NU664B Primary Care of Family I
Week 1 Discussion
Telehealth / Transgender
Imagine that you are a primary care provider in the middle of your busy Thursday. Your 10:30 a.m. telehealth appointment is as follows:
HPI: An otherwise healthy 35-year-old transgender woman on hormone suppressant therapy presents with a chief complaint of sinus congestion and runny nose that began 2 days ago. She tells you that her sinus infections always start off this way, and she has a wedding to go to this coming weekend and does not want to be sick for this event. She is requesting antibiotics and is quite insistent that she requires this treatment.
Past Medical History: Unremarkable. History of seasonal allergies and recurrent sinus infections. She does have some history of episodes of elevated blood pressure without a diagnosis of hypertension.
Family History: Noncontributory. No one else at home is sick.
ROS (completed by the medical assistant):
Constitutional: The patient denies fevers, chills, sweats, and weight changes.
EYES: The patient denies any visual symptoms.
EARS, NOSE, AND THROAT: No difficulties with hearing. Endorses sinus congestion and rhinitis.
Cardiovascular: Patient denies chest pains, palpitations, orthopnea, and paroxysmal nocturnal dyspnea.
RESPIRATORY: No dyspnea on exertion, no wheezing or cough.
GI: No nausea, vomiting, diarrhea, constipation, abdominal pain, hematochezia, or melena.
GU: No urinary hesitancy or dribbling. No nocturia or urinary frequency. No abnormal urethral discharge.
Musculoskeletal: No myalgias or arthralgias.
Neurologic: No chronic headaches, no seizures. The patient denies numbness, tingling, or weakness.
Complete the following:
Initial Post by Wednesday (Day 3) at 11:59 p.m.
List 10–20 additional questions of subjective information that you would need to elicit from your patient to help formulate your differential diagnoses and plan. You may not ask questions that were already addressed in the HPI/ROS. Make sure to watch the telehealth modules which include how to complete the physical exam via telehealth. You will need two scholarly references for the questions that you ask of your patient. See the rubric for more detail.
TIP | Watch the following videos on Telehealth:
Introduction to Conducting Physical Exams via Telehealth with Devices (1:51 Minutes)
Introduction to Conducting Physical Exams via Telehealth with Devices Video Transcript
Telehealth Physical Exam: ENT (9:10 Minutes)
Telehealth Physical Exam: ENT Video Transcript
Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:
Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.
You are answering as the patient. Make it case appropriate but imaginative. Be creative and answer thoroughly. No references are needed.
NU664B Primary Care of Family I
Week 3 Discussion
Hispanic / Nondocumented Patient with Acute Illness
Imagine that you are a primary care provider in the middle of your busy Thursday and your 2:00 p.m. appointment is as follows:
HPI: A 75-year-old patient of Hispanic descent arrives in an immigrant healthcare clinic with fever, chills, a sore throat, and a nonproductive cough. She speaks some English. The patient appears very ill, with dry mucous membranes, dark circles under the eyes, and pale skin. The patient appears anxious and is reluctant to make eye contact or speak. The health history reveals that the patient lives with extended family in a home setting, including infants and elderly. All of the family members are undocumented residents of the United States.
Past Medical History: Hypertension, Asthma.
Family History: Father (Deceased 81 / Stroke); Mother (Alive 95 / HTN, COPD, Diabetes)
Complete the following:
Initial Post by Wednesday (Day 3) at 11:59 p.m.
List 10–20 questions of subjective information that your patient will need to provide to help you formulate your differential diagnoses and plan. Include two scholarly references for the questions that you ask of your patient. See the Grading Rubric for more detail.
Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:
Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.
You are answering as the patient. Make it case appropriate but imaginative. Be creative and answer thoroughly. No references are needed.
NU664B Primary Care of Family I
Week 6 Discussion
Patient with Hypertension
Imagine that you are a primary care provider in the middle of your busy Thursday. Your 10:30 a.m. telehealth appointment is as follows:
HPI: A 50-y-old Spanish-speaking female who is bilingual returns to your office for a follow-up BP check. She is a schoolteacher and has been your patient for many years. She arrives 45 min late for her appointment. At her previous visit 4 weeks ago, her BP was 160/90 mm Hg on atenolol 50 mg QD (Tenormin, beta-blocker, max dose 100 mg QD), and you increased the atenolol to 75 mg QD at that time.
Today she feels well, and her BP is 140/85 mm Hg on 2 measurements and her HR is 50 bpm.
