Stroke/TIA Progress

8/10/2021 N580-20A_21Jul: Assignment 1

https://learn.americansentinel.edu/mod/assign/view.php?id=715384 1/4

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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

8/10/2021 N580-20A_21Jul: Assignment 1

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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

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8/10/2021 N580-20A_21Jul: Assignment 1

https://learn.americansentinel.edu/mod/assign/view.php?id=715384 4/4

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