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Group Research Article Checklist

Directions: This checklist is provided to assist your group in selecting an appropriate research article to complete the weekly Critical Thinking/Research Critique assignments. This checklist serves as a valuable guide as your group searches for an appropriate article for this assignment. Your coach will not be grading the actual checklist but will use it in approving your submitted publication. Submit the completed checklist with your article you are submitting for faculty approval.

Instructions:

· All members of the group should select an article meeting the criteria, then as a group, select one of the group member’s article. It is suggested you keep the other articles just in case you need to resubmit a second article. Establish a deadline for the selection of an article keeping in mind the need to address some specific questions related to the article and meet the established deadline.

· Please review this checklist as a group prior to submitting your group selected research article for this assignment.

· When all the group members participating in this assignment believe ALL the stated criteria has been met, please place a checkmark in the provided box.

· Submit this checklist with the full text selected article in PDF format in the provided dropbox along with the Module 1 document.

· Do not submit a web link to the selected article as this will result in a deduction on your first critical thinking submission.

		Checklist Criteria for your Article Selection:
Met	Not Met
		1. Our group selected a quantitative primary (data-based research study, written by the researchers* who conducted the study) research article (you may select a pilot/feasibility study as long as it meets other checklist criteria) (You may or may not find words in the abstract such as study, investigation, the aim of this study; look for headings such as Method/Design, Sample/Participants, Data Analysis, Findings etc).
		2. Our group selected a peer review quantitative research published between May, 2018 and July, 2019 or if it is a quarterly publication, starting January, 2019 -to current date). Do not submit an accepted draft of an article/manuscript. It must already be published in a nursing professional journal and can be located within the specific publication.
		3. Our group selected a study whose first author is a registered nurse (you should see RN behind the first author’s name or there may be an identification within the article that the first author is a registered nurse-typically on the first or last page of the publication. If the credentials of the author are not identified, then you will need to select another article)
		4. Our group selected a study published in a peer reviewed NURSINGjournal (i.e. nurses are the primary audience for the journal; journal for nurses usually (but not always) have nurse/nursing in the title).
		5. Our group selected a study from either a national or international journal; however, the entire study must be written in English including references. If you select an article from the Journal of Nursing UFPE on line-while the text of the article is in English, frequently some of the references are not in English. This would not be appropriate for this assignment unless the references are also provided in English.
		6. Our group selected a study that includes a population/sample that uses human subjects/participants. (Animal research is not appropriate for this assignment unless it is a study with humans engaged in animal therapy etc.).
		7. Our group selected a study with descriptive statistics related to data analysis and answered the question below:7a) Descriptive statistics were identified on page_____Please note: if the term “power analysis” is present, it does not address this criterion; it is another research concept and does not address either descriptive and/or inferential statistics7b) An example of a descriptive statistic found in the study was_________
		8. Our group selected a study with inferential statistics (but not advanced statistics- we did not select a study that used the following for statistical analysis: path analysis, modeling or uses the word “model” in the analysis technique like causal modeling, multiple regression, factor analysis, linear models, time series, data mining techniques, odds-ratio and logistic regression, plots, plotting or plot method-refer to page 299 of your text ) related to data analysis and answered question 8a below8a) Inferential statistic(s) were found on page______8b) An example of an inferential statistic found in the study was_________Additional Resources to assist if needed:· View your statistics notes, or LoBiondo-Wood & Harper textbook for the class (Chapters 9 and 10 may be helpful)· Read pages 327-328 (8th edition) and page 299 in the 9th edition, avoid these advanced statistics· Data Analysis may also include descriptive statistics but may not solely use this type of statistics.Please note: if you read the words “power analysis” it does not address this criterion
		9. Our group reviewed Library Guides found under Course Orientation and Overview; or accessed the following website:http://guides.pnw.edu/nur390selecting_research_article
		10. If needed, our group or select group members contacted the PUC Library Scientist, to assist with searching. (Please note: The librarian is not responsible for finding your articles, approving your article, and /or APA format; only your course coach/faculty will approve your article.
		11. For students previously enrolled in the class, no group members have used this article for this assignment previously even if assigned to another coach/faculty for this class.
		12. We are aware points will be deducted from our /my Module 1 Article Document assignments that does not meet all of these checklist criteria. Hint: Please be sure your selected publication refers to both descriptive and inferential statistics-this is where groups frequently experience the point(s) deduction.
		13. We have reviewed all the criteria, the DO NOT choose list below and the article we are submitting for faculty approval in pdf format meets all the criteria listed above. Type your group letter/number assigned to your group in this box. Name of group member(s) who specifically participated in this assignment:
		14. Name of Group member(s) who did NOT participate in this assignment: _______________________________________ (a zero (0) grade will be earned on this Module 1 Research Article Document assignment for any group member who did not participate in this assignment after faculty verification.)

