Posted: September 2nd, 2022

“pain in the left great toe for 3 days”

Rubric Title: Unit 2, Four, 6 Lab – Digital Actuality Rubric

***College students: It’s IMPORTANT to recollect to make the most of each the “Guided Mode” and “Professional Mode” in the VR Lab Simulation case situation experiences, as you observe the VR Lab situation(s). The “Guided Mode” and “Professional Mode” can help you have a number of tries/makes an attempt to observe the case. THEN, whenever you really feel you’re prepared, you’ll select the VR Lab “Examination Mode” (you can ONLY try as soon as); the rating you obtain in “Examination Mode” will then be your ultimate grade in the VR Lab. You probably have any questions relating to this, please comply with up together with your course teacher.

Task Standards Stage III Stage II Stage I Not Current
Standards 1 Stage III
Factors: 80 Stage II
Factors: 64 Stage I
Factors: 48 Not Current
Zero Factors
Whole Rating

● Inside Examination Mode, obtains 65 to 80 factors of the required whole parts for digital actuality affected person situation
● Inside Examination Mode, obtains between 49 to 64.9 factors of the required whole parts for digital actuality affected person situation ● Inside Examination Mode, obtains between 33 to 48.9 factors of the required whole parts for digital actuality affected person situation ● Doesn’t try in Examination Mode
● Doesn’t meet the standards

Rubric Title: Unit 3, 5, 7 SOAP Journal Task Rubric

Standards 1 Stage III Max Factors
Factors: Eight Stage II Max Factors
Factors: 6.Four Stage I Max Factors
Factors: Four.Eight Zero Factors
Content material High quality- Subjective Information
Subjective knowledge shows full understanding of all crucial ideas of digital actuality affected person case together with:
● Title, age, gender
● Chief criticism
● Historical past of current sickness (HPI) that follows OLD CARTS pneumonic
● Drugs
● Allergic reactions
● Previous medical historical past
● Previous surgical historical past
● Pertinent household historical past
● Social historical past
● Overview of Programs ● Subjective knowledge shows understanding of crucial ideas of chosen digital actuality affected person case; there could also be 1-2 crucial ideas with errors/omissions or lack of particulars. ● Subjective knowledge shows understanding of crucial ideas of chosen digital actuality affected person case; there could also be 3-Four crucial ideas with errors/omissions or lack of particulars. ● Doesn’t meet standards
Standards 2
Stage III Max Factors
Factors: Eight Stage II Max Factors
Factors: 6.Four Stage I Max Factors
Factors: Four.Eight Not Current
Zero Factors
Content material High quality- Goal Information
Goal knowledge shows full understanding of all crucial ideas of chosen digital actuality affected person case together with:
● Very important indicators
● Physique programs which might be pertinent to particular case ● Goal knowledge shows understanding of crucial ideas of chosen digital actuality affected person case; there could also be 1-2 crucial ideas with errors/omissions or lack of particulars. ● Goal knowledge shows understanding of crucial ideas of chosen digital actuality affected person case; there could also be 3-Four crucial ideas with errors/omissions or lack of particulars ● Doesn’t meet standards
Standards 3 Stage III Max Factors
Factors: Four Stage II Max Factors
Factors: 3.2 Stage I Max Factors
Factors: 2.Four Not Current
Zero Factors
Content material High quality- Assessment Assessment shows full understanding of all crucial ideas of chosen digital actuality affected person case together with:

● Major prognosis
● Pathophysiology of major prognosis
● Three differential diagnoses
● Rationales for differential diagnoses ● Assessment shows understanding of crucial ideas of chosen digital actuality affected person case; there could also be 1 crucial idea with errors/omissions or lack of particulars. ● Assessment shows understanding of crucial ideas of chosen digital actuality affected person case; there could also be 2 crucial ideas with errors/omissions or lack of particulars. ● Doesn’t meet standards
Standards Four Stage III Max Factors
Factors: Four Stage II Max Factors
Factors: 3.2 Stage I Max Factors
Factors: 2.Four Not Current
Zero Factors
Content material High quality- Plan of Care
Plan shows full understanding of all crucial ideas of chosen digital actuality affected person case together with:

