1. WK10 NURS 6512 ASSIGN
Assignment: Lab Assignment: Assessing the Genitalia and RectumPhoto Credit: Getty
ImagesPatients are frequently uncomfortable discussing with healthcare professional’s
issues that involve the genitalia and rectum; however, gathering an adequate history and
properly conducting a physical exam are vital. Examining case studies of genital and rectal
abnormalities can help prepare advanced practice nurses to accurately assess patients with
problems in these areas.In this Lab Assignment, you will analyze an Episodic note case
study that describes abnormal findings in patients seen in a clinical setting. You will
consider what history should be collected from the patients, as well as which physical
exams and diagnostic tests should be conducted. You will also formulate a differential
diagnosis with several possible conditions.To PrepareReview the Episodic note case study
your instructor provides you for this week’s Assignment. Please see the “Course
Announcements” section of the classroom for your Episodic note case study.Based on the
Episodic note case study:Review this week’s Learning Resources, and consider the insights
they provide about the case study. Refer to Chapter 3 of the Sullivan resource to guide you
as you complete your Lab Assignment.Search the Walden library or the Internet for
evidence-based resources to support your answers to the questions provided.Consider
what history would be necessary to collect from the patient in the case study.Consider what
physical exams and diagnostic tests would be appropriate to gather more information about
the patient’s condition. How would the results be used to make a diagnosis?Identify at least
five possible conditions that may be considered in a differential diagnosis for the
patient.The Lab AssignmentUsing evidence-based resources from your search, answer the
following questions and support your answers using current evidence from the
literature.Analyze the subjective portion of the note. List additional information that should
be included in the documentation.Analyze the objective portion of the note. List additional
information that should be included in the documentation.Is the assessment supported by
the subjective and objective information? Why or why not?Would diagnostics be
appropriate for this case, and how would the results be used to make a diagnosis?Would
you reject/accept the current diagnosis? Why or why not? Identify three possible conditions
that may be considered as a differential diagnosis for this patient. Explain your reasoning
using at least three different references from current evidence-based literature.In this Lab
Assignment, you will analyze an Episodic note case study that describes abnormal findings
in patients seen in a clinical setting. You will consider what history should be collected from
the patients, as well as which physical exams and diagnostic tests should be conducted. You
2. will also formulate a differential diagnosis with several possible conditions.1- Review this
week’s Learning Resources, and consider the insights they provide about the case study.
Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab
Assignment.2- Search the Walden library or the Internet for evidence-based resources to
support your answers to the questions provided.3- Consider what physical exams and
diagnostic tests would be appropriate to gather more information about the patient’s
condition. How would the results be used to make a diagnosis?4-Identify at least
five possible conditions that may be considered in a differential diagnosis for the
patient.Using evidence-based resources from your search, answer the following questions
and support your answers using current evidence from the literature.Analyze the subjective
portion of the note. List additional information that should be included in the
documentation.Analyze the objective portion of the note. List additional information that
should be included in the documentation.Is the assessment supported by the subjective and
objective information? Why or why not?Would diagnostics be appropriate for this case, and
how would the results be used to make a diagnosis?Would you reject/accept the current
diagnosis? Why or why not? Identify three possible conditions that may be considered as a
differential diagnosis for this patient. Explain your reasoning using at least three different
references from current evidence-based literature.Post the assignment By Day 7 of Week
10. Follow the rubric! We grade by the rubric!GENITALIA ASSESSMENTSubjective:CC: “I
have bumps on my bottom that I want to have checked out.”HPI: AB, a 21-year-old WF
college student reports to your clinic with external bumps on her genital area. She states the
bumps are painless and feel rough. She states she is sexually active and has had more than
one partner during the past year. Her initial sexual contact occurred at age 18. She reports
no abnormal vaginal discharge. She is unsure how long the bumps have been there but
noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia
was found; the exam results were normal. She reports one sexually transmitted infection
(chlamydia) about 2 years ago. She completed the treatment for chlamydia as
prescribed.PMH: AsthmaMedications: Symbicort 160/4.5mcgAllergies: NKDAFH: No hx of
breast or cervical cancer, Father hx HTN, Mother hx HTN, GERDSocial: Denies tobacco use;
occasional ETOH married, 3 children (1 girl, 2 boys)Objective:VS: Temp 98.6; BP 120/86;
RR 16; P 92; HT 5’10”; WT 169lbsHeart: RRR, no murmursLungs: CTA, chest wall
symmetricalGenital: Normal female hair pattern distribution; no masses or swelling.
Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa
pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on
external labia.Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg
McBurneyDiagnostics: HSV specimen obtainedAssessment:ChancreLearning
ResourcesRequired Readings (click to expand/reduce)Ball, J. W., Dains, J. E., Flynn, J. A.,
Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An
interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Chapter 17, “Breasts and
Axillae”This chapter focuses on examining the breasts and axillae. The authors describe the
examination procedures and the anatomy and physiology of breasts.Chapter 19, “Female
Genitalia”In this chapter, the authors explain how to conduct an examination of female
genitalia. The chapter also describes the form and function of female genitalia.Chapter 20,
3. “Male Genitalia”The authors explain the biology of the penis, testicles, epididymides,
scrotum, prostate gland, and seminal vesicles. Additionally, the chapter explains how to
perform an exam of these areas.Chapter 21, “Anus, Rectum, and Prostate”This chapter
focuses on performing an exam of the anus, rectum, and prostate. The authors also explain
the anatomy and physiology of the anus, rectum, and prostate.Dains, J. E., Baumann, L. C., &
Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th
ed.). St. Louis, MO: Elsevier Mosby.Credit Line: Advanced Health Assessment and Clinical
Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P.
Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance
Center.Chapter 5, “Amenorrhea”Amenorrhea, or the absence of menstruation, is the focus of
this chapter. The authors include key questions to ask patients when taking histories and
explain what to look for in the physical exam.Chapter 6, “Breast Lumps and Nipple
Discharge”This chapter focuses on the important topic of breast lumps and nipple
discharge. Because breast cancer is the most common type of cancer in women, it is
important to get an accurate diagnosis. Information in the chapter includes key questions to
ask and what to look for in the physical exam.Chapter 7, “Breast Pain”Determining the cause
of breast pain can be difficult. This chapter examines how to determine the likely cause of
the pain through diagnostic tests, physical examination, and careful analysis of a patient’s
health history.Chapter 27, “Penile Discharge”The focus of this chapter is on how to diagnose
the causes of penile discharge. The authors include specific questions to ask when gathering
a patient’s history to narrow down the likely diagnosis. They also give advice on performing
a focused physical exam.Chapter 36, “Vaginal Bleeding”In this chapter, the causes of vaginal
bleeding are explored. The authors focus on symptoms outside the regular menstrual cycle.
The authors discuss key questions to ask the patient as well as specific physical examination
procedures and laboratory studies that may be useful in reaching a diagnosis.Chapter 37,
“Vaginal Discharge and Itching”This chapter examines the process of identifying causes of
vaginal discharge and itching. The authors include questions on the characteristics of the
discharge, the possibility of the issues being the result of a sexually transmitted infection,
and how often the discharge occurs. A chart highlights potential diagnoses based on patient
history, physical findings, and diagnostic studies.Sullivan, D. D. (2019). Guide to clinical
documentation (3rd ed.). Philadelphia, PA: F. A. Davis.Chapter 3, “SOAP Notes” (Previously
read in Week 8)Cucci, E., Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G. (2015). Sclerosing
adenosis of the breast: Report of two cases and review of the literature. Polish Journal of
Radiology, 80, 122–127. doi:10.12659/PJR.892706. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/ Sabbagh , C., Mauvis, F.,
Vecten, A., Ainseba, N., Cosse, C., Diouf, M., & Regimbeau, J. M. (2014). What is the best
position for analyzing the lower and middle rectum and sphincter function in a digital rectal
examination? A randomized, controlled study in men. Digestive and Liver Disease, 46(12),
1082–1085. doi:10.1016/j.dld.2014.08.045Westhoff , C. L., Jones, H. E., & Guiahi, M. (2011).