For the “Selection of a Research Article Assignment”, please DO NOT choose any of the following types of research studies or

articles for this assignment:

· Qualitative research article

· Informative article

· Concept Analysis

· Quality Improvement Project (avoid studies that indicate it is project)

· Project Development/Implementation (Project/ Observational study that discusses a project (many times these are identified as projects for Doctorate of Nursing Practice requirements, you may find the credential DNP behind the first authors name; however, some authors with DNP credentials may engage in primary research so look for the word “Project” in the article, sometimes found in the abstract or under the heading “Methods”

· The title or purpose of the article states “Review of the literature OR narrative article OR integrated/integrative reviews OR systematic review of the literature”. (Please note: the review of the literature is a step in the nursing research process, so you may find review of the literature as a heading in the text of an appropriate research article but avoid if it is in the title or purpose of the article.)

· Research report in a secondary source (i.e. not written by the researchers that conducted the actual study) or secondary analysis

· A research report published as part of an article/module for continuing education units (you may find “CEU” or “CU” on the first page of the publication and may have a short quiz at the end of the article)

· Mixed method (multi-methods) design (i.e. both qualitative AND quantitative processes used in the study.

· Clinical Guidelines

· Systematic reviews

· Secondary analysis

· Meta-analysis

· Meta-synthesis

· Meta-aggregate

· Program/Project Evaluation-***this is a common error that has been made in the past; please make sure your selected article is not a program or project evaluation.

· A survey/tool/questionnaire/instrument development study (typically the article will indicate that the research focus is tool development in the title or purpose of the study. The purpose may state: The purpose of this research is to test/develop a survey/tool/ questionnaire/measurement/instrument to measure____ or something similar)

**Faculty highly recommends that you avoid studies with large data sets (refer to page 299 of your text )multiple variables (multivariate analysis with resultant data) or higher level statistical analysis. Previous students seem to be more challenged when choosing studies with large data sets. Your faculty may notify you that your selected article has a more challenging data analysis procedure and to submit another article. However, your group may have an advanced statistical background and may select not to submit another article. If this is the case for your group, please discuss this with your assigned coach.

Do not select these articles (Please note: if you select one of the following articles it will not be approved and result in a 2-point deduction (please do not request an exception as this will not be given):

Ahmadi, M., Bagheri-Saweb, M.I., Nouri, B., Mohamadamini, O., & Valiee, S. (2019). Effect of Interventional Educational Programs on Intensive Care Nurses’ Perception, Knowledge, Attitude, and Practice About Physical Restraints: A Pre-/Post-Clinical Trial. Critical Care Nursing. 42, 106-116. doi: 10.1097/CNQ.0000000000000244106

Alenezi, A. M., Aboshaiqah, A., & Baker, O. (2018). Work-related stress among nursing staff working in government hospitals and primary health care centres. International Journal of Nursing Practice, 24(5), 1-8. doi:10.1111/ijn.12676

Aloush, S.M., Abdelkader, F., Al-Sayaghi, K., Tawclbeh, L., Suliman, M., Al Bashtawy, M., & Shaban, I. (2018). Compliance of nurses and hospitals with ventilator-associated pneumonia prevention guidelines: A Middle Eastern survey. Journal of Nursing Care Quality, 33(3), E8-E14. doi: 10.1097/NCQ.000000000000028.

