TO PREPARE:
Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with musculoskeletal conditions.
Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.
Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with musculoskeletal conditions.
Assignment
As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform.
NRNP_6531_Week9_Assignment_Rubric
NRNP_6531_Week9_Assignment_Rubric
Mr. M.H., a 65-year-old Hispanic male, presents to the clinic with complaints of tiredness and nocturia that started a month or so back. He reports feeling unusually tired for the last few weeks, possibly longer, due to frequent nighttime urination. He has also experienced an
unintentional weight gain of 8 pounds. increased appetite, and blurry vision off and on in both eyes. tHis wife encouraged him to seek evaluation, suspecting a kidney issue. Mr. Hubar denies snoring, numbness, and tingling. On physical examination, he has elevated blood pressure. Otherwise, his vital signs are unremarkable. Не exhibits central obesity and large neck diameter, with no changes in prostate size, sensation, body habitus, or facial appearance. V/s Temp 36.8, pulse 86bpm, b/p 130/76 on right arm, respiration 16bpm.
my Primary diagnose : Diabetes mellitus type 2
Differential diagnosis:
1. BPH.(Benign Prostatic Hyperplasia)
2. CUSHING’S DISEASE.
3.OSA. (obstructive sleep apnea)
4.Diabetes Insipidus
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeHPI: Complete HPI including all 8 aspects and pertinent information related to chief complaint.
10 to >6.0 pts
Proficient
Clearly written HPI statement including all 8 aspects and pertinent information related to chief complaint. Includes pertinent positives and negatives.
6 to >3.0 pts
Competent
Well written HPI statement but missing 1-2 key components from the history. Missing pertinent positives and negatives.
3 to >0 pts
Novice
Poorly written HPI statement. Incomplete ideas and sentences. Lacks basic history taking skills. Missing pertinent positives and negatives.
10 pts
This criterion is linked to a Learning OutcomeManagement Plan: Problem Statement – 5 pts… Diagnosis, Differentials, and Coding – 10 pts… Medications Ordered – 10 pts… Treatment plan / SDOH / Health Promotion – 20 pts… Patient Education 10 pts… Follow up – 10 pts… References – 5 pts
70 to >49.0 pts
Proficient
Clearly written problem statement including all pertinent information related to chief complaint. Correct primary diagnosis identified. Appropriate and clearly written differential diagnoses. Minimum of three differentials with appropriate rationale included. Appropriate codes included. Medications prescribed are appropriate, evidenced based, and full prescription is included and dosing correct. Full patient education information is included. Clearly written plan covering all critical components for patient’s final diagnosis. SDOH and Health promotion / anticipatory guidance is addressed. Comprehensive patient education is included. Follow up instructions are complete and include time to next visit and specific symptoms to prompt a return visit sooner. Contains parenthetical/in-text citations and at least 3 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.
49 to >21.0 pts
Competent
Well written problem statement but missing 1-2 key components. Correct primary diagnosis identified. Well written differential diagnoses. May be missing 1-2 critical components. Priority list may be out of order. At least 2 differentials are included and rationale is generally appropriate. Most codes correct but some errors. Medications prescribed are appropriate, may not be evidenced based, and missing 1 or 2 elements of the prescription. Dosing is correct. Some patient education information is missing. . Well written plan but may be missing 1-2 key issues critical to patient’s diagnosis. Some aspects of SDOH are addressed. Some aspects of Health Promotion / anticipatory guidance are addressed. Patient education is present but missing 1 or 2 key pieces of information. Follow up instructions are generally complete but missing 1 or 2 aspects. Symptoms that would prompt a return visit sooner are included but some are missing. Contains parenthetical/in-text citations and at least 2 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.
21 to >0 pts
Novice
Poorly written problem statement. Incomplete ideas and sentences. Lacks basic information. Primary diagnosis is wrong. Differential diagnosis list too brief and inconclusive. May be missing 3 or more critical components. 0 to 2 differentials are included and rationale is lacking or not appropriate. Codes are incorrect. Medications prescribed are inappropriate, are not evidenced based, and missing more than 3 elements of the prescription. Dosing is incorrect. Patient education information is inaccurate or missing important elements. Poorly written plan. May be missing 3 or more key issues that are critical to patient’s diagnosis. There are missing aspects of SDOH and Health Promotion anticipatory guidance. Patient education is missing many aspects. Follow up instructions are missing important timing aspects. Symptoms prompting return visit sooner are incomplete or missing. Contains no parenthetical/in-text citations and 0 evidenced based references listed. Clinical practice guidelines are not cited if applicable.
70 pts
This criterion is linked to a Learning OutcomeHistory and Physical Exam: Complete an appropriate health history (Scores are automatically calculated in iHuman platform.) and physical exam (Scores are automatically calculated in iHuman Platform. Add History and Physical scores from iHuman. Max 20 points. Evidence of Academic Integrity Issues will result in a grade of 0.
20 pts
Proficient
Achieve a combined score of 170-200%
10 pts
Competent
Achieve a score of 130-168%
1 pts
Novice
Achieve a score of less than 130%
20 pts
Total Points: 100