Labs: CBC (WNL), Creatinine 2.0 mg/dl (normal range 0.5–1.3 mg/dl), potassium 3.8 MEQ/L (nml range 3.5–5 MEQ/L), and a 24 h urine protein of 1.3 g (normal <150 mg/d), similar to her previous lab results 6 month ago.
Allergies: NKDA
Family History: Father (deceased 85 y/o CVA); Mother (deceased 91 y/o MI)
Physical Exam
Vitals: BP 140/85, HR 50, RR 18, Wt 132 lbs, Ht 5’1”
HEENT: PERRL, Funduscopic exam notes cotton wool spots present.
Respiratory: Lungs were clear bilaterally with good aeration.
Cardiac: RRR, S1/S2 auscultated. 2+ pitting edema bilaterally.
Abdominal: Unremarkable
Integumentary: Intact.
Vascular: Capillary refill +3
Complete the following:
Initial Post by Wednesday (Day 3) at 11:59 p.m.
List 10–20 questions of subjective information that your patient will need to provide to help you formulate your differential diagnoses and plan. Include two scholarly references for the questions that you ask of your patient. See the Grading Rubric for more detail.
Initial Post by Wednesday (Day 3) at 11:59 pm
Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:
Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.
You are answering as the patient. Make it case appropriate but imaginative. Be creative and answer thoroughly. No references are needed.
NU664B Primary Care of Family I
Week 8 Discussion
Memory Loss
You are the nurse practitioner in family practice. You are seeing a new patient today: a 70-year-old African American woman, Selah, who is accompanied by her daughter, Britt, to the appointment. The PMH of the patient includes HTN, DM, Hyperlipidemia, TIA × 2, and Osteoarthritis of both knees, with multiple falls resulting in two diagnosed concussions. The daughter is concerned because she feels as if her mother's memory isn't what it used to be. Britt states that her mother sometimes misplaces things and forgets events, as well as the names of people she has known for a long period of time.
Helpful hint: Don't forget to ask OLDCARTS for each condition and about medication.
Complete the following:
Initial Post by Wednesday (Day 3) at 11:59 p.m.
List 10–20 questions of subjective information that your patient will need to provide to help you formulate your differential diagnoses and plan. Include two scholarly references for the questions that you ask of your patient. See the Grading Rubric for more detail.
Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:
Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.
You are answering as the patient. Make it case appropriate but imaginative. Be creative and answer thoroughly. No references are needed.
NU664B Primary Care of Family I
Week 11 Discussion
Atopic Dermatitis
Imagine that you are a primary care provider in the middle of your busy Thursday and your 4:15 pm appointment is as follows:
HPI: A 9-year-old boy, Taumi, with a history of recurrent skin infections presents with extensive redness and pruritus of the popliteal and antecubital fossae, arms, and abdomen. He’s scratched the lesions, especially at night, with the result that his sleep was disturbed. Despite the use of chronic moisturizing therapy and topical corticosteroids, he is having a seasonal flare of his condition. When he was 6 years old, he also experienced bronchial asthma with a persistent cough. This is not the first time he’s experienced this type of rash and has had issues since he was 4 years old. His mothers, Patricia and Fran, are bringing him into the clinic today for another exacerbation. They have tried the following: diphenhydramine 25mg q8h prn, hydrocortisone 2% QID, Zyrtec 10mg QD, and Aquaphor QID. The medications help some, but he’s still uncomfortable.
Family history: His father has asthma, and his younger sister has allergic rhinitis and cow’s milk allergy.
Physical Exam:
Vitals: BP 102/60, HR 68, RR 18, Wt 88 lbs (22 kg), Ht 4’11”
HEENT: Injected conjunctivae and presence of Dennie-Morgan lines. There was a ‘cobblestone’ appearance of his posterior pharynx.
Respiratory: Lungs were clear bilaterally with good aeration.
Cardiac and abdominal examinations were unremarkable.
Integumentary: Skin examination demonstrated scattered scaly eczematous patches along with the flexural areas of his upper and lower extremities. Impetigo “crust-like” lesions with serum oozing were found on the left elbow.
Complete the following:
List 10–20 questions of subjective information that your patient will need to provide to help you formulate your differential diagnoses and plan. Include two scholarly references for the questions that you ask of your patient. See the Grading Rubric for more detail.
Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:
Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.
You are answering as the patient. Make it case appropriate but imaginative. Be creative and answer thoroughly. No references are needed.