Aliyu, S. P., Furuya, Y. M., & Larson, E. R. (2019). Risk of subsequent health care−associated infection among patients with a blood stream infection present on hospital admission. American Journal of Infection Control, 47(2), 196-200. Retrieved from https://www-sciencedirect-com.pnw.idm.oclc.org/science/article/pii/S0196655318311416

Anderson, C.A., & Connolly, J.P. (2018). A model to predict birth stress in adolescents within 72 hours of childbirth. Advances in Nursing Science, 41(3), 216-229. Retrieved from https://journals.lww.com/advancesinnursingscience/pages/default.aspx

Arslan, D.E., & Akca, N.K. (2018). Pain following needle insertion into a hemodialysis fistula and influencing factors. International Journal of Caring Science,11(3), 1662-1670. Retrieved from http://www.internationaljournalofcaringsciences.org/

Arslan, D. E., Kutlutürkan, S., & Korkmaz, M. (2019). The effect of aromatherapy massage on knee pain and functional status in participants with osteoarthritis. Pain Management Nursing, 20(1), 62-69. https://doi.org/https://doi.org/10.1016/j.pmn.2017.12.00

Bell, M., Bogar, C., Plante, J., Rasmussen, K., & Winters, S. (2018, November). Effectiveness of a novel specimen collection system in reducing blood culture contamination Rates. Journal of Emergency Nursing, 44(6), 570-575. Retrieved April 4, 2019, from https://www.jenonline.org/article/S0099-1767(17)30148-4/fulltext

Bergomi, P., Scudeller, L., Pintaldi, S., & Dal Molin, A. (2018). Efficacy of non-pharmacological methods of pain management in children undergoing venipuncture in a pediatric outpatient clinic: A randomized controlled trial of audiovisual distraction and external cold and vibration. Journal of Pediatric Nursing, 42, e66-e72. https://doi.org/10.1016/j.pedn.2018.04.011

Brownie, S., Wahedna, A. H., & Crisp, N. (2018). Nursing as a pathway to women’s empowerment and intergenerational mobility. Journal of Clinical Nursing, 27(21–22), 4050–4057. Retrieved from https://doi-org.pnw.idm.oclc.org/10.1111/jocn.14540

Chou, P., Fang,S., Sun, J. & Rau, K. (2018). Gender difference in cancer patients’ adherence to analgesics and related outcomes of pain management. Cancer Nursing. 41(6). 11-18.

Ciftci, B., Avsar, G., Aydın, E., & Karaman Ozlu, Z. (2018). Assessment of the effect of nipple care with honey on nipple cracking. International Journal of Caring Sciences, 11(3), 1881–1889. Retrieved from http://www.internationaljournalofcaringsciences.org/docs/62_avsar%20_original_11_3.pdf

Costa, P., De Souza Lima, G. F., Anacleto, A. S., De Andrade, P. R., Mandetta, M. A., & Balbino, F. S. (2018). Parents’ concerns about the newborn during primary care nursing consultations in Brazil. Pediatric Nursing, 44(6), 297-300.

Engström, Å, & Forsberg, A. (2019). Peripheral intravenous catheter difficulty – A clinical survey of registered nurse and critical care nurse performance. Journal of Clinical Nursing. doi:10.1111/jocn.14668

Evans, S., Yager, E., Sutherland, L., & Downey, M. (2018). Getting your grumble back. Journal of Holistic Nursing, 36(3), 255–261. https://doi- org.pnw.idm.oclc.org/10.1177/0898010116672338

Finch, K., Osseiran-Moisson, R., Carville, K., Leslie, G., & Dwyer, M. (2018). Skin tear prevention in elderly patients using twice-daily moisturiser. Wound Practice and Research, 26, 99-109. Retrieved from

http://www.woundsaustralia.com.au/journal/2602_06.pdf

Henson, K., Thomley, J., Lowrie, L., & Walker, D. (2019). Comparison of selected outcomes associated with two postoperative analgesic approaches in patients undergoing total knee arthroplasty. American Association of Nurse Anesthetists, 87(1), 51-57. Retrieved from https://tinyurl.com/y5z9pvfa

Herrera-Gómez, A., De Luna-Bertos, E., Ramos-Torrecillas, J., Ocaña-Peinado, F. M., Ruiz, C., & García-Martínez, O. (2018). Risk assessments of epidural analgesia during labor and delivery. Clinical Nursing Research, 27(7), 841–852.

Horne, C. E., Johnson, S., & Crane, P. B. (2019). Comparing comorbidity measures and fatigue post myocardial infarction. Applied Nursing Research, 45, 1-5. doi: 10.1016/j.apnr.2018.11.004.