● Drugs
● Non-pharmacological suggestions
● Diagnostic exams
● Affected person schooling
● Cultural issues
● Well being promotion
● Referrals
● Comply with-Up ● Plan shows understanding of crucial ideas of chosen digital actuality affected person case; there could also be 1 crucial idea with errors/omissions or lack of particulars. ● Plan shows understanding of crucial ideas of chosen digital actuality affected person case; there could also be 3-Four crucial ideas with errors/omissions or lack of particulars. ● Doesn’t meet standards
Standards 5 Stage III Max Factors
Factors: 3 Stage II Max Factors
Factors: 2.Four Stage I Max Factors
Factors: 1.Eight Not Current
Zero Factors
Collegiate-level tutorial writing

● Consists of not more than three grammatical, spelling, or punctuation errors that don’t intrude with the readability.
● Helps all opinions and concepts with related and credible reference sources of data.
● Gives three or extra peer-reviewed or evidence-based observe scholarly references sources.
● All reference sources are inside the previous 5 years.

● Consists of not more than 4 grammatical, spelling, or punctuation errors that don’t intrude with the readability.
● Helps many opinions and concepts with related and credible sources of data.
● Gives two peer-reviewed or evidence-based observe scholarly references sources.
● All reference sources are inside the previous 5 years. ● Consists of 5 or extra grammatical, spelling, and punctuation errors that makes understanding elements of project tough, however doesn’t intrude with readability.
● Not all references utilized are related and/or credible sources of data.
● Gives one peer-reviewed or evidence-based observe scholarly references supply.
● Reference sources are inside the previous 5 years. ● Doesn’t meet standards
Standards 6
Stage III Max Factors
Factors: 3 Stage II Max Factors
Factors: 2.Four Stage I Max Factors
Factors: 1.Eight Zero Factors
Citations and Formatting
● The general order of data is obvious and contributes to the that means of the project. There could also be 1-2 sentences, or one paragraph that’s out of order, or different minor group points.
● Appropriately citing all reference sources. One or two formatting, in-text, or reference quotation errors could happen.
● Citation marks and citations make authorship clear. ● The general order of data is complicated in locations attributable to 3-Four sentences, or two paragraphs that could be out of order, or different group points that intrude with the that means or intent of the paper.
● Appropriately citing all reference sources. 3-Four formatting, in-text, or reference quotation errors could happen.
● Citation marks and citations typically, make authorship clear. ● The general order of data is complicated in locations attributable to 5-6 sentences or three paragraphs that could be misplaced, or different group points that intrude with the that means or intent of the paper.
● Makes an attempt to quote. 5-6 formatting, in-text, or reference quotation errors could happen.
● Citation marks and citations could also be lacking or incorrect.
● Authorship could also be unclear in areas. ● Doesn’t meet standards
Most Whole Factors 30 24 18
Minimal Whole Factors 25 19

Rubric Title: Unit Eight Journal Rubric

Standards 1 Stage III Max Factors
Factors: 15 Stage II Max Factors
Factors: 12 Stage I Max Factors
Factors:9 Zero Factors
Content material High quality- Subjective Information
Presentation of subjective knowledge shows full understanding of all crucial ideas of chosen digital actuality affected person case together with:
● Title, age, gender
● Chief criticism
● Historical past of current sickness (HPI) that follows OLD CARTS pneumonic
● Drugs
● Allergic reactions
● Previous medical historical past
● Previous surgical historical past
● Pertinent household historical past
● Social historical past
● Overview of Programs ● Presentation of subjective knowledge shows understanding of all crucial ideas of chosen digital actuality affected person case; there could also be 1-2 crucial ideas with errors/omissions or lack of particulars. ● Presentation of subjective knowledge shows understanding of all crucial ideas of chosen digital actuality affected person case; there could also be 3-Four crucial ideas with errors/omissions or lack of particulars. ● Doesn’t meet the standards
Standards 2
Stage III Max Factors
Factors: 15 Stage II Max Factors
Factors: 12 Stage I Max Factors
Factors:9 Zero Factors
Content material High quality- Goal Information
Presentation of goal knowledge shows full understanding of all crucial ideas of chosen digital actuality affected person case together with:
● Very important indicators
● Physique programs which might be pertinent to particular case ● Presentation of goal knowledge shows understanding of all crucial ideas of chosen digital actuality affected person case; there could also be 1-2 crucial ideas with errors/omissions or lack of particulars. ● Presentation of goal knowledge shows understanding of all crucial ideas of chosen digital actuality affected person case; there could also be 3-Four crucial ideas with errors/omissions or lack of particulars. ● Doesn’t meet the standards
Standards 3 Stage III Max Factors
Factors: 15 Stage II Max Factors
Factors: 12 Stage I Max Factors
Factors:9 Zero Factors
Content material High quality- Assessment Presentation of Assessment shows full understanding of all crucial ideas of chosen digital actuality affected person case together with:

● Major prognosis
● Pathophysiology of major prognosis
● Three differential diagnoses
● Rationales for differential diagnoses ● Presentation of Assessment shows understanding of all crucial ideas of chosen digital actuality affected person case; there could also be one crucial idea with errors/omissions or lack of particulars. ● Presentation of Assessment shows understanding of all crucial ideas of chosen digital actuality affected person case; there could also be two crucial ideas with errors/omissions or lack of particulars. ● Doesn’t meet the standards
Standards Four Stage III Max Factors
Factors: 15 Stage II Max Factors
Factors: 12 Stage I Max Factors
Factors:9 Zero Factors
Content material High quality- Plan of Care
Presentation of plan shows full understanding of all crucial ideas of chosen digital actuality affected person case together with:
● Drugs
● Non-pharmacological administration
● Diagnostic exams
● Affected person schooling
● Cultural issues
● Well being promotion
● Referrals
● Comply with-Up ● Presentation of plan shows understanding of all crucial ideas of chosen digital actuality affected person case; there could also be one crucial idea with errors/omissions or lack of particulars. ● Presentation of plan shows understanding of all crucial ideas of chosen digital actuality affected person case; there could also be 3-Four crucial ideas with errors/omissions or lack of particulars.s ● Doesn’t meet the standards
Standards 5 Stage III Max Factors
Factors: 15 Stage II Max Factors
Factors: 12 Stage I Max Factors
Factors:9 Zero Factors
High quality of Oral Presentation ● Presentation demonstrated thorough group and supply.
● All concepts have been acknowledged in a transparent and logical method.
● Presentation was on subject and related.
● Presentation time now not than 5 minutes ● Presentation was organized and properly spoken.
● All concepts have been acknowledged in a transparent and logical method.
● Presentation was on subject and related.
● Presentation >5 minutes ● Presentation wanted extra particulars or content material inconclusive.
● Presentation >5 minutes ● Doesn’t meet the standards
Most Whole Factors 75 60 45 Zero
Minimal Whole Factors 61 46 1

Title: James Hanson Pt. Encounter Quantity:
Date: Eight/29/2022 Age: 47 Intercourse: M
SUBJECTIVE
CC:
“ache in the left great toe for 3 days”

HPI:
47 yo male presents to the workplace c/o ache in the left great toe with related redness and swelling. He stories that the ache began 3 days in the past when it woke him from sleep throughout the night time. He stories he had “a number of too many beers with the boys” previous to the onset of the ache. Ache is positioned in the left great toe joint and has been fixed. He describes the ache as extreme, throbbing, and pulsating. He stories that the mattress sheet, socks or sneakers make it worse and he’s unable to face, bear weight or put on a shoe.. Place modifications, elevation, relaxation and aspirin have been ineffective. He did get minimal aid from ice to the space. Charges the ache a 10 on a 1-10 ache scale. Denies trauma to space. He stories he has had some periodic ache delicate ache in the joint beforehand however he has not acquired care for this situation beforehand.

