Case: AA – Hypertension Stage 2, and Overweight

Scenario Description:

Ms. A presents with complaints of headache and general fatigue. She also reports that she has had periodic nosebleeds. She reported that she has been taking many medications for her hypertension in the past, but stopped taking them because of the side effects. She could not recall the names of the medications. Prescribed one year ago and currently taking 100 mg/day atenolol and 12.5 mg/day hydrochlorothiazide (HCTZ), which she admits to taking irregularly because “… they bother me, and I forget to renew my prescription.” Despite this antihypertensive regimen, her blood pressure remains elevated, ranging from 150 to 155/110 to 114 mm Hg. In addition, Ms. A admits that she has found it difficult to exercise, stop smoking, and change her eating habits. She has not seen her primary care doctor in a year. Smokes 15 cigarettes a day for 10 years.

Purdue University Global logo

Rubric Title: Unit 2, 4, 6 Lab – Virtual Reality Rubric

***Students: It is IMPORTANT to remember to utilize both the “Guided Mode” and “Expert Mode” in the VR Lab Simulation case scenario experiences, as you practice the VR Lab scenario(s). The “Guided Mode” and “Expert Mode” allow you to have multiple tries/attempts to practice the case. THEN, when you feel you are ready, you will choose the VR Lab “Exam Mode” (that you can ONLY attempt once); the score you receive in “Exam Mode” will then be your final grade in the VR Lab. If you have any questions regarding this, please follow up with your course instructor.


Assignment Criteria


Level III

Level II

Level I

Not Present

Criteria 1

Level III

Points: 80

Level II

Points: 64

Level I

Points: 48

Not Present

0 Points

Total Score

· Within Exam Mode, obtains 65 to 80 points of the required total components for virtual reality patient scenario

· Within Exam Mode, obtains between 49 to 64.9 points of the required total components for virtual reality patient scenario

· Within Exam Mode, obtains between 33 to 48.9 points of the required total components for virtual reality patient scenario

· Does not attempt in Exam Mode

· Does not meet the criteria

Rubric Title: Unit 3, 5, 7 SOAP Journal Assignment Rubric

Criteria 1

Level III Max Points

Points: 8

Level II Max Points

Points: 6.4

Level I Max Points

Points: 4.8

0 Points

Content Quality- Subjective Data

Subjective data displays complete understanding of all critical concepts of virtual reality patient case including:

· Name, age, gender

· Chief complaint

· History of present illness (HPI) that follows OLD CARTS pneumonic

· Medications

· Allergies

· Past medical history

· Past surgical history

· Pertinent family history

· Social history

· Review of Systems

· Subjective data displays unders

Name: 

 Pt. Encounter Number:

Date:

Age:

Sex:

SUBJECTIVE

CC: 

Reason given by the patient for seeking medical care “in quotes”

 

HPI: 

Describe the course of the patient’s illness, including when it began, character of symptoms, location where the symptoms began, aggravating or alleviating factors, pertinent positives and negatives, other related diseases, past illnesses, and surgeries or past diagnostic testing related to the present illness.

 

Medications:
(List with reason for med )

 

Allergies:
(List with reaction)

 

Medication Intolerances:

Past Medical History:

 

Chronic Illnesses/Major traumas

 

Hospitalizations/Surgeries

 

“Have you ever been told that you have  diabetes, HTN, peptic ulcer disease, asthma, lung disease, heart disease, cancer, TB, thyroid problems, kidney problems, or psychiatric diagnosis?”

 

Family History

Does your mother, father, or siblings have any medical or psychiatric illnesses?  Is anyone diagnosed with: lung disease, heart disease, HTN, cancer, TB, DM, or kidney disease?

 

Social History

Education level, occupational history, current living situation/partner/marital status, substance use/abuse, ETOH, tobacco, and marijuana.  Safety status

 

ROS Student to ask each of these questions to the patient: “Have you had any…..”

General

Weight change, fatigue, fever, chills, night sweats,  and energy level

 

Cardiovascular

Chest pain, palpitations, PND, orthopnea, and edema

 

Skin

Delayed healing, rashes, bruising, bleeding or skin discolorations, and any changes in lesions or moles

 

Respiratory

Cough, wheezing, hemoptysis, dyspnea, pneumonia hx, and TB

 

Eyes

Corrective lenses, blurring, and visual changes of any kind

 

Gastrointestinal

Abdominal pain, N/V/D, constipation, hepatitis, hemorrhoids, eating disorders, ulcers, and black, tarry stools

 

Ears

Ear pain, hearing loss, ringing in ears, and discha


Unit 1 Reading: 

Textbook Reading

Primary Care: The art and Science of Advanced Practice Nursing

· Chapter 2: Caring and the Advanced Practice Nurse

· Chapter 3: Health Promotion

· Chapter 4: The Art of Diagnosis and Treatment

· Chapter 5: Evidence Based Practice

Resources

PowerPoint Links: 

·
Diagnostic Reasoning

· American Cancer Society. (2021). Cancer Screening Guidelines.
https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines.html

· Centers for Disease Control. (2021). Immunization schedules.
https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

· Center for Disease Control. (2021) Recommended Adult Immunization Schedules
https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf

· U.S. Preventive Services Task Force. (2021). USPSTF A and B screening recommendations. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

· Department of Health and Human Services, Office of Disease Prevention and Health Promotion (ODPHP). (2021). Healthy People 2030 https://health.gov/healthypeople

· U.S. Preventive Services Task Force. (2021). USPSTF all screening recommendations.
https://www.uspreventiveservicestaskforce.org/BrowseRec/Index/browse-recommendations

Unit 2 Reading:

Textbook Reading

Primary Care: The art and Science of Advanced Practice Nursing

· Chapter 34: Cardiovascular Problems

· Chapter 35: Cardiac and Associated Risk Disorders