Huthaifah1 Ibrahim, K. (2018). Quality of life determinants among lung cancer patients near end of life. International Journal of Caring Sciences, 11(3), 1580–1587.

Jenita, E., & Pushpakala, E. (2019). Effect of early ambulation versus late ambulation on patients’ outcome among patients underwent transfemoral coronary procedures. International Journal of Nursing Education, 11(1), 74–78. https://doi- org.pnw.idm.oclc.org/10.5958/0974-9357.2019.00016.3

Keskin, G., Gümüş, A. B., & Yiğitoğlu, G. T. (2019). Sexual dysfunctions and related variables with sexual function in patients who undergo dialysis for chronic renal failure. Journal of Clinical Nursing. doi:10.1111/jocn.14602

Lamont, S., & Brunero, S. (2018). The effect of a workplace violence training program for generalist nurses in the acute hospital setting: A quasi-experimental study. Nurse Education Today, 68, 45-52.

Mathew, S.M., & Sujatha, R. (2018). Effectiveness of Child To Child Approach on Practice of Hand Washing Among School Children in a Selected School at Mangalore. Nitte University Journal of Health Science. Retrieved from: http://web.a.ebscohost.com.pnw.idm.oclc.org/ehost/pdfviewer/pdfviewer?vid=3&sid=a80216fe-6975-41ef-8447-6d2863c4ade8%40sdc-v-sessmgr01

McAdam, J. L., & Puntillo, K. (2018). Pilot study assessing the impact of bereavement support on families of deceased intensive care unit patients. American Journal of Critical Care, 27(5), 372-380.

Menegueti, M. G., Araújo, T. R., Laus, A. M., Martins-Filho, O. A., Basile-Filho, A., & Auxiliadora-Martins, M. (2019). Resting energy expenditure and oxygen consumption in critically ill patients with vs without sepsis. American Journal of Critical Care,28(2), 136-141. doi:10.4037/ajcc2019168

Moreland Lewis, M., Kohtz, C., Emmerling, S., Fisher, M., & McGarvey, J. (2018). Pain control and nonpharmacologic interventions. Nursing2018, 48(9), 65-68. https://doi.org/DOI-10.1097/01.NURSE.0000544231.59222.ab

Mortimer-Jones, S. M., Wall, P. G., & Russell, S. (2018). Quantitative analysis of anxiety levels of nursing students studying bioscience in Australia. Nursing & Health Sciences. doi:10.1111/nhs.12535.

Mrayan, L., Abujbil, S., Abuidhail, J., Yassein, M. B., & Al-Modallal, H. (2019). Couvade syndrome among Jordanian expectant fathers. American Journal of Men’s Health, 1-9. doi:10.1177/1557988318810243

Nirmala, V., J. Silvia Edison, Vijayaraghavan & Suni, M. S. (January- March 2019). Effectiveness of the comprehensive intervention package on the psychological variables among adolescents. International Journal of Nursing Education, 11(1), 102- 108.

Oner, U., & Coban, G. I. (2018). Satisfaction Levels of Cardiac Patients From Oral Anticoagulant Treatment. International Journal of Caring Sciences, 11(3), 1789–1801.

Orinovsky, I., Raizman, E. (2018). Improvement of nutritional intake in intensive care unit patients via a nurse -led enteral nutrition feeding protocol. Critical Care Nurse. 28(3),38-44. doi:10.4037/ccn2018433

Ota, M., Peck, B., & Porter, J. (2018). Evaluating a blended online learning model among undergraduate Nursing Students. CIN: Computers, Informatics, Nursing, 1.doi:10.1097/cin.0000000000000456

Pandian, V., Datta, M., Nakka, S., Tammineedi, D. S., Davidson, P. M., & Nyquist, P. A. (2019). Intensive care unit readmission in patients with primary brain injury and tracheostomy. American Journal of Critical Care, 28(1), 56-63. doi:10.4037/ajcc2019883

Peršolja, M. (2018). The effect of nurse staffing patterns on patient satisfaction and needs: a cross-sectional study. Journal of Nursing Management, 26(7), 858-865. https://doi. org/10.1111/jonm.12616.

Piasai, K., Phumdoung, S., Wiroonpanich, W., & Chotsampancharoen, T. (2018). A randomized control trial of guided-imagination and drawing-storytelling in children with cancer. Pacific Rim International Journal of Nursing Research, 22(4), 386-400. Retrieved from https://www.tci-thaijo.org/index.php/PRIJNR/article/view/99745.

