Free Essay

Newborn Assessment

In: People

Submitted By minion81
Words 1519
Pages 7
Running head: NEWBORN ASSESSMENT

Newborn Assessment
College of Southern Nevada
Nurs 247

Newborn Assessment

Student Name: Date: November 21st, 2009

Infant Sex: Male Age at Exam: 6 hours old Gestational Age: 40 weeks Diet: Formula

Features of Pregnancy, Labor & Delivery: Data obtained from Prenatal History, L&D Record, and Verbal Report:

The patient is a 27 year old female that was a G3 P2. The patient did not receive any prenatal care with this pregnancy or previous pregnancy. The patient stated that this pregnancy went very fast as she didn’t realize how far along she was until her water broke at home on 10/9/09. The patient stated that she did not have much pain and did not receive any pain medication. When the patient arrived, she was 10cm, 100% and +2. The patient gave birth to the baby vaginally within 15 minutes of arriving to the hospital and stated she only pushed 3 times. The patient lost approximately 200mL of blood during birth and the patient had lab work drawn the morning of the interview however no results were available. The patient reports no known diseases or illnesses.

|Assessment |Textbook Normals |Finding |
|Posture |Vertex: arms and legs in moderate flexion; fists clenched |Flexion of arms and legs. Fists |
| |Normal spontaneous movement bilaterally asynchronous but equal extension in all |clenched closely to chest. |
| |extremities | |
| |Frank breech: legs straighter and stiff | |
|Vital Signs | |Apical pulse of 115 when lying |
|Heart Rate and Pulses |Visible pulsations in left midclavicular line, 5th intercostals space |quietly. S1 and S2 were sharp and |
| |Apical pulse, 4th intercostals space 100-160 beats/min, 80-100 bpm (sleeping), up|clear. at rest. S1 & S2 sharp and |
| |to 180 bpm (crying) |clear. |
| |Quality: first sound (closure of mitral and tricuspid valves) and second sound | |
| |(closure of aortic and pulmonic vales) sharp and clear | |
| |Possible murmur | |
| |Peripheral pulses equal and strong | |
| |Femoral pulses equal and strong |Femoral and brachial pulse was |
|Peripheral pulses: | |equal and strong. |
|Femoral, brachial, poplitieal, post.| | |
|Tibial |Axillary: 36.5(C to 37.2(C |Axillary temp: 98.2 F |
| |Temperature stabilized by 8-10 hr of age | |
|Temperature |30-60 breaths/min |Respiratory Rate: 42 |
| |Shallow and irregular in rate, rhythm, and depth while infant is awake. Breath |Breath sounds were shallow, |
|Respiratory Rate |sounds loud, clear, near |irregular and no crackles were |
|(Count respirations for full minute)|Crackles may be heard after birth |present. |
| | | |
| | |87/42 |
| |80-90s/40-50s | |
|B/P | | |
|Apgar Score (Describe) |Evaluation made 1-5 min after birth. Scores 0-3 indicate severe distress; 4-6 |1 Minute: 9/9 |
| |indicate moderate difficulty; 7-10 indicate no difficulty adjusting to |5 Minute: 9/9 |
| |extrauterine life. | |
| | | |
| | | |
| | | |
|Heart Rate | | |
|Respiratory Rate | | |
|Muscle Tone | | |
|Reflex irritability | | |
|Color | | |
| |0 |1 |2 | |
| |Absent |Slow (100 | |
| |Absent |Slow, weak cry |Good cry | |
| |Flaccid |Some flexion |Well flexed | |
| |No Response |Grimace |Cry | |
| |Blue, Pale |Body pink, extremities |Completely pink | |
| | |blue | | |
|Weight today |2500-4000g |2880g |
| |Acceptable weight loss: ( 10% | |
|Head Circumference |32-36.8 cm |34cm |
|Chest Circumference |2-3 cm less than head circumference, avg. 30-33cm |31cm |
|Abd Circumference |Same size as chest |31cm |
|Length |45-55 cm |44cm |
|Skin color |Generally pink, varying with ethnic origin, acrocyanosis (if chilled), mottling, |Pink coloring all over |
| |harlequin sign, plethora, telangiectases, erythema toxicum or neonatorum, milia, | |
| |petechiae, ecchymoses | |
|Birthmarks |Mongolian spot |N/A |
|Lanugo |Over shoulders, pinnas of ears, forehead |Minimal lanugo around ears and |
| | |forehead. |
|Fontanels | | |
|Anterior |5cm diamond, increasing as molding resolves |Normal |
|Posterior |Triangle, smaller than anterior |Normal |
|Eyes |Both present, equal size, round, firm, Symmetric, blink reflex, no discharge, |Both eyes present, round firm and |
| |pupils (PERRLA), Eyeball movement random, jerky, uneven, focus possible briefly, |of equal size. Symmetric shape |
| |following to midline, transient strabismus or nystagmus until third or fourth |noted. |
