Primary Care of Adolescents and Children NURS 6541 Entire Course Weekly Discussions And Assignments Essay Paper

Primary Care of Adolescents and Children NURS 6541 Entire Course Weekly Discussions And Assignments Essay Paper

Primary Care of Adolescents and Children NURS 6541 Entire Course Weekly Discussions And Assignments Essay Paper

NURS 6541 Entire Course Weekly Discussions And Assignments

NURS 6541 Week 1: Overview of Growth and Development

When we work with parents in a spirit of true partnership, mothers, fathers, and other caregivers are more likely to invite and welcome providers’ support in evaluating needs, developing goals, and identifying effective ways to strengthen the family and provide care for children.

—Child Welfare Information Gateway

Primary care of pediatrics begins in infancy and progresses through adolescence. During these stages of growth and development, children depend upon their families and health care providers to meet their individual health needs. As an advanced practice nurse, you must assess the family unit as a whole in order to determine the needs of the patient and the family. It is essential to work closely with parents and caregivers to provide care to pediatric patients and maintain patients’ health and well-being.

This week you explore the impact of sociocultural influences on assessments of children and families. You also examine strategies for assisting families in making health-related decisions for children at different stages of growth and development.

Note: Throughout this course, the term parent will be used to represent a pediatric patient’s caregiver, which may include a parent, stepparent, foster parent, guardian, and so on.

Learning Objectives

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By the end of this week, students will:

Assignment: Practicum – Journal Entry

As a future advanced practice nurse, it is important that you are able to connect your didactic experience to your Practicum experience. By applying the concepts you study in the classroom to clinical settings, you better prepare yourself for your future professional career. Each week, you complete an assignment that prompts you to reflect on your Practicum experiences and relate them to the material presented in the classroom.

To prepare for this course’s Practicum experience, address the following in your Practicum journal:

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NURS 6541: Primary Care of Adolescents and Children | Week 2

While every child develops a little differently, most infants, toddlers, and preschoolers meet the same basic growth and development milestones. When milestones are not met, it is often a sign of an underlying health issue. Consider Maddie’s story. In early infancy, she successfully met each of the expected growth and development milestones and was even able to roll over by her 6th month. However, at 9 months, she suddenly stopped developing normally. She quit babbling and did not learn how to crawl until she was 15 months old. Maddie did not start walking until age 3, and at age 4, she was still being spoon-fed with baby food. In Maddie’s case, growth and development milestones were not met because of autism (Autism Society, 2011). As an advanced practice nurse, you must be able to identify signs of abnormal growth and development in patients like Maddie. Whether you facilitate treatment for these patients or refer them for specialized care, it is essential to offer support and guidance to these patients and their families.

This week you examine normal and abnormal growth and development in infants, toddlers, and preschoolers. You also explore developmental red flags and assessment and management tools for these age groups.

Learning Objectives

By the end of this week, students will:

Wellness visits are an important part of pediatric primary care. During these visits, patient growth and development are assessed. As an advanced practice nurse who performs these assessments, you must be able to distinguish between normal and abnormal growth and development to recognize red flags. While some patients may not meet milestones due to differences in rates of development, abnormal development might also be a red flag of an underlying problem. In this Discussion, you examine the following case studies and consider potential developmental red flags.

Discussion board posting assignments are assigned alphabetically by FIRST NAME to ensure all cases are covered and discussed.

Case Study 1

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A mother brings in her 16-month-old, Brittany, for treatment of an acute illness. During the history, the mother reports that her mother-in-law is concerned about the toddler’s development. Further questioning reveals the following:

Case Study 2:

You see a 30-month-old named Brian for a well-child visit. His mother reports the following development:

Case Study 3

Jose is a 36-month-old who presents for a preschool evaluation. His father reports the following development:

To prepare:

By Day 3

Post an explanation of the following:

  1. Developmental red flags that presented on the stages of normal physical, social, and cognitive development for infants, toddlers, and preschoolers. Based on the red flags identified within the physical, social, and cognitive what additional questions should you ask? What additional examinations will you conduct?
  2. Explain how you differentiated between normal and abnormal growth and development for this patient.
  3. Identify which standardized screening tools, clinical guidelines, and management strategies you might use to assess and manage this patient and why.
  4. Health, promotion and anticipatory guidance:
    1. Based on the child’s age, discuss which immunizations this child should have received by now?
    2. When are the next set of immunizations? Which ones should be given?
    3. When should this child return to clinic?

