NR305 Full Course all discussions

NR305 Full Course all discussions, Assignments and course
project
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NR305 Full Course all discussions, Assignments and course project
Devry NR305 Week 1 Discussion DQ 1 & DQ 2
DQ 1
As the school nurse working in a college health clinic, you see many opportunities to promote
health. Maria is a 40-year-old Hispanic woman who is in her second year of nursing school. She
complains of a 14-pound weight gain since starting school and is afraid of what this will do to
both her appearance and health if the trend continues. After doing her history, you learn that she
is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage.
She is married with two school-age children. She is in class a total of 15 hours per week, plus 12
hours of labs and clinical. She maintains the household essentially by herself and does all the
shopping, cooking, cleaning, and chauffeuring of the children. She states that she is lucky to get
six hours of sleep per night, but that is okay with her. She lives one hour from campus and
commutes each day. Using.healthypeople.gov/”>Healthy People 2020and your text as a guide:
1. What additional information would you like to gather from Maria?
2. What are Maria’s real and potential health risks?
3. Why is Maria’s culture important when obtaining the health assessment?
4. Pick one of Maria’s health risks. Would you classify Maria’s problem as firstlevel
priority, second-level priority, third-level priority, or a collaborative
problem? What would be one reasonable short-term goal for this risk?
DQ 2

Understanding cultural phenomena is essential to the completion of an accurate and holistic
health assessment. Please review a cultural group from Table 2-3 (p. 20) from your text and
describe the cultural differences pertinent to that group (you may have to do some additional
searching). Remember, the table may not include all cultural groups. Let’s try to include all the
countries within the groups listed in the discussion, so please do not choose a group that has
already been done. To expedite this, please use the group name in the title of your post.
Devry NR305 Week 2 Discussion DQ 1 & DQ 2
DQ 1
John, a 46-year-old African American male presents for admission to your hospital for hemi
colectomy for colon polyps. He is complaining of chronic back pain. Patient is on disability from
work-related injury. History of two previous back surgeries with relief of numbness in RLE, but
pain has not been relieved. His current medications include Methadone, Neurontin, and Norco.
John states he takes Tylenol PM every night in addition to his prescribed medications. John is a
smoker and smokes 1 PPD. John confides in you that he is considering a spinal cord stimulator
for the chronic pain.
What risk factors does John have for risk of opioid withdrawal during this
hospitalization?
Is there a stigma connected to being disabled and/or methadone?
Does the nurse need to be concerned about acetaminophen use?
What are the differences in acute and chronic pain?
DQ 2

Red Yoder is an 80-year-old farmer who lives alone in the farmhouse where he grew up. It is
located 20 miles outside of town. Red has been a widower for 10 years. Red rarely cooks for
himself and mainly eats packaged or processed foods. His son, Jon, manages the farm now, but
Red is still involved in the decision making. Red’s current medical problems include insulindependent
diabetes complicated by an open foot wound. He also has some incontinence and
difficulty sleeping.
Red is awaiting a visit from the home health nurses. He relates that he has an open wound on his
big toe that developed after walking in a new pair of shoes. When his daughter-in-law, Judy, saw
the wound, she called the family doctor, who suggested a visit by the wound care nurse, who
works with the home health agency. Red agreed as long as his VA benefits cover the costs. Red
is aware that his son and daughter-in-law have concerns about him living alone, but Red insists
that while he needs a little help from Jon and Judy at times, he is still capable of caring for
himself.
What are Red’s strengths?
What are your concerns for this patient?
What is the cause of your concern?
What information do you need?
What are you going to do about it?
What is Red experiencing?
Devry NR305 Week 3 Discussion DQ 1 & DQ 2
DQ 1
General Survey and Health History (graded)
Casey is a 17-year-old high school student admitted to the ER with a compound fracture of the
left leg obtained when falling at the local skateboard park while practicing for a national
competition. He has never been hospitalized before. His mother has been notified and is on her
way. The EMTs gave him morphine and he reports his pain level as “okay.”
What part of the interview and examination can be done prior to his mother’s arrival?