Drugs: HCTZ 25mg day by day for HTN x 10 years

Allergic reactions: NKDA

Remedy Intolerances: N/A
Previous Medical Historical past: HTN, obese

Continual Diseases/Main traumas: Historical past of clavicle fracture after a fall whereas intoxicated

Hospitalizations/Surgical procedures: denies

Preventive/Immunizations: Pt stories he’s UTD on all immunizations. TDaP 2018, Flu 2019, Covid # Four/2021, Covid #2 Four/2021. Screened and unfavorable for all STD and HIV 3 months in the past.

Household Historical past
Each mom and father have historical past of HTN. Father handled for gouty arthritis in a number of joints. Maternal and paternal grandparents with historical past of CVD and diabetes.
Social Historical past
Most popular pPt is employed as a lawyer, attended regulation faculty in Boston. By no means married, lives alone and has no youngsters. Sexually energetic, in ladies. Lifetime companions 20. Reviews condom use 100% of the time. Denies tobacco use. Reviews he drinks aprox 7-10 drinks per week, typically extra. Makes use of marijuana on the weekends. CAGE rating=Zero.

ROS
Normal
Denies latest change in weight however stories needing to lose some weight. Denies fever, chills, night time sweats, fatigue. Cardiovascular
Denies chest ache, palpitations, dizziness, syncope.

Pores and skin
Denies rashes or bruising. Reviews redness and swelling of left great toe with peeling pores and skin.
Respiratory
Denies cough, SOB

Eyes
Denies any issues with eyes, no change in imaginative and prescient.
Gastrointestinal
Denies belly ache, nausea, vomiting, constipation.

Ears
Denies ear ache or problem listening to.
Genitourinary/Gynecological
Denies dysuria and frequency.

Reviews he’s sexually energetic, ladies solely. Makes use of condoms 100% of the time. Screened for HIV and STD’s 3 months in the past, all unfavorable.

Head/Nostril/Mouth/Throat
Denies trauma to move. Denies congestion, sore throat.
Musculoskeletal
Denies muscle or joint ache with the exception of the left great toe redness, swelling and ache. ROM intact all joints with the exception of left great toe which is restricted attributable to ache. Denies trauma to space. Denies problem ambulating.
Breast
N/A Neurological
Denies syncope, dizziness. Denies numbness or tingling. Denies problem with speech, coordination or sensation.
Heme/Lymph/Endo
Denies swollen glands or lymph nodes. Denies bruising or bleeding. Denies being immunocompromised. Psychiatric
Denies melancholy/SI. Reviews some hassle sleeping particularly when utilizing alcohol.
OBJECTIVE
Weight 200lbs BMI 28.7 Temp 98.5 BP 129/84 left, 128/82 proper
Top 5’10” Pulse 86 Resp 18 O2 sat 99%
Normal Look
Wholesome showing, appropriately dressed, grownup male. Alert and oriented; solutions questions appropriately.
Pores and skin
Redness and desquamation round left first metatarsophalangeal joint.
HEENT
Head is normocephalic, atraumatic, and with out tenderness, seen or palpable lots, depressions or scarring. Hair evenly distributed. Eyes: PERRLA. Visible acuity intact. EOMs intact. Ears: Canals patent. Bilateral TMs pearly grey with constructive mild reflex; landmarks simply visualized. Nostril: Nasal mucosa pink; regular turbinates. No septal deviation. Neck: Supple. No mass, trachea midline. Full ROM; no cervical lymphadenopathy; no occipital nodes. No thyromegaly or nodules. Oral mucosa, pink and moist. Pharynx is nonerythematous and with out exudate. Tooth are in good restore.
Cardiovascular
Chest regular in look, no lifts, heaves, or thrills. S1, S2 with common price and rhythm. No additional sounds, clicks, rubs, or murmurs. Capillary refills two seconds. Pedal pulses 3+ bilaterally. No edema.
Respiratory
Symmetric chest wall. Respirations common and straightforward; lungs clear to auscultation bilaterally.
Gastrointestinal
BS energetic in all the 4 quadrants. Stomach comfortable, nontender. No hepatosplenomegaly.
Breast
Deferred
Genitourinary
Deferred.
Musculoskeletal
Limping on left foot famous on ambulation, in any other case full ROM seen in all 4 extremities.
Neurological
Alert and oriented x4, speech clear. No motor deficit famous. Muscle tissues energy 5/5 bilaterally. Sensantion intact bilaterally. Stability steady.
Psychiatric
Pt doesn’t seem depressed or anxious. Maintains eye contact.
Lab Exams
6 Panel Drug Display screen-
• Amphetamines-negative
• Barbituates-negative
• Cocaine metabolites-negative
• THC-negative
• Opiates-negative
• PCP-negative
Ethanol, blood- <5mg.dL
CBC
• RBC Four
• HGB 12
• HCT 36
• WBC 7
• Plt 157
CMP
• Glucose 99mg/dL
• Calcium 9.8mg/dL
• Sodium 138 mEq/L
• Chloride 100mEq/L
• BUN 19mg/dL
• Creatinine Zero.9mg/dL
• Albumin Four.5g/dL
• Whole Protein 7.5g/dL
• Alk Phos 40 U/L
• ALT 20 U/L
• AST 15 U/L
• Bilirubin Zero.5mg/dL
ESR-5mm/hr
CRP-Zero.5
ANA < or = 1:Four
RF Unfavorable
Serum Uric Acid Eight.4mg/dL
Synovial Fluid Assessment- constructive for uric acid crystals however unfavorable gram stain

