NR 601 Week 5 Standardized Procedure Worksheet

Chamberlain University NR 601 Week 5 Standardized Procedure Worksheet– Step-By-Step Guide

This guide will demonstrate how to complete the Chamberlain University  NR 601 Week 5 Standardized Procedure Worksheet  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NR 601 Week 5 Standardized Procedure Worksheet                        

Whether one passes or fails an academic assignment such as the Chamberlain University  NR 601 Week 5 Standardized Procedure Worksheet  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NR 601 Week 5 Standardized Procedure Worksheet                        

The introduction for the Chamberlain University  NR 601 Week 5 Standardized Procedure Worksheet      is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NR 601 Week 5 Standardized Procedure Worksheet                        

After the introduction, move into the main part of the NR 601 Week 5 Standardized Procedure Worksheet      assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NR 601 Week 5 Standardized Procedure Worksheet                        

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NR 601 Week 5 Standardized Procedure Worksheet                        

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

Stuck? Let Us Help You

Completing assignments can sometimes be overwhelming, especially with the multitude of academic and personal responsibilities you may have. If you find yourself stuck or unsure at any point in the process, don’t hesitate to reach out for professional assistance. Our assignment writing services are designed to help you achieve your academic goals with ease. 

Our team of experienced writers is well-versed in academic writing and familiar with the specific requirements of the NR 601 Week 5 Standardized Procedure Worksheet  assignment. We can provide you with personalized support, ensuring your assignment is well-researched, properly formatted, and thoroughly edited. Get a feel of the quality we guarantee – ORDER NOW. 

Sample Answer for NR 601 Week 5 Standardized Procedure Worksheet

Nurse practitioners are crucial in promoting optimum health and well-being for their populations. Nurse practitioners use their clinical knowledge, skills, and experience to diagnose patients and develop patient-centered interventions to promote recovery. This study’s primary objective is to create standardized care procedures for hemorrhoids in older adults. The paper is segmented into four core sections encompassing the identification and description of hemorrhoids, disease assessment processes, diagnostic tests, and an evidence-based management plan for this condition. Protocolized (standardized) care establishes explicit clinical pathways for managing medication interventions, ensuring that desirable treatments are administered systematically, correctly, and on time.  

Description of Hemorrhoids

The assigned topic of discussion is hemorrhoids in older adults. Júnior et al. (2020) define them as normal vascular cushions comprising connective tissue, veins, smooth muscle fibers, sinusoids, and arterioles found in the anal canal, which in pathological conditions present as venous hypertension and dilation leading to mucous discharge, edema, intense pain, thrombosis, and prolapse. Júnior et al. (2020) and Sheikh et al. (2020) acknowledge that this condition is a common occurrence in adulthood, with more than 50% of persons aged over 50 years experiencing related symptoms at some point in their lives. Age is a risk factor for hemorrhoids, which, according to Sheikh et al. (2020), contributes to the weakening of the connective tissue framework supporting the anorectal apparatus. Intra-abdominal pressures as a result of obesity, constipation, physical inactivity, chronic cough, or pregnancy also contribute to hemorrhoids development (Sheikh et al., 2020). The former factor explains the high prevalence rate of up to 50% among older adults aged over 50 years (Júnior et al., 2020; Sheikh et al., 2020). Concerning the general population, the prevalence of hemorrhoids varies across countries, with Italy and Russia registering an incident rate of 16%, while the Czech Republic, Brazil, France, Spain, and Romania recording 11%, 6%, 7%, 11%, and 10% prevalence rate, respectively (Sheikh et al., 2020). In the United States, Sheikh et al. (2020) accentuate that about 1 million new cases of hemorrhoids are reported annually in the United States, which translates to an annual incidence rate of 4.4% or 10 million people. Overall, these figures may be considerably high because most hemorrhoid cases are underreported as patients desist from seeking medical intervention due to associated shame. 

