MN560 Advanced Practice Nurse Clinical
 Unit 3 Assignment  
Students will Support your work with evidence based resources no older than 5 years old.  Submit the diagnosis and treatment plan to be graded.
This Assignment will assess your ability to evaluate subjective and objective information in order to arrive at an appropriate diagnosis and treatment plan for the patient.
Hypertension Case Study
C.D is a 55-year-old African American male who presents to his primary care provider with a 2-day history of a headache and chest pressure.
PMH
Allergic Rhinitis
Depression
Hypothyroidism
Family History
Father died at age 49 from AMI: had HTN
Mother has DM and HTN
Brother died at age 20 from complications of CF
Two younger sisters are A&W
Social History
The patient has been married for 25 years and lives with his wife and two children. The patient is an air traffic controller at the local airport. He has smoked a pack of cigarettes a day for the past 15 years. He drinks several beers every evening after work to relax. He does not pay particular attention to sodium, fat, or carbohydrates in the foods he eats. He admits to “salting almost everything he eats, sometimes even before tasting it.” He denies ever having dieted or exercised.
Medications
Zyrtec 10 mg daily
Allergies
Penicillin
ROS
States that his overall health has been fair to good during the past year.
Weight has increased by approximately 30 pounds in the last 12 months.
States he has been having some occasional chest pressure and headaches for the past 2 days. Shortness of breath at rest, headaches, nocturia, nosebleeds, and hemoptysis.
Reports some shortness of breath with activity, especially when climbing stairs and that breathing difficulties are getting worse.
Denies any nausea, vomiting, diarrhea, or blood in stool.
Self treats for occasional right knee pain with OTC Ibuprofen.
Denies any genitourinary symptoms.
Vital Signs
B/P 190/120, HR 73, RR 18, T. 98.8 F., Ht 6’1”, Wt 240 lbs.
HEENT
TMs intact and clear throughout
No nasal drainage
No exudates or erythema in oropharynx
PERRLA
Funduscopy reveals mild arteriolar narrowing without nicking, hemorrhages, exudates, or papilledema
Neck
Supple without masses or bruits
Thyroid normal
No lymphadenopathy
Lungs
Mild basilar crackles bilaterally
No wheezes
Heart
RRR
No murmurs or rubs
Abdomen
Soft and non-distended
No masses, bruits, or organomegaly
Normal bowel sounds
Ext
Moves all extremities well
Neuro
No sensory or motor abnormalities
CN’s II-XII intack
DTR’s = 2+
Muscle tone=5/5 throughout
What you should do:
Develop an evidence-based management plan.
Include any pertinent diagnostics.
Describe the patient education plan.
Include cultural and lifespan considerations.
Provide information on health promotion or health care maintenance needs.
Describe the follow-up and referral for this patient.
Prepare a 3–5-page paper (not including the title page or reference page).
Assignment Requirements:
Before finalizing your work, you should:
be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:
follow the conventions of Standard English (correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style, and mechanics; and
use APA 6th Edition.
How to Submit:
Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.
When you are ready to submit your Assignment, select the unit Dropbox then attach your file. Make sure to save a copy of the Assignment you submit.
 
MN560 Advanced Practice Nurse Clinical
 Unit 5 Assignment  
Midterm Clinical Evaluation
For the Midterm Clinical Evaluation in Week 5 you will be required to schedule a preceptor call with your instructor and preceptor utilizing the faculty directions in the course Announcements. Failure to schedule or complete this preceptor call could result in failure of the course.
Grading will follow the rubric and will be a collaboration between your faculty and preceptor. Any area of clinical concern will require faculty and student conference as well as implementation of an individual learning plan.
You can find the rubric located in Course Resources.
 