| |month | |
|Nose |Midline, some mucus but no drainage, preferential nose breather, sneezing to |Located midline, minimal mucus, no|
| |clear nose, slight deformity (flat or deviated to one side) from passage of birth|drainage. |
| |canal | |
|Ears |Correct placement (line drawn through inner and outer canthus of eyes should |Correct placement noted. Cartilage|
| |reach to notch of ears) |well formed. Responds to noise. |
| |Well formed, firm cartilage | |
| |Responds to voice and other sounds | |
| |State (eg. alert, asleep) influences response | |
|Mouth | Symmetry of lip movement; buccal mucosa pink dry or moist, pink gums; tongue not|Buccal mucosa pink and moist. |
| |protruding, freely movable, symmetric in shape; sucking pads inside cheek; soft |Tongue moving freely, not |
| |and hard palates intact; uvula in midline; distinct chin; moist mouth; rooting, |protruding and soft/hard palate |
| |sucking, extrusion reflexes present |intact. |
|Chest |
|Symmetry |Circular, barrel shaped; clavicles intact; rib cage symmetric and intact; nipples|Circular, barrel shaped. Rib cage |
| |prominent and symmetrically placed |symmetric and intact. Nipple |
| | |placement symmetrical. |
|Breast Tissue |breast nodule 3-10mm, secretion of witch’s milk |N/A |
|Lungs |symmetric chest movement, chest and abdominal movements synchronized during |Symmetric chest movement, |
| |respirations; occasional retractions, especially when crying |retractions seen when crying. |
|Heart Sounds |Quality: first sound (closure of mitral and tricuspid valves) and second sound |S1 and S2 sharp and clear. No |
| |(closure of aortic and pulmonic vales) sharp and clear |murmur auscultated. |
| |Possible murmur | |
|Abdomen |Rounded, prominent, dome shaped, some diastsis of abdominal musculature, liver |No distension and bowel sounds |
| |possibly palpable 1-2 cm below right costal margin, no other masses palpable, no |present. |
| |distention; bowel sounds present within minutes after birth | |
|Umbilical Cord |Two arteries, one vein, whitish gray, definite demarcation between cord and skin,|Dry around base, odorless with |
| |no intestinal structures within cord, dry around base, drying, odorless, cord |cord clamp. |
| |clamp in place for 24hr, reducible umbilical hernia | |
|Stool |Meconium stool passing within 24-48hr after birth, meconium followed by |N/A |
| |transitional and soft yellow stools | |
|Genitals | | |
|Female |Female genitals | |
|Male |Male genitals |Male genitals, meatus visible at |
|Meatus |Meatus at tip of penis |tip of penis and testes palpable |
|Testes |Palpable on each side |when squeezed on each side. |
|Urination |Voiding within 24 hr, stream and amount adequate |N/A |
|Extremities |Full ROM, possible slight tremors, some acrocyanosis |Full ROM |
|Fingers/Toes |5 fingers on each hand, fist often clenched with thumb under fingers, 5 toes on |5 fingers/toes on each hand/foot. |
| |each foot | |
|Back/Spine |Spine straight and easily flexed |Spine straight and easily flexed. |
|Anus |One anus with good sphincter tone, passage of meconium within 24-48 hr after |One anus with good sphincter tone.|
| |birth, good “wink” reflex of anal sphincter | |
|Pulses |Peripheral pulses equal and strong |Femoral and brachial pulses equal |
| |Femoral pulses equal and strong |and strong. |
|Mother’s ABO & RH | |B (+) |
|Infant ABO & RH | |O |
|Infant Lab Values |Hemoglobin |14-24 gm/dl |Labs were drawn but results not |
| |Hematocrit |44%-64% |available at time of assessment. |
| |Glucose |46-65 mg/dl | |
| |Leukocytes (white blood cells) |9,000-30,000/mm3 | |
| |Bilirubin, total serum |( 2.0 mg/dl | |
| |Blood gases | | |
| |Arterial |pH 7.32-7.49 | |
| | |PCO2 26-41 mm Hg | |
| | |PO2 60-70 mm Hg | |
| |Base excess |-10 to –2 mEq/L | |
| |Bicarbonate, serum |21-28 (arterial) | |
| |Anion gap |7-16 mEq/L | |
| |Venous |pH 7.31-7.41 | |
| | |PCO2 40-50 mm Hg | |
| | |PO2 40-50 mm Hg | |
|Medications/Purpose | |N/A |
|Erythromycin ophthalmic ointment 5mg|To prevent ophthalmia neonatorum in newborns of mothers who are infected with |Placed in eyes at birth. |
|in each eye after birth |gonorrhea, conjunctivitis, and Chlamydia. | |
|Vitamin K 0.5mg IM |Vitamin K is used for prevention and treatment of hemorrhagic disease in the |Administered at birth. |
| |newborn. | |
| | | |
| | | |
| | | |