As you enter the room for the first time, what should you observe as part of the general
survey?
As you complete his history, what areas are especially important?
What are the important developmental considerations for Casey?
DQ 2
As you recall, our older patient, Red Yoder, with whom you met in Week 2, is preparing for
discharge from the hospital since his wound required intravenous antibiotics and wound care. Jon
(Red’s son) thinks that Red should move in with him for now, but Red is sure he is able to care
for himself and insists that his confusion was due to the fact that he did not have his glasses or
hearing aids for the last week. You have identified discharge teaching needs for him. This
morning, however, in report the night nurse has shared “Patient is alert and oriented; vital signs
stable. Fasting blood sugar this morning is 118. Red had his usual night of sleep. He was up
several times to go to the bathroom. Since his catheter was removed yesterday, he has urgency
incontinence. He is able to ambulate to the bathroom, but he is weak.” You administer his AM
medications and note that he has some difficulty grasping the water cup and needs assistance
holding it. Mr. Yoder states he needs to go to the bathroom and when you assist him up to his
feet, he seems a bit unsteady. He takes several steps and tells you he needs to sit down.
How much, if any, functional decline has occurred while Red was hospitalized and how
will this affect his recovery?
What are the risks and benefits of Red living with Jon and Judy?
What are the risks or benefits of Red living at home after discharge? If services are in
place, would it be considered a safe discharge?
Considering all aspects of aging, what are the best and appropriate options for Red at this
time?
Devry NR305 Week 4 Discussion DQ 1 & DQ 2
DQ 1

William Smaile is a 65-year-old man who presents to his general practitioner’s office with
complaint of right forearm swelling, redness, and pain. He was recently discharged from the
hospital where he had been receiving intravenous antibiotics for a respiratory infection.
Subjective Data
Pain level is a 5/10 location = right forearm, aching
Retired foreman at a local industrial plant
Objective Data
Vital signs: BP 150/68, T 37 degrees Centigrade, P 80, R 16
Swelling and reddened right forearm, warm to touch
+ pulses, brachial and radial (R)
+2 capillary refill fingers right hand
1. What other assessments should be included for this patient?
2. From your readings, what is the most probable cause of the swelling?
3. What is your nursing diagnosis?
4. What would be included in the nursing care plan?
5. What interventions might be included in the plan of care for this patient?
DQ 2
Assessment of the Head, Neck, and Regional Lymphatics (graded)
Describe the characteristics of the lymph nodes associated with the disease states listed below:
(Choose one.)
Acute infection
Chronic inflammation
Cancer

week 5
DQ 1
Kevin Valeri is a 64-year-old man who presents to the gastroenterologist’s office with
constipation and abdominal bloating.
Subjective Data
Pain level is a 4/10 location = right lower abdomen
Retired Engineer
States he has been going to the bathroom with the help of laxatives, but not having
regular movements
Appetite is decreased, some nausea
PMH: depression, anxiety, chronic constipation
Objective Data
Vital signs: T 37 degrees Centigrade, P 64, R 16, BP 124/58
Bowel sounds hypoactive in all four quadrants
Medications: Lamictal 200mg daily, Lexapro 10 mg daily
DQ 2
Weight = 210 lbs, last visit weight = 195
1. What other assessments should be included for this patient?
2. What questions should the nurse ask with regard to the abdominal pain?
3. From the readings, subjective data, and objective data, what is the most probable cause of
the abdominal pain?
4. What should be included in the plan of care?
5. What interventions should be included in the plan of care for this patient?
Choose one topic and respond:

Discuss three ways of creating an environment that provides psychological comfort for
both patient and practitioner when conducting an examination and assessment of the
Genitourinary system.
Discuss medications that can affect the sexual performance of an aging adult male,
possibly resulting in withdrawal from sexual activity.
Discuss circumcision and the arguments for and against it. Discuss its associated
religious connections.
week 6
DQ 1
Georgina Graves is a 42-year-old female who presents to the provider’s office with fatigue.
Subjective Data
PMH: none, (except gynecological issues)
Significant family history of heart disease
Fatigue started about 2 months ago, getting worse
Relieved with rest, exacerbated with activity
Denies chest pain
C/O shortness of breath on exertion
Smoker 1 PPD
Objective Data
Vital signs: T 37 P 100 R 18 BP 110/54
Lungs: clear
O2 Sat = 94%
Skin = cool to touch

CV = heart rate regular, positive peripheral pulses, ECG = intermittent complete left
bundle branch block (New Finding)
Edema
Medications: Premarin 0.3 mg po/day
1. What other questions should the nurse ask about the fatigue?
2. What other assessments would be necessary for this patient?
3. What are some causes of fatigue?
4. What should be included in the plan of care?
5. Based on the readings, what is the most likely cause of fatigue for this patient?
DQ 2
Nelson Carson is a 62-year-old man who presents to his private practitioner’s office with a
hacking, raspy cough.
Subjective Data
PMH: HTN, CAD
Cough is productive, bringing up green, thick phlegm
Runny nose, sore throat
No history of smoking or seasonal allergies
Complains of fatigue
Objective Data
Vital signs: T 37 P 72 R 14 BP 134/64
Lungs: + Rhonchi bilateral upper lobes, wheezes
O2 Sat = 98%
Medications: Metoprolol 25 mg per day, ASA 325 mg/daily

1. What other questions should the nurse ask about the cough?
2. What nursing diagnoses can be derived from the data?
3. What should be included in the plan of care?
4. What risk factors are associated with this age group?
5. Based on the readings, what is the most likely cause of cough for this patient?
6.
week 7
DQ 1
Jonah Kotter is a 5-year-old male preschooler who presents to the pediatrician’s office for
complaints that his leg “hurts”.
Subjective Data
PMH negative
Immunizations: Up to date
No medications
No allergies
Pain: 3/5 on pain scale
Attends Kindergarten
Does not remember injuring leg
Objective Data
Vital signs: T 37 degrees Centigrade, P 94, R 18, BP 100/70
Lungs: clear
Heart rate and rhythm regular
Moving all extremities

+ Range of motion legs and arms
Strength 5/5 in all extremities
1. What other questions should the nurse ask?
2. What techniques are helpful to incorporate in assessing a patient in this age group?
3. What are a few of the major differences in the musculoskeletal assessment of a child?
4. What should be included in the plan of care?
5. Based on the readings, what is the most likely cause of leg pain for this patient?
DQ 2
Read the case study below and respond to two of the questions below. Make sure you respond to
a classmate as well, before the week ends.
Katherine Trembly is a 67-year-old woman who presents to the neurologist’s office after referral
from her PCP (primary care provider) for a seizure.
Subjective Data
PMH: Seizure, hypertension, anxiety
Retired book keeper
C/o being “tired”
Periods of unresponsiveness to verbal stimuli
Objective Data
Vital signs: T 37 degrees Centigrade, P 80, R 18, BP 174/84
Lungs: clear
O2 Sat = 98%
Heart rate regular, + peripheral pulses
1. What other questions should the nurse ask?