MN560 Advanced Practice Nurse Clinical
 Unit 7 Assignment  
Students will Support your work with evidence based resources no older than 5 years old.  Submit the diagnosis and treatment plan to be graded.
Diabetes Case Study
Chief Complaint
“My left foot feels weak and numb. I have a hard time pointing my toes up.”
History of Present Illness
D.T. is 42-year-old Caucasian woman who has had an elevated blood sugar and cholesterol 2 years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed her fasting blood sugar was 160 and her cholesterol was 250. However, she felt “perfectly fine at the time” and did not want to take any more medications. Except for a number of “female infections,” she has felt fine recently.
Today, she presents to the clinic complaining that her left foot has been weak and numb for nearly 3 weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. She does report that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 50 pounds since her last pregnancy 10 years ago, 20 pounds in the last 6 months alone.
Past Medical History
Seasonal allergic rhinitis (since her early 20s)
Breast biopsy positive for fibroadenoma at age 30
Gestational diabetes with second child 10 years ago
Multiple yeast infections during the past 3 years that she has self-treated with OTC antifungal creams and salt bath
Hypertension for 10 years
Past Surgical History
C-section 14 years ago
OB-GYN History
Menarche at age 11
Last pap smear 3 years ago
Family History
Type 2 DM present in older brother and maternal grandfather. Both were diagnosed in their late 40s. Brother takes both pills and shots.
Mother alive and well
Father has COPD
Two other siblings alive and well
All three children are alive and well
Social History
Married 29 years with 3 children; husband is a school teacher
Family lives in a four bedroom single family home
Patient works as a seamstress
Smokes 1 pack per day (since age 16) and drinks two alcoholic drinks 4 days per week
Denies illegal drug uses
Never exercises and has tried multiple fad diets for weight loss with little success. She now eats a diet rich in fats and refined sugars.
Allergies
NKDA
Medications
Lisinopril 10 mg daily
Loratadine 10 mg daily
Review of Systems
General
Admits to recent onset of fatigue
HEENT
Has awakened on several occasions with blurred vision and dizziness or lightheadedness upon standing: Denies vertigo, head trauma, ear pain, difficulty swallowing or speaking
Cardiac
Denies chest pain, palpitations, and difficulty breathing while lying down
Lungs
Denies cough, shortness of breath, and wheezing
GI
Denies nausea, vomiting, abdominal bloating or pain, diarrhea, or food intolerance, but admits occasional episodes of constipation
GU
Has experienced increased frequency and volumes of urination, but denies pain during urination, blood in the urine, or urinary incontinence
EXT
Denies leg cramps or swelling in the ankles and feet; has never experienced weakness, tingling or numbness in arms or legs prior to this episode
Neuro
Has never had a seizure and denies recent headaches
Derm
Has a rash under her bilateral breast and in groin area
Endocrine
Denies a history of goiter and has not experienced heat or cold intolerance
Vital Signs
BP 165/100, T 98 F, P 88 regular, HT 5 feet 4 inches, RR 20 non labored, WT 210 lbs
What you need to do:
Develop an evidence-based management plan.
Include any pertinent diagnostics.
Describe the patient education plan.
Include cultural and lifespan considerations.
Provide information on health promotion or health care maintenance needs.
Describe the follow-up and referral for this patient.
Prepare a 3–5-page paper (not including the title page or reference page).
Format
The paper should be no more than 3–5 pages (not including the title page and reference pages.
Assignment Requirements:
Before finalizing your work, you should:
be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:
follow the conventions of Standard English (correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style, and mechanics; and
use APA 6th Edition.
How to Submit:
Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.
When you are ready to submit your Assignment, select the unit Dropbox then attach your file. Make sure to save a copy of the Assignment you submit.
 
MN560 Advanced Practice Nurse Clinical
 Unit 10 Assignment  
Final Clinical Evaluation — 300 points
This unit will contain the mandatory preceptor final evaluation in Rx Preceptor. Your preceptors will receive an automatic email from the Rx Preceptor system during week 8 and then weekly until week 9 to complete evaluations. Grading will follow the scale below and will be a collaboration between your faculty and preceptor. Any area of assessment with a score of 2.4 or below will receive an entire evaluation score of 0 points as failure in any area of assessment constitutes a failing evaluation. Any element of the evaluation that states the student is not safe or is unsafe will result in a “0” for the final evaluation and failure of the course.
Final evaluation will be worth 300 points and will follow the grading rubric below:
Score of 4 to 5 all 300 points awarded
Score of 3 to 3.9 = 240/300 points awarded 
Score of 2.5 to 2.9 = 210/300 points awarded
Score of 2.4 and below = 0
Students must also complete both the evaluation of their preceptor and site for credit. The evaluations provide faculty an overview of your clinical performance and experiences with your preceptor and clinical location. The final clinical evaluation is required to pass the course.
Failure to complete all clinical hours or all associated Rx Preceptor documentation (clinical time log, patient encounter log, preceptor evaluation of student, and student evaluation of preceptor) will result in failure of the course.