Shadow health neurologic assessment alternative writing assignment
Through this assignment, the student will demonstrate the ability to:
- Identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1)
- Differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2)
- Adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4)
Requirements:
This paper will be appraised on the quality of the information, inclusion of at least one evidence-based scholarly source, use of citations, use of Standard English grammar, and organization based on the required components (see the paper headings and content details below).
Scholarly sources:
Only scholarly sources are acceptable for citation and reference in this course. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Your textbook and lesson are not considered to be an outside scholarly source.
For the discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal. You are encouraged to use the Chamberlain library and search one of the available data bases for a peer-reviewed journal article.
The following sources should not be used: Wikipedia, Wikis, or blogs. These web sites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality. For example, the American Heart Association is a .com site with scholarship and quality. It is the responsibility of the student to determine the scholarship and quality of any .com site. Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years. Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.
The length of the paper is to be no less than 1,500 words, excluding title page and reference list.
Create this assignment using Microsoft (MS) Word. You can tell that the document is saved as a MS Word document because it will end in “.docx.”
APA format (current edition) is required in this assignment, explicitly for in-text citations and the reference list. Use 12-point Times New Roman font with 1 inch margins and double spacing. See the APA manual for details regarding proper citation.
Organize the headings and content of your paper using the outline below:
Select a body system relevant to the lesson from the previous week for the topic of this paper. (Neurology)
Discuss the physiology (structure and function) of the body system (Neurology) including details about the major organ systems (if applicable). Construct relevant health history questions (subjective data) pertaining to the body system, (NEUROLOGY). Provide an overview of the objective data and expected normal physical examination findings for this body system. NOTE: Explain special physical assessment examination techniques or procedures specific to assessing this body system.
NOTE: Analyze and discuss how you might adapt your physical assessment skills or interviewing techniques to accommodate each of the following specific populations:
Infant/pediatric
Pregnancy
Geriatric
Identify one major disease or disease process that may significantly impact this body system. Synthesis and discuss the expected abnormal physical examination findings that may be associated with this disease or disease process.
Summarize the key points.
References in correct APA format
ASSIGNMENT CONTENT
Category
Points
%
Description
Application of Knowledge, Analysis, and Clarity
10
33.33
The quality of this criterion will be evaluated based upon the following:demonstration of analysis, synthesis, and/or application of principles and concepts consistent with the principles of advanced physical assessment; relevance of content specific to the topic; expected normal findings, appropriate health history questions, and organization and clear presentation of information.
Adapted Physical Assessment Skills to Special Populations, Disease Process, Summary, and Scholarly Source
10
33.33
The quality of this criterion will be evaluated based upon the following: discussion regarding how to adapt physical assessment skills or techniques to accommodate all special populations; identification and discussion of one major disease or disease process and expected examination findings; and summation ofkey points. Must include at least one scholarly source to support the paper.
Total CONTENT Points= 20 pts
ASSIGNMENT FORMAT
Category
Points
%
Description
Grammar, Spelling, Syntax, Mechanics,APA Format, and Word Requirement
10
33.33
The assignment has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post. The length of the paper is not less than 1,500 words, excluding title page and reference list.
* APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
**Direct quote should not to exceed 15 words & must add substantively to the discussion
Total FORMAT Points= 10 pts
ASSIGNMENT TOTAL= 30 points
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Sample
Shadow health neurologic assessment alternative writing assignment
Neurology
Conducting an extensive health history and undertaking a careful physical examination can assist the health practitioner to identify the site of a particular neurological lesion or disease and to pursue a comprehensive diagnosis or a number of differential diagnoses. The World Health Organization, (2020) insisted that systematic enquiry and evidence-based approach is needed as the fundamental basis for ensuring successful neurological examinations.