Do new guidelines and technology make the routine pelvic examination obsolete? Journal of
Women’s Health, 20(1), 5–10.This article describes the benefits of new technology and
guidelines for pelvic exams. The authors also detail which guidelines and technology may
become obsolete.Centers for Disease Control and Prevention. (2019). Sexually transmitted
4. diseases (STDs). Retrieved from http://www.cdc.gov/std/#This section of the CDC website
provides a range of information on sexually transmitted diseases (STDs). The website
includes reports on STDs, related projects and initiatives, treatment information, and
program tools.Document: Final Exam Review (Word document)Optional ResourceLeBlond,
R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.).
New York, NY: McGraw Hill Medical.Chapter 8, “The Chest: Chest Wall, Pulmonary, and
Cardiovascular Systems; The Breasts” (Section 2, “The Breasts,” pp. 434–444)Section 2 of
this chapter focuses on the anatomy and physiology of breasts. The section provides
descriptions of breast examinations and common breast conditions.Chapter 11, “The
Female Genitalia and Reproductive System” (pp. 541–562)In this chapter, the authors
provide an overview of the female reproductive system. The authors also describe
symptoms of disorders in the reproductive system.Chapter 12, “The Male Genitalia and
Reproductive System” (pp. 563–584)The authors of this chapter detail the anatomy of the
male reproductive system. Additionally, the authors describe how to conduct an exam of the
male reproductive system.Review of Chapter 9, “The Abdomen, Perineum, Anus, and
Rectosigmoid” (pp. 445–527)Required Media (click to expand/reduce)Special Examinations
– Breast, Genital, Prostate, and Rectal – Week 10 (14m)Accessible player –Downloads–
Download Video w/CCDownload AudioDownload TranscriptOnline media for Seidel’s Guide
to Physical ExaminationIt is highly recommended that you access and view the resources
included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos
and animations in Chapters 16 and 18–20 that relate to special examinations, including
breast, genital, prostate, and rectal. Refer to the Week 4 Learning Resources area for access
instructions on https://evolve.elsevier.com/Rubric DetailSelect Grid View or List View to
change the rubric’s layout.Name: NURS_6512_Week_10_Assignment_RubricGrid ViewList
ViewExcellentGoodFairPoorWith regard to the SOAP note case study provided and using
evidence-based resources from your search, answer the following questions and support
your answers using current evidence from the literature:· Analyze the subjective portion of
the note. List additional information that should be included in the documentation.10
(10%) – 12 (12%)The response clearly, accurately, and thoroughly analyzes the subjective
portion of the SOAP note and lists detailed additional information to be included in the
documentation.7 (7%) – 9 (9%)The response accurately analyzes the subjective portion of
the SOAP note and lists additional information to be included in the documentation.4 (4%)
– 6 (6%)The response vaguely analyzes the subjective portion of the SOAP note and vaguely
and/or inaccurately lists additional information to be included in the documentation.0 (0%)
– 3 (3%)The response inaccurately analyzes the subjective portion of the SOAP note, with
inaccurate and/or missing additional information included in the documentation.· Analyze
the objective portion of the note. List additional information that should be included in the
documentation.10 (10%) – 12 (12%)The response clearly, accurately, and thoroughly
analyzes the objective portion of the SOAP note and lists detailed additional information to
be included in the documentation.7 (7%) – 9 (9%)The response accurately analyzes the
objective portion of the SOAP note and lists additional information to be included in the
documentation.4 (4%) – 6 (6%)The response vaguely analyzes the objective portion of the
SOAP note and vaguely and/or inaccurately lists additional information to be included in
5. the documentation.0 (0%) – 3 (3%)The response inaccurately analyzes the objective
portion of the SOAP note, with inaccurate and/or missing additional information included in
the documentation.· Is the assessment supported by the subjective and objective
information? Why or why not?14 (14%) – 16 (16%)The response clearly and accurately
identifies whether or not the assessment is supported by the subjective and/or objective
information, with a thorough and detailed explanation.11 (11%) – 13 (13%)The response
accurately identifies whether or not the assessment is supported by the subjective and/or
objective information, with a clear explanation.8 (8%) – 10 (10%)The response vaguely
identifies whether or not the assessment is supported by the subjective and/or objective