Reflexes- Test at least 5 – Learn these: Describe how to test each and the interpretation:

|Reflex |Eliciting the reflex |Characteristic Response |Interpretation |
|Sucking and rooting |Touch infant’s lip, cheek, or corner of mouth|Infant turns hear toward stimulus; opens |Infant turned head towards finger |
| |with nipple |mouth, takes hold, and sucks |when cheek rubbed. |
|Swallowing |Feed infant; swallowing usually follows |Swallowing is usually coordinated with |Infant able to suck effectively and |
| |sucking and obtaining fluids |sucking and usually occurs without gagging, |swallow formula. |
| | |coughing, or vomiting | |
|Grasp | |Infant’s fingers curl around examiner’s |Infant curled finger and toes when |
|Palmar |Place finger in palm of hand |fingers, toes curl downward |finger placed near fingers/toes. |
|Plantar |Place finger at base of toes | | |
|Crawling |Place newborn on abdomen |Newborn makes crawling movements with arms |Infant failed arms/legs when placed |
| | |and legs |on abdomen. |
|Glabellar (Myerson) |Tap over forehead, bridge of nose, or maxilla|Newborn blinks for first four or five taps |Infant blink 4 times when tapped 4 |
| |or newborn whose eyes are open | |times on forehead. |

Mother- Infant Interaction:

The interaction between the mother and infant was observed and the mother was very gentle and loving towards her baby. She stated that she missed her other children being this small and that this time was one of her favorite times as a mother. Infant did not cry and went to sleep in mothers arms.

Nursing evaluation of any abnormal or unusual findings:

Nursing evaluation of mother/baby interaction was normal and newborn assessment findings were all within normal ranges.

Similar Documents

Free Essay

Newborn Assessment

...RATES, RHYTHM AND SOUNDS, PULSES. RESPIRATIONS: RATE 30-60 BREATHS PER MIN. RESPIRATIONS IRREGULAR, SHALLOW UNLABORED. CHEST MOVEMENT IS SYMMETRIC. BREATH SOUNDS PRESENT AND CLEAR BILATTLERLLY. MILD VARRIATIONS REQUIRE CONTINUED MONITORING AND USUALLY CLEAR IN EARLY HOURS AFTER BIRTH. IF PERSISTENT OR MORE THAN MILD, SUCTION, GIVE 02, CALL PHYSCIAN AND INTITATE MORE INTENSIVE CARE. BIRTH WIEGHT: A baby's birthweight is an important indicator of health. The average weight for term babies (born between 37 and 41 weeks gestation) is about 7 lbs. (3.2 kg). In general, small babies and very large babies are at greater risk for problems. Babies are weighed daily in the nursery to assess growth, fluid, and nutrition needs. PERCENT OF WIEGHT LOSS: Newborn babies may lose as much as 10 percent of their birthweight. This means that a baby weighing 7 pounds 3 ounces at birth might lose as much as 10 ounces in the first few days. Premature and sick babies may not begin to gain weight right away. LENGTH - the measurement from crown of head to the heel HEAD CIRCUMFERENCE: NORMAL, 32-38CM (the distance around the baby's head) - is normally about one-half the baby's body length plus 10 cm CHEST CIRCUMFERENCE: NORMAL: 30-36CM -2-3CM LESS THAN THE HEAD MORO REFLEX: A reflex is a type of involuntary (without trying) response to stimulation. The Moro reflex is one of...

