Nursing

Assignment: Final Project in Nursing
Assignment: Final Project in Nursing
Question
NUR 440 Final Project Guidelines and Rubric
Overview
The world of professional nursing practice and health policy is ever-evolving to meet the new dynamics of care needs in every setting. As a registered nurse, youare accountable and responsible for making decisions that are consistent with safe, competent, and ethical practice on a daily basis. You also face a variety ofcomplex issues that impact the delivery of your nursing care.A professional practice issue is any issue or situation that either compromises client care/service by placing a client at risk, or affects a nurse’s ability to providecare/service consistent with standards and guidelines, and agency or organization policies or procedures.For this final project, you will develop an integrative review of literature about a clinical problem or issue of your choosing encountered in nursing practice. Thepurpose of an integrative review of literature assignment is to assist in preparing a scholarly paper that systematically collects, classifies, and analyzes a body ofresearch evidence about a clinical topic in order to make evidence-based practice recommendations for a practice change.The project is divided into four milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality finalsubmissions. These milestones will be submitted in Modules One, Two, Four, and Five. The final product will be submitted in Module Seven.In this assignment, you will demonstrate your mastery of the following course outcomes:? Assess diverse ways of knowing in nursing for their appropriateness in conducting nursing research and evidence-based nursing practice? Critique relevant primary research sources for their potential to provide evidence-based solutions to clinical nursing problems? Employ principles of ethical conduct of research in seeking evidence-based resources that support professional nursing practice changes? Propose evidence-based recommendations for practice changes that address clinical nursing problems for improving quality of care
Prompt
Choose a clinical problem or issue, with your instructor’s approval, that might be encountered in nursing practice. For this assessment, prepare a scholarlyintegrative review of the literature that will support a recommendation for a practice change to solve or improve the identified clinical problem or issue. To coverthe appropriate range of the research, you should search for and retrieve six current and relevant nursing research studies from primary sources that are relevantto your clinical topic of interest (these should be the articles from your annotated bibliography). Follow the assignment guidelines below to prepare a scholarlyintegrative review of the research literature you retrieved.Specifically, your integrative review of the literature should include the following critical elements:I. IntroductionA. What is the purpose of the integrative review?
B. Clearly articulate the topic of interest, problem statement, and the research question being studied.C. What variables of interest (such as concepts, target population, setting, interventions, etc.) will be used to guide the review of literature?D. Discuss the background and significance of the problem to nursing. Be sure to substantiate your claims with specific examples from your research.II. Literature Search MethodsA. Identify keywords, subject headings, and combinations used in the initial search.B. Which databases were searched?C. State the inclusion/exclusion criteria for the sample of research reports. In other words, how did you make decisions to narrow the search and focusthe literature review? How was the final sample of research reports determined?III. Data Analysis and Critical AppraisalA. Analyze the quality of each study. In other words, is the problem well formulated and the purpose of the study clear? Is the study approach welldesigned and executed? Does the study demonstrate understanding of related studies? Do the findings advance knowledge?B. Note each study’s strengths and limitations.C. Identify gaps in the literature and reflect on why these may exist.D. Identify similarities and inconsistencies across the studies.IV. Synthesis, Interpretation and Presentation of ResultsA. Develop an evidence table of your results that addresses the following criteria for each study: report citation, design, method, sample, data collection,data analysis, validity, and reliability of the findings. This table should appear in the Appendix of your paper.B. Identify major trends or patterns in the research reviewed.C. Can you make generalizations across the studies? Why or why not?D. What conclusions can you draw? Be sure to use a logical chain of evidence to support them.E. Provide a scholarly summary of the research reviewed that describes the “state of the science” presented by the research reports.F. Make practice recommendations based on the research reviewed.V. ConclusionsA. Identify the limitations of the literature review.B. Discuss the relevance of the results of your literature review to clinical practice.C. Discuss implications of the recommended practice change on future nursing practice and research.VI. Abstract: Include an abstract at the beginning of your paper that summarizes each of the following elements:A. Aims and objectivesB. BackgroundC. MethodsD. ResultsE. Conclusions
F. Relevance to clinical practiceVII. Appendix: Provide an appendix at the end of your paper that includes the following elements:G. Search method flow chartH. The table of evidence that you developed in Step IV.A
Milestones
Milestone One: Topic ProposalIn Module One, you will submit your topic proposal for instructor approval. You will briefly explain your interest and what you hope to gain through a review ofthe literature. This milestone will be graded with the Milestone One Rubric.Milestone Two: PICO(T) QuestionIn Module Two, you will submit your PICO(T) question, which will guide your research and review of the literature. This milestone will be graded with theMilestone Two Rubric.Milestone Three: Annotated BibliographyIn Module Four, you will submit an annotated bibliography to help gather resources for your final project. This milestone will be graded with the MilestoneThree Rubric.Milestone Four: Evidence TableIn Module Five, you will submit an evidence table to organize your resources and as part of your final project. This milestone will be graded with the MilestoneFour Rubric.Final Submission: Integrative Review of the LiteratureIn Module Seven, you will submit your final project. It should be a complete, polished artifact containing all of the critical elements of the final product. It shouldreflect the incorporation of feedback gained throughout the course. This submission will be graded with the Final Project Rubric.
Deliverables
Milestone Deliverable Module Due GradingOne Topic Proposal One Graded separately; Milestone One RubricTwo PICO(T) Question Two Graded separately; Milestone Two RubricThree Annotated Bibliography Four Graded separately; Milestone Three RubricFour Evidence Table Five Graded separately; Milestone Four Rubric
Final Submission: Integrative Review of theLiterature
Seven Graded separately; Final Project Rubric
Final Project Rubric
Guidelines for Submission: Your paper should be a maximum of 12 pages,

SOAP Note and eMedley Entries
SOAP Note and eMedley Entries
Week 2 project 2
SOAP Note and CORE Entries
Each week, you are required to enter your patient encounters into CORE. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using this template . The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Submissions Area. When submitting your note, be sure to include the reference number from CORE.
Submission Details:
By the end of the week enter your patient encounters into CORE and complete at least one SOAP note in the template provided.
Name your SOAP note document SU_NSG6440_W2_SOAPLastName_FirstInitial.doc.
Include the reference number from CORE in your document.
Submit your document to the Submissions Area by the due date assigned
Week 4 project 2
SOAP Note and eMedley Entries
Each week, you are required to enter your patient encounters into CORE. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using this template . The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Submission Area. When submitting your note, be sure to include the reference number from CORE.
Submission Details:
By the end of the week, enter your patient encounters into CORE and complete at least one SOAP note in the template provided.
Name your SOAP note document SU_NSG6440_W4_SOAPLastName_FirstInitial.doc.
Include the reference number from CORE in your document.
Submit your document to the Submissions Area by the due date assigned.
Week 6 project 3
SOAP Note and eMedley Entries
Each week, you are required to enter your patient encounters into CORE. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using this template . The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Submissions Area. When submitting your note, be sure to include the reference number from CORE.
Submission Details:
By the end of the week, enter your patient encounters into CORE and complete at least one SOAP note in the template provided.
Name your SOAP note document SU_NSG6440_W6_SOAPLastName_FirstInitial.doc.
Include the reference number from CORE in your document.
Submit your document to the Submissions Area by the due date assigned.
Week 8 project 3
SOAP Note and eMedley Entries
Each week, you are required to enter your patient encounters into CORE. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using this template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Submissions Area. When submitting your note, be sure to include the reference number from CORE.
Submission Details:
By the due date assigned, enter your patient encounters into CORE and complete at least one SOAP note in the template provided.
Name your SOAP note document SU_NSG6440_W8_SOAPLastName_FirstInitial.doc.
Include the reference number from CORE in your document.
Submit your document to the Submissions Area by the due date assigned.
Week 10 project 3
SOAP Note and eMedley Entries
Each week, you are required to enter your patient encounters into CORE. Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience. You will also need to include a minimum of one complete SOAP note using this template. The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Submissions Area. When submitting your note, be sure to include the reference number from CORE.
Submission Details:
By the end of the week, enter your patient encounters into CORE and complete at least one SOAP note in the template provided.
Name your SOAP note document SU_NSG6440_W10_SOAPLastName_FirstInitial.doc.
Include the reference number from CORE in your document.
Submit your document to the Submissions Area by the due date assigned.
Week 3 Midweek Assignment
Aquifer Case Study #1
For this assignment, you will complete a Aquifer case study based on the course objectives and weekly content. Aquifer cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the Aquifer case studies to promote the development of clinical reasoning through the use of ongoing assessment and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.
After you complete the Aquifer case study for the week, please print out the summary of your case session and submit as a PDF file to the Submissions Area. Note that the summary of your case session has your name on the top right hand corner. You need to submit this document as evidence that you have completed the case.
The Aquifer assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases will be present in the weekly quizzes, midterm, and final exam. You must have all Aquifer assignments completed in order to successfully pass the course.
Use this link for information on how to access and navigate Aquifer.
This week complete the case entitled “Case #22: 70-year-old male with new-onset unilateral weakness – Mr. Wright.”
Submission Details:
Name your document SU_NSG6440_W3_MidWeekProject_LastName_FirstInitial.pdf.
Submit your document to the Submissions Area by the due date assigned.
Week 6 Project
Aquifer Case Study
For this assignment, you will complete a Aquifer case study based on the course objectives and weekly content. Aquifer cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the Aquifer case studies to promote the development of clinical reasoning through the use of ongoing assessment and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.
After you complete the Aquifer case study for the week, please print out the summary of your case session and submit as a PDF file to the Submissions Area. Note that the summary of your case session has your name in the top-right corner. You need to submit this document as evidence that you have completed the case.
