NR 601 Week 5 Case Study Discussions Physical Examination (Part-1)
NR 601 Week 5 Case Study Discussions Physical Examination (Part-1)
NR 601 Week 5 Case Study Discussions Physical Examination (Part-1)
Discussion Part One (graded)
C.W. is a tall, thin 78-year-old African American male brought into the office by his son who states that the patient is restless, angry, and has been unable to sleep for the last week. The son indicates that he is very concerned about his father because he lives alone. Also, he is concerned about the “strange” symptoms that his father has presented with recently.
Background:
C.W. presents as restless, hyperverbal, obnoxious and angry. He expresses himself by periodic yelling. He is unkempt and smells strongly of urine, alcohol and body odor. ………… has an unsteady gait and sways while standing. As you converse with the son, you determine that C.W. was medically separated from military service due to mental health issues after 2 years of active duty that ended in 1947. He has been married and divorced three times over the years. He typically seeks no acute or preventative medical care. ___ was treated by a psychiatrist previously, but he did not like taking the prescribed medications so he stopped taking them and did not keep any further psychiatric appointments.
PMH:
Patient denies any previous diagnoses. However, when asked why he saw a psychiatrist in the past, he tells you that the psychiatrist diagnosed paranoid schizophrenia, but that he does not have any psychiatric diagnoses or problems. He states: “It was just a way for him to make money off me coming in and seeing him and paying the drug companies for me to take all those meds!”
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Denies prescription medications, over the counter medication, herbal therapies or vitamins.
Surgeries:
Denies surgeries
Allergies: NKA
Vaccination History:
Flu vaccine: never given
Pneumovax: never given
Tetanus: never given
Herpes zoster: never given
Screening History:
Last Colonoscopy was 2012-normal
Last dilated retinal and glaucoma exam was 2013
Social history and Risk Factors:
Patient admits to smoking cigarettes and cigars. …… estimates that he smokes about 1 pack of cigarettes daily for the last 40 years, and 2 cigars each week for the last 30 years.
He states that he drinks a 24 ounce bottle of beer 4-6 times a week. … denies drinking wine or hard
NR 601 Week 5 Case Study Discussions Physical Examination (Part-1)
liquor. …….. does admit to smoking marijuana on occasion but does not use other recreational drugs.
Patient denies falling. You notice some scrapes on his forearms, and when asked, he tells you that he fell yesterday: “I got pretty drunk out fishin’ with friends and fell off my bike trying to ride home”. He does not use any assistive devices for ambulation or balance.
Significant ROS:
Productive cough with white sputum. Denies hemoptysis.
He answers “No” to the PHQ-2 screening questions.
Family history:
Reports no significant family history
Discussion Part One:
Provide differential diagnoses (DD) with rationale.
Further ROS questions needed to develop DD.
Based on the patient data provided, choose geriatric assessment tools that would be appropriate to use in conducting a thorough geriatric assessment. Provide a rationale on why you are choosing these particular tools.
The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
Participation Guidelines
Each weekly threaded discussion is worth up to 25 points. Students must post a minimum of two times in each graded thread. The two posts in each individual thread must be on separate days. The student must provide an answer to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week. If the student does not provide an answer to each graded thread topic (not a response to a student peer) before the Wednesday deadline, 5 points are deducted for each discussion thread in which late entry occurs (up to a 10-point deduction for that week). Subsequent posts, including essential responses to peers, must occur by the Sunday deadline, 11:59 p.m. MT of each week.
Direct Quotes
Good writing calls for the limited use of direct quotes. Direct quotes in Threaded Discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the Grammar, Syntax, APA category.
NR 601 Week 5 Case Study Discussions Physical Examination (Part-1) Grading Rubric Guidelines
Performance Category
10
9
8
4
0
Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions.
Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
Evaluates literature resources to develop a comprehensive analysis or synthesis.
Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
Evaluates information from source(s) to develop a coherent analysis or synthesis.
Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
Demonstrates little or no understanding of the topic.
Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
Information is taken from source(s) without any interpretation/evaluation.
The posting uses information that is not valid, relevant, or reliable
No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
Information is not valid, relevant, or reliable
Performance Category
10
9
8
4
0
Application of Course Knowledge –
Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations
Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
Applies concepts to personal experience in the professional setting and or relevant application to real life.
Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
Applies concepts to personal experience in their professional setting and or relevant application to real life
Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
Posts are superficial and do not reflect an understanding of the lesson content
Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category
5
4
3
2
0
Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.
(5 points possible per graded thread)
Exceeds minimum post requirements
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
Replies to a post posed by faculty and to a peer
Summarizes what was learned from the lesson, readings, and other student posts for the week.
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
Replies to a question posed by a peer
Summarizes what was learned from the lesson, readings, and other student posts for the week.
Meets expectations of 2 posts on 2 different days.
The main post is not made by the Wednesday deadline
Does not reply to a question posed by a peer or faculty
Has only one post for the week
Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
Does not post to the thread
No connections are made to the topic
Minus 1 Point
Minus 2 Point
Minus 3 Point
Minus 4 Point
Minus 5 Point
Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.
Points deducted for improper grammar, syntax and APA style of writing.
The source of information is the APA Manual 6th Edition
2-3 errors in APA format.
Written responses have 2-3 grammatical, spelling, and punctuation errors.
Writing style is generally clear, focused, and facilitates communication.
4-5 errors in APA format.
Writing responses have 4-5 grammatical, spelling and punctuation errors.
Writing style is somewhat focused.
6-7 errors in APA format.
Writing responses have 6-7 grammatical, spelling and punctuation errors.
Writing style is slightly focused making discussion difficult to understand.
8-10 errors in APA format.
Writing responses have 8-10 grammatical, spelling and punctuation errors.
Writing style is not focused, making discussion difficult to understand.
Post contains greater than 10 errors in APA format.
Written responses have more than 10 grammatical, spelling and punctuation errors.
Writing style does not facilitate communication.
The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost
-5 points lost
Total Participation Requirements
per discussion thread
The student answers the threaded discussion question or topic on one day and posts a second response on another day.
The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement
per discussion thread
The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.
The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.
NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Wednesday. Any assignments and all discussion requirements must be completed by 11:59 p.m. MT Wednesday of the eighth week.
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