Words: 1298 - Pages: 6

Free Essay

My Newborn Assessment

...Newborn Assessment Prior to the delivery of the baby, the nurse performs concurrent assessments and provides the necessary interventions needed for the patient and the fetus. Gestational age is determined by measuring the fundus height. Fetal Heart Rate monitoring is assessed to ensure the baby is in good standing. During the Delivery process the time of birth is the precise time the entire body is out. The time of birth is recorded. During this time if the newborn in danger, he or she may be placed on the mother abdomen and the umbilical cord is cut. After the birth, the primary focus on the assessment and stabilizing the newborn. The nurse is responsible for numerous interventions and evaluations in relation to the well-being of the infant. After the birth of the infant, the mouth is suction and the nares with a bulb syringe to remove any excess secretions. If the baby has excess meconium in his lungs the nurse does not want the baby to cry and will not try to suction. Respiratory will do necessary interventions for the child. Following suction, the newborn is then dried to stimulate crying. Temperature regulations is maintained by a blanket and placing the baby under a warmer. APGAR scoring system is performed and recorded at 1 minute and at five minute (Perry, S. E., & Cashion, K. (2007)). Heart rate is counted by holding the tip of the umbilical cord. The final APGAR score is the sum total of the five items, with a maximum score of ten (Perry, S. E., &......

Words: 423 - Pages: 2

Premium Essay

Newborn Physical Assessment

...physical assessment of a newborn is very important because it focuses on normal and abnormal findings. Observing the head’s shape is important because of the molding that happens in majority of births that occur vaginally. There are many things that can occur to a newborn resulting from birth trauma causing unusual masses or prominences. Two most common types of birth traumas that can occur during birth are caput succedaneum or cephalhematoma. The most commonly observed scalp lesion is caput succedaneum, a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery (Hockenberry & Wilson, 2011, p 280). It more likely to form during a long or hard delivery. The swelling extends beyond the sutures and can be associated with petechiae or ecchymosis. Most of the time, the problem is noticed after birth. No treatment is needed. The problem usually goes away on its own within a few days. Complications may include a yellow color to the skin. A cephalhematoma forms when blood vessels rupture during labor or delivery to produce bleeding into the area between the bone and its periosteum (Hockenberry & Wilson, 2011, p 281). Cephalohematomas are more common in first pregnancies, if the baby's head is larger than the birth canal. It gets better with no treatment within 3 months. The boundaries of the cephalhematoma are distinguishable and do not extend beyond the limits of the bone. Hyperbilirubinemia may result during......

Words: 263 - Pages: 2

Premium Essay

Negligent Sterilization

...been many things that happen to the child but nothing happen and she should be happy with the outcome. The court can’t offer you money to help you raise a child, that’s her job even though she is not the reason the baby came. 2. I would not agree with the court when it comes to not rewarding money for educating and raising the child. The court doesn’t know if Seslar was mentally ready to have this baby. It could be really hard in her life right now, maybe that’s the reason she wanted to have a procedure to stop having children. The court doesn’t know her circumstances so maybe that’s the reason she decided to sue. I think that I would also choose to disagree with the court’s decision based on the amount of money it would take to raise a newborn child. I think that the people...

Words: 693 - Pages: 3

Free Essay

Trickster Tale

...resources they needed to survive. One night for the celebration of a new born baby in the village they were having a ritual. The ritual consisted of a bonfire and dancing as they worshipped the gods and thanked them for the newborn. One lonely coyote that had been alone for quite awhile noticed a fire in the distance and decided to draw closer for he was curious. He got as close as he could without drawing attention or giving himself away. Coyote observed the situation at hand. He saw the Indian baby all tucked away in his mother’s arms and thought to himself what a good meal that would be. The sly and sneaky coyote quickly made a plan of attack. He would make a distraction by howling as loud as he could and then charge to the village and grab the babe and take off. Coyote knew it was risky but he had faith he could get away with it. He let out a howl and a couple yips and then knew it was time. He made his charge. Everyone started to scream out of shock and terror; he caught the mother off guard and swept the baby boy out of her arms. But, he hadn’t made it out yet. A group of the warriors surrounded him; he tried to bolt and successfully got through their legs. The men were on his tracks though. The Iroquois were not foolish and would not give up finding the newborn. They kept chasing coyote and finally wore him out. He had given up. Coyote surrendered the baby boy and knew what he had coming to him,...