information, with a vague explanation.0 (0%) – 7 (7%)The response inaccurately identifies
whether or not the assessment is supported by the subjective and/or objective information,
with an inaccurate or missing explanation.· What diagnostic tests would be appropriate for
this case, and how would the results be used to make a diagnosis?18 (18%) – 20 (20%)The
response thoroughly and accurately describes appropriate diagnostic tests for the case and
explains clearly, thoroughly, and accurately how the test results would be used to make a
diagnosis.15 (15%) – 17 (17%)The response accurately describes appropriate diagnostic
tests for the case and explains how the test results would be used to make a diagnosis.12
(12%) – 14 (14%)The response vaguely and/or with some inaccuracy describes
appropriate diagnostic tests for the case and vaguely and/or with some inaccuracy explains
how the test results would be used to make a diagnosis.0 (0%) – 11 (11%)The response
inaccurately describes appropriate diagnostic tests for the case, with an inaccurate or
missing explanation of how the test results would be used to make a diagnosis.· Would you
reject or accept the current diagnosis? Why or why not?· Identify three possible conditions
that may be considered as a differenial diagnosis for this patient. Explain your reasoning
using at least three different references from current evidence-based literature.23 (23%) –
25 (25%)The response states clearly whether to accept or reject the current diagnosis, with
a thorough, accurate, and detailed explanation of sound reasoning. The response clearly,
thoroughly, and accurately identifies three conditions as a differential diagnosis, with
reasoning that is explained clearly, accurately, and thoroughly using three or more different
references from current evidence-based literature.20 (20%) – 22 (22%)The response states
whether to accept or reject the current diagnosis, with an accurate explanation of sound
reasoning. The response accurately identifies three conditions as a differential diagnosis,
with reasoning that is explained using three different references from current evidence-
based literature.17 (17%) – 19 (19%)The response states whether to accept or reject the
current diagnosis, with a vague explanation of the reasoning. The response identifies two to
three conditions as a differential diagnosis, with reasoning that is explained vaguely and/or
inaccurately using three or fewer references from current evidence-based literature.0 (0%)
– 16 (16%)The response inaccurately states or is missing a statement of whether to accept
or reject the current diagnosis, with an explanation that is inaccurate and/or missing. The
response identifies three or fewer conditions as a differential diagnosis, with reasoning that
is missing or explained inaccurately using two or fewer references from current evidence-
based literature.Written Expression and Formatting – Paragraph Development and
Organization:Paragraphs make clear points that support well-developed ideas, flow
6. logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long
and rambling nor short and lacking substance. A clear and comprehensive purpose
statement and introduction are provided that delineate all required criteria.5 (5%) – 5
(5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A
clear and comprehensive purpose statement, introduction, and conclusion are provided that
delineate all required criteria.4 (4%) – 4 (4%)Paragraphs and sentences follow writing
standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and
conclusion of the assignment are stated, yet are brief and not descriptive.3 (3%) – 3
(3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity
60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or
off topic.0 (0%) – 2 (2%)Paragraphs and sentences follow writing standards for flow,
continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion
were provided.Written Expression and Formatting – English writing standards:Correct
grammar, mechanics, and proper punctuation5 (5%) – 5 (5%)Uses correct grammar,
spelling, and punctuation with no errors.4 (4%) – 4 (4%)Contains a few (1 or 2) grammar,
spelling, and punctuation errors.3 (3%) – 3 (3%)Contains several (3 or 4) grammar,
spelling, and punctuation errors.0 (0%) – 2 (2%)Contains many (≥ 5) grammar, spelling,
and punctuation errors that interfere with the reader’s understanding.Written Expression
and Formatting – The paper follows correct APA format for title page, headings, font,
spacing, margins, indentations, page numbers, running heads, parenthetical/in-text
citations, and reference list.5 (5%) – 5 (5%)Uses correct APA format with no errors.4 (4%)
– 4 (4%)Contains a few (1 or 2) APA format errors.3 (3%) – 3 (3%)Contains several (3 or 4)
APA format errors.0 (0%) – 2 (2%)Contains many (≥ 5) APA format errors.Total Points:
100Name: NURS_6512_Week_10_Assignment_Rubric