Imaging
Left Foot Xray Regular, no radiologic proof of fracture or bony lesions.
Assessment
o Embrace not less than three differential diagnoses
▪ Present rationale for every differential prognosis
o Closing prognosis
▪ Pathophysiology of major and rationale for selecting as ultimate
Plan
o Drugs
o Non-pharmacological suggestions
o Diagnostic exams
o Affected person schooling
o Tradition issues
o Well being promotion
o Referrals
o Comply with up

Unit 1 Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing

● Chapter 2: Caring and the Superior Follow Nurse
● Chapter 3: Well being Promotion
● Chapter Four: The Artwork of Analysis and Therapy
● Chapter 5: Proof Primarily based Follow

Assets
PowerPoint Hyperlinks:
● Diagnostic Reasoning

● American Most cancers Society. (2021). Most cancers Screening Pointers. https://www.most cancers.org/wholesome/find-cancer-early/cancer-screening-guidelines.html

● Facilities for Illness Management. (2021). Immunization schedules. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

● Heart for Illness Management. (2021) Advisable Grownup Immunization Schedules https://www.cdc.gov/vaccines/schedules/downloads/grownup/adult-combined-schedule.pdf

● U.S. Preventive Companies Job Pressure. (2021). USPSTF A and B screening suggestions. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

● Division of Well being and Human Companies, Workplace of Illness Prevention and Well being Promotion (ODPHP). (2021). Wholesome Individuals 2030 https://well being.gov/healthypeople

● U.S. Preventive Companies Job Pressure. (2021). USPSTF all screening suggestions. https://www.uspreventiveservicestaskforce.org/BrowseRec/Index/browse-recommendations

Unit 2 Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 34: Cardiovascular Issues
● Chapter 35: Cardiac and Related Danger Issues
● Chapter 36 Dysrhythmias and Valvular Issues
● Chapter 37: Issues of the Vascular System

Assets
• https://www.ahajournals.org/doi/epub/10.1161/HYPERTENSIONAHA.120.15026

• Division of Well being and Human Companies, Workplace of Illness Prevention and Well being Promotion (ODPHP). (2021). Wholesome Individuals 2030. https://well being.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke
• The JNC Eight Hypertension Pointers: An In-Depth Information ( 2014),
o https://www.ajmc.com/view/the-jnc-Eight-hypertension-guidelines-an-in-depth-guide

