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The purpose of this paper is to address the following clinical scenario with the use of your textbook, external credible literature, and/or reliable electronic sources. Use the guide below to draft your paper and review the rubric to ensure you have met the assignment criteria. The expected length of the paper is 4-5 pages, which does not include the cover page and reference page(s).

James Alvarez is a 52 y.o., recently divorced, Latino male; new patient who arrives at the community health clinic for an appointment with a primary care Nurse Practitioner. His chief complaint of abdominal pain and vomiting, fatigue, and weight loss. He notes that although he has experienced overall weight loss, his stomach “looks huge.” As his history is taken, he notes no alcohol use.  In speaking with him, the Nurse Practitioner notices a yellow tinge to the whites of his eyes. During examination, the Nurse Practitioner notes organomegaly in the right upper quadrant. 

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Please use the following headings/subheadings as a guide to draft your paper:

1. Introduction (including purpose statement)

2. What would be your priority diagnosis for Mr. Alvarez? 

3. Identify the organ and describe the pathophysiological processes, which may have caused the organomegaly.

4. Develop a comprehensive and holistic plan of care for this patient based on James’ diagnosis.

5. Conclusion

1. Within your description, place in bold font the key pathophysiological concepts (terms).

1. Include recommendations for follow-up with the Nurse Practitioner.

2. Incorporate a population-based component to Mr. Alvarez’ plan of care.

In regard to APA format, please use the following as a guide:

· Include a cover page and running head (this is not part of the 4–5-page limit)

· Include transitions in your paper (i.e., headings or subheadings)

· Use in-text references throughout the paper

· Use double space, 12-point Times New Roman font

· Spelling, grammar, and organization are appropriate

· Include a reference list (this is not part of the 4–5-page limit)

· Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. ANA)

Competency20 Points12 Points6 Points0 PointsPoints Earned
Nursing Application and Analysis of Content with Connection to  Expert Nurse Level Knowledge BaseEstablishes very high level of nursing knowledge application and analysis to assignment that equates to the expert practice nurse knowledge base.Briefly describes application to nursing knowledge or that knowledge is not of an expert nurse but more than a novice nurse base knowledge.Level of nursing knowledge is of a novice nurse with little application or support to expert nurse practice.Does not include established nursing knowledge base and/or does not apply this to current clinical practice./20
Teaching ConsiderationsEvidence of intentional inclusion of patient and family teaching considerations which is sensitive to diversity, demographics and education level as necessary for the assignment. These are well supported in the literature and demonstrate clear positive impact on compliance with  excellent patient outcomes.Moderate attempt to demonstrate patient and family inclusion in teaching approaches.  Some consideration given to sensitive factors which would positively impact patient receptivity and implementation for impact on patient outcomes.Little demonstration of awareness and inclusion of patient and family sensitive teaching considerations. Impact on outcomes is not clearly addressed but can be inferred.No attempt to demonstrate sensitive approach to patient and family teaching considerations. Impact on outcomes is not addressed./20
Critical thinkingPathophysiology content and integration with current best practice standards (supported by the scholarly literature) are used to construct critical examination and application of concepts and content.Connection between pathophysiology knowledge and current best practices is stated but now well supported with scholarly sources and/or weakly used to construct examination and application of concepts and constructs.Integration of pathophysiology and current best practice standards are anecdotal and not supported by the literature or are outdated based on current best practice standards. Little attempt to apply knowledge in examination and application to concepts and constructs.No attempt to integrate pathophysiology and current best practice standards in examination and application to constructs and concepts with no support from relevant, scholarly literature./20
Scholarly, evidence based, current standards of practice, Sources: 3-5+Current, relevant and authoritative scholarly sources are used to support content. Demonstrates current, evidence-based standards of practice. Minimum of 3-5+ sources.Moderate inclusion of current, relevant and authoritative scholarly sources are used to support content. Demonstrates occasional current, evidence-based standards of practice.Little attempt to include current, relevant and authoritative scholarly sources are used to support content. Or, information is purely anecdotal or not  current, evidence-based practice knowledge.No attempt to use current, relevant and authoritative scholarly sources to support content. Does not demonstrate current, evidence-based standards of practice./20
Competency5 Points3 Points1 Point0 PointPoints Earned
OrganizationOrganization excellent, ideas clear and arranged logically, transitions smooth, no flaws in logic.Organization good; ideas usually clear and arranged in acceptable sequence; transitions usually smoot

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