D. Saa Critical Care Wk 2 Disc

/in /by

MY NUMBER ASSIGNED WAS 4 WHICH IS: Compare the following types of tidal volume: Pressure versus Volume

Initial post:Each student will be assigned a number randomly.  Whatever your number is, select the corresponding topic below, then post a minimum of 5 bullet points about the topic.Your bullet points should address key components of the topic, such as what, how, who, & why.  This information should not be basic things you learned in Med/Surg, but rather advanced critical care based. Think about this as a group effort to create a study guide. Use ONLY your textbook, but do not cut & paste from the book.Then create, find, or borrow a test style question about your topic & post at the bottom of your bullet points. The format needs to be multiple choice or select all that apply. Think NCLEX style. Each week include a paragraph with the results from one of your weekly interviews.Discussion post assignments are worth 20 points each as follows: 

  • 5 points for the quality of your bullet points.
  • 5 points for the quality of your question.
  • 5 points for answering the question of a peer as your response.
  • 5 points for the quality of your rationale.
    • Quality is defined as thorough and thoughtful while demonstrating professional level knowledge of the topic.

Disease pathophysiology

/in /by

Choose a disease or diagnosis from the following list:

a) Type I Diabetes. b) Type II Diabetes. c) Hypovolemic Shock. d) Cardiogenic Shock

e) Septic Shock. f) Surgical site infection. g) Stage 3 pressure injury. h) Lupus

i) Rheumatoid arthritis. j) Anaphylaxis. k) HIV/AIDS. l) Cancer (any type) 

Required elements:

a) Provide a description, in your own words, of the pathophysiology of the disease

b) Risk factors contributing to the development of the disease

c) Signs and symptoms – with description of why these would be found (a total of 6; be 

sure to include subjective and objective data)

d) Diagnostics – 2 ways the disease may be diagnosed, including a brief description of the significance of the findings

e) Nursing diagnoses – at least 3 relevant nursing diagnoses, properly phrased

f) Treatment – at least 2 medical treatments, including some discussion of how this 

treatment works 

g) Nursing interventions – at least 4 nursing interventions, including some discussion of the goals and outcomes of these interventions

h) References – refer to at least 3 current,  

Judaism

/in /by


Judaism Discussion

After studying 

Module 3: Lecture Materials & Resources
, as well as reviewing the 

Judaism Resources
 page, discuss the following:

In your reading of 
Chapter 10 – Encountering Judaism: The Way of God’s People as well as the other readings for the week, you have gained a better understanding of central themes of Judaism. As you learned more about the religion, you may have noticed the many similarities that Judaism shares with Christianity as the relationship between the two religions rather unique. Christianity is rooted in Judaism historically, scripturally, liturgically, and even theologically. No two major world religions have so much in common. Below are a handful of the common elements shared by these two religions, however it is important to note that even though these religions share several common elements, they articulate them differently. Last week, we expounded upon how some of these themes are understood in the context of Catholicism and now you will describe how they are understood in Judaism.

Select the two themes  below and present the Jewish teaching on the chosen theme.

· Jewish Understanding of God

· Freedom and Free Will


Each selected theme must:

· Each theme must Be explained in at least two paragraphs

· Incorporate at least 2 direct quotations with accompanying in-text citations from either the required weekly readings or a resource found on the “Judaism Resources” page linked below

Wk3soap668B

/in /by

Week 3: Problem-Focused SOAP Note

Criteria Ratings Pts

This criterion is linked to a
Learning Outcomes
(Subjective)

2.5 pts

Accomplished

Symptom analysis is well organized, with C/C,

OLD CART, pertinent negatives, and pertinent

positives. All data needed to support the

diagnosis & differential are present. Is

complete, concise, and relevant with no

extraneous data.

2.5 pts

This criterion is linked to a
Learning Outcome
(Objective)

2.5 pts

Accomplished

Complete, concise, well organized, well

written, and includes pertinent positive and

pertinent negative physical findings. Organized

by body system in list format. No extraneous

data.

2.5 pts

This criterion is linked to a
Learning Outcome A
(Assessment)

2.5 pts

Accomplished

Diagnosis and differential dx are correct,

include ICD code, and are supported by

subjective and objective data.

2.5 pts

This criterion is linked to a
Learning Outcome (Plan)

2.5 pts

Accomplished

The plan is organized, complete and supported

with 2 evidence-based references. Addresses

each diagnosis and is individualized to the

specific patient and includes medication

teaching and all 5 components: (Dx plan, Tx

plan, patient education, referral/follow-up,

health maintenance).

2.5 pts

Total Points: 10

Use the template that I gave you before. The first page needs blank for cover sheet.

Diagnoses is R300; Dysuria. Needs ICD 10 codes for differential dx,

CPT codes for labs and procedures such as UA, Urine culture and sensitivity, physical

examination etc Do not paste and copy all (it needs paraphrasing). Research a lot for

patient education, pertinent positive and pertinent negative, non-pharmacologic

treatment etc. APA 7 format. I can give you five days to complete it.

Patient initial: J. V.