The Aquifer assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases will be present in the weekly quizzes, the midterm exam, and the final exam. You must have all Aquifer assignments completed in order to successfully pass the course.
Use this link for information on how to access and navigate Aquifer.
This week, complete the case entitled “Case #26: 55-year-old male with fatigue – Mr. Cunha.”
Submission Details:
Name your document SU_NSG6440_W6_Project1_LastName_FirstInitial.pdf.
Submit your document to the Submissions Area by the due date assigned.
Week 8 Project
Aquifer Case Study
For this assignment, you will complete a Aquifer case study based on the course objectives and weekly content. Aquifer cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the Aquifer case studies to promote the development of clinical reasoning through the use of ongoing assessment and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.
After you complete the Aquifer case study for the week, please print out the summary of your case session and submit as a PDF file to the Submissions Area. Note that the summary of your case session has your name in the top-right corner. You need to submit this document as evidence that you have completed the case.
The Aquifer assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases will be present in the weekly quizzes, the midterm exam, and the final exam. You must have all Aquifer assignments completed in order to successfully pass the course.
Use this link for information on how to access and navigate Aquifer.
This week, complete the case entitled “Case #18: 24-year-old female with headaches – Ms. Payne.”
Submission Details:
Name your document SU_NSG6440_W8_Project1_LastName_FirstInitial.pdf.
Submit your document to the Submissions Area by the due date assigned.

Discussion: Disaster Planning in Nursing
Discussion: Disaster Planning in Nursing
Question
Nursing 4210Week 4 Discussion: Disaster Planning
Scenario: You are the PHN working at your local public health department in the nursing division. It is the middle of summer, and you have been receiving telephone calls asking about “the flu season” since the vaccine wasn’t accurate in predicting the strains of influenza that affected your community last year, and many people contracted the virus. Business and community leaders are concerned because they don’t want a repeat performance of last year. You have been asked to develop some solutions to community concerns. Select two of the following scenarios and respond to the questions that are posed in each. As you consider the scenarios you have selected, think about the following considerations as you develop your responses.
· Which agencies are available to lead and assist in the disaster response?
· What resources are available in your community?
· How might resources be used most efficiently?
· Are there any gaps that may pose a problem?
· Identify potential strengths and weaknesses in the community
Scenario 1: Imagine that initial pandemic flu cases have been identified in your jurisdiction. Some people are home sick, and others are staying home fearful that they may become infected with the flu. What advice would you give to local business owners to prepare for this event? Name two actions that business owners can take to keep their businesses open.
Scenario 1, Part B.As incidents of influenza continue to rise, local business owners are worried about loss of revenue if several large planned conventions are forced to cancel due to the flu. What advice can you give these business owners? Should all events be cancelled?
Scenario 2:Disease rates are rising, and estimates are that as many as 20% of the population are ill with confirmed influenza. Several businesses have closed and services have been suspended. What advice would you give to local law enforcement officials so they can continue to serve the needs of the people? Describe two actions that law enforcement workers can take to remain on the job. How will the gaps in personnel created by those who are ill be covered by those who are still well? What advice will you give?
Scenario 3: Disease rates are remaining at 20% of the population, and many schools have closed due to teacher absence. Since parents still have to work if they are not sick with the flu, what advice can you give day care providers? What two ideas can you share with them so they can stay open and able to care for the children of working parents? Should all school sporting events be cancelled? What information should parents be given? Should announcements be given daily?
Scenario 4: The numbers of influenza victims has reached 25% of the population. Many of the large grocery stores in your community are short-staffed due to employee sick calls. Shelves are bare since many of the workers are home with the flu, and even if the storeowner could stock the shelves, cashiers are home sick, too. In-store pharmacists are struggling to keep their pharmacies open to serve the public. Consumables like bread and milk are in short supply since many delivery drivers are home sick. What two actions can you recommend to these storeowners so that your community doesn’t suffer?
Scenario 5: With 25% of the total population sick with influenza, your hospital is short of staff at a time of very high census. While many of the administrative positions are unaffected by illness, at least 40% of the nurses have called in sick or are at home caring for very sick children. Name two recommendations that you can give your hospital administration to keep their services available for the community.
Scenario 6: The community is turning to the Health Department for assistance because reported incidents of influenza have risen from 5% of the population to 10% of the population in a matter of days. What is your first response to this situation? What steps will you take? Where will you start?

Assignment: Geriatric Depression Scale Tool
Assignment: Geriatric Depression Scale Tool
Question 1 (5 points)
An 88-year-old, being admitted to rule out lung cancer, is assessed using the short form of the Geriatric Depression Scale tool. When it is determines that the earned score is 9, the nurse initially:
Question 1 options:
Asks if they have any thoughts of committing suicide.
Recognizes that this score is not indicative of depression.
Knows it is not unusual for clients this age to earn such a score.
Notifies the client’s healthcare provider immediately.
Question 2 (5 points)
A widowed grandmother is about to assume the role of custodial parent for her 6-year-old grandchild. Which intervention has priority when preparing the grandmother for long-term success in this new role?
Question 2 options:
Reviewing the developmental milestones of childhood.
Identifying local sources of child counseling services.
Discussing the common challenges of parenting a 6 year old.
Teaching stress management and relaxation techniques.
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Question 3 (5 points)
The client is diagnosed with dyslipidemia. This diagnosis is supported when the client’s lipid panel indicates a: Select all that apply.
Question 3 options:
Triglyceride level of triglyceride levels (>2000 mg/dL).
Low Density Lipids (LDL) level of 120 mg/dL.
Total Cholesterol level of 260 mg/dL.
High Density Lipids (HDL) level of 70 mg/dL.
Glucose level of 230 mg/dL.
Question 4 (5 points)
Which factor is the greatest barrier to an older adult living independently?
Question 4 options:
Deficits in vision and/or hearing resulting in safety issues.
Limited finances that prevent upkeep and maintenance of a residence.
Depression that occurs after the death of a spouse or significant other occurs.
The manifestation of cognitive impairment resulting from dementia or Alzheimer’s.
Question 5 (5 points) Question 5 Unsaved
Compared with acute pain, persistent pain requires the nurse to:
Question 5 options:
Monitor vital signs more frequently.
Document the character of the pain as burning.
Administer analgesics at least every 4 hours.
Educate the client to the benefit of specific lifestyle changes.
Question 6 Unsaved
When diagnosed with diverticulosis, a client asks how this problem occurred. Which assessment data identifies a risk factor for diverticulosis?
Question 6 options:
Drinks a quart of whole milk daily.
Takes an over the counter laxative twice weekly.
History of a Helicobacter pylori infection.
Maintains a diet low in fiber.
Question 7 (5 points) Question 7 Unsaved
When focusing best on the goal of enhancing the health and well-being of the older residents of extended care living facility, the nurse:
Question 7 options:
Assures that they all receive their medications and treatments on time.
Assesses each new resident to determine their food and beverage preferences.
Asks the nursing assistant to “allow the residents to dress themselves but to check that they are dressed appropriately.”
Documents that “the residents appeared to enjoy the opportunity to socialize at the weekly Sunday brunch.”
Question 8 (5 points) Question 8 Unsaved
The nurse best addresses the spirit of the Healthy People 2020 project regarding the older adult when:
Question 8 options:
Providing information regarding where free flu vaccinations are being given to those over 65 years of age.
Facilitating a “Walking for your Health” program for residents of a senior living apartment complex.
Arranging for a registered nutritionist to hold a “Grandparents and their Grandchildren Cooking Together” class.
Encouraging their utilization of government sponsored health and wellness programs that target the senior citizen.
Question 9 (5 points) Question 9 Unsaved
When acting as a fictive kin, in which activity will a paid caregiver engage?
Question 9 options:
Being responsible for paying the client’s bills.
Organizing the client’s birthday celebration.
Accompanying the client to doctor’s appointments.
Assuring the client has clean, appropriate clothing available.
Question 10 (5 points) Question 10 Unsaved
An older adult is being treated for severe pain resulting from a history of osteoarthritis. In her discharge teaching, which information is most important to the successful management of the pain?
Question 10 options:
Check for incompatibilities before taking any new medications.
Arrange to take a dose of analgesic prior to physical activity.
To take the analgesic around the clock as prescribed.
Be alert for the signs of overdose toxicity.
Question 11 (5 points) Question 11 Unsaved
Which diagnostic laboratory test should the nurse anticipate being ordered for the purpose of evaluating an individual’s acute, unexplained weight loss? Select all that apply.
Question 11 options:
A complete blood count (CBC).
Urinalysis.
Fecal occult blood.
Serum potassium.
Serum electrolytes.
Question 12 (5 points)
When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best ensures an understanding of oral hypoglycemic medications when providing:
Question 12 options:
The package insert and assessing the client’s reading skills.
The client with the website address for the American Diabetes Association.
Oral explanations and sending the client home with a written copy.
The information in paragraph form as opposed to numbered line fashion.
Save
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Question 13 (5 points) Question 13 Unsaved
While the older African-American is at the highest risk for developing Alzheimer’s disease, the nurse demonstrates an understanding of this disease process’s risk factors when assessing this population’s:
Question 13 options:
Weight and elimination patterns.
Heart rate and capillary refill status.
Blood pressure and glucose serum levels.
Muscle strength and reflex times.
Question 14 (5 points) Question 14 Unsaved
When best promoting a sense of well-being, the role of the nurse caring for a terminally ill client is to:
Question 14 options:
Assume responsibility regarding medical decision making.
Encourage the client to identify his/her idea of a peaceful death.
Provide information regarding hospice care’s ability to prolong life.
