NURS-FPX4015 - NURS FPX 4000 Assessment

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 5 Head-to-Toe Assessment on a Volunteer Presentation

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NURS FPX 4015 Assessment 5 Head-to-Toe Assessment on a Volunteer Presentation Student Name Capella University NURS-FPX4015 Professor Name Submission Date Head-to-Toe Assessment on a Volunteer Presentation Hello, everyone! Immaculate Durvil is my name and I will perform a head-to-toe examination of my patient, Ms. Aiyana Tehanata today. During this evaluation, I will monitor the overall appearance, check her vital signs, perform focused physical examination, and examine her neurological, cardiovascular, respiratory, and musculoskeletal systems. I will also explain my process of doing every component of the assessment in order to be comprehensive and precise. The demonstration relies on the health status of Ms. Tehanata and its impact on her overall care plan, which deals with the short-term and long-term health requirements. Comprehensive and Professional Assessment I started the overall examination of Ms. Aiyana Tehanata and talked about the reason behind the examination and her medical history, including her chief complaint, which is tingling in her feet. I also insisted on the role of communication during the process to make her feel at ease and collaborate. I began by general assessment to note her overall look with alertness and demeanor and whether she was experiencing distress or not. I then did a physical examination, specifically looking at the color and texture of the skin including any edema or other abnormalities of her extremities. I proceeded to the cardiovascular assessment, which involved hearing heart sounds, where S1 and S2 were normal without any murmur, gallops, and rubs. I proceeded to have an examination of the 4 th intercostal space where I identified the presence of stenotic turbulence. The above finding indicates that there are potential vascular abnormalities that could be explored (Selvaraj et al., 2022). The vital signs were taken, with temperature (98.4degF), heart rate (75 bpm), blood pressure (130/72 mmHg), and SpO2 (98%), which were normal. The respiratory examination was also accompanied by the fact that the lungs were clear and clear in the five lobes of the lungs, which was a sign that the lungs were free of respiratory distress or abnormalities. Next, I proceeded to the genitourinary examination and the abdominal examination, which were both free of distress and abnormalities. Her stomach was tender, non-tender, and stool was normal. I would then examine the musculoskeletal system to determine whether a person has joint pain, stiffness or restricted movements. I detected complete movement in all the extremities, and no external swelling or pain in joints. The neuro-assessment also involved a rudimentary ocular nerve appraisal, where Ms. Tehanata was attentive and oriented, as well as had intact cranial nerves. She was tested using the Snellen chart, and the outcome was 20/30 in the right eye and 20/40 in the left one, which is compatible with her reported problems in focusing. The next examination was the peripheral vascular system. I inspected both legs of the fibula to determine whether it is swollen, or altered in skin color or whether it has an ulcer. Symmetrical and palpable pulses in lower extremities were +2 bilaterally, and Capillary refill was less than 3 seconds. A single 10-point monofilament examination revealed reduced sensation in both feet, specifically 1, 2, 3, and 6 on the right foot, 4, 5, 6, and 9 on the left foot, which may be a sign of a possible neurological problem, such as peripheral neuropathy. In the process of the assessment, I shared the results with Ms. Tehanata and clarified to her the importance of her symptoms regarding the possibilities of diabetes and peripheral neuropathy. I also talked about the following steps of additional diagnostic tests and treatment, and made sure she had the idea of the consequences of her current health condition. Discussion of Diagnosis and Findings Following the examination, I told Ms. Tehanata that she had the signs of peripheral neuropathy, which is one of the common complications usually observed in persons with diabetes or hypertension. One of the main findings that can be used to diagnose this diagnosis is reduced sensation in both feet that is reflected by the 10-point monofilament test (Parveen et al., 2025). These findings suggest that she may have nerve damage in the lower extremities which may be secondary to long term hyperglycemia or vascular problems. I highlighted that peripheral neuropathy is a severe disease, and unattended to, it may cause other complications like ulcers, infection and even amputations. I told her that the elevated level of blood sugar might be causing the damaging of the nervous system, and managing her blood sugar levels is the only way to avoid the amplification of the situation. This observation suggests that, possibly, stricter management of her diabetes and an assessment of her medications, including Metformin and Gabapentin, is needed to make her treatment plan optimal (Dave et al., 2025). The vascular sufficiency may be compromised as caused by constriction of her blood vessels that appears in her cardiovascular examination with stenotic turbulence in the 4th intercostal space. This might be a root cause of the numbness in her feet. I promised her that I would be watching her heart and her circulatory system very closely and would take into consideration other diagnostic procedures to determine the vascular health. Finally, I addressed the topic of the need to have regular follow-up visits and tight blood glucose control. Reduced sensation exposes Ms. Tehanata to more risks of injuries, wounds, and infections that can remain undetected because her feet have impaired sensation (Baig et al., 2022). I focused on the importance of good feet care, frequent checking of her blood sugar levels and lifestyle changes (eating healthy and exercising). These measures are critical in ensuring that there is no more damage to the nerve and that her quality of life is enhanced. Understanding of Pharmacological Needs As the assessment and evaluation show, Gabapentin is prescribed to Ms. Tehanata to control peripheral neuropathy and reduce tingling in her feet. Gabapentin acts by decreasing nerve activity related to nerve-related pain and enhancing her general comfort by balancing her nerve activity that is related to the abnormal