ALSO READ:

NR 601 Week 6 Mental Health Care Screenings Discussion

NR 601 Week 6 iHuman Virtual Patient Encounter- Neurological System (Graded)

NR 601 Week 7 Discussing Advanced Directives Collaboration Café

The pathophysiology of hemorrhoids is yet to be fully ascertained. However, according to Margetis (2019), the sliding anal canal model, also known as the cushion theory, is the universally accepted explanation of hemorrhoids development. It attributes this condition to the abnormal slippage of cushions through the anal canal. In particular, Margetis (2019) cites four critical pathophysiological events that account for its development and progression. These events entail the anal cushion slippage process, cushions’ connective tissue deterioration, incomplete venous return from sinusoids to the superior (SRV) and middle (MRV) rectal veins during defecation, and blood accumulation (stagnation) in the dilated plexus (Margetis, 2019). While these events may be attributed to various factors, Margetis (2019) considers sinusoid congestion the hallmark of the onset of hemorrhoidal disease. In layperson’s terms, hemorrhoids develop from blood accumulation in the blood vessels around the lower abdomen and anus due to reduced venous return during defecation and heightened abdominal pressure. According to Margetis (2019), the impaired or dysfunctional arteriolar sphincteric mechanism, relaxed and hypertrophied connective tissue, and decreased vascular tone contribute to the accumulation of blood, underling the congestion of the sinusoids. Conversely, fibrous tissue hypertrophy and the growth of new blood vessels (neovascularization) contribute to cushion enlargement (Margetis (2019). These events account for the pathophysiology of hemorrhoids. In conclusion, the resulting venous hypertension and dilation lead to mucous discharge, edema, intense pain, thrombosis, and prolapse, which are the primary presenting symptoms of hemorrhoids.   

Assessment

Over and above diagnostics tests, a comprehensive assessment of the patient’s presenting symptoms, social and family history, and an in-depth physical examination are paramount to diagnosing. According to Jakubauskas and Poskus (2020) and Wang et al. (2023), common subjective findings (symptoms) consistent with hemorrhoid encompass rectal bleeding, prolapse (a feeling of a lump around the anal region), itching, mucus discharge after bowel movements, and throbbing pain that might be experienced several hours after a bowel movement. Patients also report feelings of tissue prolapse, mild fecal incontinence, and the presence of painless external skin tags. Moreover, Jakubauskas and Poskus (2020) note that a careful history examination is necessary to correlate the presenting symptoms with hemorrhoids or to make a differential diagnosis. In particular, the examiner should inquire about an individual’s obstetric history to establish the presence of episiotomies, instrumental delivery, and perineal tears for female patients and perianal trauma for men. Equally, the examiner should question patients about their defecation habits (assess for signs of prolonged sitting and strain during defecation) and history of polyps, cancer, and inflammatory bowel disease (IBD) (Jakubauskas & Poskus, 2020). These variables constitute pertinent subjective data associated with hemorrhoids.   

A comprehensive physical examination is necessary to establish pertinent objective data consistent with hemorrhoids. This condition’s primary physical exam indicator is the presence of a perianal thrombosis, which, according to Jakubauskas and Poskus (2020), appears as a tender, firm purple nodule. Besides a thrombosed external hemorrhoid, the examiner should take note of a tender lump to palpation and observe the presence of ulcerations and bloody drainage on the hemorrhoids, and skin tags. Following a general physical exam, Jakubauskas and Poskus (2020) suggest that the examiner should proceed to perform a digital rectal examination to establish the presence of a distal rectal mass, anorectal fistula, fissures, and abscess. This procedure is essential for differentiating these pathologies from hemorrhoids (Jakubauskas & Poskus, 2020). Furthermore, Jakubauskas and Poskus (2020) and Picciariello et al. (2021) suggest that medical professionals should also perform an examination of the anal canal and rectum with an anoscope (anoscopy) to visualize the left lateral, right anterior, and right posterior cushions to establish the extent of prolapse and for differential diagnosis. Picciariello et al. (2021) assert that an anoscopy is essential for examining internal hemorrhoids, rectal masses, or fissures. A physical exam corroborates subjective findings and helps establish a preliminary diagnosis pending a diagnostic test for confirmation.

  Nurse practitioners in California are required to work in collaboration with a physician. In particular, physicians supervise nurses as they practice. Nurse practitioners must have an agreement with a physician who leads their practice. California nurse practitioners collaborate with physicians in certain circumstances, such as developing new care models for integrated collaborative patient care and education. Unlike in California, nurses in the District of Columbia and 22 other states in the country, including New Hampshire, Washington, Oregon, Wyoming, Nevada, Iowa, Arizona, Montana, Massachusetts, and Maryland, have approved full practice status, which means that they can practice without physician supervision, undertaking case management, including assessment, diagnosis, interpretation of diagnostic tests, and prescription of medications (American Association of Nurse Practitioners [AANP], 2024). However, they may require prompt surgical consultation in the management of grade IV internal hemorrhoids, which require surgical intervention (Perry, 2022). The idea is that nurses’ scope of practice varies across states, meaning they may require physician supervision or practice independently depending on local regulatory requirements.      