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the ways listed below. Respond to colleagues who selected different case studies than you did.

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NURS 6541 Week 3: School-Age Children and Adolescents

If adolescents cannot trust that their health information will be both private and secure, they may not seek these services.

—American Academy of Pediatrics

This statement released by the American Academy of Pediatrics draws awareness to a topic of growing importance. According to the CDC’s National Center for Health Statistics, over 9% of school-age children and adolescents do not visit a health care provider regularly (U.S. Department of Health and Human Services, 2012). While this may be partially attributed to access to health care, concerns of privacy and trust also keep patients from obtaining necessary services. Patients are sometimes hesitant to share private information such as details of sexual activity or drug use with providers for fear that their parents will find out. In your role as the advanced practice nurse, you must be prepared to handle any provider-patient confidentiality issues that may arise with pediatric patients in clinical settings.

This week you explore the role of the provider regarding confidentiality between pediatric patients and their families. You also examine treatment and management strategies for school-age children and adolescents.

Learning Objectives

By the end of this week, students will:

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NURS 6541 Week 4: Evaluation and Management of HEENT Disorders

Patients with disorders of the eye, ear, nose, and throat (EENT) often present with a variety of symptoms that can be associated with multiple disorders. This makes diagnosis difficult because what may appear to be a gastrointestinal or respiratory disorder, for example, might actually be an EENT disorder such as otitis media. Consider 8-month-old Melissa, who presents with a complaint of tugging on her left ear, fussiness, and decreased appetite over the last 3 days. She does not have a fever, and her physical examination is normal. As the advanced practice nurse caring for patients like Melissa, you must always consider the differential diagnoses and perform the appropriate assessments and diagnostics prior to providing treatment and management recommendations for patients and their families.

This week you explore eye, ear, nose, and throat disorders in pediatric patients. You also examine differential diagnoses for these disorders, as well as the impact of patient culture on treatment, management, and education.

Learning Objectives

By the end of this week, students will:

Discussion: Evaluation & Management of HEENT Disorders

In clinical settings, head, eye, ear, nose, and throat (HEENT) disorders account for the majority of pediatric visits. With the prevalence of these disorders, you must be familiar with their signs and symptoms as well as evidence-based practices for assessment and treatment. Although many pediatric patients present with common HEENT disorders such as ear infections, allergies, and strep throat, some patients present with rare disorders requiring specialist care. In your role, making this distinction between when to treat and when to refer is essential. For this Discussion, examine the following case studies and consider potential diagnoses and management strategies.

Discussion board posting assignments are assigned alphabetically by FIRST NAME to ensure all cases are covered and discussed.

Case Study 1:

HPI: A mother presents with her 2-year-old African American male child with complaints of ear pain and decreased sleep. Earlier this week, he had a runny nose and congestion with a mild cough that occurred mostly when lying down. His temperature is 100.7.

PE: Pt is walking around room, exploring in no acute distress.
HEENT: Mild nasal congestion, clear postnasal drainage, and lungs clear to auscultation. Ear exam reveals right tympanic membrane erythematous, translucent, in a neutral position, with no pus or fluid noted. Left tympanic membrane is full, reddish/orange in appearance, and opaque with pus.
Neck: Shotty anterior cervical adenopathy
Lungs: Clear to auscultation

Case Study 2

HPI: Kevin is a 5-year-old Asian American boy with an intermittent 2-day history of nasal congestion and cough in the early morning. His mother reports thick, green nasal discharge. He is afebrile, and appetite and sleep are normal.

