assignment 1 case study assignment assessing neurological symptoms

CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting. 

THE CASE STUDY ASSIGNMENT

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 

Case study: Forgetfulness 

Asia brings her 67 year old father into the office stating he is very forgetful. He has lost his car keys several times. She also states he has driven to the store and called her asking for directions to get back home 

Required Reading:

• Chapter 7, “Mental Status” This chapter revolves around the mental status evaluation of an individual’s overall cognitive state. The chapter includes a list of mental abnormalities and their symptoms.
• Chapter 23, “Neurologic System” The authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings.
• Chapter 4, “Affective Changes” Download Chapter 4, “Affective Changes” This chapter outlines how to identify the potential cause of affective changes in a patient. The authors provide a suggested approach to the evaluation of this type of change, and they include specific tools that can be used as part of the diagnosis.
• Chapter 9, “Confusion in Older Adults” Download Chapter 9, “Confusion in Older Adults” This chapter focuses on causes of confusion in older adults, with an emphasis on dementia. The authors include suggested questions for taking a focused history as well as what to look for in a physical examination.
• Chapter 13, “Dizziness” Download Chapter 13, “Dizziness” Dizziness can be a symptom of many underlying conditions. This chapter outlines the questions to ask a patient in taking a focused history and different tests to use in a physical examination.
• Chapter 19, “Headache” Download Chapter 19, “Headache” The focus of this chapter is the identification of the causes of headaches. The first step is to ensure that the headache is not a life-threatening condition. The authors give suggestions for taking a thorough history and performing a physical exam.
• Chapter 31, “Sleep Problems” Download Chapter 31, “Sleep Problems” In this chapter, the authors highlight the main causes of sleep problems. They also provide possible questions to use in taking the patient’s history, things to look for when performing a physical exam, and possible laboratory and diagnostic studies that might be useful in making the diagnosis.
• Chapter 2, “The Comprehensive History and Physical Exam” (“Cranial Nerves and Their Function” and “Grading Reflexes”) (Previously read in Weeks 1, 2, 3, and 5)
• O’Caoimh, R., & Molloy, D. W. (2019). Comparing the diagnostic accuracy of two cognitive screening instruments in different dementia subtypes and clinical depression.Links to an external site. Diagnostics, 9 (3), 93. https://doi.org/10.3390/diagnostics9030093

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Case Study Assignment: Assessing Neurological Symptoms

• Nursing Assignments Sample

A 70-year-old female comes to your clinic with complaints of forgetfulness. She noticed it about a year ago and it has progressively gotten worse. She sometimes forgets what she is going to do when she gets to another room. Her family has noticed the problem with her forgetfulness, but she is still able to manage her finances and drive, per her report.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

Episodic/Focused SOAP Note

Patient information:.

Initials: S.T.                     Age: 70 years                   Sex: Female                         Race: Hispanic

S                                                                                                                 

CC (chief complaint): “I have forgetfulness.”

HPI : S.T. is a 70-year-old Hispanic female who has visited the clinic accompanied by her daughter. Her chief complaint is forgetfulness. She reports that her symptoms began a year ago, but they have gotten worse over the years. S.T. further indicates that she sometimes forgets what she is going to do when she gets to another room. According to her daughter, the family has noticed the problem with their mother’s forgetfulness.  However, she is still able to manage her finances and drive.

Location: Psychological

Onset : 1 year ago

Character : Abstract

Associated signs and symptoms : Not indicated

Timing : Anytime

Exacerbating/ relieving factors : None mentioned

Severity : Mild

Current Medications : None

Allergies: No known drug or food allergies reported.

PMHx : S.T. is unable to remember childhood immunization history. She received Johnson & Johnson COVID-19 vaccine on 12/06/2021. She received her last tetanus vaccine 8 years ago in April 2014, but she cannot recall the date. S.T. reports a history of hospitalization which happen in her late 40s due to pneumonia complications.

Soc Hx : S.T. is a retired high school teacher. Her husband is an engineer. She denies cigarette or alcohol consumption. She hardly engages in exercise. S.T. spends a part of the day on the farm. She uses her car in case she wants to go to town. She eats a lot of fruits and vegetables and hardly eats red meat. Family members have reported a problem with her forgetfulness.

Fam Hx : S.T. reports that her father and mother died several years ago from stroke and a cardiovascular complication respectively. She denies the presence of a chronic condition among the living members of her family.