Words: 297 - Pages: 2

Free Essay

Newborn Screening

...FOR ENSURING NEWBORN SCREENING Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled: ARTICLE 1 GENERAL PROVISIONS SECTION 1. Short Title. - This Act shall be known as the "Newborn Screening Act of 2004." SEC. 2. Declaration of Policy. - It is the policy of the State to protect and promote the right to health of the people, including the rights of children to survival and full and healthy development as normal individuals. In pursuit of such policy, the State shall institutionalize a national newborn screening system that is comprehensive, integrative and sustainable, and will facilitate collaboration among government and non-government agencies at the national and local levels, the private sector, families and communities, professional health organizations, academic institutions, and non-governmental organizations. The National Newborn Screening System shall ensure that every baby born in the Philippines is offered the opportunity to undergo newborn screening and thus be spared from heritable conditions that can lead to mental retardation and death if undetected and untreated. SEC. 3. Objectives. - The objectives of the National Newborn Screening System are: 1) To ensure that every newborn has access to newborn screening for certain heritable conditions that can result in mental retardation, serious health complications or death if left undetected and untreated; 2) To establish and integrate a sustainable newborn screening......

Words: 2239 - Pages: 9

Free Essay

Cystic Fibrosis

...Cystic Fibrosis Latisha Long HCS/245 March 26, 2012 Cathy Coyle Cystic Fibrosis In today’s society there are many diseases out there. It is to contract these diseases by coming in contact with a carrier. People who are into sharing dirty needles, having unprotected sex, or not being able to maintain a healthy and clean environment, can become infected with these transferable diseases. There are some diseases out there that you can inherit; one in particular that stands out is Cystic Fibrosis (CF). CF is a life threating disease; there are 1,000 new cases each year. With the new treatments and studies, people are living longer with CF. Before people with CF were only living into the early years of their childhood, and now they are living well past their 30s. CF is an inherited disease that affects the lungs and digestive system. A defective gene and its protein cause the body to produce an abundance of thick sticky mucus in the lungs. The production of this mucus causes the lungs to clog and can lead to life threating infections. CF can also cause the pancreas to obstruct and stop enzymes, which allows the body to absorb and breakdown food. This can cause slow growth and malnutrition in the body, and the sticky mucus can block the airway which makes it difficult to breath causing this disease to be life threatening. People with CF have shorter life expectancy, because of the way CF controls the body. The treatment for CF is improving every......

Words: 1105 - Pages: 5

Premium Essay

Requiring Newborn Screening of Critical Congenital Heart Disease

...Requiring Newborn Screening of Critical Congenital Heart Disease Date With the numerous technological advances that have occurred in today’s health care system, one would think newborn screening would be required in Maryland for the most common birth defect in the United States, critical congenital heart disease (CCHD), but only just this year has the state considered the requirement (Department of Legislative Services, Office of Information Systems [DLSOIS], 2011). Critical congenital heart disease, a disorder in which an infant’s heart or blood vessels near the heart develop abnormally before birth, affects approximately 8 out of every 1,000 infants each year in the US, amounting to around 36,000 infants (DLSOIS, 2011). CCHD is the leading cause of death among infants within the first year of life, amounting to nearly 40% of deaths, often due to the fact that a large number of infants with this disease go undetected (Martin, Bradshaw, & Wright, n.d.). Although some babies are diagnosed with congenital heart disease shortly before or after birth, many diagnoses are not made until days, weeks, or months later; sometimes not at all. Many benefits are associated with implementing CCHD screening, many treatment options are available for those diagnosed with CCHD, and a bill is being proposed to the State of Maryland’s General Assembly about including this screening in the Department of Health and Mental Hygiene’s Newborn Screening Program (DLSOIS, 2011). The......