Diagnostic Tests

Medical practitioners can perform various diagnostic tests, including anoscopy, total colonoscopy, digital rectal examination, and complete blood test to confirm preliminary differential diagnosis. Anoscopy is one of the diagnostic tests performed in older adults who are suspected of having hemorrhoids. According to Jakubauskas and Poskus (2020) and Picciariello et al. (2021), an anoscopy is essential for visualizing the left lateral, right anterior, and right posterior cushions to establish the extent of prolapse and for differential diagnosis. Equally, it is instrumental in examining internal hemorrhoids, rectal masses, or fissures (Picciariello et al., 2021). In particular, an anoscopy allows the diagnosis of internal hemorrhoids or fissures and rules out the presence of rectal masses. A total colonoscopy might also be performed if there are uncertainties in the diagnoses. According to Jakubauskas and Poskus (2020), it is recommended for older adults (over 45 years) who have not been screened for colorectal cancer, with a history of polyps, cancers, or IBD, and those presenting with atypical symptoms, including blood-stained stool and significant changes in defection habits. A digital rectal examination should also be performed to determine the presence or absence of anorectal mass, scar, stenosis, and patency of the sphincter tone (Jakubauskas & Poskus, 2020). A complete blood test is also recommended to rule out anemia. Conversely, Soeseno et al. (2021) suggest performing a stool occult test for mild cases in earlier stages of development to rule out infections. The expected abnormal results include the presence of an anal lump, bleeding hemorrhoids, anal fissures, non-patent anal sphincter, bleeding after bowel movements, skin tags, and anal ulcerations, which are the pertinent indicators of hermorrhoids.

Management

Hemorrhoid management encompasses pharmacological and nonpharmacological interventions. Prescription therapy used as part of the first-line treatment of hemorrhoids in older adults includes oral flavonoids such as chrysin 400 mg once daily because of its anti-hemorrhoid properties and its capacity to improve vascular function while decreasing vascular resistance, according to Razdar et al. (2023). Although flavonoid therapy is superior to calcium dobesilate, Changazi et al. (2020) note that oral calcium dobesilate 0.5 mg once daily may be used as a second-line treatment for hemorrhoids if patients react to the first-line medication. Vahabi et al. (2019) also recommend topical treatments such as glyceryl trinitrate 0.2% for pain management, particularly following a hemorrhoidectomy surgery. Pharmacotherapy in hemorrhoid treatment is mainly used to reduce pain and constipation.

Hemorrhoids are best managed using nonpharmacological interventions. Perry (2022) considers a treatment regimen comprising increased fiber and adequate fluid intake as the first line of treatment for this condition. While this treatment approach entails the primary plan for managing hemorrhoids, case management varies according to disease severity levels. In particular, Perry (2022) notes that grade I and II hemorrhoids can be effectively managed through banding, sclerotherapy, and infrared coagulation. Complicated cases, including instances in which patients present with large III and IV hemorrhoids are often referred for surgical intervention (Perry, 2022). These operative treatments, encompassing sclerotherapy, rubber band ligation, and infrared coagulation, are highly recommended for patients that are allergic to hemorrhoid treatment-related medications. Other relevant treatment modalities entail cryotherapy, radiofrequency ablation, hemorrhoidectomy, plication, Doppler-guided hemorrhoidal artery ligation, and stapled hemorrhoidopexy. Overall, patients must seek doctors’ guidance to determine the treatment plan.

The post-treatment plan encompasses patient education centered on adherence to the prescribed treatment regimen and recommended lifestyle changes, discussion of indications for referral, and expected client follow-up. Ektov et al. (2020) indicate that the predicted client follow-up depends on the adopted treatment. For example, a client presenting with persistent or recurrent symptoms should be referred for surgical intervention after initial treatment. It might also entail starting the patient on drugs if lifestyle and dietary modification had been considered. Conversely, indications for referral include hemorrhoids unresponsive to treatment, severe bleeding, anemia, rectal prolapse, and absence of specialized care in a facility. Most importantly, patients must be advised to adhere to the prescribed treatment regimen and recommended lifestyle changes.  

