Shadow Health Assignments
NRS-434VN Health Assessment Full Course GCU
Topic 1 DQ 1:
Extremely low birth weight babies (LBWB) have a profound impact on both families and the larger community.
These babies often require intensive care in a neonatal intensive care unit (NICU), which can be a challenging and stressful experience for families.
For families in rural areas, the added burden of transporting the baby to a larger hospital can create additional emotional, logistical, and financial stress. This often includes costs for housing, transportation, and food, which can further strain the family’s resources.
In the long term, families may also face additional financial burdens related to ongoing medical needs, including specialized equipment and continuous infant care.
The short-term impacts are primarily related to the emotional and psychological stress experienced by the family. Parents may have to spend extended periods in the NICU, which can cause anxiety, depression, and fatigue. Over time, these effects can extend into long-term implications such as financial hardships due to the need for follow-up care or early intervention services. These may include therapies or specialized treatments for developmental delays and long-term disabilities resulting from complications like respiratory distress syndrome (RDS), retinopathy of prematurity, and intraventricular hemorrhage (IVH). Premature birth complications often require long-term monitoring, which can add to the strain on a family’s physical and emotional resources.
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Moreover, socioeconomic status plays a significant role in the experience of families with preterm infants. Families in lower-income areas may struggle to access the necessary healthcare resources. This is especially true for those in rural areas or underserved communities where specialized neonatal care programs and resources for low birth weight babies may be limited. There is also a noticeable disparity in preterm labor rates among different ethnic and cultural groups. For example, non-Hispanic Black mothers have a higher incidence of preterm labor and extremely low birth weight babies compared to non-Hispanic white mothers (Almeida et al., 2018). This disparity can be attributed to various factors, including socioeconomic stress, access to healthcare, and structural inequalities in healthcare delivery.
Long-term care for premature babies is essential for monitoring their growth and development. Babies born with LBWB may face a variety of medical issues, such as necrotizing enterocolitis and jaundice, which can require ongoing hospital visits and treatments throughout their early years. Community support programs are crucial in providing families with the resources they need to navigate these challenges. First 5 LA, a state-funded program in California, is an excellent example of such a resource. It supports families with preterm infants and those dealing with low birth weight babies by offering services ranging from prenatal care to programs for children up to the age of five (First 5 LA, n.d.). These services include early intervention for developmental delays and support services aimed at improving the outcomes for low birth weight babies.
Additionally, Los Angeles County Health Services offers specialized neonatal care programs for preterm infants and those with birth complications. These programs provide follow-up care, developmental monitoring, and early intervention services to ensure the infants’ needs are met as they grow. These services help bridge the gap for families, especially in rural or lower-income areas, ensuring that babies born with premature birth complications receive the care they need. 
In conclusion, support services for low birth weight infants and preterm infants are vital for addressing the unique challenges faced by families. Programs like First 5 LA and Los Angeles County Health Services play a significant role in alleviating the socioeconomic implications and providing critical services that help families navigate the journey of raising preterm infants with extremely low birth weight. These programs highlight the importance of community support for families in need and ensure better outcomes for preterm babies in the long term.
Resources:
- First 5 LA: https://www.first5la.org
- Los Angeles County Health Services: https://www.lacounty.gov
References:
Almeida, J., Erbetta, K., Bécares, L., Bettegowda, V. R., & Ahluwalia, I. B. (2018). Racial/Ethnic inequities in low birth weight and preterm birth: The role of multiple forms of stress. Maternal & Child Health Journal, 22(8), 1154–1163. https://doi-org.lopes.idm.oclc.org/10.1007/s10995-018-2500-7
First 5 LA: https://www.first5la.org
Health Services Los Angeles County: https://dhs.lacounty.gov/our-services/primary-care/premature-infant/
March of Dimes: https://www.marchofdimes.org/find-support/topics/birth/low-birthweight
Course GCU
Topic 1 DQ 1
Effect of Extremely Low Birth Weight Babies on Family and Community
Extremely low birth weight babies (LBWB) have a significant impact on families and communities. These babies often require care in a neonatal intensive care unit (NICU), which can mean transferring them to larger city hospitals, especially in rural communities. Dealing with a baby needing intensive care is stressful for families, affecting them in various ways. Financially, the costs of NICU care, housing, transportation, and food can strain families. The long-term effects also create financial challenges due to ongoing care needs and necessary equipment.
LBWB can face multiple complications like respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA), necrotizing enterocolitis, retinopathy of prematurity, jaundice, and infections (March of Dimes, 2021). These complications can lead to disabilities and developmental delays, necessitating constant care. Preterm labor (PTL), a leading cause of LBWB, affects ethnic and cultural groups differently. Non-Hispanic black mothers have higher LBWB rates and PTL at 13.1% and 13.3% respectively, compared to non-Hispanic white mothers at 7.0% and 9.0% (Almeida et al, 2018). Socioeconomic differences play a role too, as non-Hispanic black mothers often face more limited resources (Almeida et al, 2018).