Help empower the client to achieve his/her potential for wellness.
Question 15 (5 points) Question 15 Unsaved
The nurse admitting a client to a same day surgery unit makes the decision to notify the surgical team to cancel the procedure based on the client’s statement that:
Question 15 options:
“Will I start taking my St John’s Wort as soon as I can eat again?”
“I’ve haven’t taken my ginkgo for exactly 10 days.”
“I didn’t want to risk catching a cold so I took my Echinacea with just a sip of water.”
“It seemed strange not taking my garlic pill this morning.”
Question 16 (5 points) Question 16 Unsaved
The nurse shows understanding of the need to promote healthy skin in the older adult when encouraging the client to: Select all that apply.
Question 16 options:
Wear a wide-brimmed hat when outdoors.
Pad feet with socks when wearing shoes.
Clean the skin with a moisturizing soap.
Bathe in tepid water.
Always wear gloves in the winter.
Question 17 (5 points) Question 17 Unsaved
What is true about instruments to assess for depression in older adults?
Question 17 options:
Older adults tend to score inaccurately low (indicating less depression) than younger adults on the Zung Self-Rating Depression Scale.
The shortened Geriatric Depression Scale does not contain a question to evaluate suicide potential.
The Beck Depression Inventory is designed for gerontological patients.
The Geriatric Depression Scale is administered by a health care provider in an interview with the older adult.
Question 18 (5 points) Question 18 Unsaved
The family member of a patient asks if vitamin C will prevent aging. In formulating an appropriate response, the nurse considers the:
Question 18 options:
Free radical theory.
Immunity theory.
Clinker theory.
Continuity theory.
Question 19 (5 points) Question 19 Unsaved
Which housing arrangement would best address the family who wants to provide housing for an older family member who has a large degree of physical and cognitive independence and a desire to be closely involved with the family?
Question 19 options:
Dedicating the spare bedroom in the home to the family member
A house at a senior retirement community.
A “granny” apartment in a separate part of the house.
Private room at a residential care facility.
Assignment: Geriatric Depression Scale

NURS 6660 Week 2 Week 2: Assessment in Child and Adolescent Psychiatry
Week 2: Assessment in Child and Adolescent Psychiatry
All diagnosis, from infancy to adulthood, begins with an examination. While an organic basis for most medical disorders can be determined through the use of diagnostic testing, the field of psychiatry is different in that patients cannot be sent to the lab for blood tests to determine the degree of depression. Similarly, patients cannot be sent to the radiology department for a “scan” to determine how severe their bipolar disorder is. Instead, the field of psychiatry must use psychiatric assessments such as the comprehensive integrated physical exam, diagnostic interviews, and questionnaires to make diagnoses. These tools must be specialized to address the needs of children and adolescents.
Kathryn Barnard was a nurse first and second an early developmental specialist with a PhD in early ecological development. Dr. Barnard, with her nursing background, was instrumental in developing assessment tools and interventions to promote infant mental health. A center is named after her at the University of Washington, aptly named the Kathryn Barnard Center for Infant Mental Health and Development. Dr. Barnard reminds us that mental health is lifelong. Proper treatment of children from their earliest moments is instrumental to their development. One of her sayings was “infants can’t wait” (Weber, 2015).
Diagnostic assessment of the child and adolescent is a specialized area of expertise. Some of the diagnostic and clinical features will be like your assessment of the adult. However, the PMHNP will be seeing children who have been to the PCP. Many PCPs are comfortable handling ADHD and other straightforward childhood disorders. That means that the PMHNP and those in his or her office will be seeing the more complicated patients.
This week, you explore the many different psychiatric assessment tools and begin to explore treatment options. You also begin developing your resume and portfolio. Week 2: Assessment in Child and Adolescent Psychiatry
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Optional Resources
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.
Chapter 2, “Diagnosis, Diagnostic Formulations, and Classification” (pp. 17–30)
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 2, “Contributions of the Psychosocial Sciences” (pp. 93–130)
Chapter 6, “Classification in Psychiatry” (pp. 290–299)
Chapter 31, “Child Psychiatry” (pp. 1107–1152)
Neurodevelopmental Disorders”
“Intellectual Disabilities”
“Communication Disorders”
Resume, Portfolio, and Cover Letter Resources
NURS 6660 Discussion: Working With Children and Adolescents Versus Adults
Infant, childhood, and adolescent development are a continual interplay between nature (genetic or biologic predisposition) and nurture (environmental experiences). The nature/nurture continuum and debate will always be a part of your career as a PMHNP. Knowing common developmental milestone is important in the role as a child provider. Not only is it essential to the diagnostic process, but it is also important to the interdisciplinary interactions with other mental health professionals. The study of normal developmental processes, however, is only one tool that allows the mental health professional to understand the child being evaluated. There are many different assessment instruments and interviewing techniques that PMHNPs can have in their toolkit when working with children and adolescents.
In this Discussion, you examine the differences in assessing and treating children and adolescents versus adults. You take into consideration your own clinical experiences, as well as your experiences in your clinical rotation, and the information from the readings thus far. Week 2: Assessment in Child and Adolescent Psychiatry
Learning Objectives
Students will:
Analyze the importance of developmental assessments
Analyze assessment instruments used for evaluating children and adolescents
Analyze treatment options used for children and adolescents
Analyze roles parents play in assessment and treatment
To Prepare for the Discussion
Review the Learning Resources concerning psychiatric assessments and assessment tools.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post your answers to the following:
Explain why a developmental assessment of children and adolescents is important.
Describe two assessment instruments and explain why they are used for children and adolescents but not adults.
Describe two treatment options for children and adolescents that may not be used when treating adults.
Explain the role parents play in assessment and treatment.

Clinical Reasoning: Assessing Your Skill
Clinical Reasoning: Assessing Your Skill
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.

Case: Malignant Otitis Externa
Case: Malignant Otitis Externa
Question 33
A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is:
Question 34
Of the following, the patient who should be referred for periodic colonoscopy is the patient with:
Question 35
Which type of lung cancer has the poorest prognosis?
Question 36
Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as:
Question 37
Treatment of acute vertigo includes:
Question 38
Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis?
Question 39
A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is:
Question 40
Of the following choices, the least likely cause of cough is:
Question 41
An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3–4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has:
Question 42
A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to:
Question 44
The Centor criteria for diagnosis of Group A B-hemolytic streptococcus includes which of the following?
Question 45
Group A ?-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group?
Question 46
Which of the following statements about malignant melanomas is true?
Question 47
What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?
Question 48
Appropriate therapy for peptic ulcer disease (PUD) is:
Question 50
A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe?
Question 51
Risk factors for acute otitis media (AOM) include all of the following except:
Question 52
Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit?
Question 53
The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than:
Question 54
A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition?
Question 55
The most common cancer found on the auricle is:
Question 57
A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect?
Question 58
Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?
Question 59
Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication?
Question 61
An 8 year old presents to the health clinic with history of acute onset severe sore throat and respiratory distress with stridor in the last 2 hours. The child’s history is positive for fever and pharyngitis for 2 days. What is the most likely diagnosis?
Question 62
Impetigo and folliculitis are usually successfully treated with:
Question 63
Which of the following color changes in a pigmented lesion suggests malignant transformation?
Question 64
A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that “there is something in my eye.” What is the diagnosis and how should it be treated?
Question 65
A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is:
Question 66
An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the differential diagnosis for this patient’s dysphagia is:
Question 67
When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action?
Question 68
Sandra has celiac disease. You place her on which diet?
Question 69
Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?
Question 71
The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals?
Question 74
A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough?
Question 75
A middle-aged male presents to urgent care complaining of fever, dysphagia, and shortness of breath. The nurse practitioner notes the patient leaning forward in a tripod position and drooling. The clinical presentation of this patient suggests:
Question 77
A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient?
Question 78
Which of the following is not a risk factor for coronary arterial insufficiency?
Question 79
A very active elderly patient has a documented diagnosis of arteriosclerosis obliterans. Common expected lower extremity physical exam findings include:
Question 80
Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?
Question 81
John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia?
Question 82
A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:
Question 83
Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?
Question 86
Which of the following is a secondary cause of hyperlipidemia?
Question 87
What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?
Question 88
In order to decrease deaths from lung cancer:
Question 89
Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadrant abdominal cramping pain, nausea, and vomiting. Your differential diagnosis might be:
Question 90
A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is:
Question 92
The differential diagnosis for a patient complaining of a sore throat includes which of the following?
Question 93
Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?
Question 96
A false-positive result with the fecal occult blood test can result from:
Question 97
Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?
Question 98
A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:
Question 100
A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free?
Case: Malignant Otitis Externa

NR 509 Week 1: Alternative Writing Assignment September 2019
Week 1: Alternative Writing Assignment
Purpose
The Alternative Writing Assignment mirrors the discussion content of Debriefing and will allow the student to expand their knowledge of physical health assessment principles specific to the advanced practice role.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
1. Identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1)
2. Differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2)
3. Adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4)
Due Date:
The alternative writing assignment is due no later than the Sunday 11:59 PM MT of the week in which the student did not attend the weekly debriefing session. For example, if you did not attend a debriefing session for Week 3, the written assignment is due the Sunday at the end of Week 4.
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. NR 509 Week 1: Alternative Writing Assignment
Total Points Possible: 30 Points
Requirements:
NOTE: Complete the NR 509 Alternative Writing Assignment ONLY if you did not attend or do not plan to attend Debriefing for the given week.
1. This paper will be appraised on the quality of the information, inclusion of at least one evidence-based scholarly source, use of citations, use of Standard English grammar, and organization based on the required components (see the paper headings and content details below).
