yes

yes

6551 WK 3 SOAP NOTE: Gynecologic Health ( OB/GYN Issue)

Gynecologic Health

Select a patient that you examined as a nurse practitioner student during the last three weeks of clinical on OB/GYN Issue. With this patient in mind, address the following in a SOAP Note 1 OR 2 PAGES :

Subjective: What details did the patient provide regarding her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters for this patient , as well as a rationale for this treatment and management plan.

Very Important:  Reflection notes: What would you do differently in a similar patient evaluation?

Reference

Gagan, M. J. (2009). The SOAP format enhances communication. Kai Tiaki Nursing New Zealand, 15(5), 15.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.

Chapter 6, “Care of the Well Woman Across the Life Span” ,“Care of the Woman Interested in Barrier Methods of Birth Control” (pp. 275–278)

Chapter 7, “Care of the Woman with Reproductive Health Problems”

“Care of the Woman with Dysmenorrhea” (pp. 366–368)

“Care of the Woman with Premenstrual Symptoms, Syndrome (PMS), or Dysphoric Disorder (PMDD)” (pp. 414–418)

health policy

Referring to this article assume you have the ability to select one major “new” health policy for implementation. Explain why you chose your topic and describe the expected impact on population health within the next five years

 

Barton, M. (2013, November 26). Understanding population health management: A diabetes example. Health Catalyst. Retrieved from https://www.healthcatalyst.com/managing-diabetes-population-health-management.

Decision Tree for Neurological and Musculoskeletal Disorders

case study

BACKGROUND

This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”

SUBJECTIVE

The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!”

The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”

He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it.”

During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation, and is future oriented.

Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)

 

 

To Prepare

  • Review the interactive media piece assigned by your Instructor.
  • Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
  • Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
  • You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

By Day 7 of Week 8

Write a 1- to 2-page summary paper that addresses the following:

  • Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
  • Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
  • What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
  • Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

 

ExcellentGoodFairPoorBriefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Be specific.

18 (18%) – 20 (20%)

The response accurately and thoroughly summarizes in detail the patient case study assigned, including specific and complete details on each of the three decisions made for the patient presented.

16 (16%) – 17 (17%)

The response accurately summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented.

14 (14%) – 15 (15%)

The response inaccurately or vaguely summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented.

0 (0%) – 13 (13%)

The response inaccurately and vaguely summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented, or is missing.

Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.

23 (23%) – 25 (25%)

The response accurately and thoroughly explains in detail how the decisions recommended for the patient case study are supported by the evidence-based literature.The response includes specific and relevant outside reference examples that fully support the explanation provided.

20 (20%) – 22 (22%)

The response accurately explains how the decisions recommended for the patient case study are supported by the evidence-based literature.The response includes relevant outside reference examples that lend support for the explanation provided that are accurate.

18 (18%) – 19 (19%)

The response inaccurately or vaguely explains how the decisions recommended for the patient case study are supported by the evidence-based literature.The response includes inaccurate or vague outside reference examples that may or may not lend support for the explanation provided or are misaligned to the explanation provided.

0 (0%) – 17 (17%)

The response inaccurately and vaguely explains how the decisions recommended for the patient case study are supported by the evidence-based literature, or is missing.The response includes inaccurate and vague outside reference examples that do not lend support for the explanation provided, or is missing.

What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.

18 (18%) – 20 (20%)

The response accurately and thorough explains in detail what they were hoping to achieve with the decisions recommend for the patient case study assigned.The response includes specific and relevant outside reference examples that fully support the explanation provided.

16 (16%) – 17 (17%)

The response accurately explains what they were hoping to achieve with the decisions recommended for the patient case study assigned.The response includes relevant outside reference examples that lend support for the explanation provided that are accurate.

14 (14%) – 15 (15%)

The response inaccurately or vaguely explains what they were hoping to achieve with the decisions recommended for the patient case study assigned.The response includes inaccurate or vague outside reference examples that may or may not lend support for the explanation provided or are misaligned to the explanation provided.