In my community, various programs aid LBWB and low socioeconomic families. One such program is First 5 in California, including First 5 LA in my city. Funded by tobacco and alcohol taxes, they offer prenatal care through age 5, aiming to support children’s health regardless of financial ability (First 5 LA, n.d.). Los Angeles County Health Services also assists LBWB and preterm infants with developmental monitoring and early interventions (n.d.). While these resources help, more local and federal resources exist to aid families with LBWB.
References:
Almeida, J., Erbetta, K., Bécares, L., Bettegowda, V. R., & Ahluwalia, I. B. (2018). Racial/Ethnic inequities in low birth weight and preterm birth: The role of multiple forms of stress. Maternal & Child Health Journal, 22(8), 1154–1163. https://doi-org.lopes.idm.oclc.org/10.1007/s10995-018-2500-7
First 5 LA: https://www.first5la.org
Health Services Los Angeles County: https://dhs.lacounty.gov/our-services/primary-care/premature-infant/
March of Dimes: https://www.marchofdimes.org/find-support/topics/birth/low-birthweight
Topic 1 DQ 2
Consider the following patient scenario:
A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).
Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice NRS-434VN Health Assessment Full Course GCU.
The presented nine-month-old girl’s head circumference is 43 cm, which is typically the average head measurement for girls, according to the CDC. The CDC estimates that girls’ average head circumference at this age is 43.83 centimeters (Miles, 2022). “The average length for a nine-month-old is 27.6 inches for girls, according to the World Health Organization” (The Bump Editors, 2017, para 4). The presented 9-month-old girl’s length is 68.5 cm, which is below average. Lastly, the weight of the nine-month-old girl is 6.75 kg, compared to the average weight of 18.1 pounds for girls (The Bump Editors, 2017).
In terms of growth, babies develop at a phenomenal rate. In fact, at month nine, the baby typically grows alarmingly. Miles (2022) stated that most infants see a noticeable increase in weight throughout the third trimester. The 9-month-old presented in this discussion is developing slower than the average newborn, weight- and length-wise. The nurse should advise the mother to continue breastfeeding or using formula but to introduce baby food if she has not already started. The mother “can expand her baby’s diet to include soft foods such as yogurt, oatmeal, mashed banana, mashed potatoes, or even thicker or lumpy pureed vegetables” (AAP, 2022, para 2). “Eggs (including scrambled) are an excellent source of protein, as are cottage cheese, Greek yogurt, and avocado” (AAP, 2022, para 2). Let the baby get plenty of rest. Have her child examined by her primary care provider once a month to monitor growth and development and to learn about proper weaning techniques.
For healthcare providers to spot newborns at risk for delay, they must correctly identify the developmental milestones. There is a wide variety of evidence-based screening methods available to help healthcare providers determine whether newborns are on track to fulfill developmental milestones or are at risk for delays. The Centers for Disease Control and Prevention (CDC) have made a list of evaluation checkpoints that doctors and nurses can use as a basis by the end of a 9-month-old’s evaluation. This includes the Ages and Stages Questionnaire, the Child Development Inventory, and the Parent’s Evaluation of Developmental Status (CDC, 2022). These trackers come in digital milestone tracker mobile apps for iOS and Android devices, and one can use the digital online checklist or print the checklist sheet (CDC, 2022). For social/emotional milestones, the CDC states that a nine-month-old should be able to show expressions such as clinginess, happiness, anger, sadness, shyness, and fear around unfamiliar faces; be able to look when their names are mentioned, react to being left behind, like crying or reaching out for their guardian; and smile or giggle when playing pee-a-boo with them (CDC, 2022).
In the cognitive milestones, such as thinking, problem-solving, and learning, a 9-month-old should be able to bang two objects together and seek toys or any item when dropped or hidden out of sight (CDC, 2022). For language and communication, a nine-month-old should be able to lift their arms as an indication to be lifted up and make sounds like “babababa” or “mamamama” (CDC, 2022, para 4). For the physical/movement milestones, a nine-month-old is expected to be able to move objects from one hand to the other, get into a sitting position without help or support, and use their fingers to “rake” food towards them (CDC, 2022).
Per the CDC, parents are their baby’s first teachers (CDC, 2022). It is crucial for parents to be familiar with the developmental milestones of their child/children. With this knowledge, it is easier for parents to include these activities in their babies’ daily routines and become aware of any unfulfilled milestones that need to be addressed with their healthcare experts.