NU664B Primary Care of Family I
Week 1 Assignment
3P’s Predictor and Remediation Plan
You have the opportunity to complete a Diagnostic Readiness Exam for the 3P courses (Advanced Pathophysiology, Advanced Pharmacology, and Advanced Health Assessment).
The exam will evaluate your readiness for the national certification exam related to the content covered in these classes. The exam contains 100 questions and, once completed, it provides detailed rationales for all questions and answers as well as illustrative graphs. Completion of the exam will help you to pinpoint areas of strengths and areas needing further development for successful completion of the national certification exam, so it is imperative that you put full effort in taking this exam. By completing this exam early in NU664B, you will have time to identify areas that you need to focus on both in your course work as well as in clinical.
Instructions
You will receive instructions and a hyperlink to take your exam from your program director or course faculty member through the Course Announcements. This exam consists of 100 questions. You will have 100 minutes to complete the exam which must be completed in one sitting.
After you have completed the exam you will have 45 minutes to review each question and rationales for each correct and incorrect answer. Illustrative graphs are provided to identify your strengths as well as your areas needing improvement.
Once you have reviewed your results, please complete the remediation plan in the course and submit to faculty with your score report.
Once you complete the exam, you will upload the certification of completion with breakdown of the exam components and your remediation plan. Use this remediation plan template. There is no grade for this exam, however, it is a requirement to complete in this course and more importantly will help prepare you for the certification exam. You will take an additional 3P exam at the end of this course that will count for a grade, so please consider that when making your remediation plan.
Please refer to the Grading Rubric for details on how this activity will be graded.
NU664B Primary Care of Family I
Week 2 Assignment
iHuman Simulation
The iHuman platform is an opportunity for you to interact with a simulated patient and gather data. When working in iHuman, practice as if this were a real patient. For example, the platform allows you to ask several questions when taking a patient history. In real life, you likely will be limited in time. Practice setting yourself a patient history time limit and work on being efficient in your clinical interview.
If you require technical support with the iHuman platform, use the iHuman Help Center to contact iHuman Technical Support directly. Technical support only includes a malfunction of the platform; they cannot help with issues involving content!
Instructions
In this assignment, you will review a patient scenario in iHuman. Please see the course announcement for the case assigned this week. Your deliverable for this assignment is a paper based on the iHuman Soap Note Template (Word).
Follow the requirements listed in the iHuman Soap Note Template.
When your iHuman Soap Note Template is complete, upload it to this assignment.
All papers must conform to the most recent APA standards.
Please refer to the Grading Rubric for details on how this assessment and plan is graded.
NU664B Primary Care of Family I
Week 3 Assignment
Virtual Patient
In this assignment, you will complete the following?Virtual Patient: Care of an Older Adult with Asthma During the COVID-19 Pandemic CME. Upon completion of the CME on AAAAI this week, you are to provide a copy of your CEU certificate by uploading it to this assignment by Day 7.
In this patient simulation, you will evaluate and treat an older adult patient with asthma in the current setting of the COVID-19 pandemic. As the pandemic continues to evolve, you will make the best possible choices for therapy and continuation of therapy, including biologic therapies, given the potential logistical issues and limited resources available. You will become more adept at distinguishing between symptoms and signs of asthma compared with COVID-19, given the current information available. In addition, you will recommend and advise the patient on strategies to reduce exposure to COVID-19, including at home and workplace. This resource is available free of charge.
Once you have participated in the activity, submit CNE certificate with a 150–300-word written reflection. Discuss how this will change your practice and what you have learned from this experience. Use a minimum of two scholarly resources.
Open?Virtual Patient: Care of an Older Adult with Asthma During the COVID-19 Pandemic
Register for a free AAAAI account.
Complete the simulation and evaluation so that you can receive CNE credit.
Submit a 150–300-word reflection with your CNE certificate.
Please refer to the Grading Rubric for details on how this activity will be graded.
NU664B Primary Care of Family I
Week 4 Assignment
iHuman Simulation
The iHuman platform is an opportunity for you to interact with a simulated patient and gather data. When working in iHuman, practice as if this were a real patient. For example, the platform allows you to ask several questions when taking a patient history. In real life, you likely will be limited in time. Practice setting yourself a patient history time limit and work on being efficient in your clinical interview.
If you require technical support with the iHuman platform, use the iHuman Help Center to contact iHuman Technical Support directly. Technical support only includes a malfunction of the platform; they cannot help with issues involving content!