GENERAL:  Denies fever, abnormal changes in weight, reports forgetfulness.

HEENT:  Does not report a recent head injury, visual loss, ear pain, nasal congestion, or sore throat.

SKIN:  Does not report itchiness or rashes.

CARDIOVASCULAR:  No chest discomfort or pain reported.

RESPIRATORY:  No shortness of breath or cough reported.

GASTROINTESTINAL:   Denies abdominal pain or discomfort.

GENITOURINARY:  Denies a burning sensation in the genitalia during urination.

NEUROLOGICAL:  Reports forgetfulness or memory loss. Denies tingling or numbness of the extremities.

MUSCULOSKELETAL:  Denies joint-related pain or a problem with gait.

HEMATOLOGIC:  Denies a history of blood disorders.

LYMPHATICS:  Does not report pain or swelling of the lymphatics.

PSYCHIATRIC:  No anxiety reported. Denies stress. Reports forgetfulness or memory loss.

ENDOCRINOLOGIC:  Denies abnormal sweats at night.

ALLERGIES:  No drug or food allergies reported.

Vital signs : Temperature: 98 degrees Fahrenheit, blood pressure: 121/80, respiratory rate: 18 breaths per minute, heart rate: 92 beats per minute, weight: 152.7 lb, height: 5.8 feet, BMI: 23.2 kg/m 2 .

General appearance : S.T. is also properly oriented to person, place, and time.

Skin: Warm, hairy, and no lesions

HEENT: Head is normocephalic and lacks physical injury. Visual acuity is 20/20, no evidence of blockage or discharge in the ears, no evidence of nasal congestion, and evidence of a non-erythematous throat.

Neck: Lacks evidence of swelling or pain.

Chest: No wheezes or rhonchi.

Heart: Absence of murmur or gallop. Capillary refill is less than 3 seconds.

Abdomen: Evidence of abdominal tenderness absent.

Back/spine: Deformities absent.

Extremities:   No evidence of joint pain.

Genitalia/Rectal: Female genital organs present.

Neurologic:

Mental status: S.T. presents with forgetfulness. She has a normal speech.

Cranial nerves: Intact with evidence of visual fields.

Motor: Muscle strength on all joints is 5/5.

Sensory: Normal sensitivity in upper and lower limbs.

Diagnostic results : S.T. has never visited the clinic and no mental tests have been conducted (Bickley et al., 2020; Dains et al., 2019).

Differential Diagnoses

• Subjective cognitive decline (Jessen et al., 2020)
• Mild cognitive impairment
• Age-associated memory impairment
• Dementia (McCollum & Karlawish, 2020; Yoon et al., 2018)

Bickley, L., Szilagyi, P., Hoffman, R., & Soriano, R. (2020). Bate’s guide to physical examination and history taking ( Lippincott Connect). 13 th ed. Philadelphia: Wolters Kluwers.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Jessen, F., Amariglio, R. E., Buckley, R. F., van der Flier, W. M., Han, Y., Molinuevo, J. L., Rabin, L., Rentz, D. M., Rodriguez-Gomez, O., Saykin, A. J., Sikkes, S., Smart, C. M., Wolfsgruber, S., & Wagner, M. (2020). The characterisation of subjective cognitive decline.  The Lancet. Neurology ,  19 (3), 271–278. https://doi.org/10.1016/S1474-4422(19)30368-0

McCollum, L., & Karlawish, J. (2020). Cognitive impairment evaluation and management.  The Medical clinics of North America ,  104 (5), 807–825. https://doi.org/10.1016/j.mcna.2020.06.007

Yoon, P. S., Ooi, C. H., & How, C. H. (2018). Approach to the forgetful patient.  Singapore Medical Journal ,  59 (3), 121–125. https://doi.org/10.11622/smedj.2018026

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NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

by ella | Mar 1, 2024 | Health

Photo Credit: Getty Images/iStockphoto

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

CLICK HERE TO ORDER NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

• By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
• Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

• Review this week’s Learning Resources, and consider the insights they provide about the case study.
• Consider what history would be necessary to collect from the patient in the case study you were assigned.
• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
• Identify  at least five  possible conditions that may be considered in a differential diagnosis for the patient.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

By Day 6 of Week 9

Submit  your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK9Assgn1+last name+first initial.(extension)” as the name.
• Click the  Week 9 Assignment 1 Rubric  to review the Grading Criteria for the Assignment.
• Click the  Week 9 Assignment 1  link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the  Browse My Computer  button. Find the document you saved as “WK9Assgn1+last name+first initial.(extension)” and click  Open .
• If applicable: From the Plagiarism Tools area, click the checkbox for  I agree to submit my paper(s) to the Global Reference Database .
• Click on the  Submit  button to complete your submission.NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

Grading Criteria

Rubric detail.

