NR507 Week 1 Discussion: Client Scenario

NR507 Week 1 Discussion: Client Scenario – Step-by-Step Guide

The first step before starting to write the NR507 Week 1 Discussion: Client Scenario, 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 NR507 Week 1 Discussion: Client Scenario

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 words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can 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 NR507 Week 1 Discussion: Client Scenario

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 to read 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 NR507 Week 1 Discussion: Client Scenario

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 conducted from the research, 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 each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NR507 Week 1 Discussion: Client Scenario

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 NR507 Week 1 Discussion: Client Scenario

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 NR507 Week 1 Discussion: Client Scenario

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.

NR507 Week 1 Discussion: Client Scenario Instructions

Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in applying pathophysiology knowledge. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared. This discussion will support the professional formation of the nurse practitioner (NP) role. Have a look at NR 507 Week 2 Discussion: Choose Your Own Pathophysiology Adventure Part 1 of 3.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

• CO 1: Analyze pathophysiologic mechanisms associated with selected disease states across the lifespan. 
• CO 2: Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions across the lifespan. 
• CO 3: Distinguish risk factors associated with selected disease states across the lifespan.      
• CO 4: Integrate advanced pathophysiological concepts in the diagnosis and treatment of health problems in selected populations. 
• CO 5: Relate research findings to the management of patients with complex pathophysiologic dysfunction. 

Due Date

Initial posts are due to the discussion forum by Wednesday at 11:59 p.m. MT. Instructor and peer responses are due by Sunday at 11:59 p.m. MT. Students must post on a minimum of two separate days. A 10% late penalty will be imposed for discussions posted after the deadline Wednesday at 11:59 p.m. MT, regardless of the number of days late. NOTHING will be accepted after 11:59 p.m. MT on Sunday (i.e., the student will receive an automatic 0).      

Total Points Possible: 50

Preparing the Discussion

Follow these guidelines when completing each component of the discussion. Contact your course faculty if you have questions. 

General Instructions 

The purpose of this discussion is to examine disease processes associated with a client scenario following the instructions below. The course faculty will reveal the disease process at the end of the week. 

Step 1: Carefully read the following client scenario: 

Wilbur, a 55-year-old male client, presents to the NP complaining of a flat, purple-colored rash on his back and chest. Wilbur states the rash is not painful or itchy. He states it has been there for months, and he has also developed a white coating on his tongue and has “been sick a lot lately.”

Step 2: Identify your assigned disease process from the chart below. Your assigned disease process is based on the first letter of your last name. 

Last Name	Disease Process
A – H	Condition: Allergies
I – P	Condition: Human Immunodeficiency Virus (HIV)
Q – Z	Condition: Systemic Lupus Erythematosus (SLE)

Step 3: Answer the discussion prompts below with explanation and detail, providing complete references for all citations. 

Step 4: Reply to a peer with a different assigned condition. 

Include the following sections:  

1. Application of Course Knowledge: Answer all questions/criteria with explanations and detail. 

1. Discuss the underlying pathophysiological mechanisms of your assigned disease process. Which clinical manifestations observed in Wilbur’s case may be explained by the pathophysiological mechanisms? 
2. Analyze Wilbur’s clinical manifestations as they relate to your assigned disease process. Do these findings support your assigned disease process? Why or why not?  
3. Identify and justify the diagnostic tests (including labs, imaging, or other diagnostic tests) that may be most appropriate for investigating your assigned disease process as the diagnosis for Wilbur. Discuss anticipated test results.  
4. Compare and contrast your response with a peer assigned to a different condition. Does their condition fit Wilbur’s case? Why or why not? Explain your rationale. 

2. Integration of Evidence: Integrate relevant scholarly sources as defined by program expectations:

1. Cite a scholarly source in the initial post.
2. Cite a scholarly source in one faculty response post.
3. Cite a scholarly source in one peer post.
4. Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.  
5. Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations. 

3. Engagement in Meaningful Dialogue: Engage peers and faculty by asking questions and offering new insights, applications, perspectives, information, or implications for practice.

1. Peer Response: Respond to at least one peer on a topic other than the initially assigned topic.
2. Faculty Response: Respond to at least one faculty post.  
3. Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.  

4. Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.  

5. Reference Citation: Use current APA format to format citations and references free of errors.  

6. Wednesday Participation Requirement: Provide a substantive response to the graded discussion topic (not a response to a peer or faculty) by Wednesday, 11:59 p.m. MT of each week.  

7. Total Participation Requirement: Provide at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week. 

**To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.  

NR507 Week 1 Discussion: Client Scenario Example

Clinical presentations inform patient diagnosis and management. The presumptive diagnosis informs diagnostic tests for a definitive diagnosis. Clinical presentations may be similar for various conditions, given their multisystem presentations. Thus, there is a need for pathophysiology knowledge of the various conditions and diagnostic tests to diagnose them accurately. This discussion focuses on Wilbur, who has been diagnosed with systemic lupus erythematosus. It also discusses SLE pathophysiology, clinical manifestations, and diagnostic tests that can be used for the diagnosis.

