What enablers or barriers to communication did you experience? How did you overcome the barriers?

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REQUIRED UNIFORM ASSIGNMENT GUIDELINES
THE HEALTH HISTORY AND PHYSICAL EXAMINATION

PURPOSE

As you learned in NR302, before any nursing plan of care or intervention can be implemented or evaluated, the nurse conducts an assessment,collecting subjective and objective data from an individual. The data collected are used to determine areas of need or problems to be addressed by the nursing care plan. This assignment will focus on collecting both subjective and objective data, synthesizing the data, and identifying health and wellness priorities for the person. The purpose of the assignment is twofold.
• To recognize the interrelationships of subjective data (physiological, psychosocial, cultural and spiritual values, and developmental) and objective data (physical examination findings) in planning and implementing nursing care
• To reflect on the interactive process that takes place between the nurse and an individual while conducting a health assessment and a physical examination
COURSE OUTCOMES
CO 2: Utilize prior knowledge of theories and principles of nursing and related disciplines to integrate clinical judgment in professional decision-making and implementation of nursingprocess while obtaining a physical assessment. (POs 4 and 8)
CO 3: Recognize the influence that developmental stages have on physical, psychosocial, cultural,and spiritual functioning. (PO 1)
CO 4: Utilize effective communication when performing a health assessment. (PO 3)
CO 6: Identify teaching/learning needs from the health history of an individual. (POs 2 and 5)

TOTAL POINTS POSSIBLE
50 points
PREPARING THE ASSIGNMENT
There are four graded parts to this assignment: (1) Obtain a health history and conduct a physical examination on an individual of your choosing (not a patient), (2) compile ahealth educationneeds assessment, (3)self-reflection, and (4) writing style and format.

Instructions for each part follow.

HealthHistoryAssessmentand Physical Assessment(25 points)

• Using the following subjective and objective components, as well as your textbook for explicit details about each category, complete a health history and physical examination on an individual. You may choose to complete portions of this assignment as you obtain the health history and perform the physical examination associatedwith the body systems covered in NR304. Please be sure to avoid the use of any identifiers in preparing the assignment. Students may seek input from the course instructor on securing an individual for this assignment. Keep notes on each part of the health history and physical examination as you complete them so that you can refer to the notes as you write the paper.
1. Subjective Data—Health History Components to Be Included
• Demographic data
• Reason for care (why they are in the facility)
• Present illness (PQRST of current illness)
• Perception of health
• Past medical history (including medications, allergies, and vaccinations and immunizations)
• Family medical history
• Review of systems
• Developmental considerations
• Cultural considerations
• Psychosocial considerations
• Presence or absence of collaborative resources (community, family, groups, and healthcare system)
REMEMBER: Make notes of the health history findings, ensuring that you have addressed all of the components listed here. Students are also encouraged to take notes about their experiences while conducting the health history for reference when creating the assignment, particularly the reflection section.
2. Objective Data—Physical Exam Components to Be Included
• During the lab experiences, you will conduct a series ofphysical exams that includes the following systems.
• Keep notes on each part of the physical exam as you complete them to reference as you write the paper.
• Refer to the course textbook for detailed components of each system exam. Remember, assessment of the integumentarysystem is an integral part of the physical exam and should be included throughout each system.
• From NR302
o HEENT (head, eyes, ears, nose, and throat)
o Neck (including thyroid and lymph chains)
o Respiratory system
o Cardiovascular system
• From NR304
o Neurological system
o Gastrointestinal system
o Musculoskeletal system
o Peripheral vascular system
REMEMBER: Make notes of the physical examination findings, ensuring that you have addressed all of the components listed on the Return Demonstration Checklist. Students are also encouraged to take notes about their experiences while conducting the physical examination for reference when creating the assignment, particularly the reflection section.

Needs Assessment(10 points)

1. Based on the health history and physical examination findings, determine at least twohealth education needs for the individual. Remember, you may identify an educational topic that is focused on wellness.
2. Select two peer-reviewed journal articles that provideevidence-based support for thehealth teaching needs you have identified.
Reflection (10 points)

Nurses use reflection to, mindfully and intentionally, examine our thought processes, actions, and behaviors in order to betterevaluate our patients’ outcomes. You have interviewed anindividual,conducted a head-to-toe physical assessment, and identified at least two health teaching needs. You have also located within the literature evidence-based support for the teaching that will be used to address the individual’shealth education needs. As you formulateyour findings in writing within this assignment, it is time to turn your attention inward. The final element of this assignment is to write a reflection that describes your experience.