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6512_Week_9_Assignment1_Rubric Grid View List View Excellent Good Fair Poor Using the Episodic/Focused SOAP Template: · Create documentation or an episodic/focused note in SOAP format about the patient in the case study to which you were assigned.NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

· Provide evidence from the literature to support diagnostic tests that would be appropriate for your case. 45 (45%) – 50 (50%) The response clearly, accurately, and thoroughly follows the SOAP format to document the patient in the assigned case study. The response thoroughly and accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study. 39 (39%) – 44 (44%) The response accurately follows the SOAP format to document the patient in the assigned case study. The response accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study. 33 (33%) – 38 (38%) The response follows the SOAP format to document the patient in the assigned case study, with some vagueness and inaccuracy. The response provides evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study, with some vagueness or inaccuracy in the evidence selected.NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms 0 (0%) – 32 (32%) The response incompletely and inaccurately follows the SOAP format to document the patient in the assigned case study. The response provides incomplete, inaccurate, and/or missing evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study. · List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 30 (30%) – 35 (35%) The response lists five distinctly different and detailed possible conditions for a differential diagnosis of the patient in the assigned case study and provides a thorough, accurate, and detailed justification for each of the five conditions selected. 24 (24%) – 29 (29%) The response lists four to five different possible conditions for a differential diagnosis of the patient in the assigned case study and provides an accurate justification for each of the five conditions selected. 18 (18%) – 23 (23%) The response lists three to four possible conditions for a differential diagnosis of the patient in the assigned case study, with some vagueness and/or some inaccuracy in the conditions and/or justification for each. 0 (0%) – 17 (17%) The response lists three or fewer, or is missing, possible conditions for a differential diagnosis of the patient in the assigned case study, with inaccurate or missing justification for each condition selected. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. 0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors. 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6512_Week_9_Assignment1_Rubric

Assignment 2: Lab Assignment (Optional): Practice Assessment: Neurological Examination

Short of opening a patient’s cranium or requesting a brain scan, what can an advanced practice nurse do to determine the cause of neurological symptoms? A multitude of techniques can be used to generate a neurological diagnosis.

In preparation for the Comprehensive (Head-to-Toe) Physical Assessment due this week, it is recommended that you practice performing a neurological examination.

Note:  This is an  optional  practice physical assessment.

• Arrange an appropriate time and setting with a volunteer “patient” to perform a neurological examination.
• Download and review the Neurological Checklist provided in this week’s Learning Resources as well as review  Seidel’s Guide to Physical Examination  online media.

The Lab Assignment

• Perform the neurological examination. Be sure to cover all of the areas listed in the checklist and to use the plexor appropriately.

Assignment 3: Digital Clinical Experience: Comprehensive (Head-to-Toe) Physical Assessment

Throughout this course, you were encouraged to practice conducting various physical assessments on multiple areas of the body, ranging from the head to the toes. Each of these assessments, however, was conducted independently of one another. For this DCE Assignment, you connect the knowledge and skills you gained from each individual assessment to perform a comprehensive head-to-toe physical examination in your Digital Clinical Experience.

Photo Credit: Getty Images/Hero Images

• Review this week’s Learning Resources, and download and review the Physical Examination Objective Data Checklist as well as the Student Checklists and Key Points documents related to neurologic system and mental status.
• Review the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation with the Shadow Health platform. Review the examples also provided.
• Review the DCE (Shadow Health) Documentation Template for Comprehensive (Head-to-Toe) Physical Assessment found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
• Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.
• Review the Week 9 DCE Comprehensive Physical Assessment Rubric provided in the Assignment submission area for details on completing the Assessment in Shadow Health.

Note:  There are 2 parts to this assignment – the lab pass and the documentation. You must achieve a total score of 80% in order to pass this assignment. Carefully review the rubric and video presentation in order to fully understand the requirements of this assignment.

