NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)

Chamberlain University NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)-Step-By-Step Guide

This guide will demonstrate how to complete the Chamberlain University NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)                  

Whether one passes or fails an academic assignment such as the Chamberlain University NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)                  

The introduction for the Chamberlain University NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded) is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)                  

After the introduction, move into the main part of the NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)  assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)                  

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)                  

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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NR305 Week 4 iHuman Nurse Notes Template 

Sample Answer for NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded) Included After Question

Week 4 Neurovascular Assessment: Athena Washington

1. Complete each item below:  

Situation

• Ms. Athena Washington, a 48-year old African American female with a history of hypercholesterolemia and hypertension presents to the ER with stroke-like symptoms. As reported by her husband (informant), yesterday at 1830hrs, she had a severe headache, she took tylenol and slept. At 0500hrs, she woke up with disorientation, left-sided weakness, and slurred speech. Ms. Athena has a full code status, and condition is critical.  

Background

• Ms. Athena Washington has hypercholesterolemia and poorly controlled hypertension. She takes the following medications; acetaminophen 650mg PO PRN for pain, metoprolol 50mg PO BID, and simvastatin 40mg PO nocte. Ms. Athena has an uptodate immunization status, she lives with her husband, and has no known allergies.  She has two children; the eldest daughter has type 1 diabetes mellitus, and the youngest son is alive with no medical issues.

Assessment

BP: 180/110mmHg

Pulse: 110bpm

RR: 24 breaths/cycle

Temp: 37.00c

HEENT: Head: atraumatic, normocephalic, no lesions, bruising, or palpable masses. Ears: hearing bilaterally intact, no fluid or inflammation in external auditory canal, TM intact. Eyes: PERRLA. Nose & Throat:

Cardiovascular: S1 & S2 heard, no JVD, capillary refill <3 seconds, no murmurs, rubs, gallop rhythm, or bruits, pulses 2+ in the radial, brachial, pedal, and femoral, no peripheral or facial edema noted, PR 110 (tachycardia)

Respiratory: chest moves symmetrically with respiration, no use of accessory muscles, no abnormal retractions, no crackles, rhonchi, or wheeze auscultate. Chest is bilaterally clear on auscultation.

Gastrointestinal: flat abdomen, no scars, lesions, or protruding masses, normoactive bowel sounds on all quadrants, no guarding, tenderness or rebound tenderness.

Musculoskeletal: right extremities strength 5/5, left extremities strength 2/5, leg raise LLE up to 30⁰ and patient unable to maintain in the air, RLE-no drift, right hand grip 5/5, left hand grip patient unable to perform.

CNS: AOX2 (self, husband, and place), sensation is intact, patient unable to swallow, gag reflex is present, patient can only shrug right shoulders, patient has tongue deviation, left-sided facial droop and unable to provide a symmetrical smile, sensory sensation is intact. NIH stroke score-11, Head CT scan demonstrates an acute right cerebellar infarct.

Integumentary: skin color is consistent with ethnicity, normal skin turgor, no lesions, wounds, swellings, or bruises

Recommendation

• Patient to stay NPO until she undergoes a swallow study by a speech/language pathologist
• Conduct NIH stroke evaluation Qhourly
• Occupational therapy for Activities of Daily Living (ADLs)
• Patient to undergo speech therapy
• Consult cardio for hypertension (HTN)
• Strictly monitoring of I/O, continuous telemetry and pulse oximetry.
• Monitor vitals q15
• Consult neuro for stroke
• Elevate HOB at 30 degrees
• The patient’s and patient’s family current status is likely associated with anxiety, depression, and lack of control. Therefore, she will also need the intervention of a psychotherapist.
• Gradual administration of the prescribed antihypertensives to gradually lower blood pressure.
• Teach the patient and her family the need for medication adherence
• Ask for and identify any existing knowledge gaps and address them.
• Identify two other healthcare team professionals with whom you would collaborate when caring for Ms. Washington.  
• Speech/ language therapist
• Physical therapist
• In a one paragraph response, what findings in your iHuman assessment led you to select these two providers?