1. Be sure your reflection addresses each of the following questions.
a. How did this assignment compare to what you’ve learned and expected?
b. What enablers or barriers to communication did you encounter when performing a health history and physical exam? How couldyou overcome those barriers?
c. Were there any unanticipated challenges encountered during this assignment?What went well with this assignment?
d. Was there information you wished you hadavailable but did not?
e. How will you alter your approach to a obtaining a health history and conducting a physical examinationthe next time?

Writing Style and Format(5 points)

Your writing should reflect your synthesis of ideas based on prior knowledge, newly acquired information, and appropriate writing skills. Scoring of your written communication is based on proper use of grammar, spelling, and APA sixth-editionformatting, as well as how clearlyyour thoughts and reasoning are expressed in writing.

Documentation of Findings, or How to Write the Paper

Using Microsoft Word, create a double-spaced document. The paper should be formatted according to APA sixth-edition guidelines for the title page, running head, and reference page. The use of headings is required for this paper. All portions of this assignment should be included within the paper, including the reflection.

1. Begin by writing one to two paragraphs describing the individual’s stated condition of health medicationsand allergies. Also, include any of the following information that may be pertinent:demographic data, perception of health,past medical history, vaccinations and immunizations, family medical history,review of systems, developmental considerations,cultural considerations, psychosocial considerations,and the presence or absence of resources from the community, family, groups, or the healthcare system.
2. Write one paragraph describing the physical assessment findings, ensuring proper terminology is used to describe any abnormal or unusual findings.
3. Write one paragraph discussing (1) the rationale for the selection of the health teaching topics and (2) how the findings in the scholarly articles (identified in the needs assessment portion of the assignment and properly cited) were used to develop the health teaching topics to promote the individual’s health and wellness status.

4. Write one paragraph discussing (1) how the interrelationships of physiological, developmental, cultural, and psychosocial considerations will influence, assist, or become barriers to the effectiveness of the proposed health education and (2) a description of the impact of the individual’s strengths (personal, family, and friends) and collaborative resources (clinical, community, and health and wellness resources) on the proposed teaching.

5. Write one paragraph describing your reflectionof this assignment from a holistic point of view. Consider the following areas: Include the environment, your approach to the individual, time of day, and other features relevant to therapeutic communication and to the interview process. You may find your textbook helpful in providing a description of therapeutic communication and of the interview process. Be certain to address the questions listed above in the reflection instructions.

Provides a writtennarrative that includes the following
1. One to two paragraphs describingstated condition of health,medications, and allergies. Also includes the following information: demographic data, perception of health,past medical history, vaccinations and immunizations, family medical history,review of systems, any developmental considerations,cultural considerations orpsychosocial considerations,presence or absence of resources from the community, family, groups, or from the healthcare system
2. One paragraph describing: the findings of the physical examination
3. Oneparagraph discussing (1) the rationale for the selection of the health education topics and (2) how the findings in the scholarly articles were used in supportof the health teaching topicto promote or improve the individual’s health and wellness status.

4. One paragraph discussing (1) how the interrelationships of physiological, developmental, cultural, and psychosocial considerations influence (assist or become barriers to the effectiveness) the proposed health education and (2) providea description of the impact of the individual’s strengths (personal, family, and friends) and collaborative resources (clinical, family, community, and health and wellness resources) on the proposed nursingteaching.

Needs Assessment 10 20 1. Identifies two health education needs for the individualbased on the health history and physical examination findings andtwo peer-reviewed journal articles providing evidence-based support for the identified health teaching needs
2. APAsixth-edition formattingused for in-text and reference page citations

Reflection 10 20 Reflects on the interaction with the interviewee holistically. Considers the interaction in its entirety: includes the environment, the approach to the individual, time of day, and other features relevant to therapeutic communication and the interview process. The reflection should addresseach of the following questions.
• How did your interaction compare to what you’ve learned and expected?
• What enablers or barriers to communication did you experience? How did you overcome the barriers?
• Were there any unanticipated challenges to conducting the interview or performing the physical examination? What went well?
• Was there information you wished you had butdid not?
• How will you alter your approach the next time?
Writing Style and Format 5 10 Writing shouldreflectyour synthesisof ideasbased onpriorknowledge,newlyacquired information,andappropriate writingskills. Scoringofyourworkinwritten communicationisbased onproperuseof grammar,spelling, andhowclearly youexpressyourthoughts andreasoningin writing. Proper use of APA sixth-edition style and format throughout this paper is required.

Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an exacerbation.

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Application: Asthma
Complications of asthma can be sudden. Consider the case of Bradley Wilson, a young boy who had several medical conditions. He appeared in good health when he went to school, returned home, and ate dinner. However, when he later went outside to play, he came back inside wheezing. An ambulance took him to the hospital where he was pronounced dead (Briscoe, 2012). In another case, 10-year-old Dynasty Reese, who had mild asthma, woke up in the middle of the night and ran to her grandfather’s bedroom to tell him she couldn’t breathe. By the time paramedics arrived, she had passed out and was pronounced dead at the hospital (Glissman, 2012). These situations continue to outline the importance of recognizing symptoms of asthma and providing immediate treatment, as well as distinguishing minor symptoms from serious, life-threatening symptoms. Since these symptoms and attacks are often induced by a trigger, as an advanced practice nurse, you must be able to help patients identify their triggers and recommend appropriate treatment options. For this reason, you need to understand the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation.

To prepare:

Review “Asthma” in Chapter 26 of the Huether and McCance text. Identify the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Consider how these disorders are similar and different.
Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of both disorders. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Review the “Mind maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Consider the epidemiology and clinical presentation of both chronic asthma and acute asthma exacerbation.

To complete:

Write a 2- to 3-page paper that addresses the following:
Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an exacerbation.
Explain how the factor you selected might impact the pathophysiology of both disorders. Describe how you would diagnose and prescribe treatment for a patient based on the factor you selected.
Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

What statute specifies the criteria that the High Court must apply in deciding whether to grant special leave to appeal? What are those criteria?

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LEGAL RESEARCH (CASES)

Instructions:
1. This assignment comprises 8 Questions please answer all Questions.

2. Word limit. The total word limit is 1000 WORDS, including footnotes (if any). Your word tally must be written on the front of your answer.

3. Formatting. All answers should be typed, using 1.5 line spacing, with page margins of no less than 3cm on all sides, in 12-point font. Footnotes (if any) should be in 10-point font.

4. Referencing. Please use Australian Guide to Legal Citation (3rd ed, 2010) AGLC3. And Include a reference for each answer. I want to know from where you obtain the answer or which source you use to answer the question.

5. Planning. Take care to read the questions carefully and answer what is asked.

Please read the following scenario and answer all questions.
Scenario
The Australian Parliament has enacted legislation to promote the safety of government workers and provide a framework for compensating those who have been injured through their employment. However, it can be difficult to determine whether a disease or injury is attributable to employment or to other causes.

Questions:
Question 1: In 2011 a tribunal (ie not a court) considered whether a person in the Australian Defence Force, who suffered from fatigue and dizziness after receiving medical vaccinations, had a compensable ‘injury’ as a result of his employment under the relevant federal legislation. Give the name of the tribunal and the decision with its medium neutral citation.
Question 2: What was the main High Court authority relied on by the tribunal in deciding that the applicant had not suffered an injury within the meaning of the legislation?
Question 3: The tribunal decision referred to in Q1 was appealed. Give the medium neutral citation of the decision on the appeal. Did the court allow or dismiss the appeal, and (briefly) why?
Question 4: The decision referred to in Q3 was subject to a further appeal. Give the medium neutral citation of the decision on the appeal, and two additional citations to the reported decision.
Question 5: The respondent in the case referred to in Q4 applied for special leave to appeal to the High Court of Australia, which was granted. On what date was that application heard, and how many minutes did the High Court take to decide the application?
Question 6: What statute specifies the criteria that the High Court must apply in deciding whether to grant special leave to appeal? What are those criteria?
Question 7: After special leave was granted, the case proceeded to a full hearing. Name the legal counsel who represented the respondent in the full appeal. One justice who granted special leave to appeal did not sit on the appeal. Name the justice.
Question 8: The legislation considered in the above litigation was the subject of an official review. Give a reference for the review. What recommendation did the review make about the circumstances in which an incident (such as a heart attack) that is manifestation of a disease can be compensated?

What of therapeutic abortions, which take place after test have indicated a risk of birth defects or genetic diseases? How should the counseling be done in such cases? Is it really always best to abort than to give birth to a defective child?