0 (0%) – 13 (13%)

The response inaccurately and vaguely explains what they were hoping to achieve with the decisions recommended for the patient case study assigned, or is missing.The response includes inaccurate and vague outside reference examples that do not lend support for the explanation provided, or is missing.

Explain any difference between what you expected to achieve with each of the decisions and the results of the decisions in the exercise. Describe whether they were different. Be specific and provide examples.

18 (18%) – 20 (20%)

The response accurately and clearly explains in detail any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise.The response provides specific, accurate, and relevant examples that fully support whether there were differences between the decisions made and the decisions available in the exercise.

16 (16%) – 17 (17%)

The response accurately explains any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise.The response provides accurate examples that support whether there were differences between the decisions made and the decisions available in the exercise.

14 (14%) – 15 (15%)

The response inaccurately or vaguely explains any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise.The response provides inaccurate or vague examples that may or may not support whether there were differences between the decisions made and the decisions available in the exercise.

0 (0%) – 13 (13%)

vaguely explains in detail any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise, or is missing.The response provides inaccurate and vague examples that do not support whether there were differences between the decisions made and the decisions available in the exercise, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.

Written Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors

4 (4%) – 4 (4%)

Contains a few (1–2) grammar, spelling, and punctuation errors

3.5 (3.5%) – 3.5 (3.5%)

Contains several (3–4) grammar, spelling, and punctuation errors

0 (0%) – 3 (3%)

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.

5 (5%) – 5 (5%)

Uses correct APA format with

 

Bullying in Nursing

Part 2 of Order #26680 which was completed bt writer 47

In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:

  1. The purpose of the quality improvement initiative.
  2. The target population or audience.
  3. The benefits of the quality improvement initiative.
  4. The interprofessional collaboration that would be required to implement the quality improvement initiative.
  5. The cost or budget justification.
  6. The basis upon which the quality improvement initiative will be evaluated.

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. 

Recommendations For Women Searching for Men

Finding out that you are a woman searching for men, is one of the worst emotions that any kind of woman can experience. After all, what do you do when you have identified the person of your dreams but there are still things that worry you? Let me assist you to by demonstrating what to anticipate if you are a girl seeking males.

The first thing that you’ll notice if you are with a person is that he may always glance at you. This makes you are feeling very good about yourself. You may feel like you have the man of your dreams there in front of you.

If you are which has a man who wants to spend more time with afterward you this is gonna be a sign that he could be a person who is not ready for determination. When males feel like they have to get more out of the relationship than they are willing to give it, they are not ready for commitment. You should not discover this type of guy.

When a man is normally ready for the commitment he may also be prepared to show you several affection and attention. He’ll be happy to listen to whatever you have to say and may even try to make you bust a gut. If you notice that the man only seems to wish to consider proper care of you if you are around, he is ready to be in a relationship. Do not let him have all the attention.

One of the most detrimental parts of men is once they act like they are the most important people within their lives. They will not want to make decisions independent. They will need someone to perform all of the do the job and will simply not be interested in performing much of anything else.

Women are usually ready for determination when they are not competent to meet the needs of their very own men. If they find a person who is interested in these people more than http://csrtt.utb.edu.vn/inside-immediate-plans-of-marrying-a-chinese-woman/ their own needs then they will probably be ready to move forward together with the relationship.

When you have a person who wants to subside with you, then you need to be very careful about how precisely you act around him. You wish to be his better half and not his girlfriend. You want to show him respect and make him feel needed.

The majority of us that not everybody gets to like good things anytime and you may find that you do not obtain as many as you desire. but if you make the right choice you will enjoy everything you do.

One of the first things you need to do is definitely make the proper decisions about where to go just for dates. In case you have a lot of friends from school or do the job, you may go out a lot. But you will want to make sure that you can always be yourself about each other so that you both feel relaxed.