2. Scholarly sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Your textbook and lesson are not considered to be an outside scholarly source. For the discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal. You are encouraged to use the Chamberlain library and search one of the available data bases for a peer-reviewed journal article. The following sources should not be used: Wikipedia, Wikis, or blogs. These web sites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality. For example, the American Heart Association is a .com site with scholarship and quality. It is the responsibility of the student to determine the scholarship and quality of any .com site. Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years. Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.
3. The length of the paper is to be no less than 1,500 words, excluding title page and reference list.
4. Create this assignment using Microsoft (MS) Word. You can tell that the document is saved as a MS Word document because it will end in “.docx.”
5. APA format (6th edition) is required in this assignment, explicitly for in-text citations and the reference list. Use 12-point Times New Roman font with 1 inch margins and double spacing. See the APA manual for details regarding proper citation.
6. Organize the headings and content of your paper using the outline below:
o Select a body system relevant to the lesson from the previous week for the topic of this paper. For example, if you are writing this assignment for Week 2, then select the HEENT, Respiratory, or Integumentary system as the focus for the paper (not all three systems). NOTE: If you are writing this assignment for Week 1, select the Health History as the topic of the paper.
o Discuss the physiology (structure and function) of the body system including details about the major organ systems (if applicable). NOTE: If you are writing the assignment for Week 1, provide an overview of interviewing techniques. NR 509 Week 1: Alternative Writing Assignment
o Construct relevant health history questions (subjective data) pertaining to the body system. NOTE: If writing the assignment for Week 1, construct relevant health history questions for all body systems as included on the review of systems (ROS).
o Provide an overview of the objective data and expected normal physical examination findings for this body system. NOTE: If writing this assignment for Week 1, provide the expected normal subjective findings for each body systems on the ROS.
o Explain special physical assessment examination techniques or procedures specific to assessing this body system. NOTE: If writing the assignment for Week 1, explain advanced interview techniques.
o Analyze and discuss how you might adapt your physical assessment skills or interviewing techniques to accommodate each of the following specific populations:
§ Infant/pediatric
§ Pregnancy
§ Geriatric
o Identify one major disease or disease process that may significantly impact this body system. NOTE: If writing the assignment for Week 1, identify one disease process or condition that may significantly hinder conducting a Health History interview.
o Synthesis and discuss the expected abnormal physical examination findings that may be associated with this disease or disease process.
o Summarize the key points.
o References in correct APA format
ASSIGNMENT CONTENT
Category
Points
%
Description
Application of Knowledge, Analysis, and Clarity
10
33.33
The quality of this criterion will be evaluated based uponthe following: demonstration of analysis, synthesis, and/or application of principles and concepts consistent with the principles of advanced physical assessment; relevance of content specific to the topic; expected normal findings, appropriate health history questions, and organization and clear presentation of information.
Adapted Physical Assessment Skills to Special Populations, Disease Process, Summary, and Scholarly Source
10
33.33
The quality of this criterion will be evaluated based upon the following: discussion regarding how to adapt physical assessment skills or techniques to accommodate all special populations; identification and discussion of one major disease or disease process and expected examination findings; and summation of key points. Must include at least one scholarly source to support the paper.
Total CONTENT Points= 20 pts
ASSIGNMENT FORMAT
Category
Points
%
Description
Grammar, Spelling, Syntax, Mechanics,APA Format, and Word Requirement
10
33.33
The assignment has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post. The length of the paper is not less than 1,500 words, excluding title page and reference list.
* APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
**Direct quote should not to exceed 15 words & must add substantively to the discussion
Total FORMAT Points= 10 pts
ASSIGNMENT TOTAL= 30 points
Rubric
Title:
NR509 Weeks 1-6 Alternative Writing Assignment_Sept19
NR509 Weeks 1-6 Alternative Writing Assignment_Sept19
Criteria
Ratings
Pts
Edit criterion descriptionDelete criterion row
This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 20 Points
Criterion 1
Application of Knowledge, Analysis, and Clarity
Must demonstrate the following elements:
Select an appropriate topic or focus for the assignment;
Demonstrate analysis, synthesis, and/or application of principles and concepts
consistent with advanced physical assessment;
Provide appropriate health history questions;
Identify the expected normal findings;
Content is specific to the topic;
Paper is organized and clearly presented.
(6 Required Elements)
Range
threshold: pts
Edit ratingDelete rating
10.0 pts
Excellent
Demonstrates all elements of the Criterion
Edit ratingDelete rating
9.0 pts
V. Good
Missing 1 element of the Criterion
Edit ratingDelete rating
8.0 pts
Satisfactory
Missing 2 elements of the Criterion
Edit ratingDelete rating
5.0 pts
Needs Improvement
Missing 3 elements of the Criterion
Edit ratingDelete rating
0.0 pts
Unsatisfactory
Missing 4 or more elements OR No assignment
pts
10.0 pts
—
Edit criterion descriptionDelete criterion row
This criterion is linked to a Learning OutcomeCriterion 2 Adapted Physical Assessment Skills to Special Populations, Disease Process, Summary, and Scholarly Sources
Must demonstrate the following elements:
Discuss how to adapt physical assessment skills or techniques to accommodate all special populations;
Identify one major disease or disease process and expected examination findings;
Demonstrate appropriate knowledge of physical assessment examination techniques or procedures;
Identify abnormal findings;
Summarize key points
Must include at least one scholarly source
(6 Required Elements)
Range
threshold: pts
Edit ratingDelete rating
10.0 pts
Excellent
Demonstrates all elements of the Criterion
Edit ratingDelete rating
9.0 pts
V. Good
Missing 1 element of the Criterion
Edit ratingDelete rating
8.0 pts
Satisfactory
Missing 2 elements of the Criterion
Edit ratingDelete rating
5.0 pts
Needs Improvement
Missing 3 elements of the Criterion
Edit ratingDelete rating
0.0 pts
Unsatisfactory
Missing 4 or more elements OR No assignment
pts
10.0 pts
—
Edit criterion descriptionDelete criterion row
This criterion is linked to a Learning OutcomeAssignment Format Possible Points = 10 Points
Format Criterion 1
Grammar, Spelling, Syntax, Mechanics, APA Format, and Word Requirement
NOTE: Failure to comply with the word requirements for this assignment will result in the grade of zero (0) for this Criterion.
Range
threshold: pts
Edit ratingDelete rating
10.0 pts
Excellent
0-1 errors in grammar, syntax, spelling, punctuation, mechanics, and APA format
Edit ratingDelete rating
9.0 pts
V. Good
2-3 errors in grammar, syntax, spelling, punctuation, mechanics, and APA format
Edit ratingDelete rating
8.0 pts
Satisfactory
4-5 errors in grammar, syntax, spelling, punctuation, mechanics, and APA format
Edit ratingDelete rating
5.0 pts
Needs Improvement
6-7 errors in grammar, syntax, spelling, punctuation, mechanics, and APA format
Edit ratingDelete rating
0.0 pts
Unsatisfactory
8 or more errors in grammar, syntax, spelling, punctuation, mechanics, and APA format Or Less than 1,500 words, excluding title page and reference list OR No assignment
pts
10.0 pts
—
Edit criterion descriptionDelete criterion row
This criterion is linked to a Learning OutcomeLate Penalty Deductions
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
Range
threshold: pts
Edit ratingDelete rating
0.0 pts
Minus Points
Edit ratingDelete rating
0.0 pts
Minus Points
pts
0.0 pts
—
Total Points: 30.0 out of 30.0

NUR2115 Module 10 Comprehensive Plan of Care Assignment
In this third and final submission of your Course Project, you will be completing a comprehensive care plan. This written assignment should include the following: Comprehensive Plan of Care Develop a comprehensive plan of care/treatment with short and long term goals and include safety needs, special considerations regarding personal needs, cultural/spiritual implications, and needed health restoration, maintenance, and promotion.
Patient education: (Example: medication, safety, possible complications associated with the patient).Complete in a narrative format exactly how you would educate the patient.Include at least 7 narrated sentences.
Outcome: Caring:
Identify one example from your clinical day in which you observed, participated in or provided some aspect of caring for the provision of psychosocial and/or cultural diversity needs.
Evidence-based Practice (EBP): Summarize one article published within the last 3 years that you could use to improve the care you provide to this patient. Utilize learning resources available through Rasmussen Online library. Include APA citation in reference list.
References
Clinical Site/ Unit: TCU
Patient Initials: S.D
Gender: Female
Age: 71
Weight: 287lbs
Height: 64.0
Baseline vitals (from the patient chart)
Date: 02/07/19; B/P: 127/52; Pulse: 85 bpm; RR: 16 bpm; T/mode: 98? (Tympanic)
Pulse ox: 98.0%
Vital Signs Assessment (Taken by me)
B/P: 143/58; HR: 72 bpm; RR: 19 bpm; T: 97?; SpO2: 94%
Allergies: Amlodipine, Meperidine, Nitroglycerin, Polyethylene Glycol, Simvastatin, NSAIDs, Penicillin, Sulfa Antibodies
Code Status: Full code
Social Health: Husband of 44 years; Daughter (EMT); Son (EMT Firefighter)
Marital Status: Married
Cultural Background: Caucasian
Primary Language: English
Past Medical/ Surgery History: Had depression in the past and is treated for it.
