Description
DECISION TREE FOR NEUROLOGICAL AND MUSCULOSKELETAL
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 7 OF WEEK 8
Submit your Assignment, started in Week 6.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htmLinks to an external site.). All papers submitted must use this formatting.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK8Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6521_Week8_Assignment_Rubric
NURS_6521_Week8_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeBriefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Be specific.
20 to >17.8 pts
Excellent
The response accurately and thoroughly summarizes in detail the patient case study assigned, including specific and complete details on each of the three decisions made for the patient presented.
17.8 to >15.8 pts
Good
The response accurately summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented.
15.8 to >13.8 pts
Fair
The response inaccurately or vaguely summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented.
13.8 to >0 pts
Poor
The response inaccurately and vaguely summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented, or is missing.
20 pts
This criterion is linked to a Learning OutcomeBased on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
25 to >22.25 pts
Excellent
The response accurately and thoroughly explains in detail how the decisions recommended for the patient case study are supported by the evidence-based literature. … The response includes specific and relevant outside reference examples that fully support the explanation provided.
22.25 to >19.75 pts
Good
The response accurately explains how the decisions recommended for the patient case study are supported by the evidence-based literature. … The response includes relevant outside reference examples that lend support for the explanation provided that are accurate.
19.75 to >17.25 pts
Fair
The response inaccurately or vaguely explains how the decisions recommended for the patient case study are supported by the evidence-based literature. … The response includes inaccurate or vague outside reference examples that may or may not lend support for the explanation provided or are misaligned to the explanation provided.
17.25 to >0 pts
Poor
The response inaccurately and vaguely explains how the decisions recommended for the patient case study are supported by the evidence-based literature, or is missing. … The response includes inaccurate and vague outside reference examples that do not lend support for the explanation provided, or is missing.
25 pts
This criterion is linked to a Learning OutcomeWhat were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
20 to >17.8 pts
Excellent
The response accurately and thorough explains in detail what they were hoping to achieve with the decisions recommend for the patient case study assigned. … The response includes specific and relevant outside reference examples that fully support the explanation provided.
17.8 to >15.8 pts
Good
The response accurately explains what they were hoping to achieve with the decisions recommended for the patient case study assigned. … The response includes relevant outside reference examples that lend support for the explanation provided that are accurate.
15.8 to >13.8 pts
Fair
The response inaccurately or vaguely explains what they were hoping to achieve with the decisions recommended for the patient case study assigned. … The response includes inaccurate or vague outside reference examples that may or may not lend support for the explanation provided or are misaligned to the explanation provided.
13.8 to >0 pts
Poor
The response inaccurately and vaguely explains what they were hoping to achieve with the decisions recommended for the patient case study assigned, or is missing. … The response includes inaccurate and vague outside reference examples that do not lend support for the explanation provided, or is missing.
20 pts
This criterion is linked to a Learning OutcomeExplain any difference between what you expected to achieve with each of the decisions and the results of the decisions in the exercise. Describe whether they were different. Be specific and provide examples.
20 to >17.8 pts
Excellent
The response accurately and clearly explains in detail any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise. … The response provides specific, accurate, and relevant examples that fully support whether there were differences between the decisions made and the decisions available in the exercise.
17.8 to >15.8 pts
Good
The response accurately explains any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise. … The response provides accurate examples that support whether there were differences between the decisions made and the decisions available in the exercise.
15.8 to >13.8 pts
Fair
The response inaccurately or vaguely explains any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise. … The response provides inaccurate or vague examples that may or may not support whether there were differences between the decisions made and the decisions available in the exercise.
13.8 to >0 pts
Poor
vaguely explains in detail any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise, or is missing. … The response provides inaccurate and vague examples that do not support whether there were differences between the decisions made and the decisions available in the exercise, or is missing.
20 pts
This criterion is linked to a Learning OutcomeWritten 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.