Stroke patients often experience problems in communication, and motor loss/ control of movement resulting from hemiplegia (Le Danseur, 2020). Similarly, the patient Athena Washington presented with a history of slurred speech, inability to swallow, left-sided weakness with limitations in movement, which are stroke symptoms. To support this history, the physical exam was significant for dysarthria, left sided facial droop, a failed swallow screen, left leg and arm weakness, and other cranial nerve deficits. In order to improve Athena’s overall quality of Life (QoL), she will need further evaluation and management by a speech/language therapist, and physical therapist.

The role each of the two identified healthcare professionals

Generally, the roles of the speech and physical/occupational therapist will be to assist Ms. Athena become as independent as possible and improve her overall quality of life (QoL). This will happen in a way that motivates and preserves the dignity of Ms. Athena to relearn basic skills. The speech/language therapist will work closely with the patient and her family to further assess her speech, cognitive communication, language, voice, and ability to swallow. He/she will then develop Athena’s individualized management plan to help her attain the highest level of language and communication possible (Gerstenecker & Lazar, 2019). This plan will include determining whether Ms. Athena can take medications orally, and the appropriate diet. The physical therapist will assess Ms. Athena’s problems with movement and balance and recommend muscle strengthening exercises to stand, walk, among other movement activities.

References

Gerstenecker, A., & Lazar, R. M. (2019). Language recovery following stroke. The Clinical Neuropsychologist, 33(5), 928-947. https://doi.org/10.1080%2F13854046.2018.1562093

Le Danseur, M. (2020). Stroke rehabilitation. Critical Care Nursing Clinics, 32(1), 97-108. https://doi.org/10.1016/j.cnc.2019.11.004

A Sample Answer For the Assignment: NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)

Title:  NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)

This simulation was very familiar to me because I used to work in a Med-Surg ICU where the nurses were required to float to the stroke unit. For me, going through Mrs. Washington’s history and pulling out the necessary information was fairly straightforward. I was looking for Mrs. Washington’s last well-known time, what symptoms she had, what had she taken, and what happened after the event. I then looked through the meds, read what the husband reported to the nurse, and what the doctor’s conclusions were to try and paint a picture (so to speak) of what was going on with Mrs. Washington. I took all this information into the history questions and the physical assessment so that I knew exactly where to focus.

So, it has been a while since I floated to a stroke floor because I left the ICU about two years ago, and apparently my skills were a little rusty. During the history questions, I was lost as to what to ask Mrs. Washington because a lot of the information was already gathered. I struggled to figure out what the simulation was wanting me to ask her. Then going into the physical assessment, I completely forgot about all the cranial nerves until I had already completed like 40 unnecessary assessments. (facepalm!) I had to quickly use the last few allotted assessments to gather what information I could. In a real situation, I would have just gone back into the room (if I had left already) and completed the assessments I’d forgotten. I would have apologized to Mrs. Washington for the inconvenience but would have explained to her the importance of completing these necessary assessments.

The learning aspects for me that have been a common theme throughout all the simulations is that even as a nurse it is okay to make mistakes, it is okay to go back and do the assessment again, and it is okay to really lean into my nursing judgment and use my license. Now, making mistakes needs to be taken with a grain of salt. I’m not talking about medication or surgical mistakes. I mean the kind like I dropped the bedpan on the floor, I forgot to order a lunch tray, etc. Repeating or redoing an assessment, yes, can be an inconvenience, but my patient’s safety comes first – over inconvenience, over pride, over a non-compliant patient. I have the ability, as a nurse, to make decisions that will not only help my patients but ensure their safety and well-being while in my care. These simulations have really reinforced that ideal for me.

A Sample Answer 2 For the Assignment: NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)

Title:  NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)

I feel that everything went better for me with this simulation.  I was better at asking questions that were appropriate for this scenario and patient.  I still missed some questions but overall, I improved greatly.  I felt confident in performing the dysphagia screening and the NIHSS because I perform them often in my job as an ICU nurse.  I also felt knowledgeable in the treatment that this patient would require.  This scenario was very realistic and felt like something I would encounter on my job.

I need to decrease the number of extra but unnecessary assessments that I perform.  I have a tendency to want to do a full assessment as I would at work.  This is the biggest area I need to improve on.  The other area I still need to work on is still my questions.  I still want to ask a lot of questions.  I was not surprised by any of the feedback, and I find it valuable.

