NR507 Week 6 Discussion: Client Scenario

ByDaniel Rossi Updated on

NR507 Week 6 Discussion: Client Scenario – Step-by-Step Guide

The first step before starting to write the NR507 Week 6 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 6 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 6 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 6 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 6 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 6 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 6 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 6 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 7 Discussion Choose Your Own Pathophysiology Adventure: Part 3 of 3.

Course Outcomes

This discussion 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 an assigned disease process and determine which disease process explored in the discussion Bayani, the client, is experiencing. Follow the instructions below and your faculty member will reveal which disease process Bayani is experiencing at the end of the discussion week. 

Step 1: Review the following client scenario: 

Bayani, a 62-year-old male client, presents to the NP with abdominal pain with his wife. Bayani is mildly confused, and according to his wife, he is normally fully oriented. His abdomen is soft and non-distended, and his wife states he has been urinating and drinking more water than usual. She also states he has had foul-smelling urine and is concerned he also has a urinary tract infection. 

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

Last NameDisease Process
A – HCondition: Peptic Ulcer Disease (PUD)
I – PCondition: Cirrhosis
Q – Z Condition: Type 2 Diabetes

Step 3: Review the client case scenario and 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 disease process. 

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 Bayani’s case could be explained by the pathophysiological mechanisms? 
  2. Analyze Bayani’s clinical manifestations in the context of your assigned disease process. Do these findings support a diagnosis of your assigned disease process? Why or why not?  
  3. Identify and justify the diagnostic tests (including labs, imaging, or other diagnostic tests) that would be most appropriate for investigating a diagnosis of your assigned disease process in Bayani. What could the results of these tests look like in your assigned disease process? 
  4. Compare and contrast your response with a peer assigned a different condition. Does their condition fit Bayani’s case? Why or why not? 

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 6 Discussion: Client Scenario Example

Patient clinical presentations form the basis for focused health assessment, physical examination, diagnostic testing, and ultimately, diagnosis and management. Clinical manifestations of various conditions can overlap, hence the need for thorough history-taking, physical examination, laboratory tests, and imaging studies for an accurate diagnosis. This discussion reviews a patient’s (Bayani) presentation, discusses the pathophysiology of diabetes and its association with the patient’s presentation, and examines diabetes diagnoses based on clinical presentations, as well as diagnostic testing appropriate for the diagnosis.

  1. Discuss the underlying pathophysiological mechanisms of your assigned disease process. Which clinical manifestations observed in Bayani’s case could be explained by the pathophysiological mechanisms? 

Type 2 diabetes results from defective insulin secretion in the pancreas (beta cells) and a poor response to insulin by insulin-sensitive tissues (Goyal et al., 2023). Ahmad et al. (2022) state that type 2 diabetes accounts for 90% of all diabetes patients. An initial etiology is the compensatory increased insulin secretion to maintain glucose in normal ranges. Over time, the beta cells undergo physiological changes, and the insulin secreted cannot maintain glucose homeostasis, hence hyperglycemia.

Obesity and high body fat percentage, especially in the abdominal region, promote insulin resistance through inflammatory mechanisms. Other factors such as poor physical activity, gestational diabetes, hypertension, and dyslipidemia also increase the risk for type 2 diabetes through various mechanisms, including increased renal glucose reabsorption, inflammation, higher renal glucose reabsorption, and gut microbiome abnormalities (ElSayed et al., 2023). In type 2 diabetes, insulin is insufficient, and cells resist the effects of insulin, resulting in hyperglycemia.

High blood sugar concentration leads to high osmolarity, drawing water from the cells and interstitial spaces and excessive thirst. Increased blood volume triggers homeostatic mechanisms that lead to the excretion of water in urine, resulting in polyuria. Inadequate glucose entry into brain cells can reduce their metabolic activity, hence the confusion. However, other etiologies, such as infections, can lead to confusion, hence the need for further evaluation.

  1. Analyze Bayani’s clinical manifestations in the context of your assigned disease process. Do these findings support a diagnosis of your assigned disease process? Why or why not?