Conclusion

Hemorrhoids are a common occurrence in adulthood, with more than 50% of persons aged over 50 years experiencing related symptoms at some point in their life. To make a definitive diagnosis, nurses should be aware of pertinent subjective and objective findings relevant to hemorrhoids. The former encompasses symptoms such as rectal bleeding, prolapse, itching, mucus discharge after bowel movements, and throbbing pain that might be experienced several hours after a bowel movement. Conversely, the latter entails the presence of a perianal thrombosis, ulcerations and bloody drainage on the hemorrhoids, and skin tags. Equally, they are advised to perform a comprehensive assessment of the patient’s presenting symptoms, social and family history, and an in-depth physical examination and conduct diagnostics tests to simplify the differential diagnosis process. Most importantly, they must understand that hemorrhoid management encompasses pharmacological and nonpharmacological interventions.

References

American Association of Nurse Practitioners. (2024). Practice information by state. AANP. https://www.aanp.org/practice/practice-information-by-state

Changazi, S. H., Bhatti, S., Choudary, A., Sr, Rajput, M. N. A., Iqbal, Z., & Ahmed, Q. A. (2020). Calcium dobesilate versus flavonoids for the treatment of early hemorrhoidal disease: A randomized controlled trial. Cureus, 12(8). https://doi.org/10.7759/cureus.9845

Ektov, V. N., Николаевич, Э. В., Somov, K. A., Алексеевич, С. К., Kurkin, A. V., Васильевич, К. А., Muzalkov, V. A., & Александрович, М. В. (2020). Treatment options for chronic hemorrhoids. Journal of Experimental and Clinical Surgery, 13(4). https://doi.org/10.18499/2070-478X-2020-13-4-353-361

Jakubauskas, M., & Poskus, T. (2020). Evaluation and management of hemorrhoids. Diseases of the Colon & Rectum, 63(4), 420-424. https://doi.org/10.1097/DCR.0000000000001642

Júnior, C. W. S., de Almeida Obregon, C., e Sousa, A. H. D. S., Sobrado, L. F., Nahas, S. C., & Cecconello, I. (2020). A new classification for hemorrhoidal disease: The creation of the “BPRST” staging and its application in clinical practice. Annals of Coloproctology, 36(4), 249-255. https://orcid.org/0000-0002-0304-9999

Margetis N. (2019). Pathophysiology of internal hemorrhoids. Annals of Gastroenterology, 32(3), 264–272. https://doi.org/10.20524/aog.2019.0355

Perry, K. R. (2022, May 31). Hemorrhoids treatment & management. Medscape. https://emedicine.medscape.com/article/775407-treatment

Picciariello, A., Tsarkov, P. V., Papagni, V., Efetov, S., Markaryan, D. R., Tulina, I., & Altomare, D. F. (2021). Classifications and Clinical Assessment of Haemorrhoids: The Proctologist’s Corner. Reviews on Recent Clinical Trials, 16(1), 10–16. https://doi.org/10.2174/1574887115666200312163940

Razdar, S., Panahi, Y., Mohammadi, R., Khedmat, L., & Khedmat, H. (2023). Evaluation of the efficacy and safety of an innovative flavonoid lotion in patients with haemorrhoid: A randomized clinical trial. BMJ Open Gastroenterology, 10(1). https://doi.org/10.1136/bmjgast-2023-001158

Sheikh, P., Régnier, C., Goron, F., & Salmat, G. (2020). The prevalence, characteristics and treatment of hemorrhoidal disease: Results of an international web-based survey. Journal of Comparative Effectiveness Research, 9(17), 1219–1232. https://doi.org/10.2217/cer-2020-0159

Soeseno, S. W., Wahyudi, P. A. E., & Febyan, F. (2021). Diagnosis and management of internal hemorrhoids: A brief review. European Journal of Medical and Health Sciences, 3(5), Article 5. https://doi.org/10.24018/ejmed.2021.3.5.1014

Vahabi, S., Beiranvand, S., Karimi, A., & Moradkhani, M. (2019). Comparative study of 0.2% glyceryl trinitrate ointment for pain reduction after hemorrhoidectomy surgery. Surgery Journal (New York, N.Y.), 5(4), e192–e196. https://doi.org/10.1055/s-0039-3400532

Wang, L., Ni, J., Hou, C., Wu, D., Sun, L., Jiang, Q., & Fan, W. (2023). Time to change? Present and prospects of hemorrhoidal classification. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1252468