Punthmatharith, B., & Mora, J. (2018). Effects of positioning on respiration rate, heart rate, and oxygen saturation in preterm infants during feeding: A cross-over design. Pacific Rim International Journal of Nursing Research, 22(3), 187-199. https://search.ebscohost.com.pnw.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=129898555&site=ehost-live

Sleutel, M.R., True, B., Gustus, H., Baldwin, K. & Early, B. (2018). Response to a national issue: Moving beyond “back to sleep” at three hospitals. Journal of Pediatric Nursing, 43, 16-22. doi:10.1016/j.pedn.2018.07.013.

Soares, C.G., Mello, M.C.V.A. de., Santos, K.N.S.C. dos., Modernel, D.X., Cezar-

Vaz, M.R. (2018). Excessive daytime sleepiness among nursing professionals. Journal of Nursing Online, 12(6), 1603-1609. DOI: 10.5205/1981-8963-v12i6a231336p1603-1609-2018.

Tongvichean, T., Aungsuroch, Y. & Preechawong, S. (2019). Effect of

Self-Management Exercise Program on physical fitness among people

with prehypertension and obesity: A quasi-experiment study. Pacific

Rim International Journal of Nursing Research, 23 (1), 6–17. Retrieved from

http://search.ebscohost.com.pnw.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=1

33461325&site=ehost-live

VonStein, M., Buchko, B., Millen, C., Lampo, D., Bell, T., & Woods, A. (2019). Effect of a scheduled nurse intervention on thirst and dry mouth in intensive care patients. American Journal of Critical Care. 28(1). DOI: https://doi.org/10.4037/ajcc2019400.

Winkelman, C., Sattar, A., Momotaz, H., Johnson, K., Morris, P., Rowbottom, J., … Levine, A. (2018). Dose of early therapeutic mobility: Does frequency or intensity matter? Biological Research of Nursing, 20(5), 522-530. http://dx.doi.org/10.1177/1099800418780492

Young, C. C., Minami, H., Aguilar, R., & Brown, R. A. (2018). Testing the feasibility of a mindfulness-based intervention with underserved adolescents at risk for depression. Holistic Nursing Practice, 32(6), 316–323. https://doi-org.pnw.idm.oclc.org/10.1097/HNP.0000000000000295

 

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Soap Note 2 Chronic Conditions

Chronic Conditions (15 Points)

Pick any Chronic Disease from Weeks 6-10

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
 Follow the MRU Soap Note Rubric as a guide

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement

SOAP NOTE SAMPLE FORMAT FOR MRC

Name:  LP

Date: 

Time: 1315

Age: 30

Sex: F

SUBJECTIVE

CC:  

“I am having vaginal itching and pain in   my lower abdomen.”

HPI:  

Pt is a   30y/o AA female, who is a new patient that has recently moved to Miami. She seeks treatment today after   unsuccessful self-treatment of vaginal itching, burning upon urination, and   lower abdominal pain. She is concerned   for the presence of a vaginal or bladder infection, or an STD. Pt denies fever. She reports the itching and burning with   urination has been present for 3 weeks, and the abdominal pain has been   intermittent since months ago. Pt has   tried OTC products for the itching, including Monistat and Vagisil. She denies any other urinary symptoms,   including urgency or frequency. She   describes the abdominal pain as either sharp or dull. The pain level goes as high as 8 out of 10   at times. 200mg of PO Advil PRN   reduces the pain to a 7/10. Pt denies   any aggravating factors for the pain. Pt reports that she did start her menstrual cycle this morning, but   denies any other discharge other that light bleeding beginning today. Pt denies douching or the use of any   vaginal irritants. She reports that   she is in a stable sexual relationship, and denies any new sexual partners in   the last 90 days. She denies any   recent or historic known exposure to STDs. She reports the use of condoms with every coital experience, as well   as this being her only form of contraceptive. She reports normal monthly menstrual cycles that last 3-4 days. She reports dysmenorrhea, which she also   takes Advil for. She reports her last   PAP smear was in 7/2016, was normal, and reports never having an abnormal PAP   smear result. Pt denies any hx of   pregnancies. Other medical hx includes   GERD. She reports that she has an Rx   for Protonix, but she does not take it every day. Her family hx includes the presence of DM   and HTN. 