Family Health History: Mental health problem, had depression in the past
Diet: Consistent carbohydrate diet, Regular Texture texture, Thin Liquid consistency
Special Instructions: Preferences for taking medications – water with ice, ice tea
Activity/Assistive Devices: No assistive devices required
Treatment Orders: Not required
Tubes/ Drains/ Ostomies: No Tubes/ Drains/ Ostomies required
Interdisciplinary Cares (OT/ PT/ ST) and frequency: No interdisciplinary cares noted
Dressings/ Wounds: (type & location): No Dressing/ Wounds noted
ASSESSMENT SUMMARY
Body System Subjective: Patient’s Health History Objective: My assessment findings
Pain Level (pain scale 0-10/ location): Patient reports pain of 6.5 out of 10 (leaning forward) and 3 out of 10 (still sitting) Pain rating: 0-10:
Characteristic: Temporal
Onset: When leaning forward
Location: Right shoulder
Description (dull, aching,
sharp): Sharp pain
Exacerbating factors factor(s): Comes and go.
Relieving factor(s): Pain medications (oxyCODONE)
Orientation:
Head/Eyes/ Ears/ Nose/ Throat (HEENT): Patient reports no trauma to the head. Does not experience any headache.
Patient reports no problem with vision, no eye pain, no glasses or contact lenses, no history of an ocular problem, no blurring, no blind spot.
Patient reports no ear pain, no history of ear infections, no ear discharge, and no hearing loss.
Patient reports nose is always clogged. Patient reports no experience of headaches and trauma to the head.
Orientation (person, place, time and situation): Patient alert and oriented X 4. Had four (4) brain surgery to stop trimmers.
Speech (clear/appropriate): Speech is clear
PERL (pupils equal and reactive to light): Pupils are equal and reactive to light. Had a cataract surgery.
Ears (clean/dry): No lesions, no drainage, CN8 intact, no hearing aids
Nose (clean/dry/intact): Symmetrical no deformities, no lesions, mucosa and turbinate are pink, moist, no exudates, no septal deviation, no perforations.
Throat (pink, moist): Thrush on her tongue from a fungal infection, has sore on the mouth (lip), oral mucosa is pink and moist, and the patient has good dentition. Good symmetrical movement. The pharynx is normal in appearance without tonsillar or exudates. No adenopathy is noted. CNS I-XII (All intact).
Musculoskeletal: Patient reports arthritis in fingers but does not have rheumatoid arthritis
MAE (moves lower extremities very well, and left upper extremity
Weakness: Right shoulder
Assist (transfers/ambulation): Stand by assist with all transfers and ambulation.
Assistive device (walker, cane): no use of any assistive devices (walker or cane).
Respiratory: Patient reports no cough, no shortness of breath, no chest pain, no smoking history, no history of respiratory infections, and no environmental exposure. Respirations: 19 bpm
Rate: Regular
Lung sounds: quick deep on inspiration and quick shallow on expiration
Cough: No cough noted
SOB: no shortness of breath
Cardiac: Patient reports no chest tightness, no recent fatigue. AP (apical pulse): 72 bpm
Rate (regular): Is regular.
Chest pain: No chest pain
Peripheral pulses: Brachial, Carotid, Radial, Dorsal Pedis
Edema: Lower extremities – 4+ pitting edema
Capillary refill: Less than 3 seconds
Integument: Patient reports no leg pain, no leg cramps Skin ( moist, intact): Skin is moist and intact, not dehydrated, warm to touch
Color (pink, pale, cyanotic): Skin is pink
Wound(s): 2-3 inches red bruise on left foot from blister.
Dressing(s): No dressings on any part of body.
Gastrointestinal (GI): Patient reports no bowel problems. Patient reports having a bowel a day before. Bowel sounds (x4): Bowel sounds regular and present in all 4 quadrant.
Nausea/vomiting: no nausea or vomiting
Pain/tenderness with palpation: No pain on palpation
Last BM: 2 bowel movements a day ago (02/06/19)
Continent: Continent of bowels
Genitourinary (GU); Patient reports no problem with voiding. Patient reports voiding 8-10 times a day Frequency of urination (q2h, q4h, foley): 8-10 times a day. Approximately q2h.
Color: Pale yellow
Dysuria (frequency, burning):
No pain or burning sensation
Continent: Continent
Endocrine; Patient reports no abnormal growth, no endocrine disease or disorders, no abnormal temperature Diabetic/ Blood sugar: 193.0
Diet: Consistent carbohydrate diet, Regular Texture texture, Thin Liquid consistency
Appetite (%): 75%
Psychosocial/ Spiritual: Patient reports associating with Native American Spirituality and is Buddhist. Patient reports having a strong family support. Good spirits/ Pleasant: Very active and good spirit
Sad/ Tearful/ Anxious: She is not sad, tearful or anxious
What is resident main concern during their stay? To walk 3-4 times a day to get lower extremities working.
Main concern after they discharge? To be able to go back to work and go about normal business.
Medication Data Sheet
Drug Name Trade and generic name, dose, route& frequency Drug Classification Expected action and indication for use Medical Diagnosis
Side Effects and Adverse Reactions Nursing Administration special instructions and assessments Client Education Evaluation of medication effectiveness, e.g., Pin Scale
Acetaminophen (Tylenol) Tablet 500 mg. Give 2 tablets by mouth orally 3 times a day. No more than 4000 mg in 24 hours, also a PRN dose of 1000 mg. It is used to treat mild to moderate pain. For pain experiencing in Right shoulder. Side effects: Nausea, stomach pain, loss of appetite, itching, rash, headache, dark urine.
Adverse reaction: Difficulty breathing or swallowing, swelling of the face, lips, throat or tongue. Hives, severe itching
Assess the history of pain.
Demonstration of relieving of pain on the pain scale 0-10
Vitamin D3 (Cholecalciferol) tablet 5000 units. Give one pill by mouth two times a day.
Treatment or prevention of vitamin D deficiency. For Closed Fracture off the head of the right humerus Side Effects: Kidney stones, confusion, disorientation, muscle weakness, frequent urination, nausea, vomiting, constipation.
Adverse Effects: Extremely large doses can cause toxicity. I am assessing patient carefully for evidence of hypocalcemia, assessing for symptoms of vitamin deficiency before and periodically.
Normalization of serum calcium and parathyroid hormone levels.
Resolution of prevention of vitamin D deficiency.
Gabapentin (Neurontin) Capsule 300 mg. Give 300 mg by mouth two times daily. Neuropathic pain, diabetic peripheral neuropathy. For neuropathic pain Side effects: sleepiness, dizziness, fatigue, clumsiness while walking, weight gain, tremor
Adverse effects: Skin rash, unusual bruising, swollen glands, muscle aches. Assess the location, characteristics, and intensity of pain periodically during therapy.
Decreased intensity of neuropathic pain.
Wellbutrin (buPROPion HCL, ER) SR Tablet Extended Release. Every 12 hours 200 mg.
Give 1 tablet by mouth two times a day. Treatment of depression. The patient is taking for depression and has a history of depression. Side Effects: dry mouth, sore throat, nausea, vomiting, flushing, headache, abdominal pain.
Adverse Effects: mood or behavior changes, anxiety, depression, panic attack. Assess mental status and mood changes, inform health care provider if the patient demonstrates a significant increase in signs of depression.
Increased sense of well-being, renewed interest of surroundings.
Protonix (Pantoprazole Sodium) Tablets Delayed-Release 40 mg.
Give 1 mg tablet by mouth two times a day. Erosive esophagitis associated with GERD. Maintenance of healing of erosive esophagitis. The patient is taking this medication for GERD. Side Effects: headache, nausea, vomiting, diarrhea, stomach or abdominal pain, gas, dizziness.
Adverse Effects: Facial edema, hyperglycemia, photosensitivity
I am assessing patient routinely for epigastric or abdominal pain.
Decreased in abdominal pain, heartburn, gastric irritation and bleeding in patients with GERD.
Nursing Diagnosis Expected Outcomes (S.M.A.R.T) Specific, measurable, attainable, realistic, & time oriented (ID a future time or date for reassessment/ evaluation Nursing Interventions
#1
Acute pain
R.T.
Movement of bone fragments, edema, and injury to the soft tissue
A.M.B.
Reports of pain The patient will verbalize relief of pain.
Short-term goal: Patient verbalizes minimized or controlled feeling of pain.
Long-term goal: Patient is free of pain on surgical site.
Maintain immobilization of affected part by means of bed rest, cast, splint, traction.
#2
Impaired Physical Mobility
R.T.
Neuromuscular skeletal impairment; pain/discomfort; restrictive therapies (limb immobilization)
A.M.B.
Reluctance to attempt movement; limited ROM The patient maintain position of function.
Short-term goal: After 4 days of nursing intervention, the patient will be able to demonstrate techniques and behaviors that enables resumptions of activities.
Long-term goal: After 4 days of nursing intervention, the patient will be able to maintain or increase strength and functions of affected body part.
Instruct patient or assist with active and passive ROM exercises of affected and unaffected extremities.
#3
Skin/Tissue Integrity, impaired: actual/risk for
R.T.
Physical immobilization
A.M.B.
Reports of itching, pain, numbness, pressure in affected/surrounding area The patient verbalize relief of discomfort.
Short-term goal: After 6-8 hours of nursing intervention the patient will have reduced risk of further impairment of skin integrity.
Long-term goal: After 3-4 days of nursing intervention the patient will be able to reduce risk of infections.
Assess position of splint ring of traction device.
Which of your diagnoses are Priority using Maslow’s Hierarchy of Needs: Impaired Physical Mobility according to Maslow’s Hierarchy of Needs, physiologic needs should satisfy first, so that the patient should satisfy this to satisfy her physiologic needs.
Evaluation: Were any of your short term expected outcomes met during your shift? None of the short-term expectations were met during my shift.
How might you revise your care plan next time to achieve at least one outcome during your shift? I plan on improving my care plan next time by monitoring my patients’ recovery process keenly and offering effective ways to have my patient be able to decrease edema and promotes venous return.