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 4 Caring for Special Population Teaching Presentation

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NURS FPX 4015 Assessment 4 Caring for Special Population Teaching Presentation Student Name Capella University NURS FPX 4015 A4 Professor’s Name Submission Date Caring for Special Population Teaching Presentation Slide 1 Hi, my name is……., Today I’m going to speak about special populations, homeless/housing insecure populations. Slide 2 The care of culturally competent nursing care is still essential for delivering appropriate health care solutions to homeless and housing-insecure individuals. Homelessness affects individuals’ health care access, leading to higher prevalence of chronic diseases, mental health problems, and infectious diseases (Sleet & Francescutti, 2021). Nurses have the opportunity to address health disparities by utilizing evidence-based patient-centered strategies that center on trust and providing accessible, compassionate care. In this presentation, we will explore homeless healthcare needs, their inequitable treatment, and cultural needs, and will showcase some helpful nursing practices for the delivery of fair and effective healthcare. Slide 3 Population Group and Their Healthcare Needs Homelessness and housing insecurity are made up of a diverse population of people with mental illness, financial problems, families, and veterans. People experiencing homelessness can be defined as those who do not have a fixed, regular nighttime residence while staying in a shelter, transitional housing, or in a car, a bus or train, an abandoned building, or a public building or place, such as a hospital or mental health facility (Sleet & Francescutti, 2021). Housing insecurity is a term used to describe people who are at risk of becoming homeless due to financial issues, moving frequently, or living too close together. The constant switching of housing from shelters to other insecure environments negatively impacts access to care and exacerbates acute and chronic health issues. Slide 4 Because of their lack of coverage, homeless people often suffer from chronic health problems, such as high blood pressure, diabetes, and respiratory diseases. Non-compliance with drugs and medication and harsh weather conditions are combined with poor nutrition, which hastens the progression of the disease (Mejia-Lancheros et al., 2020). Diabetic ketoacidosis (DKA), peripheral neuropathy, and lower extremity amputation are some examples of complications of uncontrolled diabetes, while stroke and heart failure are some examples of complications of uncontrolled Hypertension. Environmental pollution, smoking, and exposure to repeated cold weather worsen chronic obstructive pulmonary disease (COPD), leading to increased hospital admissions and premature death. Shelter overcrowding increases homeless persons’ vulnerability to infectious diseases due to insufficient sanitation. Homeless individuals suffer more from tuberculosis, hepatitis, and COVID-19 infection than other people, resulting in higher death rates (Tsai & Wilson, 2020). Homeless individuals are often affected by depression, anxiety, post-traumatic stress disorder (PTSD), and substance abuse disorders. Homeless people have been less likely to use medical services because of their experience of trauma, abuse, and systemic neglect. Integrated prevention programs and early detection with person-centered coordinated services are needed to address the healthcare needs of this population. Slide 5 Culturally Sensitive Nursing Strategies To provide culturally competent nursing care to homeless people, it is necessary to know about the unique challenges and cultural experiences of these individuals. Trauma-informed care is beneficial for equitable care delivery as it allows healthcare providers to be more aware of how past trauma can impact patient behaviors and medical service engagement. Trauma-informed care practices create safe environments that are open for patients, as well as active listening techniques and experiences validation (Barry et al., 2023). Nurses should not use stigmatizing language as they assess patients’ barriers to care, such as issues of medication storage and survival being more important than health management. Creating trust and showing empathy between nurse and patient is a practice that increases patients’ involvement in their treatments. Medication access and management are a substantial challenge for homeless people due to financial, cognitive, and storage issues. To advocate for the use of long-acting medications, nurses will support monthly injectable antipsychotics in individuals with schizophrenia, and extended release antihypertensive in those with unstable living conditions (Adams et al., 2020). Healthcare providers who make medications easier to take and do not require refrigeration, and simplify medication regimens, enhance treatment adherence. Properly educated patients can become active players in their healthcare management during periods of instability if they are informed of and educated about the various treatment options and ways of risk reduction. Street medicine services are useful strategies to improve healthcare services for homeless people when they are mobile, moving between multiple locations. Those living in homelessness prefer to avoid traditional health care settings due to adverse experiences, extended wait times, and challenges with transportation (Gutman et al., 2024). Mobile health units deliver health care services at encampments, drop-in centers, and shelters, where individuals receive services focused on chronic disease management, wound care, and substance use counseling in addition to preventive services. Boston Health Care for the Homeless program has been a successful model whose primary care is delivered in community-based settings, resulting in better health outcomes (Koh et al., 2020). Healthcare models that offer flexibility in appointment times, such as walk-in clinics and same-day appointments, offer medical care convenience for individuals who experience homelessness by meeting ongoing medical care needs. Slide 6 Physical Assessment Findings Physical evaluations must be conducted since people who are homeless are more likely to delay health care until their condition is serious. Nurses should examine for skin infections, wounds, frostbite, and foot problems that are caused by long hours of walking and possibly wearing inappropriate footwear. A patient’s overall health needs can be understood by assessing their dehydration and malnutrition. Mental health assessments are equally critical because homeless people often have depression, PTSD, a nd substance use disorders that can compromise their capacity to take care of themselves and follow instructions (Adams et al., 2020). No judgement builds trust between healthcare providers and patients, resulting in disclosure of health concerns. Wound care, hydration, and mental health referrals are key activities that nurses conduct in health care settings as they perform physical and mental health screenings that will have a positive impact on chronic disease outcomes. Slide 7 Diversity within the Special Population Group