Current Medications: 

Protonix   40mg PO Daily for GERD

MTV OTC   PO Daily

Advil   200mg OTC PO PRN for pain

PMHx:

Allergies:  

NKA & NKDA

Medication Intolerances: 

Denies

Chronic Illnesses/Major traumas

GERD

Hospitalizations/Surgeries

Denies

Family History

Father-   DM & HTN; Mother- HTN; Older sister- DM & HTN; Maternal and paternal   grandparents without known medical issues; 1 brother and 3 other sisters   without known medical issues; No children.

Social History

Lives   alone. Currently in a stable sexual   relationship with one man. Works for   DEFACS. Reports occasional alcohol   use, but denies tobacco or illicit drug use.

ROS

General 

Denies   weight change, fatigue, fever, night sweats

Cardiovascular

Denies   chest pain and edema. Reports rare palpitations that are relieved by drinking   water

Skin

Denies   any wounds, rashes, bruising, bleeding or skin discolorations, any changes in   lesions

Respiratory

Denies   cough. Reports dyspnea that accompanies the rare palpitations and is also   relieved by drinking water

Eyes

Denies corrective   lenses, blurring, visual changes of any kind

Gastrointestinal

Abdominal   pain (see HPI) and Hx of GERD. Denies   N/V/D, constipation, appetite changes

Ears

Denies   Ear pain, hearing loss, ringing in ears

Genitourinary/Gynecological

Reports   burning with urination, but denies frequency or urgency. Contraceptive and STD prevention includes   condoms with every coital event. Current stable sexual relationship with one man. Denies known historic or recent STD   exposure. Last PAP was 7/2016 and normal. Regular monthly menstrual cycle   lasting 3-4 days. 

Nose/Mouth/Throat

Denies   sinus problems, dysphagia, nose bleeds or discharge

Musculoskeletal

Denies   back pain, joint swelling, stiffness or pain

Breast

Denies   SBE

Neurological

Denies   syncope, seizures, paralysis, weakness

Heme/Lymph/Endo

Denies   bruising, night sweats, swollen glands

Psychiatric

Denies   depression, anxiety, sleeping difficulties

OBJECTIVE

Weight   140lb 

Temp -97.7

BP 123/82

Height 5’4”

Pulse 74

Respiration 18

General Appearance

Healthy   appearing adult female in no acute distress. Alert and oriented; answers   questions appropriately. 

Skin

Skin is   normal color for ethnicity, warm, dry, clean and intact. No rashes or lesions   noted.

HEENT

Head is   norm cephalic, hair evenly distributed. Neck: Supple. Full ROM. Teeth are in   good repair.

Cardiovascular

S1, S2   with regular rate and rhythm. No extra heart sounds. 

Respiratory

Symmetric   chest walls. Respirations regular and easy; lungs clear to auscultation   bilaterally.

Gastrointestinal

Abdomen   flat; BS active in all 4 quadrants. Abdomen soft, suprapubic   tender. No hepatosplenomegaly.  

Genitourinary

Suprapubic   tenderness noted. Skin color normal   for ethnicity. Irritation noted at   labia majora, minora, and perineum. No ulcerated lesions noted. Lymph nodes   not palpable. Vagina pink and moist   without lesions. Discharge minimal,   thick, dark red, no odor. Cervix pink   without lesions. No CMT. Uterus normal size, shape, and consistency.  

Musculoskeletal

Full   ROM seen in all 4 extremities as patient moved about the exam room.

Neurological 

Speech   clear. Good tone. Posture erect. Balance stable; gait normal.

Psychiatric

Alert   and oriented. Dressed in clean clothes. Maintains eye contact. Answers   questions appropriately.

Lab Tests

Urinalysis   – blood noted (pt. on menstrual period), but results negative for infection

Urine   culture testing unavailable

Wet   prep – inconclusive 

STD   testing pending for gonorrhea, chlamydia, syphilis, HIV, HSV 1 & 2, Hep B   & C 

Special Tests- No ordered at this   time.

