This is a comprehensive answer to NR305 week 3 assignment.

Nr305 – Week 3 Summary, Discussion, Assessment, and Answers

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iHuman Case Summary (Michael Granger)

Patient Disposition

Mr. Granger was given appropriate heart failure education and was discharged to home. He was taught about the importance of diet and quitting smoking. While he agreed to adhere to his prescribed diet, he did not commit to quitting smoking. After six months of his heart failure progressively worsening, he was taken to surgery for an automatic implantable cardioverter- defibrillator and participated in cardiac rehabilitation.

Student Learning Objectives

The student will:

1. Explain the approach for a comprehensive nursing assessment for an adult male who is being admitted exacerbation of heart failure
2. Discriminate between subjective and objective data needed to assess an adult male who is being admitted for exacerbation of heart failure.

Heart Failure

Heart Failure (HF) is an impairment of the ventricle’s ability to fill or eject blood. HF was previously referred to as congestive heart failure or CHF. HF can be caused by a number of conditions, including:

iHuman Case Play Instructions

Complete the “Prework” assignments and review your answers with your faulty as appropriate.

Review the Electronic health record (EHR)

• Click each blue button to review the different components of the EHR (admission note, orders, nursing notes, MAR, etc.).
• Document your “key findings” (example: diagnosis or other relevant history or physical findings from HCP or nurse notes) on the findings list on the left. This key findings list will be used to help you answer the multiple-choice question in the next section.
• Click “Next” to proceed to the MCQ section.
• Select those findings on your list from the MCQ list.
• Click “Compare with Expert” to lock in your answers and compare them to the findings identified by the case author.
• Compare your answers with those of the case author. You may go back to the EHR to review any sections.

Conduct your patient history assessment

• Introduce yourself and then consider what questions are relevant to ask this patient, based on what is occurring with the patient. Remember to ask yourself what type of assessment should I be conducting; is it an admission/comprehensive assessment; a focused assessment; or a shift assessment. Refer to the video “How to take a patient history” for some helpful hints
• Note the Blue Interview Progress button at the bottom of the screen. You can use this button up to five times to get hints from the case author on questions you may have missed.
• Remember, you only are allowed 120 questions. You must keep track of the number of questions yourself, the counter is above the question list.
• Document your key findings on the findings list on the left.
• If you see the “gear head icon” click on it and follow the instructions.
• “Next” to proceed to the MCQ section.
• Click “Compare with Expert” to lock in your answers and compare them to the findings identified by the case author.

Perform a physical assessment of your patient

• Assess vital signs and perform the examinations appropriate for the patient’s chief problem. Remember to ask yourself what type of assessment should I be conducting; is it an admission/comprehensive assessment; a focused assessment; or a shift assessment.
• You will be limited to 50 physical assessments.
• Document your key findings on the list of the key findings on the left.
• If you see the “gear head icon” click on it and follow the instructions.
• Click “Next” to proceed to the MCQ section.
• Click “Compare with Expert” to lock in your answers and compare them to the findings identified by the case author.

Nurse notes

• Click on the “Nurse Notes” tab. Follow the instructions provided by your faculty and write the appropriate Nurse Note
• Your Nurse Note will be graded separately from your case play
• If you see the “gear head icon” click on it and follow the instructions.

 Summary

• Click “Submit and Review Summary” to see the patient outcomes, student learning outcomes, nursing pearls, and pharmacology notes.
• Click on “See Evaluation” and review your entire case performance analytics.

Grading Rubric:

1. EHR MCQ: 15%
2. History: 20%
3. History MCQ: 20%
4. Physical assessment: 20%
5. Physical assessment MCQ: 20%
6. Exercises: 5%

Week 3 Assignment Instructions

Directions

1. Access the Michael Granger Case Assignment in iHuman by clicking on the “Load Assignment in a New Window” button at the bottom of this assignment page. If prompted, select to load the case in a new browser window.
   • Note: It may take a few moments for iHuman cases to load in your web browser, so please be patient.
2. Complete the prework questions associated with the case. Prework is required to be completed before you can move on or before you can replay a case. Be sure that you have submitted each pre-work exercise for evaluation before you move on to the next. Your answers are not graded but are intended to get you thinking about the case.
3. Begin the case and complete these sections: (100 points total, immediate feedback/grade will be provided to you by iHuman when complete)
   • EHR Review
   • Health History
   • Physical Assessment
   • Note: there is no time limit on completing cases
4. As you move through your first attempt and once you complete the case, you will receive feedback from the “Expert” on the important findings that you included (or should have included), and information that should have been collected on the health history and physical assessment. The system will also tell you if you asked questions or performed assessments that are considered extraneous or inappropriate for that particular case. Review this information carefully and take notes to be used on your second attempt, if you would like to work toward a higher score.
5. If you must leave the case for any reason before you have totally completed it, the program will save your spot and will return you to the same point when you re-enter the case. (Look for the green “Resume” arrow at the bottom of the screen.) If you had fully completed a section, you will be able to review the section, but you will not be able to change your answers. You will only be able to move forward in the case.
6. Type your responses to the questions in the Nurse Notes section in the box provided (50 points, graded by instructor after submission). The Nurse Notes will be graded by your instructor, not iHuman. See the grading rubric to understand how it is evaluated. Note: You only need to type out the Nurse Notes once. Your instructor can see both attempts. If you make revisions on your second attempt, inform your instructor.
7. When you have completed a case review the final score and feedback provided by iHuman. You have the option to complete this case a second time before the submission deadline (total of 2 attempts) to improve your score. Your instructor will convert your highest score in iHuman to points earned in the grading rubric. Scores are adjusted based on your performance level. 

Week 3 Assignment Solution

Write an SBAR note to summarize Mr. Granger’s current health state for the next nursing shift.

Situation: Michael Granger is a 69-year-old African American male on admission for exacerbation of stage II right-sided failure. The patient complained of weight gain, shortness of breath, and edema.

Background: The patient was diagnosed with CAD, Hyperlipidemia, MI, and HNT, three years ago. The patient admitted to smoking 1 pack of cigarettes per day, and an increased swelling in his right leg with shortness of breath that started two days ago. Stage II right-sided failure was diagnosed last year. The patient stated non-compliance with a low sodium diet and needs flu vaccination.

Assessment: Temp 98.6,………………(BUY ANSWER TO READ MORE)

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