References
American Academy of Pediatrics. (2022, August 12). Sample menu for a baby 8 to 12 months old. https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/sample-one-day-menu-for-an-8-to-12-month-old.aspx
Centers for Disease Control and Prevention. (2022, July 5). What developmental milestones is your 9-month-old reaching? https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html
Miles, K. (2022, April 7). Average newborn head circumference. BabyCenter. https://www.babycenter.com/baby/baby-development/baby-head-circumference_40009394
The Bump Editors. (2017, June 19). 9-Month-Old baby – Baby month by month. TheBump.com – Pregnancy, Parenting and Baby Information. https://www.thebump.com/baby-month-by-month/9-month-old-bab
Environmental Factors and Health Promotion Presentation: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants
Requires Lopeswrite
Assessment Description
The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to parents and caregivers.
Create a 10-12-slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end.
In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored.
Include the following in your presentation:
- Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants.
- Create a health promotion plan that can be presented to parents and caregivers to address the environmental factor and improve the overall health and well-being of infants.
- Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.
- Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly sources are required. Two of the three sources must be peer-reviewed and no more than 5 years old.
- Provide readers with four resources: two community resources, one national resource, and one web-based resource. Include a brief description and contact information for each resource.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
Refer to the resource, “Loom,” located in the Student Success Center, for additional guidance on recording your presentation.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Topic 2 DQ 1
Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. Identify two factors that increase the vulnerability of a child for abuse in the age group you have selected.
There are several forms of child abuse. The World Health Organization (WHO) identifies them under the term maltreatment, and it includes abuse that is physical, emotional, and sexual. It also includes negligence, neglect and exploitation that can be commercial in nature (World Health Organization, 2022).
The most common abuse for toddlers is that of neglect. As nurses we can watch for toddlers that are withdrawn and nervous along with not meeting milestones or potentially regressing on milestones reached as red flags that there is a potential issue emotionally with the child (Gonzalez, D., et al., 2022). Neglect includes many environmental deficiencies such as lack of food and water, not taking a child to needed healthcare appointments, not providing a safe place to live, and not maintain a child’s hygiene. Neglect is reported to be more prevalent in homes that are in the poverty line, homes where domestic violence occurs, and homes that have more than two children (Gonzalez, D., et al., 2022).
I reside in the state of Idaho and our main contact for reporting abuse is the Idaho Department of Health and Welfare. Once contacted and reported, a case is created, and a social worker is assigned. Follow-up is then completed by the assigned social worker for further investigation if warranted. We do have to be mindful as nurses when reporting potential abuse as there are many cultures that have different practices for health management. Cupping is one practice that can leave marks or bruising on the body that can be easily mistaken for physical abuse (Xun Lin., et al., 2018). Regardless of cultural practices, it is best to report any instance that could potentially be abuse as it is better to over report than under report.
References:
Gonzalez D, Bethencourt Mirabal A, McCall JD. (2022). Child Abuse and Neglect. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459146/
Idaho Department of Health and Welfare. (n.d.). Report neglect, abuse and abandonment. https://healthandwelfare.idaho.gov/services-programs/children-families/child-and-family-services-and-foster-care/reporting-neglect
World Health Organization. (2022). Responding to child maltreatment: A clinical handbook for health professionals. https://www.who.int/publications/i/item/toolkit-on-mapping-legal-health-and-social-services-responses-to-child-maltreatment
Xun Lin, Hon Foong Wong, & Shih Chau Ng. (2018). Cupping, the past and present application. Chinese Medicine and Culture, 1(3), 121–126. https://doi-org/10.4103/CMAC.CMAC_37_18
Topic 2 DQ 2
Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.
Developmental Assessment and the School-Aged Child
Assessment Description
The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:
Describe the different physical characteristics/findings within the school-aged child. Explain how you would modify assessment techniques to match the age and developmental stage of this child.
- Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
- Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Adolescence: Contemporary Issues and Resources
Start Date
Mar 27, 2023, 12:00 AM
Due Date
Apr 2, 2023, 11:59 PM
Points
90
Rubric
Status
Ungraded
Requires Lopeswrite
Assessment Description
Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:
- Describe the contemporary issue and explain what external stressors are associated with this issue.
- Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.
- Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented. NRS-434VN Health Assessment Full Course GCU
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center NRS-434VN Health Assessment Full Course GCU.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Topic 4: Health Assessment Of The Young And Middle-Aged Adult
Max Points:198
Objectives:
- Discuss strategies to reduce at-risk behavior in adults.
- Evaluate assessment of diverse populations.
- Perform and document a comprehensive health assessment.
Assessments
Topic 4 DQ 1
Start Date
Apr 3, 2023, 12:00 AM
Due Date
Apr 5, 2023, 11:59 PM
Points
8
Status
Upcoming
Assessment Description
You are admitting a 19-year-old female college student to the hospital for fevers. Using the patient information provided, choose a culture unfamiliar to you and describe what would be important to remember while you interview this patient. Discuss the health care support systems available in your community for someone of this culture. If no support systems are available in your community, identify a national resource.