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 3 Mental Health Diagnosis Concept Map

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NURS FPX 4015 Assessment 3 Mental Health Diagnosis Concept Map Student Name Capella University NURS FPX 4015 Professor Name Submission Date Mental Health Diagnosis Concept Map References Bandelow, B. (2020). Current and novel psychopharmacological drugs for anxiety disorders. Advances in Experimental Medicine and Biology, 1191, 347–365. https://doi.org/10.1007/978-981-32-9705-0_19 Bains, N., & Abdijadid, S. (2020, July 10). Major depressive disorder. Europepmc.org. https://europepmc.org/article/nbk/nbk559078 Chand, S. P., Arif, H., & Kutlenios, R. M. (2023, July 17). Depression (Nursing). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/sites/books/NBK568733/ Huang, X.-J., Ma, H.-Y., Wang, X.-M., Zhong, J., Sheng, D.-F., & Xu, M.-Z. (2022). Equating the PHQ-9 and GAD-7 to the HADS depression and anxiety subscales in patients with major depressive disorder. Journal of Affective Disorders, 311, 327–335. https://doi.org/10.1016/j.jad.2022.05.079 Walter, H. J., Abright, A. R., Bukstein, O. G., Diamond, J., Keable, H., Ripperger-Suhler, J., & Rockhill, C. (2022). Clinical practice guideline for the assessment and treatment of children and adolescents with major and persistent depressive disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 62(5), 479–502. https://doi.org/10.1016/j.jaac.2022.10.001

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 2 Enhancing Holistic Nursing Care with the 3Ps