DCE Comprehensive Physical Assessment:

Complete the following in Shadow Health:

• Episodic/Focused Note for Comprehensive Physical Assessment of Tina Jones (180 minutes)

Note:  Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve a total of 80% or better (this includes your DCE and your Documentation Notes), but you must take all attempts by the Week 9 Day 7 deadline.

By Day 7 of Week 9

• Complete your Comprehensive (Head-to-Toe) Physical Assessment DCE Assignment in Shadow Health via the Shadow Health link in Blackboard.
• Once you complete your Assignment in Shadow Health, you will need to download your lab pass and upload it to the corresponding Assignment in Blackboard for your faculty review.
• ( Note:  Please save your lab pass as “LastName_FirstName_AssignmentName”.) You can find instructions for downloading your lab pass here:  https://link.shadowhealth.com/download-lab-pass
• Once you submit your Documentation Notes to Shadow Health,  make sure to copy and paste the same Documentation Notes into your Assignment submission link below .
• Download ,  sign ,  date , and  submit  your  Student Acknowledgement Form  found in the Learning Resources for this week.
• Note: You must pass this assignment with a minimum score of 80%  in order to pass the class. Once submitted, there are not any opportunities to revise or repeat this assignment. 

Name: NURS_6512_Week_9_DCE_Assignment_3_Rubric Description: Note: To complete the Shadow Health assignments it is helpful to use the text and follow along with each chapter correlating to the area of assessment to assist in covering all the subjective questions. Review the Advanced Health Assessment Nursing Documentation Tutorial located in the Week 4 Resources, the model documentation in Shadow Health, as well as sample documentation in the text to assist with narrative documentation of the assessments. Do not copy any sample documentation as this is plagiarism. Shadow Health exams may be added to or repeated as many times as necessary prior to the due date to assist in achieving the desired score. You must pass this assignment with a total cumulative score of 79.5% or greater in order to pass this course.NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms Grid View List View Excellent Good Fair Poor Student DCE score

(DCE percentages will be calculated automatically by Shadow Health after the assignment is completed.)

Note: DCE Score – Do not round up on the DCE score. 56 (56%) – 60 (60%) DCE score>93 51 (51%) – 55 (55%) DCE Score 86-92 46 (46%) – 50 (50%) DCE Score 80-85 0 (0%) – 45 (45%) DCE Score <79

No DCE completed. Documentation in Provider Notes Area

Subjective documentation of the comprehensive exam in Provider Notes is detailed, organized, and includes documentation of identifying data, general survey, reason for visit/chief complaint, history of present illness, medications, allergies, medical history, health maintenance, family history, social history, mental health history, and review of systems.NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

The review of systems is clearly defined by each body system (skin, eyes, cardiac, etc.) and all conditions or illnesses asked of the patient are documented along with the patient response. 16 (16%) – 20 (20%) Documentation is detailed and organized with all pertinent information noted in professional language.

Documentation includes all pertinent documentation to include Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS). 11 (11%) – 15 (15%) Documentation with sufficient details, some organization and some pertinent information noted in professional language.

Documentation provides some of the Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS). 6 (6%) – 10 (10%) Documentation with inadequate details and/or organization; and inadequate pertinent information noted in professional language.

Limited or/minimum documentation provided to analyze students critical thinking abilities for the Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS). 0 (0%) – 5 (5%) Documentation lacks any details and/or organization; and does not provide pertinent information noted in professional language.

No information is provided for the Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS).

No documentation provided. Objective Documentation in Provider Notes – this is to be completed in Shadow Health

Physical exam: Document in a systematic order starting from head-to-toe, include what you see, hear, and feel when doing your physical exam using medical terminology/jargon. Document all normal and abnormal exam findings. Do not use “WNL” or “normal”.NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

Diagnostic result- Include any pertinent labs, x-rays, or diagnostic test that would be appropriate to support the differential diagnoses mentioned

Differential Diagnoses (list a minimum of 3 differential diagnoses). Your primary or presumptive diagnosis should be at the top of the list (#1). 16 (16%) – 20 (20%) Documentation detailed and organized with all abnormal and pertinent normal assessment information described in professional language.

Each system assessed is clearly documented with measurable details of the exam. 11 (11%) – 15 (15%) Documentation with sufficient details and some organization; some abnormal and some normal assessment information described in mostly professional language.

