40 yo Asia woman comes into the clinic complaining of red rash all down her back but more noted under her bra strap, noted 14 days ago, painful, and used Tylenol with no real relief. Ms. Kim has not been to the doctor for over 2 years, with no insurance in the past. She has a medical card now. Ms. Kim is married, Last menstrual period not sure, maybe 1 month ago, g2 para 2l living 1, no real medical problems, no medications other than women vitamins but can’t afford now, business slow at her restaurant. It is located on the south side of Chicago, and lots of renovations are causing her to lose business. She also stated she couldn’t see out of her peripheral vision. This is a new issue for her too. She stated she sometimes has a blurry vision with headaches. No glasses, no eye exam in years

 

1.List 3 Differential Diagnosis for Ms. Kim’s complaints

2. What system or systems should be addressed with this patient?

3. What other questions need to be asked? If any, what do gravida para and living mean in this case? explain in details

4. What would be the plan for this patient? Please include education, referral, recommendations

5 What guidelines were used to come to the final diagnosis? What is the diagnosis(es)?

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

 

 

 

A 62-year-old female  presents with severe right eye pain, tearing, photophobia, and blurry vision after being kicked in the eye by her 9-year-old niece 2 hours ago while she was helping her niece practice prior to her niece’s  soccer game.  She denies any flashing lights or floaters or mucous drainage from her right eye but she does complain of feeling “like something is in my right eye”. She denies any other pain or discomfort.

Past Medical History:

Hypertension

Type 2 DM

Past Surgical History

Bilateral Cataract surgery 2 years ago.

Cholecystectomy 10 years ago

Social History:Denies alcohol, tobacco, or illicit drug use.

Medications:Hydrochlorothiazide

Allergies:None

ROS:Negative except HPI

 

1.Discuss the specific health history questions you need to ask and why.

2. Discuss the specific physical exam techniques/procedures/imaging/laboratory tests you need to perform

    and why.

3. Identify 3 differential diagnoses supported by evidence-based practice.

4. What is your working definitive diagnosis/assessment and evidenced-based practice rationale?

5. What is your evidence-based treatment/management plan?

 

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

A 38 -year-old morbidly obese Caucasian woman inquires about bariatric surgery, a treatment option for patients with a body-mass index of 40 or more (or 35 or more when there are coexisting medical conditions). Bariatric surgery has been shown to result in substantial weight loss and resolution of associated conditions. A successful clinical outcome requires an experienced multidisciplinary management team and an informed patient who will follow a long-term management plan and self-care plan.

Questions

Please discuss who would be included in the multidisciplinary team.

What are the updated guidelines for bariatric surgery?

Please discuss the various types of bariatric surgeries available.

Discuss cost and insurance coverage

Discuss a minimum of 3 complications related to Bariatric Surgery

Discuss the global approach to obesity includes 2 countries. 

Discuss obesity in your clinical setting( gender, race, age, etc.). How is it addressed, if at all?  As a future APN, what will be your approach? What resources are available?

 

Don’t forget to use a minimum of  3 scholarly references, no later than 2016, and  7th edition APA

 

Thank you

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

A 38 -year-old morbidly obese Caucasian woman inquires about bariatric surgery, a treatment option for patients with a body-mass index of 40 or more (or 35 or more when there are coexisting medical conditions). Bariatric surgery has been shown to result in substantial weight loss and resolution of associated conditions. A successful clinical outcome requires an experienced multidisciplinary management team and an informed patient who will follow a long-term management plan and self-care plan.

Questions

Please discuss who would be included in the multidisciplinary team.

What are the updated guidelines for bariatric surgery?

Please discuss the various types of bariatric surgeries available.

Discuss cost and insurance coverage

Discuss a minimum of 3 complications related to Bariatric Surgery

Discuss the global approach to obesity includes 2 countries. 

Discuss obesity in your clinical setting( gender, race, age, etc.). How is it addressed, if at all?  As a future APN, what will be your approach? What resources are available?

 

Don’t forget to use a minimum of  3 scholarly references, no later than 2016, and  7th edition APA

 

Thank you

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

Mr. Baxter is an 86 year-old gentleman who just returned to the surgical floor after having a left below-the knee amputation.   He is a nonverbal patient with a history of noncompliant diabetes management.   The family is at the bedside, and they have expressed their concern about how his pain will be managed. 

 

 

 

Please answer the following questions regarding the Case Study.

 

1.            Since this patient is non-verbal, how can the nurse recognize symptoms of pain?

2.            What assessments need to be conducted before pain medication is administered, and why?

3.            Vicki administers IV pain medication at 11:00am.  What does Vicki need to do next, and why?

               

               

RUBRIC

 

 

 

Each question is worth 2 points and will be graded with the following rubric.

EXCELLENT = 2 points

ACCEPTABLE = 1 point

POOR = 0 points

Clear, direct & concise. Writing free of grammatical & spelling errors.

Few grammatical and/or spelling errors. Clear & concise writing.

Numerous grammatical and/or spelling errors. Confusing content.