This scenario reinforced the importance of timely treatment of a stroke and how important the last known well time is in this treatment.  Unfortunately, we do not always have that data as many patients wake up with their stroke symptoms.  With the patients that we are able to administer TPA, we do see a great improvement in the disabilities, and it is pretty amazing to watch the improvement as you do your hourly neuro assessments.  It also reinforced the need for discharge planning involvement from the beginning of the patients’ admission.

Purpose

The purpose of this assignment is for learners to demonstrate completing a neurovascular assessment on a virtual patient.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

• CO 1: Demonstrate a head to toe physical assessment. (PO 1)
• CO 2: Differentiate between normal and abnormal health assessment findings. (PO 4)
• CO 4: Demonstrate effective communication skills during health assessment and documentation. (PO 3)
• CO 5: Identify collaborative opportunities for health promotion, risk reduction, and disease prevention. (POs 1, 2)
• CO 6: Demonstrate professional behavior and caring during patient interactions. (POs 6, 7)

Due Date

Sunday 11:59 p.m. MT at the end of Week 4

Total Points Possible

This assignment is worth 150 points.

• 100 points – Case Completion
• 50 points – Nurse Notes Responses

Late Assignment Policy

If the assignment is not submitted by due date, a late deduction will be applied. See rubric below.

Directions

1. Access the Athena Washington case assignment by locating the case in the Week 4 Module menu under Application to Practice. If prompted, select to load the case in a new browser window. Note: it may take a few moments for iHuman cases to load in our web browser.
2. Select Proceed and begin by answering the Prework questions. Your prework answers are not graded. The questions are intended to get you thinking about the case. You will continue to select the Proceed button to move you through the entire case.
3. Begin the case and complete these sections: (100 points total, immediate feedback/grade will be provided to you by iHuman when complete)
   • EHR Review
   • Health History
   • Physical Assessment
   • Note: there is no time limit on completing cases
4. As you move through your first attempt and once you complete the case, you will receive feedback from the “Expert” on the important findings that you included (or should have included), and information that should have been collected on the health history and physical assessment. The system will also tell you if you asked questions or performed assessments that are considered extraneous or inappropriate for that particular case. Review this information carefully and take notes to be used on your second attempt, if you would like to work toward a higher score.
5. If you must leave the case for any reason before you have totally completed it, the program will save your spot and will return you to the same point when you re-enter the case. (Look for the green “Resume” arrow at the bottom of the screen.) If you had fully completed a section, you will be able to review the section, but you will not be able to change your answers. You will only be able to move forward in the case.
6. Nurse Notes (50 points) are completed outside of iHuman and are graded by your instructor. To complete the Nurse Notes, download and save the required template below under Template. Rename the template as Your Last Name Week 4 Nurse Notes. This must be saved as a Microsoft Word document (.docx). Save it to your computer or flash drive in a location where you will be able to retrieve it later. Type your answers directly on the saved document. When your Nurse Notes answers are completed, save and close the template. Click the Submit button at the top of this page to upload your completed assignment. 
7. When you have completed a case review the final score and feedback provided by iHuman. You have the option to complete this case a second time before the submission deadline (total of 2 attempts) to improve your score. Your instructor will convert your highest score in iHuman to points earned in the grading rubric. Scores are adjusted based on your performance level. (See grading rubric.)

Template

Week 4 Nurse Notes TemplateLinks to an external site.

iHuman Support

Click the blue question mark icon at the bottom right of your iHuman screen at any time to access iHuman Resources. A menu will appear to assist with trouble shooting. Click “Help” from the menu to contact iHuman Support.