Diagnosis 

Differential Diagnoses

• 1-Bacterial Vaginosis (N76.0)
• 2- Malignant neoplasm of female genital organ,         unspecified. (C57.9)
• 3-Gonococcal infection, unspecified. (A54.9)

Diagnosis

o Urinary   tract infection, site not specified. (N39.0) Candidiasis of vulva and vagina.   (B37.3) secondary to presenting symptoms (Colgan & Williams, 2011) &   (Hainer & Gibson, 2011). 

Plan/Therapeutics

• Plan:  
  • Medication – 

§ Terconazole cream 1 vaginal application QHS for 7 days for   Vulvovaginal Candidiasis; 

§ Sulfamethoxazole/TMP DS 1 tablet PO twice daily for 3 days   for UTI (Woo & Wynne, 2012)

• Education – 

§ Medications prescribed. 

§ UTI and Candidiasis symptoms, causes, risks, treatment,   prevention. Reasons to seek emergent care, including N/V, fever, or back   pain. 

§ STD risks and preventions. 

§ Ulcer prevention, including taking Protonix as prescribed,   not exceeding the recommended dose limit of NSAIDs, and not taking NSAIDs on   an empty stomach. 

• Follow-up         – 

§ Pt will be contacted with results of STD studies. 

§ Return to clinic when finished the period for perform   pap-smear or if symptoms do not resolve with prescribed TX.

References

Colgan, R. & Williams, M. (2011). Diagnosis and Treatment of Acute Uncomplicated Cystitis. American Family Physician, 84(7), 771-776.

Hainer, B. & Gibson, M. (2011). Vaginitis: Diagnosis and Treatment. American Family Physician, 83(7), 807-815. 

Woo, T. M., & Wynne, A. L. (2012). Pharmacotherapeutics for Nurse Practitioner Prescribers (3rd ed.). Philadelphia, PA: F.A. Davis Company.

 

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Report Issue

Urinary Obstruction

Case Studies

The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft.

Studies

Results

Routine laboratory studies

Within normal limits (WNL)

Intravenous pyelogram (IVP)

Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate

Uroflowmetry with total voided flow of 225 mL

8 mL/sec (normal: >12 mL/sec)

Cystometry

Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O)

Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O)

Electromyography of the pelvic sphincter muscle

Normal resting bladder with a positive tonus limb

Cystoscopy

Benign prostatic hypertrophy (BPH)

Prostatic acid phosphatase (PAP)

0.5 units/L (normal: 0.11-0.60 units/L)

Prostate specific antigen (PSA)

1.0 ng/mL (normal: <4 ng/mL)

Prostate ultrasound

Diffusely enlarged prostate; no localized tumor

Diagnostic Analysis

Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems.

Critical Thinking Questions

1. Does BPH predispose this patient to cancer?

2. Why are patients with BPH at increased risk for urinary tract infections?

3. What would you expect the patient’s PSA level to be after surgery?

4. What is the recommended screening guidelines and treatment for BPH?

5. What are some alternative treatments / natural homeopathic options for treatment?

 

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The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.

Subjective Data

• Complains of pain and heaviness in her leg.
• States she cannot bear weight on her leg and has been in bed for 3 days.
• Lives alone and has not had anyone to help her with meals.

Objective Data

• Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
• Left leg red from knee to ankle
• Calf measurement on left 3 in > than right
• Temperature: 38.9 degrees C
• Height: 160 cm; Weight: 83.7 kg

Laboratory Results

• WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
• Wound culture: Staphylococcus aureus

Critical Thinking Questions

1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
2. Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
3. What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
4. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

 

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Data-Based Changes

Write an essay addressing each of the following points/questions. Be sure to completely answer all the questions for each number item. There should be three sections, one for each item number below, as well the introduction (heading is the title of the essay) and conclusion paragraphs. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) citations in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.

1. Identify one aspect of big data and data mining that is interesting to you. Explain the concept and how it might bring value to healthcare. 
2. Describe the concept of continuity planning. If you were the director or manager for your current workplace, describe the preparedness program you would recommend.
3. Locate an article discussing the use of informatics in healthcare education of the general public or of nursing students. Discuss the benefits and drawbacks to using technology in this situation and recommendations from the author. Do you feel this use of technology is a viable method of educating (the public or nursing students)? Why or why not?

Assignment Expectations:

Length: 500 words per essay prompt/section (1500 total for this assignment)

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment. All APA Papers should include an introduction and conclusion.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

 

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