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Please use simple words since I am an international student. You could choose any 3 from the 16 questions that are listed. Each question 2 pages please . With MLA style please use only proper websites as references 7 at least and no books. Please let me know which 3 questions you choose. You could just indicate the number of the question above the page when answering them. Please make sure to fully answer the question I need the best quality possible with simple words.

Final Term Paper: Choose three of the following 16 questions to answer in 3-2 pages for each question indicate the number of the question above each page.

  1. Consider the right to health care and the obligation to treat those who can’t afford to pay for it. Is this obligation a collective one to be born by the whole medical profession, or does it require every individual doctor to do at least some pro bono service at some time during their career? If there is a right to healthcare, how can we best make sure that those who face discrimination don’t get left out? How far do you think we should go in changing our basically private system into one which is more socialist? Is a multi-tiered system, which guarantees that the lowest tier is adequate, compatible with the demand that the right to health should be guaranteed to everyone? How should it be financed? Give reasons for holding your view.
  1. Deal with the issues involved in the macro-allocation of healthcare resources. Do you think the present allocation is just or unjust? Why? Give an account of the various views on social justice and how each one determines what justice is. What are the pros and cons of each and which do you tend to agree with? Do you think a distributive or procedural justice approach is best? Why? When dealing with healthcare, do you think an approach, which provides it because it is a basic need or one which provides it as a means to guarantee equality of opportunity more promising? Give reasons for holding your view.
  1. Deal with the arguments pro and con on public vs. private ways of managing healthcare allocation. Who should be responsible for providing healthcare, the individual, employer, or the society through the state? Should we mandate coverage or leave it voluntary? Should access to adequate healthcare be a right? Why has the A.M.A. and other special interests fought against socialized medicine? Are physicians right to continue to favor a private, free market approach to healthcare or should they switch to a system which guarantees universal access, particularly coming to the rescue of the least well-off, not just those on welfare but also the working poor who usually don’t have healthcare benefits through their employer? Are doctors letting their patients down by opposing universal coverage? Are they putting their own interests first by not only protecting their own income but also their professional autonomy, which includes the power to determine the fees? Should we regard the talents and abilities of health-care professionals as common assets to be used for the benefit of society as a whole or as marketable skills belonging the the providers as individuals to dispose of as they see fit? Give reasons for holding your view.
  1. Deal with how we should allocate scarce medical resources, such as expensive operations, artificial and natural organs, life support and diagnostic machines, etc. Examine the utilitarian and Kantian approaches on this issue and the pros and cons of each. Do you believe that some sort of age-based rationing will be necessary and what should be the guidelines determining what should be rationed and who will lose out? Would it be better for the government to make such decisions or allow privately owned insurance companies to do so? On organs, should we continue to rely on voluntary donors or switch to a system in which one is presumed to have given permission unless one has specifically stated otherwise? Would you resent having your organs used without your specific permission once brain dead, or should the interests of the living always take precedence over those of the dead? Give reasons for holding your view.
  1. Deal with the broad issue of social justice and access to healthcare. Should we be concerned that given lack of universal coverage, that if we in America legalize euthanasia or cloning, the net effect will be bad for society as a whole because the burden and promise will be spread around unequally? Should we make sure we get universal access first before making such changes to taboos and traditional restrictions concerning the medical professions, because it could have potentially unfair or even genocidal effects? Give reasons for holding your view.
  1. Should doctors and other healthcare professional be used mainly as a social asset to achieve broad social goals like public health and screening? Or should they be regarded mainly as private practitioners who are free to sell their trained expertise to the highest bidder? Consider the investment in money and effort doctors make to educate themselves. Should they have a sense of entitlement or regard themselves as public servants because they provide something vitally needed and that not everyone can provide? Should we take over the expense of training them, if we were to develop such socially obligatory expectations? If we in America move toward universal access and expect doctors to play their role in such a system, how can we provide the incentives necessary to motivate people to go through the rigorous training involved? Give reasons for holding your view.
