64, R 16, BP 124/58 Bowel sounds hypoactive in all four quadrants Medications: Lamictal 200mg daily, Lexapro 10 mg daily Weight = 210 lbs, last visit weight = 195 What other assessments should be included for this patient? What questions should the nurse ask with regard to the abdominal pain? From the readings, subjective data, and objective data, what is the most probable cause of the abdominal pain? What should be included in the plan of care? What interventions should be included in the plan of care for this patient? DQ 2 Assessment of the Genitourinary System (graded) Choose one topic and respond: Discuss three ways of creating an environment that provides psychological comfort for both patient and practitioner when conducting an examination and assessment of the Genitourinary system. Discuss medications that can affect the sexual performance of an aging adult male, possibly resulting in withdrawal from sexual activity. Discuss circumcision and the arguments for and against it. Discuss its associated religious connections. Devry NR305 Week 6 Discussion DQ 1 & DQ 2 Latest 2016 March DQ 1 Assessment of Cardiac Status (graded) Georgina Graves is a 42-year-old female who presents to the provider’s office with fatigue. Subjective Data PMH: none, (except gynecological issues) Significant family history of heart disease Fatigue started about 2 months ago, getting worse Relieved with rest, exacerbated with activity Denies chest pain C/O shortness of breath on exertion Smoker 1 PPD Objective Data Vital signs: T 37 P 100 R 18 BP 110/54 Lungs: clear O2 Sat = 94% Skin = cool to touch CV = heart rate regular, positive peripheral pulses, ECG = intermittent complete left bundle branch block (New Finding) Edema Medications: Premarin 0.3 mg po/day What other questions should the nurse ask about the fatigue? What other assessments would be necessary for this patient? What are some causes of fatigue? What should be included in the plan of care? Based on the readings, what is the most likely cause of fatigue for this patient?

DQ 1

Healthy People Initiative (graded)

As the school nurse working in a college health clinic, you see
many opportunities to promote health. Maria is a 40-year-old Hispanic woman who
is in her second year of nursing school. She complains of a 14-pound weight
gain since starting school and is afraid of what this will do to both her
appearance and health if the trend continues. After doing her history, you
learn that she is an excellent cook and she and her family love to eat foods
that reflect their Hispanic heritage. She is married with two school-age
children. She is in class a total of 15 hours per week, plus 12 hours of labs
and clinical. She maintains the household essentially by herself and does all
the shopping, cooking, cleaning, and chauffeuring of the children. She states
that she is lucky to get six hours of sleep per night, but that is okay with
her. She lives one hour from campus and commutes each day. Using.healthypeople.gov/”>Healthy People 2020and your text as a guide:

What
additional information would you like to gather from Maria?
What
are Maria’s real and potential health risks?
Why
is Maria’s culture important when obtaining the health assessment?
Pick
one of Maria’s health risks. Would you classify Maria’s problem as
first-level priority, second-level priority, third-level priority, or a
collaborative problem? What would be one reasonable short-term goal for
this risk?
DQ2

Cultural Bias (graded)

Understanding cultural phenomena is essential to the completion of
an accurate and holistic health assessment. Please review a cultural group from
Table 2-3 (p. 20) from your text and describe the cultural differences
pertinent to that group (you may have to do some additional searching).
Remember, the table may not include all cultural groups. Let’s try to include
all the countries within the groups listed in the discussion, so please do not
choose a group that has already been done. To expedite this, please use the
group name in the title of your post.

Devry NR305 Week 2 Discussion DQ 1 & DQ 2 Latest
2016 March

DQ 1

Pain Assessment: The Fifth Vital Sign (graded)

John, a 46-year-old African American male presents for admission
to your hospital for hemi colectomy for colon polyps. He is complaining of
chronic back pain. Patient is on disability from work-related injury. History
of two previous back surgeries with relief of numbness in RLE, but pain has not
been relieved. His current medications include Methadone, Neurontin, and Norco.
John states he takes Tylenol PM every night in addition to his prescribed
medications. John is a smoker and smokes 1 PPD. John confides in you that he is
considering a spinal cord stimulator for the chronic pain.

What
risk factors does John have for risk of opioid withdrawal during this
hospitalization?
Is
there a stigma connected to being disabled and/or methadone?
Does
the nurse need to be concerned about acetaminophen use?
What
are the differences in acute and chronic pain?
DQ 2

Nutritional Assessment (graded)

Red Yoder is an 80-year-old farmer who lives alone in the
farmhouse where he grew up. It is located 20 miles outside of town. Red has
been a widower for 10 years. Red rarely cooks for himself and mainly eats
packaged or processed foods. His son, Jon, manages the farm now, but Red is
still involved in the decision making. Red’s current medical problems include
insulin-dependent diabetes complicated by an open foot wound. He also has some
incontinence and difficulty sleeping.

Red is awaiting a visit from the home health nurses. He relates
that he has an open wound on his big toe that developed after walking in a new
pair of shoes. When his daughter-in-law, Judy, saw the wound, she called the
family doctor, who suggested a visit by the wound care nurse, who works with
the home health agency. Red agreed as long as his VA benefits cover the costs.
Red is aware that his son and daughter-in-law have concerns about him living
alone, but Red insists that while he needs a little help from Jon and Judy at
times, he is still capable of caring for himself.