**Academic Integrity**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

Rubric

iHuman Case Assignments – Rubric

Criteria	Ratings	Pts
This criterion is linked to a Learning Outcome iHuman ScoreInstructor to enter student’s highest score achieved for the iHuman Case here.	100 pts i-Human score of 90-100 90 pts i-Human score of 80-89 80 pts i-Human score of 70-79 70 pts i-Human score of 60-69 60 pts i-Human score of 50-59 50 pts i-Human score of 40-49 40 pts i-Human score of 30-39 30 pts i-Human score of 20-29 20 pts i-Human score of 10-19 0 pts No Score	100 pts
This criterion is linked to a Learning Outcome SBAR Note1.All components of SBAR (Situation, Background, Assessment, Recommendations) addressed; 2. Appropriate information in each section; 3. All key findings mentioned; 4. Data is well organized and concise.	20 pts All four criteria met. 1. All components of SBAR (Situation, Background, Assessment, Recommendations) addressed; 2. Appropriate information in each section; 3. All key findings mentioned; 4. Data is well organized and concise. 18 pts One criterion is missing. 16 pts Two criteria are missing. 8 pts Three criteria are missing. 0 pts All criteria are missing.	20 pts
This criterion is linked to a Learning Outcome Paragraphs1.Thoroughly answers the questions in a detailed manner. 2. Fully demonstrates an understanding of ongoing patient needs. 3. Response includes specific resources or references as requested in the questions.	20 pts All criteria met 1.Thoroughly answers the questions in a detailed manner. 2. Fully demonstrates an understanding of ongoing patient needs. 3. Response includes specific resources or references as requested in the questions. 18 pts Answers the questions and demonstrates understanding of ongoing patient needs. Response includes specific resources or references as requested in the questions. Answer is not detailed. 16 pts Partially answers the questions and partially demonstrates understanding of ongoing needs. Resources or references included but are not specific to this case. 8 pts Minimally answers the questions and minimally demonstrates knowledge and understanding of course concepts. No resources or references included. 0 pts Did not answer the questions.	20 pts
This criterion is linked to a Learning Outcome Clarity of Writing1.Excellent mechanics; 2. Well organized, clear, and logical; 3. Professional writing style; 4. Proper grammar, punctuation, and spelling.	10 pts All criteria met 1.Excellent mechanics; 2. Well organized, clear, and logical; 3. Professional writing style; 4. Proper grammar, punctuation, and spelling. 8 pts One criterion is missing. 6 pts Two criteria are missing. 4 pts Three criteria are missing. 0 pts All criteria not met.	10 pts
This criterion is linked to a Learning Outcome Late Deduction	0 pts 0 points deducted Submitted on time. 0 pts Not Submitted on Time – Points deducted 1 day late= 7.5 deduction; 2 days late= 15 deduction; 3 days late= 22.5 deduction; 4 days late= 30 deduction; 5 days late= 37.5 deduction; 6 days late= 45 deduction; 7 days late= 52.5 deduction	0 pts
Total Points: 150

A Sample Answer For the Assignment: NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)

Title: NR 305 Neurovascular Assessment: Athena Washington (iHuman) (Graded)

I am completing the simulations with more confidence than the previous cases. I felt knowledgeable about the appropriate questions to ask during the history assessment. This was the first case that I asked all the correct questions according to the expert. I asked a lot of questions about habits and lifestyle which put Ms. Washington at risk for more damage in the future. The scenario was very realistic to me. I have seen how quickly a suspected stroke patient is triaged and sent for imaging in practice and the scenario seemed to follow the real-life protocols. The questioning about onset of symptoms and NIH Stroke Assessment score helped to guide my questions just like I would if she were my patient.

Next time, I would familiarize myself on the cranial nerves and study which body parts are linked to the appropriate location in the brain. I thought that I had plenty of room for improvements. I realize now that I really do not have a whole lot of experience with stroke patients and need to keep up with the most up to date protocols. This simulation took me longer to complete due to my lack of experience. I read through the feedback carefully so that I could learn where my weaknesses were. The neuro assessment was not a strongpoint. I was surprised that I missed how often the NIH Assessment needed to be completed. Now I understand it is to be done every hour. 

I learned how to be a more thorough nurse when completing my assessments on stroke symptomology. I need to pay close attention to detail and make sure I am ensuring that all orders are completed on the timeline for best outcomes. I need to involve a team approach for care and ensure collaborative communication between all healthcare providers. At the end of this assessment, I was wanting to call lab and imaging to complete the outstanding orders and get the ball rolling. This was a great opportunity to self-reflect on time management skills. I feel much better on my ability to care for a stroke patient.