N580-20A_21Jul_Assignment1RUBRIC1
Scenario: Mr. C, a 64 year-old faculty member teaching computer science, presents with headache, weakness, and numbness on his left extremities. He’s by himself and a little confused, so his history is “sketchy.” CC: “I had these problems this morning. I then seemed to improve, and then got worse. Now I’m getting scared.” Past medical history: Hypertension, possible transient ischemic attacks s last year per verbal history (patient was on vacation). Has been taking ASA 81 mg and amlodipine (Norvasc) 10 mg daily. Physical exam: Blood pressure, 162/96; respiration rate, 26/min. Patient awake but confused, left foot slightly externally rotated, difficulty walking, bilateral high-pitched carotid bruits, decreased sensation in left lower extremity. Questions to think about when writing paper per instructor but not mandatory- criteria given is straight from rubric and should be used as the paragraph headings. 1. What additional subjective data do you think the patient will share? 2. What additional objective data will you be assessing for? 3. What National Guidelines are appropriate to consider? What level of evidence supports these guidelines? 4. What tests will you order? 5. Will you be looking for a consult? 6. What are the medical and nursing diagnoses? 7. Are there any legal/ethical considerations? 8. What is your plan of care? medical nursing complementary therapies 9. Are there any Healthy People 2020 objectives that you should consider? 10. Using the Circle of Caring, what or who else should be involved to truly hear the patient’s voice, getting him and the family involved in the care to reach optimal health? 11. What additional patient teaching is needed? 12. What billing codes would you recommend? Criteria from rubric: Assessment Develops and demonstrates a clear & precise assessment plan supported with professional literature and includes objective and subjective data. Guidelines/Evidence Thoroughly describes all relevant practice guidelines. Clearly defines and delineates the levels of evidence that support the guidelines. Diagnostics Clearly describes all appropriate diagnostics (including sensitivity and specificity). Clearly differentiates the difference between a positive and a negative finding and APN considerations Treatment Plan Develops and provides a clearly written set of orders inclusive of all essential elements in a treatment plan Evaluation Develops and demonstrates a clear & precise evaluation plan for the next office visit inclusive of data that will indicate no change necessary in plan or changes necessary in the plan Healthy People 2020/Health Promotion Develops and demonstrates a clear & precise desсrіption of the Healthy People 2020 goals and specifically relates one goal to current case. Patient/Family Teaching Develops and demonstrates a clear & precise educational plan for the patient and family. Billing Discusses all levels of billing that apply to the case and most likely appropriate level for first visit and one follow up visit What billing codes would you recommend? Follow up Develops a follow up plan that specifically identifies the data that will need to be reviewed during the follow up visit. (This may function as communication to the team…i.e. check BP, cholesterol, and EKG next visit)
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/2021 N580-20A_21Jul:
Assignment 1
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N580-20A_21Jul Advanced Practice Nursing I
Assignment 1
Scenario:
Mr. C, a 64 year-old faculty member teaching computer science, presents with headache, weakness, and numbness on his left
extremities. He s̓ by himself and a little confused, so his history is “sketchy.”
CC: “I had these problems this morning. I then seemed to improve, and then got worse. Now Iʼm getting scared.”
Past medical history: Hypertension, possible transient ischemic attacks s last year per verbal history (patient was on vacation). Has
been taking ASA 81 mg and amlodipine (Norvasc) 10 mg daily.
Physical exam: Blood pressure, 162/96; respiration rate, 26/min. Patient awake but confused, left foot slightly externally rotated,
difficulty walking, bilateral high-pitched carotid bruits, decreased sensation in left lower extremity.
Questions:
1. What additional subjective data do you think the patient will share?
2. What additional objective data will you be assessing for?
3. What National Guidelines are appropriate to consider? What level of evidence supports these guidelines?
4. What tests will you order?
5. Will you be looking for a consult?
6. What are the medical and nursing diagnoses?
7. Are there any legal/ethical considerations?
8. What is your plan of care?
medical
nursing
complementary therapies
9. Are there any Healthy People 2020 objectives that you should consider?
10. Using the Circle of Caring, what or who else should be involved to truly hear the patient s̓ voice, getting him and the family involved
in the care to reach optimal health?