PE: A smiling male patient sitting on mom’s lap.
HEENT: Tympanic membranes pearly gray without fluid in a neutral position, no cervical adenopathy, nasal turbinates are red, and clear rhinorrhea and postnasal drip.
CV: RRR, no murmurs or gallop
PULM: clear to auscultation

Case Study 3

HPI: Marcus is an 8-year-old with a 36-hour complaint of headache (frontal), sore throat, fever to 102°F, and nausea. Mom says his appetite is decreased and his breath smells “like a puppy dog’s.”

PMH: A Polish 8-year-old boy, in mild distress.
HEENT: Tympanic membranes partially obscured by cerumen but in neutral position and transparent, 2+ enlarged and red tonsils with exudate, strawberry tongue, and petechiae on the soft palate enlarged tonsillar and anterior cervical lymph nodes.
CV: RRR
PULM: Clear to auscultation bilaterally

To prepare:

By Day 3

Post an analysis of your assigned case by responding to the following:

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to a colleague who chose one of the first three case studies and a second colleague who chose one of the last three case studies. Choose colleagues who selected a different case study than you did.

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NURS 6541 Week 5: Evaluation and Management of Respiratory, Cardiovascular, and Genetic Disorders

Baby Eden was only 1 month old when she presented with difficulty breathing, a high fever, and wheezing. Eden’s mother thought her daughter had a common cold, but the baby’s illness quickly led to admission to the pediatric intensive care unit. A diagnosis of respiratory syncytial virus (RSV) resulted in a weeklong hospital stay with antibiotic treatments (Azar, 2012). Like RSV, many respiratory disorders such as asthma and pneumonia also present symptoms often identified with common cold and flu viruses. As an advanced practice nurse, you must be able to distinguish between the various respiratory disorders to appropriately diagnose and treat pediatric patients. This is essential because, similarly to RSV, many disorders can quickly develop into a serious health issue.

An advanced practice nurse must know when to diagnose and treat, when to gather additional information prior to a diagnosis, and when to refer for specialized care. Consider 5-year-old Cristian Serrano. After waking up one morning with a fever and rash that covered his body, Cristian’s mother took him to his health care provider for examination. He was immediately diagnosed with scarlet fever and sent home with antibiotics. However, Cristian had not been properly diagnosed; his illness was actually the result of Kawasaki disease. Fortunately, the misdiagnosis was discovered quickly enough that there was no long-term damage to his heart’s arteries (Pritchett, 2011). With Kawasaki disease and other cardiovascular and genetic disorders, diagnostics and continued patient observation are sometimes necessary prior to determining diagnoses. In your role, you must be able to identify patient situations that require different approaches than the more typical diagnosis and treatment response.

This week you explore respiratory disorders in pediatric patients, as well as pediatric cardiovascular and genetic disorders, including the pathophysiology, epidemiology, and patient presentation. You also examine differential diagnoses for these disorders, as well as the impact of patient culture on treatment, management, and education.

Learning Objectives

By the end of this week, students will:

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NURS 6541 Week 6: Behavioral and Mental Health Issues

Behavioral and mental health issues can impact every facet of a child’s life, making the most basic activities difficult for patients and their families. This was the case for 13-year-old Kara. For more than 8 years, Kara suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues. Her behavior created problems at home and at school. As an advanced practice nurse working with pediatric patients, you must be able to assess if these types of problems are caused by psychological, social, or underlying growth and development issues.

This week, as you explore behavioral and mental health issues in pediatric patients, you consider strategies for promoting positive behavior, mental wellness, and good self-perception. You also examine growth and development and psychosocial issues, as well as management strategies and potential cultural impact on care.

Learning Objectives

By the end of this week, students will:

Select a patient who you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

By Day 7

You will submit this SOAP Note.

