DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders

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DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders – Step-by-Step Guide

The first step before starting to write the DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last few years and review each one for credibility. Ensure that you obtain the references in the required format, for example, in APA, to save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested in reading through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence collected from the research, and ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between paragraphs by using transition words and a flow of ideas.

How to Write the In-text Citations for DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders Instructions

Assessing, Diagnosing, And Treating Hematological And Immune System Disorders

Many factors affect patients’ hematological and immune status. Additionally, manifestations of these disorders may appear in different organ systems. As an advanced practice nurse, you must be able to diagnose and treat patients with hematological and immune status disorders by prescribing necessary treatments, assessments, and follow-up care. Have a look at DRNP 6540 Week 9 Discussion – Harvard Implicit Bias Test – Persons Of Advanced Age.

To prepare:

  • Review the Week 8 Case Assignment and questions provided by your instructor.
  • Reflect on the patient’s symptoms and aspects of disorders that may be present.
  • Consider how you might assess, perform diagnostic tests, and recommend medications to treat patients presenting with the symptoms in the case study.

The Assignment:

After reviewing the case and the accompanying case analysis questions, included in the document, answer the questions directly in a word document. When providing evidence to support your answers, be sure they evidenced-based, current (no more than 5 years old), and follow current standards of care. Follow APA 7th edition formatting, including a cover page and references. 

By Day 7

Submit your Assignment.

WEEK 8 CASE STUDY

Mrs. Susan Derrick is a 77-year-old female who comes to the office with complaints of increasing symptoms of lethargy; fever, night sweats, a 15 lb. weight loss over 6 months; bleeding gums when she brushes her teeth; purplish patches in the skin; and shortness of breath. She also reports a feeling of deep pain in her bones and joints, worse than her usual arthritis pain. She notes that her employment history includes working at a dry-cleaning shop for 15 years, with an exposure to dry cleaning chemicals (benzenes are known to be a possible cause of leukemias).

She currently lives with her son and daughter-in-law and their teenage son in a single family home. She has Medicare, a Medicare supplement plan and has a modest social security payment each month. She is financially comfortable living with her family. Generally she has been in good health, only treated for hypertension, occasional gastric reflux and osteoarthritis – worse in left hip.

HPI: As stated in case above.

Allergies: NKDA

Medications:

  • Omeperzol 20mg po daily
  • HCTZ 25mg po daily
  • Acetaminophen 325mg 2 po every 6 hours PRN hip pain

PE: Enlarged lymph nodes and swelling or discomfort in the abdomen.

You diagnose this patient with acute lymphoblastic leukemia (ALL).

ANSWER THE FOLLOWING QUESTIONS:

  1. What additional history about her past work environment would you explore?
  2. What additional objective data will you be assessing for?
  3. What tests will you order? Describe at least four lab tests.
  4. What are the differential diagnoses that you are considering? Describe two.
  5. List at least two diagnostic tests you will order to confirm the diagnosis of ALL.
  6. Will you be looking for a consultation? Please explain.
  7. As the primary care provider for this patient with ALL:
  8. Describe the education and follow-up you will provide to this patient during and after treatment by the hematologist-oncologist.
  9. Describe at least three (3) roles as the PCP for the ongoing care of the ALL patient.

DRNP 6540 Week 8 Assignment – Assessing Diagnosing and Treating Hematological and Immune System Disorders Example

Week 8 Case Study Analysis

Mrs. Susan Derrick is a 77-year-old female presenting with symptoms suggestive of acute lymphoblastic leukemia (ALL). Given her history of exposure to benzene in a dry-cleaning environment, combined with her clinical presentation of lethargy, fever, weight loss, and unusual bleeding, this case offers a complex interplay between occupational health risks and hematologic disorders.

The purpose of this paper is to explore her diagnostic workup, including necessary laboratory tests and differential diagnoses while providing a comprehensive treatment plan and ongoing care strategy. By adhering to evidence-based guidelines, this document aims to outline the critical steps in managing ALL in an older adult, ensuring optimal outcomes through early detection, accurate diagnosis, and integrated care.

  1. What additional history about her past work environment would you explore?

Given Mrs Derrick’s long-term exposure to dry-cleaning chemicals, particularly benzene, it is crucial to delve deeper into her work environment. Benzene is a well-established risk factor for hematologic malignancies, including leukemia, as it can cause DNA damage in hematopoietic cells (American Cancer Society, 2023). Key questions to explore include:

  • Duration and frequency of benzene exposure: How long did she work in the dry-cleaning shop, and how frequently was she in contact with the chemicals?
  • Protective measures: Did she use protective equipment such as gloves or masks during her work hours? If so, how consistent was this use?
  • Symptoms during and after exposure: Did she experience any early symptoms such as headaches, dizziness, or unusual fatigue while working with these chemicals?
  • Workplace incidents or similar cases: Were there other employees with similar health concerns, suggesting a pattern related to benzene exposure?
  • What additional objective data will you be assessing for?