Instructions
In this assignment, you will review a patient scenario in iHuman. Please see the course announcement for the case assigned this week. Your deliverable for this assignment is a paper based on the iHuman Soap Note Template (Word).
Follow the requirements listed in the iHuman Soap Note Template.
When your iHuman Soap Note Template is complete, upload it to this assignment.
All papers must conform to the most recent APA standards.
Please refer to the Grading Rubric for details on how this assessment and plan is graded.
NU664B Primary Care of Family I
Week 5 Assignment 1
Hypertension Management Annotated Study Guide
In this assignment, you will complete the following Annotated Study Guide. The study guide is based on the content from this module and is to be completed as you go through your learning material for this module.
It is strongly suggested that you complete this assignment to better prepare for upcoming assignments and exams. This tool will make a handy reference as you go forward in your practice and career.
Instructions
Download the Hypertension Management Annotated Study Guide (Word) before you begin your week’s assigned geriatric assessment assigned readings.
Review the study guide for topics that will be of particular importance during your reading, and type notes from your reading into the guide to annotate it.
Save your final file with your name and assignment title, then follow the instructions to submit your study guide file.
Use this study guide for yourself to study for the course exams and to review for your boards.
Please refer to the Grading Rubric for details on how this activity will be graded.
NU664B Primary Care of Family I
Week 5 Assignment 2
Cardiac Annotated Study Guide
In this assignment, you will complete the following Annotated Study Guide. The study guide is based on the content from this module and is to be completed as you go through your learning material for this module.
It is strongly suggested that you complete this assignment to better prepare for upcoming assignments and exams. This tool will make a handy reference as you go forward in your practice and career.
Instructions
Download the Cardiac Annotated Study Guide (Word) before you begin your week’s assigned geriatric assessment assigned readings.
Review the study guide for topics that will be of particular importance during your reading, and type notes from your reading into the guide to annotate it.
Save your final file with your name and assignment title, then follow the instructions to submit your study guide file.
Use this study guide for yourself to study for the course exams and to review for your boards.
Please refer to the Grading Rubric for details on how this activity will be graded.
NU664B Primary Care of Family I
Week 7 Assignment
iHuman Simulation
The iHuman platform is an opportunity for you to interact with a simulated patient and gather data. When working in iHuman, practice as if this were a real patient. For example, the platform allows you to ask several questions when taking a patient history. In real life, you likely will be limited in time. Practice setting yourself a patient history time limit and work on being efficient in your clinical interview.
If you require technical support with the iHuman platform, use the iHuman Help Center to contact iHuman Technical Support directly. Technical support only includes a malfunction of the platform; they cannot help with issues involving content!
Instructions
In this assignment, you will review a patient scenario in iHuman. Please see the course announcement for the case assigned this week. Your deliverable for this assignment is a paper based on the iHuman Soap Note Template (Word).
Follow the requirements listed in the iHuman Soap Note Template.
When your iHuman Soap Note Template is complete, upload it to this assignment.
All papers must conform to the most recent APA standards.
Please refer to the Grading Rubric for details on how this assessment and plan is graded.
NU664B Primary Care of Family I
Week 7 Assignment 2
For this assignment, you will be completing an interactive case study electronically. You will progress through a patient case much like you would in practice. You will need to make decisions for your patient as you complete the case and provide a rationale for your answers and decisions. You will have one attempt to complete this assignment, which must be completed in one sitting.
Once you have completed your Comprehensive Case Study, save your Summary, and then upload it to Dropbox for grading.
Please refer to the Grading Rubric for details on how this activity will be graded.
NU664B Primary Care of Family I
Week 9 Assignment
iHuman Simulation
The iHuman platform is an opportunity for you to interact with a simulated patient and gather data. When working in iHuman, practice as if this were a real patient. For example, the platform allows you to ask several questions when taking a patient history. In real life, you likely will be limited in time. Practice setting yourself a patient history time limit and work on being efficient in your clinical interview.
If you require technical support with the iHuman platform, use the iHuman Help Center to contact iHuman Technical Support directly. Technical support only includes a malfunction of the platform; they cannot help with issues involving content!
Instructions
In this assignment, you will review a patient scenario in iHuman. Please see the course announcement for the case assigned this week. Your deliverable for this assignment is a paper based on the iHuman Soap Note Template (Word).
Follow the requirements listed in the iHuman Soap Note Template.