Each system assessed is somewhat clearly documented with measurable details of the exam. 6 (6%) – 10 (10%) Documentation with inadequate details and/or organization; inadequate identification of abnormal and pertinent normal assessment information described; inadequate use of professional language.

Each system assessed is minimally or is not clearly documented with measurable details of the exam. 0 (0%) – 5 (5%) Documentation with no details and/or organization; no identification of abnormal and pertinent normal assessment information described; no use of professional language.

None of the systems are assessed, no documentation of details of the exam.

No documentation provided. Total Points: 100 Name: NURS_6512_Week_9_DCE_Assignment_3_Rubric Description: Note: To complete the Shadow Health assignments it is helpful to use the text and follow along with each chapter correlating to the area of assessment to assist in covering all the subjective questions. Review the Advanced Health Assessment Nursing Documentation Tutorial located in the Week 4 Resources, the model documentation in Shadow Health, as well as sample documentation in the text to assist with narrative documentation of the assessments. Do not copy any sample documentation as this is plagiarism. Shadow Health exams may be added to or repeated as many times as necessary prior to the due date to assist in achieving the desired score. You must pass this assignment with a total cumulative score of 79.5% or greater in order to pass this course.NURS6512 Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

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• minimum-4-and-half-page-s-essay-question-answer-is-required-in-apa-format

Assignment 1: Assessing Neurological Symptoms Case Study

Question Description I don’t understand this Health & Medical question and need help to study.

Discussion: Assessing Neurological Symptoms Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma . Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors. In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

ORDER A CUSTOMIZED, PLAGIARISM-FREE Assignment 1: Assessing Neurological Symptoms Case Study HERE

Remember that all Episodic/Focused SOAP notes have specific data included in every patient case. Case 1: Headaches

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

Case 2: Numbness and Pain

A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.

Case 3: Drooping of Face

A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.

To prepare:

pick any case study:

Review this week’s Learning Resources, and consider the insights they provide about the case study. Consider what history would be necessary to collect from the patient in the case study you were assigned. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

template attached

episodic_focus

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Week 9 NEURO SOAP Note

Patient Initials: T.N              Age: 67 years                        Gender: Male

SUBJECTIVE DATA:

Chief Complaint (CC): “Very Forgetful”

History of Present Illness (HPI): N.S is a 67-year-old Asian male who was brought in by his daughter for psychiatric evaluation since he was very forgetful. She reports that the patient has lost his car keys several times. She also reports that sometimes when the patient goes to the store, he forgets his way back and calls for help. The patient claims that he started being forgetful about 2 years back, and it has been getting worse ever since as reported by his daughter. The patient denies any associated symptoms. No hallucination or delirium.

Medications:

• Losartan 50mg PO once daily for the management of his high blood pressure.

No known drug, food, or environmental allergies

Past Medical History (PMH):

High Blood Pressure

Past Surgical History (PSH):

Denies ever undergoing any surgical procedure in the past.

Sexual/Reproductive History:

Heterosexual

Personal/Social History:

Married with a daughter and a son. His wife however passed on 2 years ago.

Retired but owned and ran his café downtown for several years.

He lives by himself, but the daughter lives next door and checks on him now and then.

Confirms taking one or two beers when with friends.

Denies smoking tobacco or using any other recreational drug.

Health Maintenance:

The patient used to exercise before by walking the dog, but ever since he started being forgetful, he does not remember the last time he went for a long walk. He however consumes a healthy diet which his daughter makes sure of. He uses a seat belt when in the care and lives in a well-maintained house. Confirms sleeping for about 8 hours every night.

Immunization History:

Flu shot 16/1/2022

Covid Vaccine #1 4/1/2021 #2 2/1/2021 Moderna

All other immunization up to date

Significant Family History:

The patient’s mother passed on at the age of 86 years due to cardiac arrest, upon receiving a report that her grandson had been involved in a car accident. His father is alive at the age of 94 years with a history of diabetes, dementia, arthritis, and thyroid disorder. Both his children are healthy with no significant history of any chronic medical condition.

Review of Systems:

General: Appears healthy with no signs of distress. No signs of fatigue, chills, fever, or generalized body weakness.