Patient DOB: 1963 Sex: F

SUBJECTIVE:

Chief Complaint:

History Of Present Illness:

-Patient is seen today for flank pain and dysuria

Medical History:

COVID pos 5/7/22

anemia

UTI, pyelonephritis s/p hospitalization w/sepsis

Mx kidney stones

Varicose Veis

Scoliosis

Surgical History:

Lithotripsy 2020

Gynecological History:

G5P5A0

denies h/o abnormal pap or mammo

Family History:

M: dementia, lupus, hypothyroid

F: varicose veins

Social History:

-single

-lives with children

-works as food service worker HMH

-denies tobacco

-denies ETOH

-denies recreational drugs

Smoking Status: Never Smoked

Allergies:

Macrobid; ; Dizziness

Morphine; ;

Current Medications:

Currently not taking medications

Review of System:

Constitutional: #fatigue#

Patients deny weight change, fever, chills, weakness, sleep changes, appetite changes.

Head: Patient denies headache.

Neck: Patient denies abnormal masses, neck stiffness.

Eyes: Patient denies vision loss, blurring, discharge, excessive tearing, dryness.

Ears: Patient denies hearing loss, tinnitus, vertigo, discharge, pain

Nose: Patient denies rhinorrhea, stuffiness, sneezing, itching.

Mouth: Patient denies ulcers, bleeding gums, taste problems.

Throat: Patient denies throat pain, difficulty swallowing,

Cardiovascular: Patient denies chest pain, chest pressure, palpitations, DOE,

orthopnea.

Respiratory: Patient denies shortness of breath, cough, increased sputum, hemoptysis.

Gastrointestinal: Patient denies nausea, vomiting, heartburn, dysphagia, diarrhea,

constipation, melena, abdominal pain, jaundice, hemorrhoids.

Genitourinary: #R flank pain, dysuria, increased frequency#

Patient denies abnormal urgency, hesitancy, incontinence, hematuria, nocturia, stones.

Musculoskeletal: Patient denies arthralgias, joint stiffness, myalgias, muscle weakness,

instability and abnormal range of motion

Integumentary (Skin and/or Breast): Patient denies rash, changes in hair, changes in

nail, pruritus

Neurological: Patient denies headache, syncope, seizures, vertigo, ataxia, diplopia,

tremor, numbness, tingling.

Psychiatric: #insomnia#

Patient denies depression, mood abnormalities, anxiety, memory loss, appetite

changes

Endocrine: Patient denies sensitivity to cold or heat, polyuria, polydipsia.

Hematologic/Lymphatic: Patient denies bleeding, bruising, lymphadenopathy.

GYN: Patient denies abnormal bleeding, changes in menstrual cycle, hot flashes.

OBJECTIVE:

Vital Signs:

Height: 64.50 in

Weight: 139.40 lbs

BMI: 23.56

Blood Pressure: 135/78 mmHg

Temperature: 98.60 F

Pulse: 86 beats/min

Physical Exam:

Constitutional:

WD, WN, Alert, Oriented X3 in NAD. Affect appropriate. Gait normal.

Eye: PERRLA, EOMI, nl conjunctiva

Ear: No pinnea/tragal tenderness. Drums are visualized, no wax in canals

Nose: N1 mucosa. N1 Nasal septal walls and turbinates.

Mouth: N1 bucal mucosa, no lesions noted.

Throat: Clear, no erythema or exudates.

Neck: supple, no masses. No thyromegaly. Trachea is midline. N1 carotid auscultation.

No JVD

Cardiovascular: RRR, N1 S1 and S2, No cardiac murmurs, rubs or gallops.

Lungs: ctab, no wheezes, rhonchi or crackles

Chest/Breasts: 4/12/22: #L breast 3 o clock lumpiness, ttp#

Gastrointestinal (Abdomen): soft, nt, nd, bs(+). No palpable masses.

Genitourinary: #R flank CVAT#

Lymphatic: -No LAN noted

Musculoskeletal: #ttp over medial aspect of L knee with preserved ROM with small

healed 1 x1 cm scar from abrasion#

strength symmetrical and wnl. No muscle weakness or stiffness. No joint effusion

Skin: #callus noted between 4th and 5th metatarsal on L foot#

Normal color and texture.

Extremities: #varicose veins R greater than L#

Warm, no clubbing, cyanosis or edema. N1 DP/PT pulses bilaterally

Neurological/Psychiatric: CN I-XII intact, neurosensory wnl, strength (5/5), (2+) DTR

UE/LE bilaterally

-Judgment and insight intact

Imaging: 9/21/22 arterial u/s neg

ASSESSMENT:

Diagnosis:

ICD-10 Codes:

1)M545; Low back pain

2)R300; Dysuria

3)R946; THYROID ABNORMAL RESULT

4)D649; Anemia, unspecified

5)R5383; Fatigue

PLAN:

Procedures:

1) 99215; Comprehensive

2) 99401; 15 min

3) 99000; Handling of specimen from doctor to lab

4) 81002; Urinalysis/Dip

Orders:

1) 5463; UA complete (lab order)

2) 395; UCX (lab order)

Medications:

Augmentin 500-125 MG Oral Tablet; Take 1 tablet orally every 12 hours; Qty: 14;

Refills: 0

Care Plan:

.