2. What techniques are helpful to incorporate in assessing a patient in this age group?
week 8
3. What are some of the more common conditions that may cause seizure activity in this age
group?
4. What diagnostic tools will the physician use to diagnose this condition?
5. What should be included in the plan of care?
Discussion 1
Give an example of a rapid assessment of a client and provide a SBAR report to a classmate.
Remember to include all concepts of patient safety, standard precautions, and professional
standards.
OR
Finish the story on our subject, Mr. Red Yoder, who is a patient you met in Week 2 and wrote a
teaching plan on. What do you think his status might be today? Remember to include all
concepts of patient safety, standard precautions, and professional standards.
week 2
Discharge Teaching Plan Form
Your Name: Date:
Your Instructor’s Name:
Purpose:The focus of this assignment is identifying patient’s needs and analysis and synthesis of
details within the written client record and planning an appropriate discharge plan with necessary
patient teaching of the disease process.
Points:This assignment is worth a total of 100 points.
Directions: Please refer to the Discharge Teaching Plan Guidelines found in Doc Sharing for
details about how to complete this form. Remember there is a 6 page maximum limit on this
assignment.

Type your answers on this form. Click “Save as” and save the file with the assignment name and
your last name, e.g., “NR305_Discharge_Teaching_ Plan_Form_Smith” When you are finished,
submit the form to the Teaching Plan Dropbox by the deadline indicated in your guidelines. Post
questions in the Q&A Forum or contact your instructor if you have questions about this
assignment.
Look at the EXAMPLE in the first assessment area. This is NOT an all-inclusive response and
you will need to add your responses as well. Please be sure to review your guidelines.
Assessment area
Example:Special/age
related needs
Need(s)
identified.
These are
some ideas,
there may be
others that
you identify.·
Age, lives
alone, is noncompliant
with
diet.· Expected
aging changes
such as
decreased
hearing, visual
difficulties.
· Red appears
to
notunderstand
his glucose
numbers and
how that
relates to his
diet and
insulin
administration.
· Home health
nurse to assist
Red and
Teaching
technique or
approach to Rationale for choosing
problem this technique/approach.
identified.Describe
content.
Ideas for teaching
methods/approach
based on the
scenario and
problems noted.
You may have
identified others.·
Teach importance
of diet and insulin
management to Red
and family and how
to better manage his
diabetes.· Use
videos, audio and
teach back
methods. It may
even be helpful to
assure proper
reading of the
glucometer and
administration of
the insulin by Red
or his family.
Provide a brief rationale
on why you chose these
particular
technique/approaches.For
example, Red may have
poor eyesight due to the
diabetes and needs audio
and demonstration with
return demonstration. He
may not be able to see the
lines on the insulin syringe.

family in
proper insulin
management
and
administration
Cognitive issues
Physical barriers
Medications
Nutrition
Roles and
Relationships
Self-concept
Wound care
Resources/ referrals
needed
week 3
Family Genetic History Form
YourName: Date:
Your Instructor’s Name:
Purpose: This assignment is to help you gain insight regarding the influence of genetics on an
individual’s health and risk for disease. You are to obtain a family genetic history on a willing,
nonrelated, adult participant.
Disclaimer:When taking a family genetic history on an actual client, it is essential that the
information is accurate. Please inform the person you are interviewing that they do NOT need to
disclose information that they wish to keep confidential. If the adult participant decides not to
share information, please write, “Does not want to disclose.”
Directions: Refer to the Family Genetic History guidelines and grading rubric found in Doc
Sharing to complete the information below. This assignment is worth 100 points.
Type your answers on this form. Click “Save as” and save the file with the assignment name and
your last name, e.g., “NR305_Family_Genetic_History_Form_Smith”.When you are finished,
submit theform to theFamily Genetic History Dropbox by the deadline indicated in your