HEENT: Head: No signs of trauma or headache reported. Eyes: Denies blurred vision, use of corrective lenses, excessive tearing, or redness. Ears: No tinnitus, itchiness, or hearing loss. Nose: no congestion, running nose, sinus problems, or nose bleeding. Throat & Mouth: No sore throat, coughing, swallowing difficulties, or dental problems. Neck: No tenderness, signs of injury, enlarged tonsils, or a history of disc disease or compression.

Respiratory: No wheezing, coughing, shortness of breath, or breathing difficulties.

CV: Denies chest pain, edema, orthopnea, syncope, or palpitations. Dyspnea on exertion

GI: No abdominal tenderness, constipation, diarrhea, distention, changes in bowel movement, or jaundice.

GU: Denies incontinence, urinary frequency, hematuria, dysuria, or burning sensation when urinating.

MS: Denies back pain, with a full range of movement in all the extremities. No signs of spinal code injury.

Psych: Denies paranoia, hallucinations, delirium, suicidal ideation, mental disturbance, memory loss, anxiety or depression, or a history of psychosis.

Neuro: Denies vertigo, tremors, syncope, seizures, paresthesia, or transient paralysis.

Integument/Heme/Lymph: No bruising, ecchymosed, ulcers, lesions, or rashes. No signs of enlarged lymph nodes.

Endocrine: Denies heat intolerance, cold intolerance, polyuria, polyphagia, or polydipsia.

Allergic/Immunologic: Denies hay fever, urticaria, or persistent infections.

OBJECTIVE DATA:

Physical Exam:

Vital signs: T: 97.7°F (36.5°C), BP: 125/70 mm Hg, HR 70/min, R: 18/min, memory loss 8/10. Ht. 5’9’’, Wt. 179 pounds, BMI: 23.5

General: N.S appears healthy and well cooperative through the examination with a pleasant mood. He experiences no chills, fever, fatigue, or recent changes in body weight.

Chest/Lungs: Lungs are clear to auscultation and percussion bilaterally. No rhonchi or wheezing.

Heart/Peripheral Vascular: S1 and S2 present. No rubs, gallops, or murmurs. Regular rate and rhythm

Lymphatics: No signs of enlarged lymph nodes.

Neurological: The CN II-VII and the DTR are undamaged. Denies headache, syncope, or dizziness. Confirms worsening memory loss for the past 2 years

Psychiatric: Denies feeling hopeless, or having suicidal ideations. Confirms being in mild distress due to memory loss leading to cognitive impairment.

Diagnostic results:

TSH – To determine if the patient memory loss is associated with hypothyroidism.

MRI of the head – To assess whether there is any form of damage to the neurotransmitters or the presence of any form of brain cell tumor.

Cerebral angiography – To measure the blood flow through the brain for any signs of deficiencies.

Amyloid imaging –

Cognitive test – To determine whether the patient’s memory loss is associated with anxiety or distress (Bruno, 2020).

ASSESSMENT:

• Alzheimer’s disease: Alzheimer’s disease is a progressive neurologic disorder that leads to atrophy of the brain and death of brain cells (Glymour et al., 2018). This disorder is the most common form of dementia among the elderly above the age of 65 years. It is characterized by significant cognitive deterioration which undermines the patient’s ability to sustain independent living. The diagnosis of this disorder is based on three stages, with the first stage regarded as the preclinical stage with no symptoms. The second stage which is referred to as the middle stage is characterized by mild cognitive impairment, whereas the final stage is characterized by marked symptoms of dementia. The patient in the provided case study presents with worsening memory loss, for the past two years, which indicates the final stage of Alzheimer’s as the primary diagnosis.
• Vascular cognitive impairment (VCI): This is a disorder of the mind with undermines the patient’s mental ability to think, feel and be awake (Ghafar et al., 2019). VCI presents with cognitive symptoms ranging from being forgetful in mild cases. However, in severe cases, patients may present with serious cognitive impairments leading to problems with memory, attention, language, and executive functions such as problem-solving. The patient in the provided case study reports being forgetful, However, cognitive testing is required to confirm this diagnosis.
• Vascular dementia: This refers to a decline in the patients thinking skills due to conditions that reduce or block the flow of blood to various parts of the brain, depriving them of nutrients and oxygen (Bruno, 2020). Patients will present with symptoms such as forgetfulness, poor balance, confusion, and disorientation among others. The patient in the provided case study however presented with forgetfulness only, with no associated symptoms.
• Idiopathic normal pressure hydrocephalus (INPH): This is a disorder of the brain characterized by impairment of the patient’s gait, urinary incontinence, and decline in cognitive function. It is normally associated with ventriculomegaly in the absence of increased cerebrospinal fluid (CSF) pressure (Kockum et al., 2020). Forgetfulness and confusion are one of the most common early symptoms, among others such as depression, trouble walking, poor balance, and falling. Neuroimaging with either CT or MRI is however required to confirm this diagnosis to assess for hydrocephalus pressure.
• Lewy body dementia (LBD): It is a rare disease associated with abnormal deposition of alpha-synuclein in the brain. These deposits, known as Lewy bodies lead to a progressive decline in the patient’s cognitive ability (Gan et al., 2021). Patients will present with common signs and symptoms such as memory loss, tremors, slow movement, muscle rigidity, loss of coordination, and reduced facial expression. However, the diagnosis of this disorder requires the patient to present with declining thinking ability in addition to at least two of the following symptoms, parkinsonian symptoms, repeated visual hallucinations, and fluctuating alertness.