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

Ms. M is 42 years old and has had rheumatoid arthritis for six years. At baseline, her fingers are stiff and show slight ulnar deviation. She has come to see you as she is currently experiencing an exacerbation, and her wrists are red and swollen. She finds it to be painful when something such as clothing touches the skin over her wrists. Her elbows and knees are also stiff and painful, especially after she has been resting. She is feeling extremely tired and depressed and has not been eating well.

Answer questions below in this format:

  1. 1-Describe the pathophysiologic process that leads to the appearance and the pain occurring at her wrists. Is this an acute or chronic process? Could it be both?
  2. 2-Describe the pathophysiology contributing to the stiff, deformed fingers. What terms can be used to describe this?
  3. 3-Explain why some activity relieves the pain and stiffness of rheumatoid arthritis and why the pain tends to be worse with immobility. Is this true for other inflammatory or musculoskeletal conditions?
  4. 4-Describe several factors contributing to Ms. M’s systemic symptoms. Is this an acute or chronic process?
  5. 5-Explain how each of the following medications interact with the pathophysiology of rheumatoid arthritis and help return Ms. M to a more homeostatic state.
    1. NSAIDs
    2. Glucocorticoids
    3. Disease-modifying agents
    4. Biologic agents.
  6. 6-If we didn’t already know that Ms. M had rheumatoid arthritis, what other conditions would be on the differential for this patient? Think about what other conditions can present with erythematous, painful, swollen joints. Identify two such conditions and describe the most common signs and symptoms.
  7. What are some possible long-term effects of chronic inflammation in conditions such as rheumatoid arthritis and other inflammatory conditions?

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

Ms. M is 42 years old and has had rheumatoid arthritis for six years. At baseline, her fingers are stiff and show slight ulnar deviation. She has come to see you as she is currently experiencing an exacerbation, and her wrists are red and swollen. She finds it to be painful when something such as clothing touches the skin over her wrists. Her elbows and knees are also stiff and painful, especially after she has been resting. She is feeling extremely tired and depressed and has not been eating well.

  1. Describe the pathophysiologic process that leads to the appearance and the pain occurring at her wrists. Is this an acute or chronic process? Could it be both?
  2. Describe the pathophysiology contributing to the stiff, deformed fingers. What terms can be used to describe this?
  3. Explain why some activity relieves the pain and stiffness of rheumatoid arthritis and why the pain tends to be worse with immobility. Is this true for other inflammatory or musculoskeletal conditions?
  4. Describe several factors contributing to Ms. M’s systemic symptoms. Is this an acute or chronic process?
  5. Explain how each of the following medications interact with the pathophysiology of rheumatoid arthritis and help return Ms. M to a more homeostatic state.
    1. NSAIDs
    2. Glucocorticoids
    3. Disease-modifying agents
    4. Biologic agents.
  6. If we didn’t already know that Ms. M had rheumatoid arthritis, what other conditions would be on the differential for this patient? Think about what other conditions can present with erythematous, painful, swollen joints. Identify two such conditions and describe the most common signs and symptoms.
  7. What are some possible long-term effects of chronic inflammation in conditions such as rheumatoid arthritis and other inflammatory conditions?

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

Nervous System Concept Outline:   Please follow instructions on the document attached for the concept outline.     APA format for the references.  Use the template.   You can fill in the attached document or any word document  and then upload it when complete.

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

Case Study: Mrs. J.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

  1. Is very anxious and asks whether she is going to die.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is “running away.”
  4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5kg.
  2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
  3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
  5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)
  5. Inhaled short-acting bronchodilator (ProAir HFA)
  6. Inhaled corticosteroid (Flovent HFA)
  7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mrs. J.
  2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
  3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
  4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
  5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
  6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
  7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and 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. An abstract is not required. 

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. Refer to the LopesWrite Technical Support articles for assistance.

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

Patient 3: 15-year-old female, never smoked or used any illicit substances; well supported by her sister and brother, but her parents “don’t understand” her. She lives just a few blocks from school and usually walks. She tells the counselor she just doesn’t feel herself and thinks that “God made a mistake.” The counselor notices that she seems especially thin and is concerned, but the student states that she is “just trying to get her breasts to go away.”

 

  •  
  • Choose one patient scenario
  • Offer three differential diagnoses for what might be troubling your patient.
  • Provide rationale with citations for each of your differential diagnoses.
  • What would be your first course of action for your patient?
  • What safety issues, if any, did you recognize for your patient?
  • Summarize the scenario and what you chose as your final diagnosis for your patient and why.
  • Make sure that you address psychosocial issues/concerns/contributors, along with content related to substance abuse, should this be appropriate.
  • This assignment should take no more than 1–2 pages, not including your title and reference pages.

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

Case Study on Biomedical Ethics in the Christian Narrative

This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.

Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:

Part 1: Chart

This chart will formalize the four principles and four boxes approach and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.

Part 2: Evaluation

This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.

Remember to support your responses with the topic study materials.

APA style is not required, but solid academic writing is expected.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

Attachments PHI-413V-RS-T3T5CaseStudyHealingAndAutonomy.docx PHI-413V-RS-T3ApplyingFourPrinciplesCaseStudy.docx

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.

please see the attached documents 

Get 15% discount on your first order with us
Use the following coupon
FIRST15

Order Now
CategoryUncategorized
Write a comment:

Your email address will not be published.