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NURS FPX 4015 Assessment 2 Enhancing Holistic Nursing Care with the 3Ps Student Name Capella University NURS FPX 4015 Instructor Name Due Date Enhancing Holistic Nursing Care with the 3Ps The 3Ps (pathophysiology, pharmacology, and physical assessment) are part of enhancing holistic nursing care. The three-point combination of disease process, medication management, and patient appraisal provides nurses with the most complete information about the disease process (Sapna et al., 2023). By gaining knowledge in these areas, nurses can, however, provide care that is patient-centered and addresses the complexities of physical, psychological, and social health. It aids in getting better patient outcomes and overall health. This evaluation seeks to showcase their role in enhancing patient outcomes and well-being. Holistic Nursing Care and Its Benefits Holistic nursing care is patient-centered care that considers the whole person- mind, body, spirit, and emotions rather than physical ailments when caring for the patient. A compassionate, personalized approach to care and treatment combines conventional treatment with complementary approaches. Holistic nursing can be defined as a healing-whole-person provider (Kwame & Petrucka, 2021). This approach helps to build a meaningful nurse-patient relationship and takes into account the emotional, cultural, and lifestyle factors. Holistic care for patients does not focus on treating symptoms but rather the root causes, thus creating overall wellness. This will improve patient satisfaction as individuals feel heard, appreciated, and will have high trust in the care providers (Kwame & Petrucka, 2021). Cultural and personal preferences are considered in treatment plans, and stress and anxiety are minimized with mindfulness and emotional support, leading to better health. Nurses also reap great advantages from holistic treatment. Deeper connections with patients increase job satisfaction, and practicing self-care helps to stave off burnout and emotional fatigue (Kwame & Petrucka, 2021). Holistic nursing extends beyond clinical skills to alternative therapies to enhance clinical skills and foster a positive work culture based on teamwork and empathy. The positive impact of holistic care has been well documented in numerous research studies and has been shown to reduce readmission rates, improve patient outcomes, and increase the quality of life for patients and healthcare providers. According to Hovde et al. (2023), holistic methods such as music therapy, guided imagery, and therapeutic touch can make a huge difference in decreasing the anxiety level, pain level, and stress of the patient, leading to improved healing and satisfaction. Additionally, nurses who practice holistic self-care techniques have less burnout and a higher level of job engagement (Williams et al., 2022). The results highlight the importance of the role of holistic nursing in creating a better, caring, sustainable health care system Pathophysiology and Its Role in Nursing Practice Pathophysiology is the study of changes in the functions of the body at the molecular, cellular, or organ level that occur due to trauma or illness, causing pain or damage. Nurses can use it to gain insight into the mechanisms of the disease, and to be able to provide better care, both for the symptoms and the mechanism. The recognition of the progression of a disease can enable a nurse to anticipate the potential complications and intervene in a timely manner and to help educate patients on how to effectively manage a disease (Peate, 2022). A nurse with a knowledge of pathophysiology can see beyond symptoms and can see what impact symptoms have on the whole person physically, emotionally, and mentally. For example, those suffering from diabetes mellitus are insulin-resistant and may also have problems with glucose metabolism, which is known to lead to neuropathy, kidney disease, and cardiovascular issues. Knowing these links helps the nurses develop a comprehensive care plan that includes lifestyle changes, counseling, and prevention. The pathophysiology also aids in clinical decision-making. In a condition such as heart failure, nurses’ understanding of the role of fluid retention as well as decreased cardiac output can help them observe early signs of deterioration in the heart failure condition, alter the plan of care, and educate the patient about self-care strategies (Peate, 2022). Further, the knowledge of the inflammatory response of the body during an infection enables the nurse to evaluate the pattern of the fever, to give the necessary treatment, and to assist with good immune function. Incorporating the pathophysiology in a comprehensive educational program for holistic nursing care enables nurses to take on physical, psychological, and social care for patients, which helps enhance patient outcomes and encourages a more holistic approach to healthcare. Pharmacology and Its Role in Nursing Practice Pharmacology is a subject that gives nurses the necessary information on medications such as mechanism of action, therapeutic effects, and possible side effects. With this understanding, nurses can choose the best medications to use, know how to administer them safely, and keep a check on how the patients respond to these medications. Nurses play a key role in helping to prevent medication errors by taking the time to review factors such as dosages, drug interactions, and contraindications before prescribing a medication. The need for nurses to assess how all the factors – medications included – interact with a patient’s overall heal rather than simply following prescriptions to administer medications (Ernstmeyer & Christman, 2023). For instance, a patient with hypertension who is using beta blockers will need to be monitored for adverse effects such as dizziness and fatigue while also factoring in lifestyle changes, such as diet and exercise. In mental health care, knowing what these medications do to the neurotransmitter levels can help nurses help patients who may be affected by the side effects of a medications such as mood changes or drowsiness. As a part of Pharmacology, the psychological and social aspects as well as the physical aspects are of interest. Emotional readiness for self-administering medication and/or social support for self-administering medication may impact patient education surrounding medication use for chronic conditions such as insulin use for diabetes. Similarly, balancing effective pain management and avoiding dependency is a challenge in pain management, and nurses will need to provide reassurance and alternative coping mechanisms (Vaismoradi et al., 2024).