Medical Diagnosis
1. The patient diagnosed with an Unspecified Displaced Fracture of Surgical Neck of Right Humerus the pieces of bone at the fracture site are separated and shifted out of position. This type of fracture typically requires surgery. Proximal humerus fractures are diagnosed by a thorough physical examination and diagnostic imaging (Stanley, n.d.).
2. Humerus fractures are caused by direct harm to the arm shoulder. About 20% of humerus fractures are displaced and mostly occur in baseball games. Such type of fracture requires a more intrusive treatment like surgery
3. A subsequent encounter is experienced when an active treatment of the patient’s injury has been offered, and the patient is now receiving routine care for the injury in the healing process (Deter, 2006). An example is medical ex-rays to monitor the healing process of the fracture
4. Asthma is an inflammatory disease of the airway demonstrated by various recurring symptoms and bronchospasm. Common symptoms of asthma include; coughing, wheezing, short breaths, and chest tightness.
5. A major depressive disorder is a mental disorder demonstrated by two weeks or more of low mood. It is accompanied by loss of interest in several things, low self-esteem, pain with no clear cause and low energy. Patients with depression often hear or see things that are unseen by other people. They affect patients negatively as some end up committing suicide (Deter, 2006).
LAB RESULTS
DATE LAB TEST NORMAL VALUE CLIENT VALUE SIGNIFICANCE OF ABNORMAL LAB VALUE
01/27/19 Sodium
135-145 mmol/L 134 (L) The significance of abnormal sodium lab value is hyponatremia.
01/27/19 BUN/Creatinine Ratio
10-20 mg/DI 27 (H) This mean the patient may not be getting enough blood flow to their kidneys, and could have conditions such as congestive heart failure, dehydration, or gastrointestinal bleeding.
01/27/19 Hemoglobin
12.0-16.0 g/DI 7.8 (L) This mean that there is a nutritional deficiencies such as iron, folate or B12 deficiency.
01/27/19 ALK Phosphate 50-136 IU/L 144 (H)
Elevated ALK Phosphate is most commonly caused by liver disease or bone disorders.
01/27/19 RBC 4.00-5.20 mil/cu mm 2.95 (L)
This could signify trauma in the patient.
Diagnostic Tests
Tests Results Significance
US Venous Upper Extremity Right Indication: Right Humerus Fracture The right arm veins are negative of DVT It enables the nurse to know where exactly the fracture happened and the intensity of the fracture to administer proper medication.
EKG 12- Lead Interpretation: Artifact, Sinus rhythm, right Atrial enlargement, Abnormal ECQ It directs the nurse on the exact medication to use.
References
Deter, L. L. (2006). Basic medication administration skills. Australia: Thomson Delmar Learning.
Stanley, L. (n.d.). Moving Forward: Physical Therapy Brings Motion to Life. https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=937e6560-3300-4bdc-9285-16d9cb759554

MHA610 Introduction to Biostatistics Assignments and DQs
MHA610 Introduction to Biostatistics Assignments and DQs
Course Guide
This course explores the application of fundamental statistical methods to the healthcare environment. Course content includes both descriptive and inferential methods including: data analysis, statistical estimation, regression analysis, analysis of variance, hypothesis testing, and analysis of longitudinal data.
Note: This course uses software that is not Mac OS compatible. Access to a Windows PC or a Windows-based platform is required.
Table of Contents
Course at a Glance
Course Description
This course explores the application of fundamental statistical methods to the healthcare environment. Course content includes both descriptive and inferential methods including: data analysis, statistical estimation, regression analysis, analysis of variance, hypothesis testing, and analysis of longitudinal data.
Course Design
The purpose of this course is to provide an introduction to statistics relating to health care research. Students will be introduced to various health data sources, and will proceed to analyze, assess, and evaluate these data using basic statistical concepts and methodology. Students will learn how to use statistical software in order to obtain and interpret descriptive and inferential statistical results.
Students will also learn basic principles of probability theory and how to draw conclusions from available data utilizing statistical tools, assessing whether observed statistics could occur by chance alone. Notions of probability are of fundamental importance, and students will utilize both frequentist and Bayesian probability concepts in their evaluations.
Statistics not only plays a crucial role in undertaking and interpreting research in the health sciences, but also arises in quotidian settings. For example, what does it mean to have a 20% chance of precipitation today? At the conclusion of this course, the students’ increased understanding of statistics and probability will empower them in their studies, their work, and their daily lives.
Prerequisites
There are no prerequisites for MHA610.
Course Learning Outcomes
Upon successful completion of this course, students will be able to
Apply basic statistical principles for describing, analyzing, and interpreting health
Apply statistical methods of estimation and hypothesis testing in biostatistics and
Analyze relationships between quantitative variables using correlation and linear
Evaluate health care delivery and services using epidemiological data and appropriate statistical
Communicate the findings and implications from statistical analyses to health care
Course Materials
Required Text
Triola, M. M., & Triola M. F. (2006). Biostatistics for the biological and health sciences. Boston, MA: Pearson Education, Inc.
Triola, M. M., & Triola M. F. (2006). [Student companion website].
Boston, MA: Pearson Education, Inc. Retrieved from:
The software and data sets for the course may be accessed through
Note: This course uses software that is compatible with both Mac and Windows-based platforms. In addition, Microsoft Excel and Word will be used extensively throughout the course.
Required Resources
Supplemental Materials
Koziol, J. (2014). (2014). [PDF]. College of Health, Ashford University: San Diego, CA.
Websites
Centers for Disease Control. (2014). . Retrieved from
Centers for Disease Control and Prevention. (2014). Retrieved from
(2012). Retrieved from by-age-and-gender
Recommended Resources
Multimedia
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
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Koziol, J. (Producer). (2014). [Video file]. Retrieved from
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Koziol, J. (Producer). (2014). [Video file]. Retrieved from
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Koziol, J. (Producer). (2014). [Video file]. Retrieved from
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Koziol, J. (Producer). (2014). [Video file]. Retrieved from mortality%29/0_snyfubtn
Course Grading
Multiple measures of assessment are used in the course, allowing students opportunities to demonstrate their learning in more than one way and giving consideration to individual learning styles. Course components that will be assessed include:
Discussions
Each week students will participate in online discussions with classmates, which are related to the week’s readings. These discussions replace the interactive dialogue that occurs in the traditional classroom setting. Each week, students’ initial discussion posts are due by 11:59 p.m. (in the time zone in which each student resides) on Day 3 (Thursday). Students will have until 11:59 p.m. on Day 7 (the following Monday) to make the required minimum number of response posts to classmates. Discussions represent 26% of the overall course grade.
Quizzes
In Weeks Three and Six, students will demonstrate and reinforce their understanding of the week’s content by taking open-book quizzes. There is no time limit to complete the quiz, and each quiz can be taken two times. The quiz must be completed in one sitting, by Day 6 of the week in which it is due. The questions are multiple choice and true/false. Each quiz is worth 5 percent. Quizzes represent 16% of the overall course grade.
Assignments
There are written assignments due in Weeks One through Five of this course. These assignments must reflect college- level writing. Assignments represent 40% of the overall course grade.
Final Project
The final assignment for this course is a Final Project. The purpose of the Final Project is for you to culminate the learning achieved in the course by taking a new approach to the datasets that you have looked at throughout the course. The Final Project represents 18% of the overall course grade.
Grading Percent Breakdown
Activity
Grading Percent
Discussions 26
Quizzes 16
Assignments 40
Final Project 18
Total 100
Week One
Course Content
To be completed during the first week of class
Overview
Activity Due Date Format Grading Percent
Post Your Introduction Day 1 Discussion 2
Hospital Data Day 3 (1st post) Discussion 4
U.S. Mortality Rates Histogram Day 7 Assignment 8
Weekly Learning Outcomes
This week students will
Calculate summary statistics from
Create appropriate graphs and charts for nominal and ordinal
Introduction
During Week One, you will be introduced to quantitative (continuous) and qualitative (discrete or categorical) data. You will learn appropriate graphical techniques for displaying and summarizing both types of data. You will learn about descriptive statistics for location (i.e., mean, median) and scale (i.e., standard deviation, range), for reporting purposes. You will begin to learn fundamentals of probability theory.
Required Resources
Text
Triola, M.M., & Triola, M.F. (2006). Biostatistics for the Biological and Health Sciences. Boston, Ma: Pearson Education, Inc.
Chapter 1: Introduction
After reading the chapter, review your grasp of the material in Chapter 1 by solving the odd- numbered questions in the Review Exercises and the Cumulative Review Exercises at the end of Chapter 1. Solutions to these problems are given at the end of the
Chapter 2: Describing, Exploring, and Comparing Data
After reading the chapter, review your grasp of the material in Chapter 2 by solving the odd- numbered questions in the Review Exercises and the Cumulative Review Exercises at the end of Chapter 2. Solutions to these problems are given at the end of the
Triola, M. M., & Triola M. F. (2006). [Student companion website].
Boston, MA: Pearson Education, Inc. Retrieved from:
Supplemental Materials
Koziol, J. (2014). MHA610_Week 1_Discussion_Hospital data [Excel file].
Koziol, J. (2014). MHA610_Week 1_Discussion_Hospital data [Statdisk file].
Website
World Life Expectancy. (2012). Retrieved from
This website houses the data that will be used for the U.S. Mortality Rates histogram assignment for this week.