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NURS 6541 Week 7: Evaluation and Management of Dermatological Disorders

Skin disorders can be very challenging for adolescents and children because they often not only impact physical health but also mental and emotional health. Moderate to severe acne, for instance, impacts approximately one in five adolescent patients, and studies show that these patients are more than twice as likely to develop mental health problems than those without acne (Peeples, 2010). Like acne, many other skin disorders such as eczema or roseola also impact pediatric patients emotionally, often resulting in issues with self-confidence for even preschool-age patients. In your role as the advanced practice nurse, you must support these patients and treat the whole patient to improve physical and mental health.

This week you explore differential diagnoses for common skin disorders in pediatric patients. You also examine factors that impact the presentation, treatment, and management of patients with these disorders.

Learning Objectives

By the end of this week, students will:

Dermatologic disorders can present due to an actual skin problem or as the result of a systemic problem that manifests in the skin. Depending on the type of disorder, the presentation might be unique, making a quick diagnosis possible. However, some disorders have similar presentations in terms of symptoms and appearance, making diagnosis more difficult. Skin color and tone can also contribute to difficulty in diagnosis, making it important to consider cultural variations during assessments. In this Discussion, you examine the following case studies of skin disorders.

Discussion board posting assignments are assigned alphabetically by FIRST NAME to ensure all cases are covered and discussed.

Case Study 1

An adolescent presents to your office with a complaint of an itchy, red rash that first appeared on his lower legs 1 week ago after he returned from a camping trip. The rash has since spread to the upper legs, trunk, and groin. He denies fever or other systemic symptoms.

Case Study 2

An 8-month-old presents to your office with a rash on both cheeks that has progressively worsened over the last week. Mom first noticed the rash after his 6-month checkup. He has generalized dry skin and rubs at his cheeks often.

Case Study 3

A 24-month-old presents with a red rash that began on his trunk yesterday and has now spread to the face and upper extremities. His grandmother reports that earlier in the week, the toddler had intermittent fevers up to 101.5°F without other symptoms. The fever broke approximately 48 hours ago and the rash began a few hours later.

Case Study 4:

You see a 9-year-old male who presents with a white, scaly patch on the back of his head. There is some alopecia in the area with hair breakage noted at the scalp.

To prepare:

By Day 3

Post an explanation of the skin disorder in the case study you selected. Include in your explanation the lesion type, lesion distribution, color, and any ancillary findings. Then, present 3 differential diagnoses and explain which is the most likely diagnosis for the patient and why. Finally, explain a treatment and management plan for the patient’s skin disorder, including appropriate dosages for any recommended treatments.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.

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NURS 6541 Week 8: Gastrointestinal Disorders

Many gastrointestinal (GI) disorders have overlapping symptoms, making diagnosis difficult, especially for those disorders that are less common among pediatric patients. This was the case for 8-year-old Erin. After becoming sick with flu-like symptoms, Erin’s parents took her to their family health care provider, who diagnosed her with a viral infection that would simply run its course. However, after 3 weeks, Erin had lost all energy and 25 pounds. She was so weak, her parents had to carry her into the emergency room. Diagnostic tests revealed a massive bleeding lesion in her colon, confirming a suspected diagnosis of Crohn’s disease (Nationwide Children’s Hospital, n.d.). Like Crohn’s, many GI disorders initially present with flu-like symptoms. As an advanced practice nurse, you must identify when to treat these symptoms, when to order diagnostics, and when to refer for specialized care.

This week you explore gastrointestinal disorders in pediatric patients. You also examine differential diagnoses for these disorders, as well as the impact of patient culture on treatment, management, and education.

Learning Objectives

By the end of this week, students will:

Assignment: Practicum – SOAP Note #3: Comprehensive: Get NURS 6541 Primary Care of Adolescents and Children Essay Help

Your Well Child Note is due by Day 7 of Week 8. Take some time to review the provided example. Select a patient who you examined during the last 4 weeks. With this patient in mind, address the following in a SOAP Note:

By Day 7

Please submit the Week 8 SOAP Note.