Structure and function of the body system and its major organ systems
The Nervous System has a highly complex anatomical structure comprising of many different organs and organ systems. As the human body’s prime coordination and communication network, the structure of the nervous system is divided into two main regions: the Central Nervous System (CNS) (made up of the brain and the spinal cord) and the Peripheral Nervous system (PNS) (made up of the nerves and sensory organs) (Whiteley, 2016). In terms of key functions, the brain and the spinal cord operate as the control center based on how they receive feedback and information from the different nerves and sensory organs throughout the human body. As part of the PNS, the nerves assumes a highly integral function as the pathways for carrying the incoming and outgoing signals and motor commands that travels up and down the spinal cord, heading to and from the brain (World Health Organization, 2020). Other key functions of the nervous system include sensation (stimulus) through receiving data and information about the natural environment (for example heat from the sun) and inside the human body (i.e. heat from muscle activity) (Mazengenya & Bhikha, 2017). Usker and Sherman (2019) established that the nervous system is also responsible for generating a response in effector organs (glands and muscles) as a result of the sensory stimuli. As a body system, the CNS and the PNS function to ensure the various stimuli and signals received by the different nerves, sensory organs and structures are communicated to the Nervous System where that data, signals and information of processed.
Construct Relevant Health Questions (subjective data)
In order to test the functioning of the nervous system a number of health questions can used by the healthcare provider strengthen the outcomes of the physical assessment and neurological examination. As identified in the reviewed literature, the following are some of the key questions and subjective data that may be tests and assessed during a neurological exam.
| Health Questions Checklist | |
| STEPS | ADDITIONAL INFORMATION |
| Ask about the symptoms:
· What are they? · Which part of the body do they affect? Are they widespread or localized? · When did they start? · Are the symptoms deteriorating or static or are there remissions and exacerbations? · Does anything trigger symptoms (posture, sleep or external stimulus such as smell, light?
· Ask the person about any associated complaints (headaches, fever, fatigue, and change in balance or coordination, injury to the health, back or neck, numbness, or tingling in the arms, change in behavior, tremor, seizures, slurred speech or body weakness). · Ask about activities of daily life. How the has the health concern affected life and daily engagements?
|
Alterations may imply the possibility of a neurologic impairment, and hence unusual results are expected to be accompanied with a comprehensive Neurological System Assessment.
|
| Past medical history:
· Ask about other medical conditions, past and present · Have your experienced atrial fibrillation? · Any recurrent miscarriage” or vascular problems? · Have you been diagnosed with diabetes mellitus? · Ask about pregnancy, delivery and neo-natal health · Ask about any convulsions, infections, or injuries (spinal cord or head injury) in infancy, childhood and adult life. · What aggravates this health condition · |
· Chief complaint
· Onset and duration of present health concern · Course of the health problem · signs, symptoms and related symptoms
|
| Social and family history
· Ask about drug/alcohol consumption · Ask about current medications, herbal remedies, over-the-counter and prescriptions. · Ask about sexual orientation · Ask about marital status · Ask about psychiatric or emotional challenges (if pertinent) · Ask about pertinent health status of family members |
Check for any cases of Allergies (reaction), Recent hospitalizations, Chronic or serious illness, and Pertinent family history of diabetes, heart disease, arthritis, tuberculosis, hypertension, cancer, neurological disorders, mental illness, obesity and genetic disorders. |
| Functional Assessment (encompassing operations of day-to-day living)
Do you engage in physical exercise? Do you get enough sleep? Do you consume a balance diet: Are you exposed to occupational/environmental hazards? What are some the common coping and stress management approaches at your disposal?
|
Check for any changes that may indicate exposure to occupational/environmental hazards, lack of proper nutrition, lifestyle factors. In the event of abnormal findings follow up with a comprehensive Neurological system assessment
|
| Examination
Examination of speech · Focus on spontaneous speech, fluency and use of words in a conversation · Ask the patient to name objects/things · Ask the patient to read aloud. · Ask the patient to conduct some commands in order to examine their comprehension · Look at the client’s handwriting Examination of the neck and head · Is there evidence of generative disease? · Is there any neck stiffness · Look for enlarged cervical ribs or lymph nodes · Inspect eye drainage · Inspect tongue, mouth and teeth for color, moisture and dentures |
The existence of facial asymmetry may imply neurological injury or impairment. Unusual results are expected to be followed-up with a comprehensive neurological system assessment. |
| Examination of the sensory and motor systems
An examination of both the lower and upper limbs in a logical progression is recommended. A number of sensory modalities should be tested and they include: temperature, light touch and pinprick, vibration sense, two-point discrimination and proprioception.