Recommended Resources
Multimedia
Koziol, J. (Producer). (2014). MHA610 Week 1 Assignment (Part 1) [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
Koziol, J. (Producer). (2014). [Video file]. Retrieved from
These screencasts help explain the Week One
Discussions
Participate in the following discussions:
Post Your Introduction. 1st Post Due by Day 1. Post a brief introduction on the first day of class. Share any past experiences (academic or professional) that you have had with epidemiology, biostatistics, or
health data analysis. What topic are you most interested in as it relates to epidemiology and biostatistics? Briefly explain why you are interested in this topic. Additionally, describe what you are looking forward to learning in this course.
Guided Response: Review several of your classmates’ posts. Welcome at least three of your peers to this course. What similarities in experience did you note between you and your classmate? Did your colleague’s description of his or her topic of interest differ from your own? If so, did the description spark your interest in that topic as well? If so, how? Introduction should be at least 250 words in APA format.
Hospital Data. 1st Post Due by Day 3. The MHA610_Week 1_Discussion_Hospital Data Excel file (available in the classroom) and MHA610_Week 1_Discussion_Hospital Data Statdisk file (available in the classroom) contains basic demographic information on 250 patients admitted to a community hospital over a two week period. The first row of the worksheet indicates the variable names:
Gender Male (M) or female (F)
Ethnicity
SevIllnessCode These are All Patient Refined Diagnosis Related Groups (APR-DRG) categories of severity of illness, ranging from:
SevIllnessDescr Mild (Category 1) to extreme (Category 4)
Age In years
Wt Patient weight in kilograms
Ht Patient height in centimeters
BMI Patient body mass index (BMI) where BMI = wt/ht*2, with weight in kilograms and height in meters
APR-DRG Denotes All Patient Refined Diagnosis Related Group, a widely used inpatient classification system.
For this discussion, describe and summarize the demographic information on these patients. You may use tables or graphs (or both) for this purpose. Your goal is to convey to the reader an accurate snapshot of these patients. Support your response with correct scholarly sources. You initial post must be at least 250-500 words.
Guided Response: Respond to at least two of your peers by Day 7, 11:59PM. Review your colleague’s summary of the data. Did the method of presentation provide you with any new insights? If so, what are they? If not, what suggestions might you make to your colleague that could improve his or her representation of the data? All initial and peer postings should be at least 250-500 words in APA format supported by scholarly sources. MHA610 Introduction to Biostatistics Assignments and DQs
Assignment
U.S. Mortality Rates. Due by Day 7. Examine the burden of disease in the United States to provide important information on which parameter is to base decisions on public health priorities.
To do this, we will utilize mortality data for the United States. In the first part of this assignment, you will download and examine mortality data for your home state.
Go to
Choose your home state under the Choose State option (panel on left hand side)
Select BOTH under the Choose gender option in the middle
Scroll down to the bottom of the page, and read the fine print to learn for which year the mortality data have been
Copy and paste the relevant mortality data into
Drag your mouse over all of the Cause of Death rows, (50 rows), right click, and select Copy,
Open Excel and paste your selection into Excel. You should have a spreadsheet with 50 row and 19 columns (Columns A-S).
For the first part of the assignment, you will prepare a histogram of the leading causes of death (regardless of age) in your state. Follow the steps below in order to prepare your histogram:
Sort the Data
The numbers of deaths, all ages, are given in Column
Select all the
Then, select Data>Sort>Sort by Column C, Values, largest to smallest. (Make sure that my data has headers is not
You now have the leading causes of death in your state in Column A (cause) and Column C (frequency).
If you already know how to draw a histogram in Excel, proceed to do so with Columns A and C, making sure to truncate the data to the 30 leading
If you do not know how to draw a histogram in Excel, here’s one method:
Choose the Chart Wizard, chart type column, chart sub-type clustered column (Step 1).
Click Next for Step
At Step 2, Click the Series button, which will open a new
Click Add under Series,
Enter Causes of Death in the Name box;
Clear the Values box, then
Drag your mouse over the 30 largest frequencies for the Values; and,
Drag your mouse over the first 30 causes of death (Column A) for the Category (X) axis labels box.
Click Next, and you’ll be brought to the Chart Options
Add a suitable title (e.g., Leading Causes of Death, 2010, your state)
Label the Y axis Frequency.
Click Next, and place the histogram in a new
You now have a histogram with the leading causes of death for your state. This presents one picture of the burden of disease in your state, but it isn’t the only picture. We shall now look at a different metric: years of life lost due to each cause.
To do this, we will assume that the average life span is 80 years, and we will calculate how many years of life are lost for each cause of death, according to the age at death.
Please note that the ages are in categories (0 – 14, 15 – 24, 25 – 34, …, 65 – 74, and 75+). For this exercise, we will assume that the average age of death is at the middlepoint of each of these intervals (eg., 7.5, 19.5, 29.5, …, 69.5, and 80 for the last age category respectively). For example, an individual death in the 15-24 (19.5) age group incurs equals 60.5 years of life lost (80-19.5 = 60.5).
To make this histogram, we will compute a new column of values, years of life lost for each cause of death. (This entails writing a simple formula in Excel for the calculation corresponding to the first row of data, then dragging the formula down that column. If you have never done this calculation before in Excel, consult the screencast for detailed instructions.)
Go back to the original Excel spreadsheet that contained your
Using the formula above, create a column that calculates the years of life lost.
Now, sort the data by the years of life lost column, in descending order, before drawing a histogram of the results.
Finally, create a histogram of the 30 leading causes of death, in decreasing order of years of life
Do not forget to label the y-axis and provide a title for the
You now have two histograms representing the burden of disease in your state. The first histogram orders the causes of death in terms of overall mortality, and the second orders causes of death in terms of years of life lost.
Create a report of your findings that contains both of the histograms. The report should be at least 250-500 words supported by scholarly resources and in APA format. Assume that your task is to assess and prioritize public health needs in your state, and you need to inform and persuade policy makers for improving the well-being of your state’s constituents. Describe which findings are most relevant for this.
You should also explain any methodological or data limitations that exist in either histogram. In particular, describe your conclusions would be altered if you were to refine your findings by reanalyzing mortality rates based on gender and race in addition to age. The assignment should be at least 500 words in APA format supported by scholarly sources.
Week Two
Course Content
To be completed during the second week of class
Overview
Activity Due Date Format Grading Percent
Game of Chance Day 3 (1st post) Discussion 4
Sex Ratios Day 7 Assignment 8
Weekly Learning Outcomes
This week students will
Calculate probabilities of events using fundamental notions and rules of probability
Apply the binomial distribution to discrete data
Apply the Poisson distribution to discrete data
Introduction
In Week One, you were introduced to some fundamentals of probability. You will continue your exploration of probability theory in Week Two, including Bayes theorem for determination of posterior probabilities on the basis of prior and marginal probabilities. You will examine properties and parameterization of the two basic discrete probability distributions, the binomial and the Poisson. You will begin to use the binomial and Poisson distributions for inferential procedures.
Required Resources
Text
Triola, M.M., & Triola, M.F. (2006). Biostatistics for the Biological and Health Sciences. Boston, Ma: Pearson Education, Inc.
Chapter 3: Probability
After reading the chapter, review your grasp of the material in Chapter 3 by solving the odd-numbered questions in the Review Exercises and the Cumulative Review Exercises at the end of Chapter 3. Solutions to these problems are given at the end of the
Chapter 4: Discrete Probability Distributions
After reading the chapter, review your grasp of the material in Chapter 4 by solving the odd-numbered questions in the Review Exercises and the Cumulative Review Exercises at the end of Chapter 4. Solutions to these problems are given at the end of the
Triola, M. M., & Triola M. F. (2006). [Student companion website].
Boston, MA: Pearson Education, Inc. Retrieved from:
Supplemental Material
Koziol, J. (2014). (2014). [PDF]. College of Health, Ashford University: San Diego, CA.
This document provides an example that will be used in the Game of Chance discussion for this
Website
Center for Disease Control. (2014). Retrieved from
This website houses the data that will be used for the Sex Ratios assignment for this
Recommended Resources
Multimedia
Koziol, J. (Producer). (2014). MHA610 Week 2 Assignment (Part 1) [Video file]. Retrieved from
Koziol, J. (Producer). (2014). MHA610 Week 2 Assignment (Part 2) [Video file]. Retrieved from
These screencasts help explain the Week Two
Discussion
Participate in the following discussion:
Game of Chance. 1st Post Due by Day 3. For this discussion, select a game of chance, explain it briefly if it is likely to be unfamiliar to your classmates, then calculate probabilities of various outcomes like winning or losing
in this game. For example, you might choose your state lottery, scratch card game, a card game like poker, or a dice game like Craps or Yahtzee, as your game of chance.
As illustration, read a lottery analysis in
Guided Response: Respond to at least two of your classmates who chose a different game of chance than you by Day 7 at 11:59PM. Did your colleague provide enough explanation of the game to allow you to understand the analysis? Was the analysis provided by your classmate correct? If so, what optimal strategy for playing that particular game was described? If not, what suggestions would you make to your colleague to amend any issues?
Assignment
Sex Ratios. Due by Day 7. The normal male to female live birth sex ratio ranges from about 1.03 to 1.07. The sex ratio is defined as the ratio of male births to female births. You might expect boy and girl births to be equally likely, but in fact, baby boys are somewhat more common than baby girls.
Higher sex ratios are thought to reflect prenatal sex selection, especially among cultures where sons are prized more heavily than daughters. We will review sex ratios in the United States as a whole, as well as in individual states, to determine whether sex ratios vary significantly among various ethnic and racial groups.
To do this analysis, we will utilize natality data for the United States, provided by the Centers for Disease Control.
In the first part of the assignment, we will look at sex ratios for your home state, over the time period 1995 to 2002, by race. To obtain this information:
Go the
Click on Births under the WONDER Online Databases to bring you to the Natality Information screen
On this screen, click Natality for 1995-2002.