Type 2 diabetes is characterized by the classical presentations of polyuria, polydipsia, and polyphagia, as well as manifestations such as fatigue, blurred vision, numbness in the extremities, poorly healing wounds, weight changes, and skin infections (American Diabetes Association, n.d.). According to Kalarani and Veerabathiran (2023), neurological presentations such as vascular dementia, stroke, cranial nerve palsies, seizures, confusion, numbness and pain in extremities, and ascending pain are common in advanced disease. The patient presents with mild confusion, polyuria, and polydipsia, which can support the type 2 diabetes diagnosis and warrant a further health assessment and physical examination for key findings related to the disease’s pathophysiology, and diagnostic tests are necessary for a definitive diagnosis.

  1. Identify and justify the diagnostic tests (including labs, imaging, or other diagnostic tests) that would be most appropriate for investigating a diagnosis of your assigned disease process in Bayani. What could the results of these tests look like in your assigned disease process? 

Various diagnostic tests, particularly those focusing on blood sugar parameters, are used to diagnose type 2 diabetes. Random blood sugar (RBS), fasting blood sugar (FBS), and HbA1c tests are the most common diagnostic tests for diabetes. The expected test results for a patient with this diagnosis are an RBS of above 200 mg/dL (11.1mmol), an FBS of above 126mg/dL (7.0mmol/L), and an HbA1c test result of 6.5% and above (American Diabetes Association, 2021). An oral glucose tolerance test may also be performed after 24 hours for this patient, with expected results showing blood glucose levels above 200 mg/dL. These definitive tests are crucial for diagnosing type 2 diabetes in Bayani.

Additional tests can be performed to aid in the patient’s management. A urinalysis can be done for type 2 diabetes. It is not a definitive/selective diagnosis, but can be used to identify the disease process. The expected results are glycosuria and albuminuria in advanced stages, resulting from renal damage in diabetes (Poloni & Rotta, 2022). Given the patient’s foul-smelling urine history and now the type 2 diabetes diagnosis, it is likely that he has a urinary tract infection, and the urinalysis would likely show leukocytes or nitrites and bacteriuria (Nabi, 2021). Additionally, metabolic and lipid panels may be necessary to help determine the patient’s current health status and inform management interventions. Screening the patient for hypertension will also be crucial to his appropriate management.

References

Ahmad, E., Lim, S., Lamptey, R., Webb, D. R., & Davies, M. J. (2022). Type 2 diabetes. The Lancet, 400(10365), 1803-1820. https://doi.org/10.1016/S0140-6736(22)01655-5

American Diabetes Association. (2021). 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes—2021. Diabetes care, 44(Supplement_1), S15-S33. https://doi.org/10.2337/dc21-S002

American Diabetes Association. (n.d.). About diabetes: Diagnosis. https://diabetes.org/about-diabetes/diagnosis

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., &  R. A. Gabbay. (2023). 2. Classification and diagnosis of diabetes: Standards of care in diabetes-2023. Diabetes Care, 46(Suppl 1), S19–S40. https://doi.org/10.2337/dc23-S002

Goyal, R., Singhal, M., & Jialal, I. (2023). Type 2 diabetes. StatPearls [Internet].

Kalarani, I. B., & Veerabathiran, R. (2023). Diabetes and neurological disorders. In Advances in Diabetes Research and Management (pp. 63–79). Singapore: Springer Nature Singapore. https://doi.org/10.1007/978-981-19-0027-3_4

Nabi, T. (2021). Symptomatic urinary tract infection in patients with type 2 diabetes: A prospective study. Medical Journal of Babylon, 18(2), 131–137. https://doi.org/10.4103/MJBL.MJBL_81_20

Poloni, J. A. T., & Rotta, L. N. (2022). Diabetic kidney disease: pathophysiological changes and urinalysis contribution to diagnosis—a narrative review. Journal of Laboratory and Precision Medicine, 7. https://doi.org/10.21037/jlpm-21-20