Words: 1743 - Pages: 7

Free Essay

Whatttt

...Commonwealth of Pennsylvania, Department of Health Authorization to Obtain Newborn Screening Results and for Disclosure of Protected Health Information Fax form to the Department of Health’s Bureau of Family Health Newborn Screening Section at 717-213-3784 1. I authorize the Pennsylvania Department of Health (Department) to use/disclose individual newborn screening information/results obtained from the records of: (Please Print) Name at Birth: ___________________________________________________________ Date of Birth: __________________________ Sex: M F Telephone:__________________________________ Address:________________________________________________________________ Hospital of Birth: _________________________________________________________ Mother’s Full Name: ______________________________________________________ Mother’s Maiden Name: ____________________________________________________ Last 4 digits of Mother’s Social Security Number: _______________________________ 2. Reason for disclosure of Department Newborn Screening Results:(Describe each specific purpose – such as: use for direct patient care or college application) _College Application__________________________________________________________________ 3. I understand that: a. This authorization may be revoked at any time by writing to the Department except to the extent that information has already been disclosed. If information has already been......

Words: 309 - Pages: 2

Free Essay

Crime Scene Investigation

...Crime Scene Investigation On Friday, there was a house that had been broken into, and many things were stolen. It was revealed that the crime was committed at night, and the house belonged to someone named Billy Albert. Who is the thief guilty of this crime? Suspects (and blood types): Danny Brown (O) Peggy Brown (O) James Thomas (A) Ricky Green (A) Christopher Albert (B) Clues: Billy is close friends with siblings Danny and Peggy. James and Billy are best friends. James is a taxi driver, living on a low income and always asking Billy for money, who was always happy to help his friend. Christopher, Billy’s brother, didn’t seem to like him very much. They were always competing with each other to be the most successful businessman. Ricky is Billy’s business partner. Ricky stated that he was in his office working late at night. Hayley, a coworker of Billy’s, confirmed that Ricky was indeed in his office and not with Billy during the night of the robbery. James claims he did not see Billy at all that night, refusing to answer any other questions. James also seemed angry that his friend had to go through such a terrible thing. Christopher said that when he left Billy' house at around 11 pm, he saw James walking towards the house. When Christopher was questioned, he said he was having dinner at Billy’s house at around 8 pm. Christopher also revealed that Danny and Peggy were at Billy’s house and they were enjoying a fun night together playing games. Danny and......

Words: 432 - Pages: 2

Free Essay

Paper

...Assignment: Clinical Assessment Chaz Hedgspeth Axia College What other information would you like to learn during the interview with the family? What questions would you ask? If I were interviewing the family I would want to know extensive information about the child, including her home life, her life at school, and what types of relationships she has in both environments. Does she interact with the children well at school? Does she get punished for doing bad and rewarded for doing well? I would also want to know when she started behaving this way in the first place. Has she always behaved in this fashion? When did the behavior begin? Knowing if the behavior has affected her everyday living would be essential as well and if they feel like she is a threat to herself. Do her teachers say anything about her in the classroom? Is her attitude affecting her grades? Do you as the parents feel like your child is a threat to herself or anyone else around her? Finding out all of the information about the child’s life is essential to getting a complete outlook on what the possibilities of her behavior are. In addition to the clinical interview, what other types of assessments would you utilize? What would you hope to learn with each type of assessment? Since a patient is able to be assessed from the different psychological perspectives, I would want to assess the child with a combination of each of the perspective theories. First, I would want to assess......

Words: 826 - Pages: 4

Premium Essay

Nurse Prescribing V150 a Case Study

...UNIVERSITY OF THE WEST OF SCOTLAND NURSE PRESCRIBING V150 CASE STUDY COURSE: NURS09125 BANNER NUMBER: B00113677 DATE OF SUBMISSION 13/12/10 COURSE LEADER FRANCES DOWNER WORD COUNT: 3745 CONTENTS PAGE 1. INTRODUCTION & GENERAL OVERVIEW, Pgs3-4. 2. ASSESSMENT PROCESS, Pgs 5-8 3. TREATMENT OPTIONS, Pgs 9-12. 4. EVALUATION, Pgs 13-16 5. CONCLUSION. Pg 17 6. COPY OF PRESCRIPTION, Pg 18 7. REFERENCE SECTION, Pgs 19-23 8. BIBLIOGRAPHY, Pg 24. INTRODUCTION In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of prescribing in the community setting. The author a (trainee nurse prescriber) will display the need for a robust assessment, exploring all areas of health and well-being in order to achieve a safe outcome. The author will further follow current guidelines and be mentored by a senior nurse prescriber throughout the process. The aim of the case study is to display the implications involved in issuing a nurse prescription if deemed appropriate. With regard to writing a prescription as a qualified practioner, the author will adhere to the guidance within the Nursing and Midwifery Council (NMC 2006a) standards for safe prescribing. To protect this patient’s identity and maintain confidentiality, she will be referred to as Mrs X throughout the...