PLAN: This section is not required for the assignments in this course (NURS 6512), but will be required for future courses.

Bruno, A. (2020). Forgetfulness.  The Family Nurse Practitioner: Clinical Case Studies , 245-249.

Gan, J., Liu, S., Wang, X., Shi, Z., Shen, L., Li, X., … & Ji, Y. (2021). Clinical characteristics of Lewy body dementia in Chinese memory clinics.  BMC neurology ,  21 (1), 1-11. https://doi.org/10.1186/s12883-021-02169-w

Ghafar, M. Z. A. A., Miptah, H. N., & O’Caoimh, R. (2019). Cognitive screening instruments to identify vascular cognitive impairment: A systematic review.  International Journal of Geriatric Psychiatry ,  34 (8), 1114-1127.

Glymour, M. M., Brickman, A. M., Kivimaki, M., Mayeda, E. R., Chêne, G., Dufouil, C., & Manly, J. J. (2018). Will biomarker-based diagnosis of Alzheimer’s disease maximize scientific progress? Evaluating proposed diagnostic criteria.  European Journal of Epidemiology ,  33 (7), 607-612. https://doi.org/10.1007/s10654-018-0418-4

Kockum, K., Virhammar, J., Riklund, K., Söderström, L., Larsson, E. M., & Laurell, K. (2020). Diagnostic accuracy of the iNPH Radscale in idiopathic normal pressure hydrocephalus.  PLoS One ,  15 (4), e0232275.

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Clinical Diagnosis & Treatment of Acute Bacterial Meningitis Case Study

User Generated

Health Medical

Description

Assignment 1: case study assignment: assessing neurological symptoms.

Photo Credit: Getty Images/iStockphoto

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient's quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

• By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
• Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

• Review this week's Learning Resources, and consider the insights they provide about the case study.
• Consider what history would be necessary to collect from the patient in the case study you were assigned.
• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient's condition. How would the results be used to make a diagnosis?
• Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient's differential diagnosis, and justify why you selected each.

The sample/template is attached. Please check that. Rubric and problem statement in detail is also attached. Please let me know if you need me to send any resources which are listed in the materials

My case study is:

CASE STUDY 1: Headaches: Adaso, Adekakun, Cole-Godfrey, Coleman, Dyson and Ekenta

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

Unformatted Attachment Preview

Explanation & Answer

Please view explanation and answer below. Episodic/Focused SOAP Note Template Patient Information: Initials: T.I Age: Twenty Years Sex: Male Race: Caucasian S. CC: Irregular headaches HPI: The 20-year-old Caucasian man complains about irregular headaches. The headache particularly diffuses over the past three weeks. However, they happen diffusely; however, the severe intensity is felt around the jaw, above the eyes, nose, and cheekbones. Location: Jaw, cheekbones, above the eyes, and head. Onset: 3 weeks ago Character: at first, he is dull and then intensifies to throbbing/aching Associated signs and symptoms: the client has been facing stress the past few weeks with college and a job. Timing: headaches come about during various periods of the day. Exacerbating/ relieving factors: light bothers eyes; Aleve makes it tolerable but not completely better. Severity: 6/10 pain scale Current Medications: 400mg of Ibuprofen PO six hours as required for pain Allergies: The client reports no recognized drug allergies PMHx: immunizations are up to date, and there is no essential past medical history. The last Tet...

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