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that attacks the immune system’s cells and tissues. The disease symptoms range from mild to severe and can cause inflammation in various parts of the body, including blood vessels, tendons, joints, and skin. The disease’s pathophysiology begins with the activation of autoimmunity in genetically susceptible individuals, primarily triggered by infections (Vaillant et al., 2023).

Cell damage exposes the immune system to self-antigens; hence, T and B cells are activated, which is sustained by a self-directed immune response. The cell-membrane-bound toll-like receptors are activated by exposure to DNA and RNA from dying cells, thereby triggering the activation of the interferon cascade. T-cells in SLE are characterized by distorted gene expression and the production of several cytokines, as well as the activation of autoreactive B-cells, which leads to antibody production, a key role in SLE (Vaillant et al., 2023).

Cytokine and antibody release lead to organ damage. Constitutional symptoms, such as fatigue, malaise, fever, and weight loss, are evident in approximately 90% of all SLE patients; over 80% experience mucocutaneous manifestations, including lupus lesions (acute, subacute, and chronic lesions) (Vaillant et al., 2023). The flat, purple-colored rash and frequent sickness can indicate SLE due to the various skin infections and weakened immunity associated with the disease (Ameer et al., 2021).

Most of Wilbur’s clinical presentations relate to the SLE process. These presentations include recurrent infections, purple rash, and oral white coating. According to Heck et al. (2023), approximately 15% of individuals with SLE experience purpura, characterized by red or purple discoloration during the course of the illness (petechiae or ecchymoses). Thus, the clinical manifestation of flat purple rashes is consistent with SLE. The patient’s oral white coating is consistent with oral candidiasis.

Garcias-Rios et al. (2022) evaluated the oral presentations in SLE patients. The study revealed a higher prevalence of candidiasis and other infections in SLE, but these were often associated with the immunosuppressive medications used in SLE patients. Li et al. (2023) note that infections in SLE are often linked to the duration of the disease and corticosteroid use. However, the autoimmune nature of SLE can lead to a weakened immune system and increased susceptibility to infections, including candidiasis (Ameer et al., 2022).

Several diagnostic tests are appropriate for investigating Wilbur’s diagnosis. Complete blood count is an important test due to autoimmune blood cell destruction; anticipated results include anemia, leukopenia, and thrombocytopenia (Huang et al., 2922). The erythrocyte sedimentation rate (ESR) is a key marker of inflammation and can indicate an underlying autoimmune process. The anticipated results are elevated ESR levels. The anti-dsDNA and anti-Smith antibodies are specific antibodies that are important tests for SLE and kidney involvement (Huang et al., 2022).

A positive result is anticipated for this test, indicating the presence of an autoimmune process. A chest X-ray may detect fluid or lung inflammation, which is common in SLE patients. Additionally, a skin biopsy of the suspected SLE lesion can aid in diagnosing the condition by revealing characteristic skin changes (Connelly & Morand, 2021). These diagnostic tests can be used to diagnose or rule out the diagnosis. Wilbur’s presentation can be linked to other diagnoses; hence, the need to critically evaluate the patient’s presentation for an accurate diagnosis and appropriate management.

References

Connelly, K., & Morand, E. F. (2021). Systemic lupus erythematosus: a clinical update. Internal Medicine Journal, 51(8), 1219–1228. https://doi.org/10.1111/imj.15448

Garcia-Rios, P., Pecci-Lloret, M. P., & Oñate-Sánchez, R. E. (2022). Oral manifestations of systemic lupus erythematosus: a systematic review. International Journal of Environmental Research and Public Health, 19(19), 11910. https://doi.org/10.3390/ijerph191911910

Heck, R., Leopoldo, L. R., Perazzoli, S., & Lopes, N. T. (2023). Purpura. In Dermatology in Public Health Environments: A Comprehensive Textbook (pp. 1587–1606). Cham: Springer International Publishing.

Huang, X., Zhang, Q., Zhang, H., & Lu, Q. (2022). A contemporary update on the diagnosis of systemic lupus erythematosus. Clinical Reviews in Allergy & Immunology, 63(3), 311–329. https://doi.org/10.1007/s12016-021-08917-7

Li, G., Liu, X., Zhao, J., Li, M., & Wu, G. (2023). Infections in patients with systemic lupus erythematosus: microbiological, clinical characteristics and risk factors. Research Square. 1 https://doi.org/10.21203/rs.3.rs-3238196/v1

Vaillant, A. A. J., Goyal, A., & Varacallo, M. (2023). Systemic Lupus Erythematosus. In StatPearls [Internet]. StatPearls Publishing.