11. What additional patient teaching is needed?
12. What billing codes would you recommend?
Grading Rubric
Criteria 10 Points 8 Points 6 Points 0 Points
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Assessment Develops and
demonstrates a clear
& precise assessment
plan supported with
professional literature
and includes objective
and subjective data.
Develops and
demonstrates an
assessment plan but
not fully supported
with professional
literature may be
missing one important
piece of data
Develops and
demonstrates a brief &
vague assessment
plan while missing
important details of
the assessment data;
supported with
minimal professional
literature.
No paper submitted or
content missing
/10
Guidelines/Evidence Thoroughly describes
all relevant practice
guidelines. Clearly
defines and delineates
the levels of evidence
that support the
guidelines.
Describes relevant
practice guidelines
and/or describes
levels of evidence to
support guidelines but
does not do both.
Describes a brief &
vague treatment plan
but lists no guidelines
and does not level
evidence.
No paper submitted or
content missing
/10
Diagnostics Clearly describes all
appropriate
diagnostics (including
sensitivity and
specificity). Clearly
differentiates the
difference between a
positive and a
negative finding and
APN considerations
Describes all
appropriate
diagnostics but does
not discuss the
difference between a
positive and negative
finding or lacks a
discussion of
specificity and
sensitivity for each
diagnostic
Simply lists some
diagnostics but does
not discuss specificity,
sensitivity, negative, or
positive and APN
considerations
No paper submitted or
content missing
/10
Treatment Plan Develops and provides
a clearly written set of
orders inclusive of all
essential elements in a
treatment plan.
Develops a clear set
of written orders but
omits an important
order for the diagnosis
Develops and provides
a brief set of orders
for the treatment plan
with more than one
omission.
No paper submitted or
content missing
/10
Evaluation Develops and
demonstrates a clear
& precise evaluation
plan for the next office
visit inclusive of data
that will indicate no
change necessary in
plan or changes
necessary in the plan
Develops a evaluation
plan for next office
visit. Includes data
but does not describe
predictive changes
Develops a vague
evaluation plan. There
is no data identified or
plan
No paper submitted or
content missing
/10
Criteria 10 Points 9 Points 7 Points 0 Points
Healthy People 2020
Health Promotion
Develops and
demonstrates a clear
& precise description
of the Healthy People
2020 goals and
specifically relates one
goal to current case.
Develops a Health
Promotion plan and/or
discusses Healthy
People 2020 and the
relation to the case
Describes Health
Promotion but does
not relate back to the
case
No paper submitted or
content missing
/10
Patient/Family Teaching Develops and
demonstrates a clear
& precise educational
plan for the patient
and family.
Educational topics are
described but no plan
is developed for the
patient and family
A general educational
plan is shared but is
not specific to the
current case..
No paper submitted or
content missing
/10
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Billing Discusses all levels of
billing that apply to the
case and most likely
appropriate level for
first visit and one
follow up visit
Discusses only the
billing level that the
APN may utilize
without rationalization
and the differences in
initial and follow up
Discusses billing levels
however provides
inaccurate levels or
rationalization
No paper submitted or
content missing
/10
Follow up Develops a follow up
plan that specifically
identifies the data that
will need to be
reviewed during the
follow up visit. (This
may function as
communication to the
team…i.e. check BP,
cholesterol, and EKG
next visit)
Discusses a general
plan for follow up but
no specific data is
listed. May not
indicate when follow
up should occur or
why?
Describes a
generalized follow up
plan that applies to all
patients not the
specific case.
No paper submitted or
content missing
/10
5 Points 4 Points 2 Point 0 Points
Grammar, spelling, and
punctuation
There are no errors in
grammar, spelling, and
punctuation
There are a few minor
errors in grammar,
spelling, and
punctuation that do
not detract from the
meaning
There are major errors
in grammar, spelling,
and punctuation that
do not reflect
scholarly writing
No submission /5
APA The paper meets APA
format guidelines
There are minor APA
format errors
There are significant
errors in format
No Submission /5
Total Points Possible = 100
Submission status
Submission
status
No attempt
Grading status Not graded
Last modified –
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