Malignant Melanoma and Dysplastic Nevi
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Patient Profile
G.L. is a 59-year-old white fair-skinned man who is a
long-distance truck driver. In his leisure time, he
enjoys swimming. He comes to the clinic for evaluation of a changing lesion on his left arm.
Subjective Data
• History of a basal cell carcinoma (BCC) on his left
ear in the last 4 years
• Father treated for metastatic malignant melanoma
in the last 2 years
• First noted the lesion 5 months ago when it started changing size
• Anxious the lesion might have spread and require extensive, disfiguring
surgery
Objective Data
Physical Examination
• Has a 4-mm lesion, dark brown, scalloped with vaguely defined borders
• Four dysplastic nevi found on back
Diagnostic Studies
• Excisional biopsy confirmed malignant melanoma.
• Sentinel node biopsy results were negative.
• Diagnostic tests indicate melanoma stage I.
Discussion Questions
1. What risk factors for malignant melanoma does he have?
2. What are the usual clinical manifestations associated with malignant
melanoma?
3. What is the prognosis for a patient with this stage of malignant melanoma?
4. What treatment options are available for him?
5. How would you help G.L. deal with his anxiety over the treatment
outcomes?
6. Priority Decision: What is the priority of care for G.L.?
7. What would you include in his patient teaching plan to address future
sun exposure?
8. Delegation Decision: Which of the following nursing personnel
should be responsible for teaching G.L.: RN, LPN/LVN, or UAP?
9. Priority Decision: Based on the assessment data presented, what
are the priority nursing diagnoses? Are there any collaborative problems?
10. Evidence-Based Practice: G.L. wants to know whether regularly
applying sunscreen will reduce his risk for developing a second melanoma. How would you reply?
Grading Rubrics
| Critical Elements | Distinguished
(100%) | Proficient
(85%) | Basic
(70%) | Below Expectations
(50%) | Non-Performance
(0%) |
| Thesis Statement | Raises the strongest objection to the thesis presented in the assignment. The objection is strongly grounded in research and logical reasoning. | Raises a plausible objection to the thesis presented in the assignment. The objection is mostly grounded in research and logical reasoning.
| Raises an objection to the thesis presented in the assignment. The objection is somewhat grounded in research and logical reasoning. | Attempts to raise an objection to the thesis presented in the assignment. The objection is minimally grounded in research and logical reasoning.
| The objection to the thesis is either nonexistent or lacks the components described in the assignment instructions. |
| Counter Argument | Provides a strong, thorough rebuttal to the objection. The rebuttal effectively demonstrates that the thesis can withstand the objection and applies the principles of charity and accuracy.
| Provides a rebuttal to the objection. The rebuttal mostly demonstrates that the thesis can withstand the objection and mostly applies the principles of charity and accuracy.
| Provides a limited rebuttal to the objection. The rebuttal somewhat demonstrates that the thesis can withstand the objection and somewhat applies the principles of charity and accuracy.
| Attempts to provide a rebuttal to the objection; however, the rebuttal minimally demonstrates that the thesis can withstand the objection and does not apply the principles of charity and accuracy.
| The rebuttal is either nonexistent or lacks the components described in the assignment instructions. |
| Conclusion | – Provides clear and concise closing remarks that comprehensively summarize the essay. The remarks consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem.
| Provides closing remarks that summarize the essay. The remarks mostly consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem. The closing remarks are somewhat unclear.
| Provides closing remarks that minimally summarizes the essay. The remarks minimally consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problems. The closing remarks are unclear and/or vague.
| Attempts to provide closing remarks that summarize the essay, however, the remarks do not consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem. The closing remarks are unclear and vague. | The closing remarks are either nonexistent or lack the components described in the assignment instructions.
|
| Written Communication: Context of and Purpose for Writing
| Demonstrates methodical application of organization and presentation of content. The purpose of the writing is evident and easy to understand. Summaries, quotes, and/or paraphrases fit naturally into the sentences and paragraphs. Paper flows smoothly.
| Demonstrates sufficient application of organization and presentation of content. The purpose of the writing is, for the most part, clear and easy to understand. There are some problems with the blending of summaries, paraphrases, and quotes. Paper flows somewhat smoothly. | Demonstrates a limited understanding of organization and presentation of content in written work. The purpose of the writing is somewhat evident but may not be integrated throughout the assignment. There are many problems with the blending of summaries, paraphrases, and quotes. Paper does not flow smoothly in all sections.
| Organization and presentation of content are extremely limited. The purpose of the writing is unclear. There is little or no blending of summaries, paraphrases, and quotes. Paper does not flow smoothly when read.
| The assignment is either nonexistent or lacks the components described in the instructions.
|
| Written Communication: Control of Syntax and Mechanics
| – Displays meticulous comprehension and organization of syntax and mechanics, such as spelling and grammar. Written work contains no errors and is very easy to understand.
| Displays comprehension and organization of syntax and mechanics, such as spelling and grammar. Written work contains only a few minor errors and is mostly easy to understand | Displays basic comprehension of syntax and mechanics, such as spelling and grammar. Written work contains a few errors which may slightly distract the reader.
| Fails to display basic comprehension of syntax or mechanics, such as spelling and grammar. Written work contains major errors which distract the reader.
| The assignment is either nonexistent or lacks the components described in the instructions.
|
| Written Communication: Required Formatting
| Accurately uses required formatting consistently throughout the paper, title page, and reference page.
| Exhibits required formatting throughout the paper. However, layout contains a few minor errors. | Exhibits limited knowledge of required formatting throughout the paper. However, layout does not meet all requirements.
| Fails to exhibit basic knowledge of required formatting. There are frequent errors, making the layout difficult to distinguish as required style.
| The assignment is either nonexistent or lacks the components described in the instructions.
|
| Written Communication: Word Requirement
| The length of the paper is equivalent to the required number of words. | The length of the paper is nearly equivalent to the required number of words.
| The length of the paper is equivalent to at least three quarters of the required number of words. | The length of the paper is equivalent to at least one half of the required number of words.
| The assignment is either nonexistent or lacks the components described in the instructions.
|
| Written Communication: Resource Requirement | Uses more than the required number of scholarly sources, providing compelling evidence to support ideas. All sources on the reference page are used and cited correctly within the body of the assignment.
| Uses the required number of scholarly sources to support ideas. All sources on the reference page are used and cited correctly within the body of the assignment.
| Uses less than the required number of sources to support ideas. Some sources may not be scholarly. Most sources on the reference page are used within the body of the assignment. Citations may not be formatted correctly. | Uses an inadequate number of sources that provide little or no support for ideas. Sources used may not be scholarly. Most sources on the reference page are not used within the body of the assignment. Citations are not formatted correctly.
| The assignment is either nonexistent or lacks the components described in the instructions. |
Malignant Melanoma and Dysplastic Nevi Essay
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