  1. Deal with the main pros and cons on the abortion debate and spell out what the pro-life, pro-choice and more moderate positions are. Then state your own view on this and justify and defend it from likely criticisms. Is there a slippery slope effect here from allowing abortions? Will society lose respect for life and the medical profession be changed for the worse, or is this fear over-stated? What about the image and respect for the medical professions? Will they suffer because they continue to perform legal abortions? Give reasons for holding your view.
  1. Deal with the issue of whether all doctors should be trained, able and willing to provide abortion services, or whether doctor’s should have a right to be conscientious objectors when it comes to abortion. What about pharmacists who refuse to fill prescriptions for birth control pills or morning after pills? Should filling such prescriptions be expected of them as pharmacists, or so they too have the right to be conscientious objectors? What of referring such patients to a collegue who doesn’t find it morally problematic? Give reasons for holding your view.
  1. What of therapeutic abortions, which take place after test have indicated a risk of birth defects or genetic diseases? How should the counseling be done in such cases? Is it really always best to abort than to give birth to a defective child? What if the test shows only a statistical correlation between an abnormal chromosome and an actual genetic disease? Should the choice be left to the mother or the parents, and how much should an attempt be made to influence them to be socially responsible in such cases? Give reasons for holding your view.
  1. Should a doctor regard himself as having two patients when women come for prenatal care or does his fidelity remain mainly with the woman, unless she decides to put a greater priority on the unborn’s health and life than on her own? What if she continues to smoke, drink, or do other things which put the fetus at risk and make it more likely that its future life after birth will be compromised? Should coercion in such case be considered to force her to be more responsible to the child she is carrying to term, or should she be educated and counseled on the likely consequences of her behavior and allowed to choose for herself? What of the extreme case of fetuses damaged by a crack addicted mother, so that they will later have learning disabilities? Would it be better to urge her to abort than carry to term? What if she repeatedly abuses the right to an abortion? Give reasons for holding your view.
  1. When infertile couples seek treatments, and they fail, should in vitro fertilization and surrogacy be legally available as an option, so that at least one member of the couple can have a child of his/her own? What is both morally and legally problematic about this? Could scarce medical resources and personnel be better spent on other things than catering to the needs of such couples? What of surrogate motherhood in general? Is this a good thing that we should encourage? Now that test tube babies are common place, we have gotten used to it. Will the same thing happen with other reproductive technologies like cloning? Give reasons for holding your view.
  2. Give an account of the pros and cons on the euthanasia and doctor-assisted suicide issue. Particularly, deal with the sanctity of life and slippery slope arguments on the con side, and the right to self-determination and the claim that sufficient regulation can prevent the slippery slope effects on the pro side. Take sides in this controversy. If Massachusetts were to vote on an Oregon-style law which would allow doctor-assisted suicide under carefully regulated conditions, would you vote for it or not? Give reasons for holding your view.
  1. Deal with the distinctions between active/passive and voluntary/involuntary euthanasia, and differentiate them form both doctor-assisted suicide and refusal of life-sustaining treatment. Is there a morally significant difference to you between letting die by letting nature take its course and killing a patient if they are bound to die very soon anyway? What of the use of morphine drips? Is it active euthanasia if upping the dosage leads to cessation of breathing and heartbeat? Should the medical profession admit that this is active euthanasia or continue to regard it as mainly pain relief when dying? Do we have de facto legalized active euthanasia if using morphine drips routinely kills people? Give reasons for holding your view.
  1. Deal with the use of either active or passive euthanasia in the case of severely defective newborns. Is it less cruel to give such a child a lethal injection than to allow it to die after 9-10 days of withdrawing food and hydration? If the child is going to die sooner or later anyway, which is morally preferable? Should active euthanasia be a legal option open to doctors and the parents or remain illegal in these types of cases? Give reasons for holding your view.
  1. Deal with hospice care and how it is different from traditional care as well as euthanasia. What do you think of doctors not treating treatable conditions like having pneumonia in order to hasten death, while keeping the patient as free from pain as possible while they are dying? Is this preferable for many terminal patients compared with both aggressive treatment to keep them alive and actual euthanasia? Give reasons for holding your view.
  1. Deal with DNR orders and advance directives, proxy agreements, and living wills. Is it better to have terminal patients put down in writing what their own wishes are in order to prevent the situation presented by Terry Schiavo. What did you think about politicians attempting to intervene to prevent a court order from being carried through to remove her feeding tube, after the courts had decided it was in her best interest and accordance with her next of kin’s wishes, ie. her husband’s? Do you think that, If she had done such advanced paper work, it might have been less problematic? Why? What lesson should we draw from this case? Should these documents be legally binding or only advisory? Give reasons for holding your view.