When your iHuman Soap Note Template is complete, upload it to this assignment.
All papers must conform to the most recent APA standards.
Please refer to the Grading Rubric for details on how this assessment and plan is graded.
NU664B Primary Care of Family I
Week 9 Assignment 2
Alzheimer CME
In this assignment, you will complete the Practical Recommendations for Timely and Accurate Diagnosis of Alzheimer's Disease in Primary Care in the United States from Medscape. Upon completion of the CME on Medscape this week, you are to provide a copy of your CEU certificate by uploading it to this assignment by day 7.
The goal of this activity is to increase the ability to recognize and assess patients with mild cognitive impairment (MCI) due to AD.This resource is available free of charge.
Once you have participated in the activity, submit CME with a 150–300-word reflection with your CNE certificate. Write how this will change your practice and what you have learned from this experience. Use a minimum of two scholarly resources.
Open Medscape: Practical Recommendations for Timely and Accurate Diagnosis of Alzheimer's Disease in Primary Care in the United States to begin your certificate training.
Click “Log in to Start” and register for a free Medscape account.
Complete the simulation and evaluation so that you can receive CNE credit.
Submit a 150–300-word reflection with your CNE certificate.
NU664B Primary Care of Family I
Week 10 Assignment
Five Levels of Prevention
This assignment should mostly be a review for you on knowledge from prior courses, but it is important for you to review as you consider screening and prevention at the APRN level. When you have completed the module, please complete the Reflection and upload it to the Drobox in Moodle.
Describe three things that you have learned from completing this module? Was this new knowledge for you or a refresher of past knowledge?
How will you apply this new knowledge to your developing advanced practice? Please use specific examples in your reply. Consider patients who you have seen in clinical and how this information may impact how you care for them. You should provide one example for each point of newly acquired knowledge.
You must completely and adequately address all parts of the Reflection to receive credit for this assignment. References are not needed for this assignment, but please be sure to address this from a scholarly, advanced practice level.
Please refer to the Grading Rubric for details on how this activity will be graded
NU664B Primary Care of Family I
Week 12 Assignment
iHuman Simulation
Introduction
The iHuman platform is an opportunity for you to interact with a simulated patient and gather data. When working in iHuman, practice as if this were a real patient. For example, the platform allows you to ask several questions when taking a patient history. In real life, you likely will be limited in time. Practice setting yourself a patient history time limit and work on being efficient in your clinical interview.
If you require technical support with the iHuman platform, use the iHuman Help Center to contact iHuman Technical Support directly. Technical support only includes a malfunction of the platform; they cannot help with issues involving content!
Instructions
In this assignment, you will review a patient scenario in iHuman. Please see the course announcement for the case assigned this week. Your deliverable for this assignment is a paper based on the iHuman Soap Note Template (Word).
Follow the requirements listed in the iHuman Soap Note Template.
When your iHuman Soap Note Template is complete, upload it to this assignment.
All papers must conform to the most recent APA standards.
Please refer to the Grading Rubric for details on how this assessment and plan is graded.
NU664B Primary Care of Family I
Week 12 Assignment
AAD Dermatology Modules
Complete the following quizzes for the following modules and upload the certificate of completion. All quizzes are located at the end of each of the listed modules from the American Academy of Dermatology. Students can upload a document indicating completion or screenshot a jpg and upload.
To access each quiz:
Access each AAD module listed in the assignment instructions.
Select Access the Module. Use your personal AAD login information to log in to the AAD website. You should have created this while reviewing resources in this week's Instructional Materials. If you have not already done so, create this account now.
Review each learning module and complete the associated quiz:
Acne and Rosacea (Module: Acne and Rosacea)
Atopic Dermatitis (Module: Two-week rotation: General dermatology)
Contact Dermatitis (Module: Two-week rotation: General dermatology)
Pediatric Fungal Infections (Module: Two-week rotation: General dermatology)
Dermatologic Therapies (Module: Two-week rotation: General dermatology)
Dermatoses in Pregnancy (Module: Four-week rotation: General dermatology – Week 4)
Newborn skin disease: Rashes (Module: Three-week rotation: General dermatology for pediatricians – Week 2)
Students can take the quizzes more than once and must achieve a grade of 80% or higher, but have multiple attempts.
Study Tip: These are the required modules, but every single module on the ADD is helpful. If you have time to complete more, please complete The Four-Week rotation: General Dermatology.
Please refer to the Grading Rubric for details on how this activity will be graded.