guidelines. Post questions in the Q&A Forum or contact your instructor if you have questions
about this assignment.
1: Family Genetic History (35 points):
Develop a family genetic history that includes,at a minimum, three generations of your chosen
adult’s family, including grandparents, parents, and the adult’s generation. If the adult has any
children, include them as the fourth generation. **PLEASE NOTE: This assignment is to reveal
the potential impact of the family’s health on the adult participant. You do not need to identify
anyone who is not biologically related to the adult except for a spouse or significant other.
You do not need to use symbols, but instead write brief descriptions for each person. Each
description should include the following information: first name, birthdate, death date,
occupation, education, primary language, and a health summary, including any medical
diagnoses. An example is below:
Family Member Description
Paternal
grandfatherFirst RL
and last initials:
Birthdate: 1921
Death date: 1981
Retired as a
Occupation:
coal miner
Education: 6 th grade
Primary
English
language:
He was
diagnosed
with chronic
lung disease,
Health summary: diabetes, and
hypertension.
He died from
a heart
attack.
Paternal
grandmotherFirst ML
and last initials:
Birthdate: 1932
Death date: 1998
Occupation: House wife
Does not
Education: want to
disclose

Primary
language:
Health summary:
English
Diagnosed
with chronic
lung disease
from
smoking
cigarettes.
Died from
heart failure.
This example points to common problems among this generation on both sides of the family.
Consider the implications this would have for the adult participant’shealth if these were that
person’s family members.
Complete the family genetic history form below. Indicate if any information is N/A (not
applicable) or unknown. Indicate any information the person did not want to disclose by noting
“Does not want to disclose.”
Family Member Description
Paternal
grandfatherFirst
and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
Paternal
grandmotherFirst
and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
FatherFirst and
last initials:
Birthdate:
Death date:

Occupation:
Education:
Primary
language:
Health summary:
Father’s siblings
(write a brief
summary of any
significant health
issues)
Maternal
grandfatherFirst
and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
Maternal
grandmotherFirst
and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
MotherFirst and
last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
Mother’s siblings
(write a brief
summary of any
significant health
issues)

Adult
ParticipantFirst
and last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
Adult
participant’s
siblings (write a
brief summary of
any significant
health issues)
Adult
participant’s
spouse/significant
otherFirst and last
initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
Adult
participant’s
children (write a
summary for each
child, up to four
children)Child #1
first and last
initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
Child #2 first and

last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
Child #3 first and
last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
Child #4 first and
last initials:
Birthdate:
Death date:
Occupation:
Education:
Primary
language:
Health summary:
2. 2. Evaluation of family genetic history (25 points)
Evaluate the impact of thefamily’s genetic history on your adult participant’s health. For
example, if the adult participant’s mother and both sisters have diabetes, hypertension, or
cancer, what might that mean for the adult participant’s future health?
3. 3. Planning for future wellness (35 points)
Plan changes based on the evaluation of the adult participant’sfamily’s health history that will
promote an optimal level of wellness both now and in the future. Include what information you
would provide to the adult participant regarding the results of the family genetic history.
week 4

Course Project Milestone #1: Health History Form
Your Name: Date:
Your Instructor’s Name:
Directions: Refer to the Milestone 1: Health History guidelines and grading rubric found in Doc
Sharing to complete the information below. This assignment is worth 175 points, with 5 points
awarded for clarity of writing, which means the use of proper grammar, spelling, and medical
language.
Type your answers on this form. Click “Save as” and save the file with the assignment name and
your last name, e.g., “NR305_Milestone1_Form_Smith”. When you are finished, submit the form
to the Milestone #1 Dropbox by the deadline indicated in your guidelines. Post questions in the
Q&A Forum or contact your instructor if you have questions about this assignment.
Disclaimer:The focus of this assignment is on communicating details within the written client
record. When taking a health history on an actual client, it is essential that the information is
accurate. Please inform the person you are interviewing that they do NOT need to disclose
information that they wish to keep confidential. If the interviewee decides not to share
information, please write, “Does not want to disclose.”
BIOGRAPHICAL
DATA (10 pts)
Date:
Initials:
Age:
Date of birth:
Birthplace:
Gender:
Marital status:
Race:
Religion:
Occupation:
Health insurance:
Source of information:
Reliability of source
of information:
PRESENT HEALTH
HISTORY/ILLNESS
(15 pts)