On the following screen, click I Agree in order to agree to abide by the government rules for data use (primarily, concerning confidentiality).
This will bring us to the Natality, 1995-2002 Request
In the block Organize table layout, group results by year, followed by race, and then gender.
In the block Select maternal residence, choose your state.
You can leave blocks 3 through 6 at their default values (i.e., All).
Click Send.
A new screen will open, with data (births) tabulated by Year, Race, and Gender.
Click Export, click Save, and a text file named Natality, _1995-2002 .txt or something similar will be downloaded onto your computer.
We can now process the downloaded data in Excel.
Load the text file into Excel. This will probably open the Text Import
Accept the defaults, and you should have a spreadsheet with the natality data
We will need to edit the data slightly before calculating sex ratios and drawing graphs of the sex ratios. To do this:
Scroll down to the end of the spreadsheet, and delete the rows with the extraneous information about the dataset. (This starts on or about row )
You may also delete the columns with headings Year CodeRace Code, and Gender Code since we will not be using them, however this is not
Next, sort the data, in order to delete some extraneous rows. Select the remaining columns, choose Data > Sort, then sort by Race in ascending
Scroll down to the end of the worksheet, and delete all rows with blanks for Race.
We will now add a new column to the worksheet for
Go to the first blank column in the worksheet: this column should be immediately to the right of a column labeled Births.
In the first row of this column, type Ratios.
Now, we will calculate different proportions of births, using formulas in excel. It is important to use excel to do the calculation, because it will allow you to quickly complete all of the
First, calculate the ratio of female births to total births for the American Indian race (female births/total births).
Next, calculate the ratio of male births to total births for the American Indian race (male births/total births).
Finally, calculate the ratio of male births to female births (male births/total births)
If you don’t know how to do this calculation easily in Excel, please check out the screencast, which reviews
Once you have completed the first three cells in the ratio column, you can select them and copy
Select the remaining cells in the column and
You have now completed calculating all of the ratios, however, you may wish to double check to ensure that the formulas have adjusted for each
Once you have the Ratio column filled out, select that column, then Copy.
With the column still selected you want to select, click Paste Special and then Values. This will convert the formulas you entered to numbers, so they do not change when you do the next
Select all the columns, then Data>Sort>Notes in ascending order. We will be graphing the sex ratios for the years 1995 to 2002, by
Feel free to drop the two to four races that have the fewest numbers of births in your
Draw a line chart with markers with the year along the X-axis (we are looking at 1995 through 2002) and sex ratio along the Y-axis (with sex ratios typically between 1 and 1.1, though this may vary in your state).
If your version of excel has the Chart Wizard:
In step two of the Chart Wizard, choose the Series tab; in this window you’ll be adding all the information for the various
Under category (X) axis labels, drag your mouse over the cells 1995, 1996…
For values, draw your mouse over the seven successive sex ratios for the particular racial group you chose; in the name box, enter the racial group; do this for each of the groups you want to display.
Select Next when you have finished with all the racial groups, and you will be brought to the Chart Options
Here, you can customize your graph, with a title and X and Y axis labels (i.e., your state births, year, and sex ratio respectively).
Continue with Next, and finish the
If your version of excel does not have the Chart Wizard, you will need to do some reformatting of your data before you can create a line chart. It is good practice to create a new worksheet in order to preserve your original
Your data should mimic the way you want your line chart to look. In this case, you want to create horizontal labels for each of the years (1995 through 2002) and vertical labels for each of the races. It should follow this format:
Year 1 Year 2 Year 3
Race A Ratio for Race A in Year 1 Ratio for Race A in Year 2 Ratio for Race A in Year 3
Race B Ratio for Race B in Year 1 Ratio for Race B in Year 2 Ratio for Race B in Year 3
After you have reformatted your data, select all of the data, then select Insert, then Line, then Line with Markers.
You should now have a line chart with each race having its own line, the ratios on the Y- axis, and the years on the X-axis.
You may wish to modify the Y-axis by right-clicking on it. Your upper and lower values on the axis should be just above and below your highest and lowest ratio
In a Word document, paste the graph you created (or, alternatively, submit your Excel workbook along with the Word document) and describe your findings, making sure to:
Summarize the sex ratios for each of the racial
Explain whether the sex ratios are relatively constant through the 1995 to 2002 period for all of the racial groups or if there are trends?
Explain any racial groups that have noticeably higher or lower sex ratios than other
Explain the conclusions you are drawing from your
In the second part of this assignment, you will undertake some formal statistical procedures with the natality data. We will repeat the previous steps, with some slight modifications.
Return to the
Click on Births under the WONDER Online Databases to get to the Natality Information
Select Natality for 2007 – 2012.
On the next screen, click I Agree in order to agree to abide by the government rules for data use (primarily, concerning confidentiality).
This will bring us to the Natality, 2007-2012 Request
In block Organize table layout, group results by race and then gender (not year).
In block Select maternal residence, choose your state.
You can leave block 3 at its default values (typically, All).
In block Select birth characteristics; select All Years under Year, and 1st child born alive to mother under Live Birth Order.
Blocks 5 and 6 can be left at their default
Click Send. A new screen will open, with data (births) tabulated by race and
Click Export, click Save, and a text file named Natality 2007-2012.txt (or something similar) will be downloaded onto your computer.
We have only four racial groups in this dataset: American Indians or Alaska Natives, Asian or Pacific Islanders, Black or African Americans, and Whites.
Using the normal approximation to the binomial distribution (without continuity correction), calculate z statistics for assessing whether the proportion of boys is .51 in each of the 4 racial groups, where n is the total number of births in a particular cohort, p = .51, q = 1 – p = .49, and x is the number of boy births; z = ((x – np) / sqrt(npq) ).
Under the null hypothesis that the proportion of boys should be 0.51, and under the normal approximation to the binomial distribution, the z statistics should have (approximately) standard normal distributions, (mean 0, standard deviation 1). Do any of the z statistics suggest that the proportion of boy births in any particular racial group differs significantly from .51?
Comment on your findings in your written report. Describe whether you think your results would change if we hadn’t limited consideration to the first-born. This assignment should be at least 250-500 words in APA format supported by scholarly sources.
Week Three
Course Content
To be completed during the third week of class
Overview
Activity Due Date Format Grading Percent
Confidence Intervals Day 3 (1st post) Discussion 4
Week Three Quiz Day 6 Quiz 8
Immune Responses Day 7 Assignment 8
Weekly Learning Outcomes
This week students will
Apply the normal distribution to continuous data
Explain the use of statistical estimators in practice.
Construct confidence intervals for sample
Introduction
In Week Two, you examined two fundamental discrete probability distributions, the binomial and the Poisson. In this week, you will be introduced to the fundamental continuous probability distribution, the normal or Gaussian. You will learn how the normal distribution is parameterized by the mean and the variance, and how to undertake probability calculations based on the normal distribution. You will be introduced to the central limit theorem, and how it relates to the normal distribution.
You will also learn about sampling distributions (especially, the t distribution), and properties of estimators. Estimation is a key concept in statistics, and you will learn how to construct confidence intervals for sample estimators. You will learn about planning of experiments, for which sample size and power are fundamental notions.
Required Resources
Text
Triola, M.M., & Triola, M.F. (2006). Biostatistics for the Biological and Health Sciences. Boston, Ma: Pearson Education, Inc.
Chapter 5: Normal Probability
After reading the chapter, review your grasp of the material in Chapter 5 by solving the odd- numbered questions in the Review Exercises and the Cumulative Review Exercises at the end of Chapter 5. Solutions to these problems are given at the end of the
Chapter 6: Estimates and Sample Sizes with One
Review your grasp of the material in Chapter 6 by solving the odd-numbered questions in the Review Exercises and the Cumulative Review Exercises at the end of Chapter 6. Solutions to these problems are given at the end of the
Triola, M. M., & Triola M. F. (2006). [Student companion website].
Boston, MA: Pearson Education, Inc. Retrieved from:
Supplemental Materials
Koziol, J. (2014). MHA610_Week 3_Assignment_Data [Excel file].
Koziol, J. (2014). MHA610_Week 3_Assignment_Data [Statdisk file].
Recommended Resources
Multimedia
Koziol, J. (Producer). (2014). MHA610 Week 3 Assignment (Part 1) [Video file]. Retrieved from
Koziol, J. (Producer). (2014). MHA610 Week 3 Assignment (Part 2) [Video file]. Retrieved from
These screencasts help explain the Week Three
Discussion
Participate in the following discussion:
Confidence Intervals. 1st Post Due by Day 3. In this discussion, we will investigate confidence intervals for binomial probabilities. The discussion is in two parts.
Return to the data you had generated in the second part of the Week Two assignment. You should have total numbers of first-born boys and girls in your state between the years 2007 and 2012 separately by racial group: American Indians or Alaska Natives, Asian or Pacific Islanders, Black or African Americans, and Whites. For the first part of this discussion, construct and report the 95% confidence intervals for the proportions of first-born boys, separately for each racial group. (Use the normal approximation to the binomial distribution.) Comment on the confidence intervals: can you infer from the confidence intervals that the proportions of first-born boys differ among the racial groups? Explain what the widths of the confidence intervals tell
Leading up to elections, you often hear results of polls of voters’ preferences, with statements such as: “This poll was taken from a random sample of 600 potential voters, and has an accuracy exceeding 96%.” You may want to interpret the accuracy statement in terms of “margin of error”, as explained in the text, Section 6-2. Remember, the width of a confidence interval is a measure of the precision of the estimate
Guided Response: Respond to at least two of your peers by Day 7, 11:59PM. Consider the 95% confidence intervals your colleague pre