Topic 4 DQ 2
Start Date
Apr 3, 2023, 12:00 AM
Due Date
Apr 7, 2023, 11:59 PM
Points
8
Status
Upcoming
Assessment Description
For the middle-aged adult, exercise can reduce the risk of various health problems. Choose two at-risk health issues that regular physical exercise and activity can help prevent and manage. Discuss the prevalence of each of these health problems in society today. Describe measures that you would take as a nurse to assist patients with health promotion measures to incorporate exercise and physical activity into their lives. Include the kind of activities you would recommend, the amount of exercise, and the approach you would use to gain cooperation from the patient. Support your response with evidence-based literature.
Start Date
Apr 3, 2023, 12:00 AM
Due Date
Apr 9, 2023, 11:59 PM
Points
150
Status
Upcoming
Assessment Description
Within the Shadow Health platform, complete the Comprehensive Assessment. The estimated average time to complete this assignment each time is 3 hours. Please note, this is an average time. Some students may need longer.
This clinical experience is a comprehensive exam. Students must score at the level of “Proficient” in the Shadow Health Digital Clinical Experience. Students have three opportunities to complete this assignment and score at the Proficient level. Upon completion, submit the lab pass through the assignment dropbox.
Students successfully scoring within the Proficient level in the Digital Clinical Experience on the first attempt will earn a grade of 150 points; students successfully scoring at the Proficient level on the second attempt will earn a grade of 135 points; and students successfully scoring at the Proficient level on the third attempt will earn a grade of 120 points. Students who do not pass the performance-based assessment by scoring within the Proficient level in three attempts will receive a failing grade (102 points).
If the Proficient level is not achieved on the first attempt it is recommended that you review your answers with the correct answers on the Experience Overview page. Review the report by clicking on each tab to the left titled; Transcript, Subjective Data Collection, Objective Data Collection, Documentation, and SBAR to compare your work. Reviewing this overview and course resources may help you improve your score.
Please review the assignment in the Health Assessment Student Handbook in Shadow Health prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Topic 5: Health Assessment Of The Older Adult
Max Points:258
Objectives:
- Describe characteristics of the aging process.
- Recommend strategies for supporting patients in end-of-life care.
- Apply use of a focused assessment to an assigned individual patient.
Assessments
Topic 5 DQ 1
Start Date
Apr 10, 2023, 12:00 AM
Due Date
Apr 12, 2023, 11:59 PM
Points
8
Status
Upcoming
Assessment Description
Describe the characteristics of the aging process. Explain how some of the characteristics may lead to elder abuse (memory issues, vulnerability, etc.). Discuss the types of consideration a nurse must be mindful of while performing a health assessment on a geriatric patient as compared to a middle-aged adult.
Topic 5 DQ 2
Start Date
Apr 10, 2023, 12:00 AM
Due Date
Apr 14, 2023, 11:59 PM
Points
8
Status
Upcoming
Assessment Description
End-of-life care becomes an issue at some point for elderly patients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your patients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.
Benchmark – Human Experience Across the Health-Illness Continuum
Start Date
Apr 10, 2023, 12:00 AM
Due Date
Apr 16, 2023, 11:59 PM
Points
110
Rubric
Status
Upcoming
Benchmark
Requires Lopeswrite
Assessment Description
Research the health-illness continuum and its relevance to patient care. In a 750-1,000-word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:
- Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
- Explain how understanding the health-illness continuum enables you, as a health care provider, to better promote the value and dignity of individuals or groups and to serve others in ways that promote human flourishing and are consistent with the Christian worldview.
- Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
- Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assesses the following programmatic competency:
RN-BSN
5.3: Understand the human experience across the health-illness continuum.
Shadow Health: Focused Exam: Abdominal Pain
Start Date
Apr 10, 2023, 12:00 AM
Due Date
Apr 16, 2023, 11:59 PM
Points
100
Status
Upcoming
Assessment Description
Within the Shadow Health platform, complete the Focused Exam: Abdominal Pain. The estimated average time to complete this assignment is 1 hour and 25 minutes. Please note, this is an average time. Some students may need longer.
This clinical experience is a focused exam. Students have one opportunity to complete this assignment and score at the Proficient level. Upon completion, submit the lab pass through the assignment dropbox.
Students successfully scoring within the Proficient level in the Digital Clinical Experience will earn a grade of 100 points. Students who do not pass the performance-based assessment and scoring within the Proficient level will receive a failing grade (68 points).
Please review the assignment in the Health Assessment Student Handbook in Shadow Health prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite NRS-434VN Health Assessment Full Course GCU.
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