Also you need to make sure that you don’t overdo this on goes. You do not want to turn your boyfriend or perhaps husband off by just currently being so ruthless. You should be relaxing enough to let him be himself.

The best way to start that is to make him a list of facts that you experience doing together and make sure that you are planning for a few nights out together each legitimate mail order bride sites week. This way you are sure to make sure that you will be going out with someone that definitely will not make you unpleasant and will make you feel treasured.

Making the right decision about how to go forwards can help to choose your life less of a challenge eventually. You will never maintain love in case you are generally not in control of that. You will only be in soreness if you let a man to build these choices for yourself.

Literature Review Matrix

To prepare:

This Assignment expands upon the work you have been conducting for this week’s Discussion. For this Assignment (which you will start this week, and submit by the end of Week 7), you will conduct a search for literature on your selected practice problem. A Literature Review Matrix template will be used to identify gaps in the literature.

To prepare:

  • Consider the practice problem you addressed in this week’s Discussion. (You may select a new issue if necessary, but it is not recommended.)
  • Review the guidelines in the Literature Review Matrix, included in the Learning Resources. Formulate a research question around your issue as indicated in Part I. Then complete Part II of the Matrix, identifying the resources you will use, search terms and criteria, and Boolean search strings.
  • Using the Walden Library, locate 10 articles related to your research question. At least one article must be a systematic review. All of the articles should be primary sources. NOTE: If appropriate, you may use the four articles you reviewed for this week’s Discussion. https://academicguides.waldenu.edu/library
  • Review Part III of the Literature Review Matrix and notice which middle range theories were used most frequently in the articles you reviewed.
  • Consider the appropriate use of the theoretical frameworks in each article.
  • Review the information on empiricism presented in Chapter 1 of Theoretical Basis for Nursing and Chapter 6 in The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence as you consider your response to Part IV.
  • Complete Part III of the Literature Review Matrix.
  • In your analysis of the strengths and weaknesses of the existing literature, note the appropriate use of the theoretical frameworks.
  • Complete Part IV addressing the influence of empiricism on quantitative methodology.

Literature Review Matrix

To prepare:

This Assignment expands upon the work you have been conducting for this week’s Discussion. For this Assignment (which you will start this week, and submit by the end of Week 7), you will conduct a search for literature on your selected practice problem. A Literature Review Matrix template will be used to identify gaps in the literature.

To prepare:

  • Consider the practice problem you addressed in this week’s Discussion. (You may select a new issue if necessary, but it is not recommended.)
  • Review the guidelines in the Literature Review Matrix, included in the Learning Resources. Formulate a research question around your issue as indicated in Part I. Then complete Part II of the Matrix, identifying the resources you will use, search terms and criteria, and Boolean search strings.
  • Using the Walden Library, locate 10 articles related to your research question. At least one article must be a systematic review. All of the articles should be primary sources. NOTE: If appropriate, you may use the four articles you reviewed for this week’s Discussion. https://academicguides.waldenu.edu/library
  • Review Part III of the Literature Review Matrix and notice which middle range theories were used most frequently in the articles you reviewed.
  • Consider the appropriate use of the theoretical frameworks in each article.
  • Review the information on empiricism presented in Chapter 1 of Theoretical Basis for Nursing and Chapter 6 in The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence as you consider your response to Part IV.
  • Complete Part III of the Literature Review Matrix.
  • In your analysis of the strengths and weaknesses of the existing literature, note the appropriate use of the theoretical frameworks.
  • Complete Part IV addressing the influence of empiricism on quantitative methodology.

health management

Explain why you chose your topic and describe the expected impact on population health within the next five years

Barton, M. (2013, November 26). Understanding population health management: A diabetes example. Health Catalyst. Retrieved from https://www.healthcatalyst.com/managing-diabetes-population-health-management

geopolitical and phenomenological

Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention. Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population.