Advanced Health Assessment Assignment: Module 6 Acute Headaches

 Learning Outcomes By completing this case study, you will be able to: • 1.0 Recognize the roles and responsibilities of the RN when assessing client health needs, communicating with the client, and prescribing. (Case Study #1) o 1.1 Recognize when the client’s health care needs — at any point during assessment, diagnosis or treatment — are beyond the scope, skills, knowledge and competencies of the RN who prescribes; and collaborates, consults with, or transfers accountability for care to another health care provider. (CNO Competency #6) o 1.2 Clearly articulate the role of the RN who prescribes when interacting with the client. (CNO Competency #5) Scenario You are a prescribing RN working in a primary care clinic. A new patient, Petra, comes to your clinic in the afternoon complaining of an acute headache that started that morning. She has had infrequent headaches like this in the past and states the acetaminophen (Tylenol) and iburpofen (Advil) she’s taking “aren’t working anymore, and I want something stronger prescribed”. Petra has a complex medical history, including type II diabetes and hypertension. You’re tasked with assessing her condition and prescribing appropriate treatments.

Questions: 1. In this scenario, discuss how you, as the prescribing RN, would assess your own ability to meet Petra’s needs considering your scope of practice. What factors or considerations would you take into account? (5 marks) 

2. Detail how you would gather information from Petra to assess her condition, and explain the signs or red flags that might indicate her health care needs are beyond your scope, skills, knowledge, and competencies as a registered nurse who prescribes. (10 marks) 

3. Outline the steps you would take for collaboration, consultation, or transfer of accountability for Petra’s care to another healthcare provider, if necessary. Consider Petra’s health care priorities and your communication methods in your response. (5 marks) 

4. Explain to Petra the role of an RN who prescribes in the context of her care. Include information about the type of care you provide, what you can prescribe, and how your role fits within the larger healthcare team. Describe how you would encourage Petra to ask questions and seek more information about her treatment plan.(5 marks)

 5. When the patient’s states she wants “something stronger” for pain relief for her acute headache, what within your prescribing RN scope, could you offer in response to this request? (5 marks)

Multiple Choice Questions (1 mark each) 1.Which of the following physical exam findings, warrants a consultation with another healthcare provider, such as a family physician, or a nurse practitioner: a) a blood pressure of 140/80 b) photophobia c) a positive Kernig’s sign d) +2 deep tendon reflexes throughout 2. If the patient has no red flags in her subjective history taking, and objective physical examinations, the prescribing RN can diagnose and treat this patient. a) True b) False 3. What medication cannot be prescribed by the prescribing RN to someone presenting with an acute headache? a) Sumatriptan b) Ibuprofen c) Acetaminophen d) Co-enzyme Q10 4) What part of the headache health assessment examination, is out of scope for the prescribing RN? a) CN1–18 testing b) carotid auscultation c) dermatological examination d) fundoscopic examination 5) What important piece of health history is NOT considered a headache “warning sign” when present during an acute headache? a) presence of cancer b) presence of sinusitis c) presence of HIV infection d) presence of pregnancy