Unit 2 Task:
VR Angela Atwater Hypertension Stage 2, and obese
Unit 3 Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 28: Widespread Respiratory Complaints
● Chapter 29 Sleep Apnea
● Chapter 30: Infectious Respiratory Issues
● Chapter 31: Inflammatory Respiratory Issues
● Chapter 32: Lung Most cancers
● Chapter 33: Smoking Cessation
Assets
● _sites_default_files_publications_AsthmaManagementGuidelinesReport-2-Four-21.pdf
● Heart for Illness Management and Prevention, (2021) Bronchial asthma Motion Plans https://www.cdc.gov/bronchial asthma/actionplan.html
● Cleaning soap Be aware Template SOAP NOTE TEMPLATE (3).docx

Unit Four Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 56: Widespread Endocrine and Metabolic Complaints
● Chapter 57: Glandular Issues
● Chapter 58: Diabetes Mellitus
● Chapter 59: Metabolic Issues

Assets
American Diabetes Affiliation. (2021) Follow Guideline Assets.
https://skilled.diabetes.org/content-page/practice-guidelines-resources

Heart For Illness Management, (2021). Gout.https://www.cdc.gov/arthritis/fundamentals/gout.html

Egan,B.,(2021),Therapy of Hypertension in Black People. UpToDate.
https://www.uptodate.com/contents/treatment-of-hypertension-in-black-individuals
Fitzgerald,J.d, etal.American Faculty of Rheumatology Pointers; 2020 American Faculty of Rheumatology Guideline for the Administration of Gout Arthritis Care & Analysis Vol. Zero, No. Zero, June 2020, pp 1–17 DOI 10.1002/acr.24180 © 2020. https://www.rheumatology.org/Portals/Zero/Information/Gout-Guideline-Early-View-2020.pdf

Mayo Clinic, (2021) Gout. https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897

Unit Four Task:

For this Exercise, go to VR /James Hanson/Gout

Unit 5 Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 6: Widespread Neurological Complaints
● Chapter 7: Seizure Issues
● Chapter Eight: Degenerative Issues
● Chapter 9 Stroke
● Chapter 10: Infectious and Inflammatory Neurological Issues

Assets
● Cleaning soap Be aware Template SOAP NOTE TEMPLATE (3).docx

Unit 6 Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 52: Widespread Musculoskeletal Complaints
● Chapter 53: Spinal Issues
● Chapter 54: Tender Tissue Issues
● Chapter 55.: Osteoarthritis and Musculoskeletal Issues

Unit 7 Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 43: Widespread Urinary Complaints
● Chapter 44: Urinary Tract Issues
● Chapter 45: Kidney and Bladder Issues
Useful resource
Heart For Illness Management and Prevention (CDC),2021 Acute Low Again Ache
https://www.cdc.gov/acute-pain/low-back-pain/index.html

SOAP Be aware Template SOAP NOTE TEMPLATE (3).docx

Unit Eight Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 18: Widespread Eye Complaints
● Chapter 19: Lid and Conjunctival Pathology
● Chapter 20: Visible Disturbances and Impaired Imaginative and prescient
● Chapter 21: Widespread Ear, Nostril and Throat Complaints
● Chapter 22: Listening to and Stability Issues
● Chapter 23: Inflammatory and Infectious Issues of the Ear
● Chapter 24: Inflammatory and Infectious Issues of the Nostril, Sinuses and Throat
● Chapter 25: Epistaxis

Unit 9 Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 79: Moral and Authorized Problems with a Caring Primarily based Follow
● Chapter 38: Widespread Stomach Complaints
● Chapter 39: Infectious Gastrointestinal Issues
● Chapter 40: Gastric Issues
● Chapter 41: Gall Bladder and Pancreatic Issues
● Chapter 42: Cirrhosis and Liver Failure

Unit 10 Studying:
Textbook Studying
Major Care: The artwork and Science of Superior Follow Nursing
● Chapter 64: Widespread Psychosocial Complaints
● Chapter 65: Substance Use Dysfunction
● Chapter 66: Schizophrenic Spectrum Issues
● Chapter 67: Temper Issues
● Chapter 68: Nervousness, Stress and Trauma-Associated Issues
● Chapter 69: Obsessive Compulsive Issues
● Chapter 70: Behavioral Issues
● Chapter 71: Neurodevelopmental Issues

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