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NURS 6541 Week 9: Evaluation and Management of Renal and Genitourinary Disorders

The care of genitourinary (GU) disorders can range from primary care diagnosis and treatment to referral for specialized care, making it essential for you to identify when a patient’s needs fall within your scope of practice. Consider Hannah, who received specialized treatment for a GU disorder. When Hannah was born, her bladder was misshapen and located outside of her body, requiring immediate surgery. Although the surgery was a success, she began to present with complications at age 2. As is common among children with her condition, bladder exstrophy, she suffered from frequent urinary tract infections (Miami Children’s Hospital, 2012). Although you might not treat bladder exstrophy as an advanced practice nurse, you must be able to treat resulting complications that present later in the patient’s life. In your role, you will care for pediatric patients with GU disorders, and like Hannah, some of these patients will have unique needs, requiring long-term treatment and management.

This week you explore genitourinary disorders in pediatric patients. You also examine differential diagnoses for these disorders, as well as the impact of patient culture on treatment, management, and education.

Learning Objectives

By the end of this week, students will:

*These Learning Objectives support assignments that are due this week but were assigned in Weeks 8 and 9.

Many genitourinary (GU) disorders such as kidney disease begin developing during childhood and adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for pediatric patients, to identify potential signs and symptoms. Although some pediatric GU disorders require long-term treatment and management, other disorders such as bedwetting or urinary tract infections are more common and frequently require only minor interventions. In your role with pediatric patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following three case studies.

Discussion board posting assignments are assigned alphabetically by FIRST NAME to ensure all cases are covered and discussed.

Case Study 1

HPI: This is a 3 year old girl with a 2-day history of complaints of dysuria with frequent episodes of enuresis despite potty training about 7 months ago. She is afebrile and denies vomiting.

PMH: Last UTI, 6 months ago.
PE: Dipstick voided urine analysis reveals: specific gravity 1.015, Protein 1+ non-hemolyzed blood, 1+ nitrites, 1+ leukocytes, and glucose-negative.

Case Study 2

Jacob is a 1.5 week old brought in by his distressed mother. While changing his diaper last night, she noted that his penis was edematous and erythematous. He has been crying and fussy. Per mom, no other complaints. He’s been breastfeeding every 1-2 hours without any issues.

PE: Stable VS and growth patterns. Essentially a normal examination with the exception of a slightly erythematous and edematous glans penis with retracted prepuce.

Case Study 3

HPI: Mark is a 15-year-old with complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago after a wrestling match. He describes the pain as a dull ache and has gradually worsened to where he can no longer stand without doubling over. He is afebrile and in marked pain.

PE: Physical exam is negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign.

Case Study 4

HPI: Maya is a 5-year-old who presents for a well-child visit. She is a healthy child with no complaints.

PE: VS stable; Height and weight within the 60th percentile. Head to toe examination is normal.
Diagnostics: Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood, leukocytes, and nitrites. 60th percentile for height and weight.

To prepare:

By Day 3

Post an analysis of your assigned case by responding to the following:

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.

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NURS 6541 Week 10: Evaluation and Management of Musculoskeletal and Neurological Disorders

For many children and adolescents, sports are one way to build friendships, work in teams, engage in healthy competition, and earn scholarships—Tracy Yatsko was no exception. Tracy played on her high school’s basketball and track teams until suffering from a severe concussion. Initially, her concussion was thought to be mild. However, the dizziness and nausea lingered into the next evening when she collapsed in the locker room after another game. Tracy spent much of the remaining school year at home with migraines, nausea, vomiting, and difficulty concentrating. She was prescribed several different medications, was forced to stop playing sports, and lost many friends (Mishori, 2012). Sports injuries such as concussions are only one of several musculoskeletal and neurologic disorders that impact pediatric patients. Patients with these disorders often require extensive care, and as the advanced practice nurse, it is your role to provide this care, develop treatment strategies, and identify factors that impact adherence to care.

This week you explore musculoskeletal and neurologic disorders in pediatric patients. You also examine differential diagnoses for these disorders, as well as the impact of patient culture on treatment, management, and education.