Complete Physical Examination: A thorough examination to assess for further signs of systemic involvement, including additional lymphadenopathy, hepatosplenomegaly, and petechiae. ALL frequently present with enlarged lymph nodes and spleen, which could indicate bone marrow involvement or extramedullary disease (Puckett & Chan, 2022).

Cardiopulmonary Assessment: Given her complaints of shortness of breath, a thorough evaluation of her respiratory and cardiovascular status is necessary. ALL patients may present with pleural effusions or heart failure as a result of leukemic infiltrates (Puckett & Chan, 2022).

Neurological Evaluation: Assess for any signs of central nervous system (CNS) involvement, such as confusion, headaches, or visual disturbances. CNS relapse is common in ALL and can manifest early in the disease.

Nutritional and Musculoskeletal Assessment: Evaluate for signs of cachexia or muscle wasting, which are common in cancer patients, and assess her ability to maintain normal activities due to her reported joint pain. Nutritional deficiencies may also arise due to the systemic effects of leukemia.

  • What tests will you order? Describe at least four lab tests.
  • Complete Blood Count (CBC) with Differential: This test will help assess white blood cell count, platelet levels, and hemoglobin. In ALL, a CBC typically shows elevated white blood cell counts with a predominance of immature lymphoblasts, low platelets, and anemia (Puckett & Chan, 2022).
  • Peripheral Blood Smear: to examine the morphology of blood cells, the presence of abnormal, immature lymphoblasts would support the diagnosis of ALL (Puckett & Chan, 2022).
  • Bone Marrow Biopsy: A bone marrow biopsy is essential to confirm the diagnosis. It would reveal hypercellularity with more than 20% lymphoblasts, which is diagnostic of ALL (Puckett & Chan, 2022).
  • Flow Cytometry: This test is used to identify cell surface markers that are characteristic of ALL.
  • What are the differential diagnoses that you are considering? Describe two.

Chronic Lymphocytic Leukemia (CLL): CLL can present with similar symptoms, such as lymphadenopathy, fatigue, and weight loss. However, CLL typically progresses more slowly and often presents in older adults without the rapid onset seen in ALL. Additionally, CLL often does not involve high blast counts in the blood. CLL is characterized by a mature appearance of lymphocytes on peripheral blood smear and a more indolent course, whereas ALL involves immature lymphoblasts and a more acute clinical presentation (Puckett & Chan, 2022).

Myelodysplastic Syndrome (MDS): MDS presents with symptoms like anemia, thrombocytopenia, and fatigue, which overlap with ALL. However, MDS usually results in ineffective hematopoiesis and dysplastic cells in the bone marrow rather than the rapid proliferation of lymphoblasts. MDS typically shows dysplastic marrow cells and peripheral cytopenias without the high blast count seen in ALL. Bone marrow biopsy findings in MDS would show abnormal cell maturation rather than lymphoblast infiltration (Puckett & Chan, 2022).

  • List at least two diagnostic tests you will order to confirm the diagnosis of ALL.

Bone Marrow Aspiration and Biopsy: This test will reveal hypercellularity with >20% lymphoblasts, confirming the diagnosis.

Cytogenetic Analysis and Molecular Testing: To identify chromosomal abnormalities like the Philadelphia chromosome (t(9;22)) or other genetic markers associated with ALL prognosis.

  • Will you be looking for a consultation? Please explain.

Consultation with a hematologist-oncologist is essential for initiating and managing chemotherapy and other advanced treatments. Additional consultations may include:

  • Infectious Disease Specialist: To address risks of infections due to immunosuppression.
  • Nutritionist: To manage nutritional deficits and optimize the patient’s health during treatment.
  • As the primary care provider for this patient with ALL:
  • Describe the education and follow-up you will provide to this patient during and after treatment by the hematologist-oncologist.

Education: Mrs. Derrick will be educated on the nature of ALL, chemotherapy side effects (e.g., nausea, fatigue, risk of infection), and bleeding precautions (e.g., signs of bruising, nosebleeds). Emphasis will be placed on infection prevention, such as hand hygiene avoiding sick contacts, and understanding the importance of adhering to treatment schedules.

Follow-Up: Regular follow-up appointments will be scheduled to monitor treatment side effects, manage symptoms, and track blood counts. Coordination with the hematologist-oncologist will be necessary to adjust treatment as needed and monitor for relapse.

  • Describe at least three (3) roles as the PCP for the ongoing care of the ALL patient.

Symptom Management: Manage side effects like pain, nausea, and fatigue through appropriate medications and lifestyle recommendations.

Care Coordination: Serve as the main point of contact for coordinating care with specialists and ensuring timely follow-up (Duffy, 2022).

Preventive Care: Monitor for complications like infections and secondary cancers, providing vaccinations and long-term health screening as needed.

References

American Cancer Society. (2023). Risk factors for acute lymphocytic leukemia (ALL). Www.cancer.org. https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/causes-risks-prevention/risk-factors.html

Duffy, L. (2022). Advanced practice nursing in the care of older adults. F A Davis.

Puckett, Y., & Chan, O. (2022, June 27). Acute lymphocytic leukemia (ALL). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459149/