NU 665B Week 9 Discussion 1: Hematology Patient

Sample Answer for NU 665B Week 9 Discussion 1: Hematology Patient Included After Question

Initial Post

You are working in a family practice when a 65-year-old developmentally-delayed woman, Ms. Jennifer Robinson, presents to the office with complaints of excessive fatigue and shortness of breath after activity, which is abnormal for her. Ms. Robinson has a history of trisomy 21 and congestive heart failure with decreased kidney function within the last year. The woman appears unusually tired and slightly pale. Additional history and examination rules out worsening heart failure, acute illness, and worsening kidney disease.

You were able to get the following results and vitals in the clinic today:

• The complete blood count (CBC) results indicate that hemoglobin is 9.5 g/dL, which is a new finding, and the hematocrit is 29%. Previous hemoglobin levels have been 11 to 13g/dL. The patient’s vital signs are temperature 98.7°F, heart rate 92 bpm, respirations 28 breaths per minute, and blood pressure 138/72.

Initial Post by Wednesday (Day 3) at 11:59 p.m.

List 10 to 20 additional pieces of subjective information you need to elicit from the mother and patient to help formulate your differential diagnoses and plan. You may not ask questions that were already addressed in the HPI/ROS. You will need two scholarly references for the questions you ask. See the rubric for more detail.

Reply Posts

Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:

• Choose a classmate’s questions to answer.
• Every peer post should have only one response post. Please do not reply to a peer if a response is already posted.
• You are answering as the patient. Make it case-appropriate but imaginative. Be creative and answer thoroughly. No references are needed.

Reflective Response Post by Sunday (Day 7). Please respond with the following:

• Four differential diagnoses and rationales with references. Support your answers with references.
• Create a plan of care for that patient.
• Plan must include pharmacology, non-pharmacology, labs/diagnostics, referrals/interprofessional communications, patient education (10 to 15 individual items minimum), and follow-up.
• Make sure to pick one health maintenance item for this patient (primary or secondary) and explain to the patient why this is important.
• Address one existing or potential social determinant of health for this patient during your visit. How will you help the patient overcome this obstacle to health care?

Please refer to the Grading Rubric for details on how this activity will be graded.

Posting to the Discussion Forum

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A Sample Answer For the Assignment: NU 665B Week 9 Discussion 1: Hematology Patient

Title: NU 665B Week 9 Discussion 1: Hematology Patient

Simulated Office Visit Assignment Rubric

Note: Scholarly resources are defined as evidence–based practice, peer–reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Criteria	Exemplary Exceeds Expectations	Advanced Meets Expectations	Intermediate Needs Improvement	Novice Inadequate	Total Points
Initial Post	Post includes 10–20 questions of subjective information that are appropriate for the patient vignette. Questions are targeted toward the content of the vignette. Questions are supported by appropriate references. Initial Post by Wednesday (Day 3) at 11:59 p.m. 30 points	Post includes questions of subjective information that are appropriate for the patient vignette. Questions are general and NOT targeted toward the content of the vignette. Questions are supported by appropriate references. Initial Post by Wednesday (Day 3) at 11:59 p.m. 26 points	Post includes less than 10–20 questions of subjective information and/or are not appropriate for the patient vignette. Questions are vague. Questions are supported by appropriate references. Initial Post is late. 23 points	Post includes less than 10–20 questions of subjective information and/or are not appropriate for the patient vignette. Questions are vague or not appropriate for patients. Questions are NOT supported by appropriate references. Initial Post is late. 20 points	30
Initial Response Post	Student answers ALL peer’s questions appropriately, as the patient. Answers drive discussion and analysis forward. Initial Response Post by Friday (Day 5) 11:59 p.m. 30 points	Student answers ALL peer’s questions appropriately, as the patient. Answers struggle to drive discussion and analysis forward. Initial Response Post by Friday (Day 5) 11:59 p.m. 26 points	Student does not answer ALL questions appropriately or from patient perspective. Initial Response Post by Friday (Day 5) 11:59 p.m. 23 points	Student does not answer ALL questions appropriately or from patient perspective. Questions are irrelevant or do not makes sense. Initial Response Post is late. 20 points	30
Reflective Response Post	Student replies to additional post with 4 appropriate differentials and rationale that are well supported by evidence. Appropriate and evidence–based plan of care is developed for one differential; supported by references. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. 30 points	1–2 minor omissions from differentials or plan of care. These do not constitute missing must not miss differentials or safety issues. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. 26 points	3+ minor omissions from differentials or plan of care. These do not constitute missing must not miss differentials or safety issues. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. 23 points	1–2 major omissions from differentials or plan of care. These constitute missing must not miss differentials or safety issues. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. Responses after Day 7 will not receive any credit. 20 points	30
Organization	Well–organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas. 5 points	Organized content with minimal issues in content flow. 4 points	Poor organization, and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work. 3 points	Illogical flow of ideas. Missing significant content. Prose rambles. Purpose statement is unclear or missing. Demonstrates incomplete understanding of content and/or inadequate preparation. 2 points	5
APA, Grammar, and Spelling	Correct APA formatting with no errors. There are no spelling, punctuation, or word–usage errors 5 points	Correct and consistent APA formatting of references and cites all references used. No more than two unique APA errors. The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability. There are minimal to no grammar, punctuation, or word–usage errors. 4 points	Three to four unique APA formatting errors. The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused. Multiple grammar, punctuation, or word usage errors. 3 points	Five or more unique formatting errors or no attempt to format in APA. The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language). The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented. Grammar and punctuation are consistently incorrect. Spelling errors are numerous. 2 points	5
Total Points					100