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 1 Comprehensive Head-to-Toe Assessment Transcript

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NURS FPX 4015 Assessment 1 Comprehensive Head-to-Toe Assessment Transcript Student Name Capella University NURS-FPX4015 Professor Name Submission Date Marco Mancini – Physical Assessment Transcript Nurse: Well, good morning, Mr. Mancini. My name is Shazia. Today I will be doing your head to toe physical examination. I know you have been experiencing certain sleeping problems and anxiety. Would it be alright to go ahead with the assessment before we start? Client: Yes, that’s fine. Nurse (professional demeanor): You are welcome. During the exam, be able to inform me that you are not comfortable or have to rest. We shall start with measuring your vital signs. [Vital Signs – Objective] Temperature:6°F Heart Rate: 82 bpm, regular rhythm Respiratory Rate: 16 breaths/min, unlabored Blood Pressure: 148/92 mmHg O2 Saturation: 98% on room air Height: 5’10” Weight: 175 lbs BMI:1 (normal range) Note: Elevated BP is consistent with known hypertension diagnosis. General Appearance Mr. Mancini is of the correct age, dressed and groomed well. He maintains good eye contact and appears slightly nervous. His speech is clear though there are times that he stops speaking when talking on emotionally sensitive issues. Nurse: I can notice that you are tense. You are feeling good–you are very open. Neurological & Cognitive Status Level of Consciousness: Alert and oriented ×4 (person, place, time, situation) Cognition: Mild impairment in concentration in responding to emotionally evoking questions. Memory: Intact short- and long-term recall. Cranial Nerves II–XII: Grossly intact (CN VII facial symmetry observed during conversation; CN II gross visual acuity normal). Nurse: Are you able to count backwards by sevens starting with 100? Client: 93… 86… 79… umm… 72… Note: Processing slowed, however, proper effort and accuracy were observed. Head, Eyes, Ears, Nose, Throat (HEENT) Head: Normocephalic, atraumatic Eyes: PERRLA, no nystagmus Ears: Tympanic membranes clear bilaterally Nose: Mucosa pink, no congestion Mouth/Throat: Moist mucous membranes, no lesions, teeth intact. Skin Color: Normal for ethnicity Temperature: Warm, dry Turgor: Good elasticity Lesions: No rashes, ulcers, or abnormal findings Psychomotor activity: No apparent self-harm, scarring. Cardiovascular Heart sounds: S1 and S2 audible, no murmurs Rate & rhythm: Regular Peripheral pulses: 2+ bilaterally Capillary refill: <2 seconds Respiratory Breath sounds: Clear to auscultation bilaterally Respiratory effort: Non-labored, even pattern Chest expansion: Symmetrical Gastrointestinal Abdomen: Flat, soft, non-tender Bowel sounds: Present in all four quadrants No hepatosplenomegaly Reports no recent nausea, vomiting, or changes in appetite Genitourinary Subjective only as per outpatient exam protocol. Denies dysuria, hematuria, or frequency Denies sexual dysfunction No history of STIs reported Musculoskeletal Gait: Steady ROM: Full range in upper/lower extremities Muscle strength: 5/5 bilaterally No joint swelling or tenderness Psychiatric/Mental Health Observations Mood: “Some days I feel guilty… I get scared easily.” Affect: Constricted but appropriate Thought processes: Logical and goal-directed Insight/Judgment: Fair Suicidal ideation: Denies current or past SI/HI Sleep: Problems in sleeping because of nightmares and flashbacks. Coping mechanisms: Avoidance (e.g., violence in media), isolation Nurse: I am glad you told me, Marco. Understanding how these memories affect your everyday life is important. You are not the only one and we are to assist in your recovery process. Plan of Care – Immediate Follow-Up Continue lisinopril for hypertension Citalopram 20 mg for depression/anxiety Prazosin 1 mg qHS for nightmares Closing Statement Assess for orthostatic hypotension related to medication interactions Refer for individual psychotherapy (CBT) Educate the patient about PTSD, medication side effects, and suicide prevention resources. Arrange follow-up with Psychiatric NP in three weeks Nurse: Thank you again, Marco. Today you are open, and this will assist us in constructing a robust care plan. You are improving, and you will not stop collaborating with us in order to achieve your recovery. We will follow up with you in a week and three weeks to have a therapy session and medication follow-up, respectively.