5 to >4.45 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4.45 to >3.95 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3.95 to >3.45 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
3.45 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.45 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors
4.45 to >3.95 pts
Good
Contains a few (1–2) grammar, spelling, and punctuation errors
3.95 to >3.45 pts
Fair
Contains several (3–4) grammar, spelling, and punctuation errors
3.45 to >0 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 to >4.45 pts
Excellent
Uses correct APA format with no errors
4.45 to >3.95 pts
Good
Contains a few (1–2) APA format errors
3.95 to >3.45 pts
Fair
Contains several (3–4) APA format errors
3.45 to >0 pts
Poor
Contains many (≥ 5) APA format errors
5 pts
Total Points: 100
PreviousNext
please see document attached as I have highlighted my “decisions” for the treatments which is needed for the assignment.
Unformatted Attachment Preview
Decision Point One
Highlighted = my decision
Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per
day
RESULTS OF DECISION POINT ONE
•
Client returns to clinic in four weeks
•
Client comes to the office still using crutches. He states that the pain has improved but he is a
bit groggy in the morning
•
Client’s pain level is currently a 6 out of 10. You question the client on what would be an
acceptable pain level. He states, “I would rather have no pain but don’t think that is possible. I
could live with a pain level of 3.” He states that his pain level normally hovers around a 9 out
of 10 on most days of the week before the amitriptyline was started. You ask what makes the
pain on a scale of 1-10 different when comparing a level of 9 to his current level of 6?” The
client states, “I’m able to go to the bathroom or to the kitchen without using my crutches all
the time. The achiness is less and my toes do not curl as often as they did before.” The client is
also asked what would need to happen to get his pain from a current level of 6 to an
acceptable level of 3. He states, “Well, that is kind of hard to answer. I guess I would like the
achiness and throbbing in my right leg to not happen every day or at least not several times a
day. I also could do without my toes curling in like they do. That really hurts.”
•
Client denies suicidal/homicidal ideation and is still future oriented
Decision Point Two
Continue current medication and increase dose to 125 mg at BEDTIME this week continuing
towards the goal dose of 200 mg daily. Instruct the client to take the medication an hour earlier than
normal starting tonight and call the office in 3 days to report how his function is in the morning
RESULTS OF DECISION POINT TWO
•
Client returns to clinic in four weeks
•
The change in administration time seemed to help. The client states he is not as groggy in the
morning and is able to start his day sooner than before
•
Client’s current pain level is a 4 out of 10. He states that he is now taking 125 mg of
amitriptyline at bedtime.
•
Client’s has noticed that he is putting on a little weight. When asked, the client states that he
has gained 5 pounds since he started taking this medication. He currently weighs in at 162
pounds. He is 5’ 7”. He states that his right leg doesn’t bother him nearly as much as it used to
and his toes have only “cramped up” twice in the past month. He states that he is able to get
around his apartment without his crutches and that he has even started seeing someone he
met at the grocery store. The weight gain seems to bother him a lot and he is asking if there is
a way to avoid it
Decision Point Three
Continue the current dose of Elavil of 125 mg per day, refer the client to a life coach who can
counsel him on good dietary habits and exercise
Guidance to Student
At this point, the client is almost at his goal pain control and increased functionality. Weight gain is a
common side effect with amitriptyline and should be a counseling point at the initiation of therapy. He
has a small weight gain of 5 pounds in 8 weeks. A reduction in dose may have an effect on the weight
gain but at a considerable cost of pain to the client. This would not be in the best interest of the client at
this point. Amitriptyline has a side effect of cardiac arrhythmias. He is not experiencing this at this point.
The drug, qsymia contains a product called phentermine which has a history of causing cardiac
arrhythmias at higher doses. This product is also only approved for a client with obesity defined as a BMI
greater than 30 kg/m2. Your client’s BMI is currently 25.5 kg/m2. He does not meet the definition of
obesity but is considered overweight. His best course of action would be to continue the same dose of
Elavil, counsel him on good dietary and exercise habits and connect him with a life coach who will help
him with this problem in a more meaningful way than a 10 minute counseling session will be able to
accomplish.
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