|
The examination is expected to encompass: inspection, power, tone, deep tendon reflexes, coordination and superficial tendon reflexes. |
An overview of the objective data and expected normal physical examination findings
The neurological system is assessed with the use of inspections, mental status testing, palpation, sensation, motor exam, and screening. As a neurological examination technique, inspection is conducted to determine impairment of coordination, balance and motor function. An observation of the client’s gait (body and extremity posture, base of gait, speed, length, and rhythm of steps). Expected normal findings may reveal noteworthy differences in the steadiness, rhythm, precision and speed of movements (Whiteley, 2016). In order to assess the mental status of the client, the healthcare provider may observe and engage in a conversation with the client in order to determine his/her awareness of person, time and place. Expected normal findings are realized in the event the client makes proper and sustained eye contact, and is able to converse normally with the healthcare professional and responds to questions about recent events and medical history in a consistent way (Mazengenya & Bhikha 2017). Reflex testing would assist the healthcare practitioner to conduct the sensory exam through the use of a reflex hammer for testing different reflexes as indicated by the movement that the hammer triggers. Expected normal findings would reveal key data about the functioning of the brain. Sensory testing is another useful examination technique designed to help the practitioner to check the client’s ability to feel, and this is attained through the use of numerous instrumental inducing alcohol swabs dull needles, tuning fork, and other objects. Expected normal findings would identify the specific examination (for instance cold or hot, dull or sharp) (Bhowmik, 2019).
Specific populations
Adapting my physical assessment skills and interviewing skills to suit the distinct needs of specific populations (infant, geriatric and pregnancy) is key in ensuring the success of a neurological examination. Precisely, when examining reflexes among newborn and infants, specific reflexes (primitive or infant reflexes) will be tested. Empirical findings indicated that eh infant reflexes (blinking, crawling, and startle reflex, palmar and plantar gasp) tend to disappear during the developmental stages of the infant (Usker & Sherman, 2019). In geriatric, the adoption of the reflex hammer will enable the practitioner to conduct a test of the numerous reflexes during a neurological examination. In pregnancy, my interviewing skills will focus on ensuring a complete evaluation of the 12 main nerves as the fundamental basis for assessing the functioning of the brain (Bhowmik, 2019).
Disease and expected abnormal physical examination findings
Ataxia: A degenerative neurological disease characterized by incoordination, falling, stumbling and slurred speech. The condition is often associated with reduced ability of some parts of the nervous system to coordinate movement including the cerebellum, spinal cord and other key nerves. Some of the abnormal findings include instances of depression, dizziness, muscle cramps, fatigue, neuropathy, imbalance, and tremor (National Ataxia Foundation, 2020).
Summary of the key points
The nervous system is an extensive and complex body system responsible for the functions of sensation, response and integration of data and information throughout the human body. A comprehensive neurological assessment and examination is required to identify cases of neurological impairment or disorder in order to facilitate the adoption of tailored, holistic and patient-centered treatment and management approaches.
References
Bhowmik, S.R., (2019).Neurological Assessment: Medical-Surgical Nursing Perspective. Indian
Journal of Surgical Nursing, 8(3), 80-87.DOI: www.10.21088/ijsn.2277.467X.8319.3
Mazengenya P, & Bhikha R. (2017). The structure and function of the central nervous system
and sense organs in the canon of medicine by Avicenna. Arch Iran Med. 2017; 20(1), 67–70. https://pubmed.ncbi.nlm.nih.gov/28112536/
National Ataxia Foundation, (2020). Ataxia. https://www.ataxia.org/what-is-ataxia/
Usker N, & Sherman, A., (2019). Muscle Strength Grading, Jan 2019. https://www.ncbi.nlm.nih.go
Whiteley, V. (2016).Describe the structure of the nervous system. How do neurons
communicate? DOI: www.10.13140/RG.2.1.3305.0484
World Health Organisation, (2020).Mental health: neurological disorders. https://www.who.int/news-room/q-a-detail/mental-health-neurological-disorders