Reason for seeking
care:
Health patterns:
Health goals:
HEALTH BELIEFS
AND PRACTICES
(15 pts)
Beliefs and practices:
Factors influencing
healthcare decisions:
Related traits, habits
or acts:
MEDICATIONS (15
pts) (Please refer to
your assignment
guidelines.)
Prescription
medications:
Over-the-counter
medications:
Herbals:
PAST HISTORY (15
pts)
Childhood diseases:
Immunizations:
Allergies:
Blood transfusions:
Major illnesses:
Injuries:
Hospitalizations:
Labor and deliveries:
Surgeries:
Use of alcohol:
Use of tobacco:
Use of illicit drugs:
EMOTIONAL
HISTORY (15 pts)
Mental, emotional or
psychiatric problems:
FAMILY HISTORY
(15 pts)
Father:
Mother:

Siblings:
Grandparents:
PSYCHOSOCIAL/
OCCUPATIONAL
HISTORY (15 pts)
Occupational history:
Educational level:
Financial background:
ROLES AND
RELATIONSHIPS
(15 pts)
Significant others:
Support systems:
ETHNICITY AND
CULTURE (10 pts)
Ethnicity and culture:
Physical and social
characteristics that
influence healthcare
decisions:
SPIRITUALITY (5
pts)
Religious and spiritual
needs:
SELF-CONCEPT (5
pts)
View of self-worth:
Future plans:
REVIEW OF
SYSTEMS (20
pts)(Please refer to
your assignment
guidelines and
chapter 4 of your
text. This is NOT a
physical assessment.)
Skin, hair, nails:
Head, neck, related
lymphatics:
Eyes:
Ears, nose, mouth, and
throat:
Respiratory:
Breasts and axillae:

Cardiovascular:
Peripheral vascular:
Abdomen:
Urinary:
Reproductive:
Musculoskeletal:
Neurologic:
week 6
Course Project Milestone #2: Nursing Diagnosis and Plan of Care Form
YourName: Date:
Your Instructor’s Name:
Directions: Refer to the Milestone 2: Guidelines found in Doc Sharing to complete the
information below. This assignment is worth 250 points, with 10 points awarded for clarity of
writing, which means the use of proper grammar, spelling, and medical language.
Type your answers on this form. Click “Save as” and save the file with the assignment name and
your last name, e.g., “NR305_Milestone2_Form_Smith”.When you are finished, submit theform
to the Milestone 2 Dropbox by the deadline indicated in your guidelines. Post questions in the
Q&A Forum or contact your instructor if you have questions about this assignment.
1: Analyze Assessment Data:
Based on the health history information, identify the following:
1. A. Areas for focused assessment (30 points)
Provide a brief overview of those areas of strength and weakness noted from Milestone 1:
Health History.
1. B. Client’s strengths (30 points)
Expand on areas identified as strengths related to the person’s overall health. Support your
conclusions with data from the textbook.
1. C. Areas of concern (30 points)
Expand on areas previously identified as abnormal and those that place the person at a health
risk. Support your observations with data from the textbook.

1. D. Health teaching topics (30 points)
Identify health education needs. Support your statements with facts from the Health History and
information from your textbook.
2: Nursing Plan of Care
Next, plan your care based on your analysis of your assessment data:
1. A. Diagnosis (30 points)
Write one nursing diagnosis that reflects a priority need for this person. Remember a health
promotion diagnosis is a possibility.
1. B. Plan (30 points)
Write one goal and one measurable expected outcome related to your nursing diagnosis. Explain
why this goal and outcome is a priority. Include cultural considerations for this client.
1. C. Intervention (30 points)
Write as many nursing orders, or nursing interventions, that you need in order to achieve the
outcome. Provide the rationale for each intervention listed.
1. D. Evaluation (30 points)
You will not carry out your care plan so you cannot evaluate the effectiveness of your nursing
interventions. Instead, comment on what you would look for in order to evaluate your
effectiveness.