Words: 4607 - Pages: 19

Premium Essay

Essay Questions

...Essay Questions Kristy Bazzanella Liberty University Essay Questions Assessment is a vital component in the counseling process. Use of both informal and formal assessment methods ensure that clinicians judgments are non-biased, and when utilized correctly aide in formulating of case conceptualizations and treatment plans (Whitson, 2013). The primary purpose of assessments, for the counselor, is to obtain information to effectively counsel clients. According to Whitson (2013), once all information is gained, the counselor, can “either formally or informally, diagnose the client” (p.285). It is critical that the counselor choose assessments that are both reliable and valid. The choice of assessment type and instrument will vary depending on the presenting problem, age, and cognitive and developmental state of client. Assessments will also vary according to settings. For example, the choice of assessment instruments utilized by a school counselor will differ greatly from the assessments utilized in a drug treatment or psychiatric facility. Assessments can have either a negative or positive impact on treatment planning. Counselors who use informal assessment techniques, such as unstructured interviews may find that the information gathered is not reliable and, therefore, prone to error (Whitson, 2013, p.111). Inexperienced counselors who use unstructured interviews have been observed to focus on minor issues and have failed to collect adequate......

Words: 750 - Pages: 3

Premium Essay

Financial Analysis

...Weeks 13 and 14 (4/21-5/1): Lease Financing and Course Conclusion Yikes! We are at the bittersweet time in our course together. It is almost over. We’ll miss it so much, but we might also want to do something else with the rest of our lives. In these last 1.7 weeks, we’ll cover another topic which, in addition to Financial Analysis and Planning, serves the function of integrating much of the material we have covered. That topic is Lease Financing. There is a lot of material on the structure of the lease and on the accounting treatment of leases, but the analytical focus will be on the lease-buy decision. The lease-buy decision is actually a financing decision. The analysis of the advisability of a lease typically follows a prior decision to acquire an asset (based on an investment decision analysis). In lease analyses we are comparing lease financing (which is a type of debt) to “regular” debt financing. Video 20 and Chapter 25 in BMA are the main materials. As you review the video, work through the lease example in the Excel file (financing uma 13.xlsx). Toward the end of video 20 is described the concept of adjusted present value. Pay close attention to this material as well, because it describes how in some very specific cases the results of an investment decision and a financing decision must be considered together. The deliverable for this two-week period is Exercise 4, which is an individual, i.e., not a team, exercise. We’ll also use the time to......

Words: 666 - Pages: 3

Premium Essay

Informal Assessment of a Student

...Running Title: Informal Assessment Informal Assessment of a Student Barbara Brown Grand Canyon University: SPE-536 Professor Haynes October 31, 2012 Informal Assessment of a Student In the process of developing an informal assessment I have discovered how important it is to effectively develop an assessment that matches the criteria that I want to assess my students’ progress. To do an informal assessment on my students, I chose the unit that we are working on in Biology. At the moment we are learning about the parts of the cells and how the cell works to maintain life. As I did an informal observation on different students in the classroom, I observed that several of the students were having difficulties remembering the parts of the cell and their functions. To solve this problem, I developed an informal assessment that would allow students to learn the cell parts and its functions. The informal assessment that I developed is a game of battle ship on Quia. Quia is a learning tool that I have had the opportunity to use and observe other educators use to help educate and enhance their students learning. The game consists of the game battleship. Like the game, the player is looking for the ships of the enemy. When the student picks a spot that the enemy ship is located on, a question pops up asking a question supply a multiple choice of four answers that the student can choose from. If answered correctly the student gets a hit. There are about 17......

Words: 796 - Pages: 4