Learning Objectives

By the end of this week, students will:

Musculoskeletal and neurologic disorders can present complications for pediatric patients from infancy to adolescence. These disorders affect patients physically and emotionally and often impact a patient’s ability to participate in or carry out everyday activities. Patients with these disorders frequently need long-term treatment and care requiring extensive patient management and education plans. Musculoskeletal and neurologic disorders present various symptoms because they affect multiple parts of a patient’s body. Consider treatment, management, and education plans for the patients in the following three case studies.

Case Study 1:

HPI: Clay is a 7-year-old male who presents in your office with complaints of right thigh pain and a limp. The pain began approximately 1 week ago and has progressively worsened. There is no history of trauma.

PE: Pleasant Caucasian boy, in mild distress. VS and growth pattern stable.
MS: flexion and internal rotation of the right hip and limited abduction of the right hip. Limb lengths are equal.

Case Study 2:

HPI: A 12-year-old girl presents with left knee pain during and after playing soccer. She’s been a member of an elite soccer team for the last 6 years. She has 2 hour practices 3 times a week. Does not recall any injuries.

PMH: asthma, eczema
MS: Anterior/posterior drawer tests negative; negative ballottement; negative edema/erythema; bony tenderness, slight swelling at the left tibial tubercle.

Case Study 3:

HPI: Trevon is an 18-month-old with a 3-day history of upper-respiratory-type symptoms that have progressively worsened over the last 8 hours. Mom states he spiked a fever to 103.2°F this morning and he has become increasingly fussy. He vomited after drinking a cup of juice this afternoon and has refused PO fluids since then.

PE: VS: Temp: 102.5°F;
HEENT: Marked irritability with inconsolable crying, and he cries louder with pupil examination and fights head and neck assessment
ABD: negative abdominal exam
NEURO: You are unable to elicit Kernig’s or Brudzinski’s signs due to patient noncompliance.

Case Study 4:

HPI: Molly is a 12-year-old who comes to your office after hitting her head on the ground during a soccer game. Her mother reports that she did not lose consciousness, but that she seems “loopy” and doesn’t remember what happened immediately following her fall. She was injured when she collided with another player and fell backward, striking her head on the ground. She has no vomiting and denies diplopia but complains of significant headache.

PE: Physical examination is negative except for the presence of slight nystagmus. All other neurologic findings including fundoscopic examination are normal.

To prepare:

By Day 3

Post an analysis of your assigned case by responding to the following:

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in both of the wayslisted below. Respond to colleagues who selected different case studies than you did.

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NURS 6541 Week 11: Evaluation and Management of Hematological and Metabolic Disorders

Hematologic and metabolic disorders often require long-term treatment and management plans. In your role as an advanced practice nurse, you support patients, their families, and other members of the care team throughout this process as adherence to some plans can be difficult. Consider Charlie Rider. At age 4, Charlie was diagnosed with acute lymphoblastic leukemia and underwent care for 4 years. When he was finally strong enough to return home from the hospital, there were many restrictions placed on him because his body was vulnerable to infection. He could not go to indoor gatherings, eat in restaurants, or have friends visit. These restrictions were part of the management plan set up for Charlie (Dana-Farber/Children’s Hospital Cancer Center, 2013). As an advanced practice nurse, you work with pediatric patients like Charlie and their care teams to help develop and facilitate management plans for various hematologic and metabolic disorders. It is important to consider factors that impact these plans, as each patient has unique needs and circumstances.

This week you explore hematologic and metabolic disorders in pediatric patients. You also examine differential diagnoses for these disorders, as well as the impact of patient culture on treatment, management, and education.

Learning Objectives

By the end of this week, students will:

Final Exam: Week 11

This Exam covers the content you have explored throughout Weeks 7-11 of this course. This Exam is a test of your knowledge in preparation for your certification exam. No outside resources including books, notes, websites, or any other type of resource are to be used to complete this quiz.

You have 200 minutes to complete the Exam. You may only attempt this Exam once.

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