What
are Red’s strengths?
What
are your concerns for this patient?
What
is the cause of your concern?
What
information do you need?
What
are you going to do about it?
What
is Red experiencing?
Devry NR305 Week 3 Discussion DQ 1 & DQ 2 Latest
2016 March

DQ 1

General Survey and Health History (graded)

Casey is a 17-year-old high school student admitted to the ER with
a compound fracture of the left leg obtained when falling at the local
skateboard park while practicing for a national competition. He has never been
hospitalized before. His mother has been notified and is on her way. The EMTs
gave him morphine and he reports his pain level as “okay.”

What
part of the interview and examination can be done prior to his mother’s
arrival?
As
you enter the room for the first time, what should you observe as part of
the general survey?
As
you complete his history, what areas are especially important?
What
are the important developmental considerations for Casey?
DQ 2

The Older Adult (graded)

As you recall, our older patient, Red Yoder, with whom you met in
Week 2, is preparing for discharge from the hospital since his wound required
intravenous antibiotics and wound care. Jon (Red’s son) thinks that Red should
move in with him for now, but Red is sure he is able to care for himself and
insists that his confusion was due to the fact that he did not have his glasses
or hearing aids for the last week. You have identified discharge teaching needs
for him. This morning, however, in report the night nurse has shared “Patient
is alert and oriented; vital signs stable. Fasting blood sugar this morning is
118. Red had his usual night of sleep. He was up several times to go to the
bathroom. Since his catheter was removed yesterday, he has urgency
incontinence. He is able to ambulate to the bathroom, but he is weak.” You
administer his AM medications and note that he has some difficulty grasping the
water cup and needs assistance holding it. Mr. Yoder states he needs to go to
the bathroom and when you assist him up to his feet, he seems a bit unsteady.
He takes several steps and tells you he needs to sit down.

How
much, if any, functional decline has occurred while Red was hospitalized
and how will this affect his recovery?
What
are the risks and benefits of Red living with Jon and Judy?
What
are the risks or benefits of Red living at home after discharge? If
services are in place, would it be considered a safe discharge?
Considering
all aspects of aging, what are the best and appropriate options for Red at
this time?
Devry NR305 Week 4 Discussion DQ 1 & DQ 2 Latest
2016 March

DQ 1

Assessment of the Skin (graded)

William Smaile is a 65-year-old man who presents to his general
practitioner’s office with complaint of right forearm swelling, redness, and
pain. He was recently discharged from the hospital where he had been receiving
intravenous antibiotics for a respiratory infection.

Subjective Data

Pain
level is a 5/10 location = right forearm, aching
Retired
foreman at a local industrial plant
Objective Data

Vital
signs: BP 150/68, T 37 degrees Centigrade, P 80, R 16
Swelling
and reddened right forearm, warm to touch
+
pulses, brachial and radial (R)
+2
capillary refill fingers right hand
What
other assessments should be included for this patient?
From
your readings, what is the most probable cause of the swelling?
What
is your nursing diagnosis?
What
would be included in the nursing care plan?
What
interventions might be included in the plan of care for this patient?
DQ 2

Assessment of the Head, Neck, and Regional Lymphatics (graded)

Describe the characteristics of the lymph nodes associated with the
disease states listed below: (Choose one.)

Acute
infection
Chronic
inflammation
Cancer
Devry NR305 Week 5 Discussion DQ 1 & DQ 2 Latest
2016 March

DQ 1

Assessment of the Abdomen (graded)

Kevin Valeri is a 64-year-old man who presents to the
gastroenterologist’s office with constipation and abdominal bloating.

Subjective Data

Pain
level is a 4/10 location = right lower abdomen
Retired
Engineer
States
he has been going to the bathroom with the help of laxatives, but not
having regular movements
Appetite
is decreased, some nausea
PMH:
depression, anxiety, chronic constipation
Objective Data

Vital
signs: T 37 degrees Centigrade, P 64, R 16, BP 124/58
Bowel
sounds hypoactive in all four quadrants
Medications:
Lamictal 200mg daily, Lexapro 10 mg daily
Weight
= 210 lbs, last visit weight = 195
What
other assessments should be included for this patient?
What
questions should the nurse ask with regard to the abdominal pain?
From
the readings, subjective data, and objective data, what is the most
probable cause of the abdominal pain?
What
should be included in the plan of care?
What
interventions should be included in the plan of care for this patient?
DQ 2

Assessment of the Genitourinary System (graded)

Choose one topic and respond:

Discuss
three ways of creating an environment that provides psychological comfort
for both patient and practitioner when conducting an examination and
assessment of the Genitourinary system.
Discuss
medications that can affect the sexual performance of an aging adult male,
possibly resulting in withdrawal from sexual activity.
Discuss
circumcision and the arguments for and against it. Discuss its associated
religious connections.
Devry NR305 Week 6 Discussion DQ 1 & DQ 2 Latest
2016 March

DQ 1

Assessment of Cardiac Status (graded)

Georgina Graves is a 42-year-old female who presents to the
provider’s office with fatigue.

Subjective Data

PMH:
none, (except gynecological issues)
Significant
family history of heart disease
Fatigue
started about 2 months ago, getting worse
Relieved
with rest, exacerbated with activity
Denies
chest pain
C/O
shortness of breath on exertion
Smoker
1 PPD
Objective Data

Vital
signs: T 37 P 100 R 18 BP 110/54
Lungs:
clear
O2
Sat = 94%
Skin
= cool to touch
CV
= heart rate regular, positive peripheral pulses, ECG = intermittent
complete left bundle branch block (New Finding)
Edema
Medications: Premarin 0.3 mg po/day

What
other questions should the nurse ask about the fatigue?
What
other assessments would be necessary for this patient?
What
are some causes of fatigue?
What
should be included in the plan of care?
Based
on the readings, what is the most likely cause of fatigue for this
patient?

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