***recurrent UTI, h/o pyelo and sepsis- last UCx 4/12/22 showed 100K E coli resistant to

cipro and levaquin. Pt reports 2 day h/o R flank pain, dysuria, frequency and fatigue.

Tried Macrobid in the past which caused severe dizziness.

-UA 12/23/22 pos for leukocytes

-send out Ucx 12/23/22

-Rx Augmentin 500/125mg bid x7 days, r/b d/w pt

-ER precautions over holiday weekend

-referred to uro given recurrent UTI and high-risk history

***abnormal TSH- noted on labs 4/19/22. TSH 0.266 unsure if ever discuss

-reordered TSH 12/23/22

**fatigue- h/o anemia. pt reports hgb dropped to 9 once, donates blood occasionally. per

pt took iron in the past. no overt bleeding 4/19/22 cbc and irons normal. Pt requesting

again to check

-ordered iron panel, ferritin 12/23/22 per pt request

***elevated B12- 4/19/22 B12 level over 1500

-discuss nv, but will need to stop any supplementation

***L knee pain- fell and landed on L knee. worsen with prolonged standing. Reports she

had same pain on R knee and had steriod injection, which resolved it. On PEX, ttp over

medial aspect of L knee with preserved ROM with small healed 1 x1 cm scar.

-on 8/8/22 spoke to pt regrading her L knee x ray. MRI is recommended given that she

sustained a trauma to her knee and has radiologic findings of possible soft tissue injury.

She is in significant pain, takes Ibuprofen, reports difficulty with ambulation. Pt states

that she tried to make appt with ortho and radiology, but no slots were available anytime

soon.

-Needs MRI. Can either order or she can see ortho and do it with them. I was able to

arrange an appt for her to see Dr Panosyan tomorrow at 1:30.

***varicose veins, bil leg pain- to b/l LEX, R greater than L, chronic. c/o occasional

aching. prolonged standing and walking at work. 9/21/22 arterial duplex neg

-Ordered venous u/s 8/3/22

-referred to vein specialist 4/12/22 and 8/3/23

Plan Notes Continued: .

***Tinea cruris bilaterally – noted on PEX on 10/26/22

-Rx ketoconazole 2% cream top bid x 2wks, r/b, d/w pt

***Callus- Pt reports painful, itchy lesion in between 4th and 5th metatarsal. Works long

hours on her feet. Pt reports she has new shoes and tried OTC counter products with

no relief. Admits to trying her son's salicylic acid acne med on lesion. On PEX, small,

hardened callus is noted.

-Referred to podiatry on 10/26/22

***insomnia- chronic. has failed melatonin and hydroxyzine 50 mg. also took Ambien

5mg prn in past

-cont w/caution

Patient Instructions: .

-Pt has been instructed to take medications as prescribed

-Pt received education on compliance with medications and recommendations

-Pt received counseling regarding Medication Side Effects

-Pt received counseling on following a well-balanced healthy diet with veg, fruit and

fiber.

-Pt was instructed to do CV exercise at least 3-4 times every week for 30 minutes.

-Pt received counseling regarding stress management

PHCM: .

58 yo F:

-annual PEX: done 4/12/22–next due 4/12/23

-annual labs: done 4/19/22 unsure if ever discussed

-cervical CA screening: referred to gyn 4/12/22

-breast CA screening: dx mammo L breast u/s ordered 4/12/22

-colon CA screening: referred to GI 4/12/22

-skin CA screening: referred to derm 4/12/22

Immunizations:

-influenza: fall 2021

-tetanus: unsure, rec 4/12/22

-shingrix: rec 4/12/22

-COVID: Pfizer 5/2021, 6/2021, booster 3/2022

  • Week 3: Problem-Focused SOAP Note

Fibrinolytic agents

/in /by

 

Discussion:

Fibrinolytic agents present the only available pharmacotherapy able to dissolve a thrombus and open occluded vessels.  Despite the worldwide experience with fibrinolytic therapy, there are limitations that must be considered. 

As with all other management strategies for Acute Coronary Syndrome (ACS), contraindications for fibrinolytics in patients diagnosed with an ST-elevated myocardial infarction (STEMI) must be considered.  

Discuss in detail the absolute and relative contraindications for fibrinolytic therapy in STEMI. 

Instructions:

Post your discussion to the Moodle Discussion Forum.  Word limit 500 words.  Reply to at least two other student posts with a reflection of their response.  Please make sure to provide citations and references (in APA, 7th ed. format) for your work.  

SOAP note Epilepsy

/in /by

SOAP note Epilepsy

HERE2

/in /by

Introduction

The health care industry is always striving to improve patient outcomes and attain organizational goals. Nurses can play a critical role in achieving these goals; one way to encourage nurse participation in larger organizational efforts is to create a shared vision and team goals (Mulvale et al., 2016). Participation in interdisciplinary teams can also offer nurses opportunities to share their expertise and leadership skills, fostering a sense of ownership and collegiality.

You are encouraged to complete the Budgeting for Nurses activity before you develop the plan proposal. The activity consists of seven questions that will allow you the opportunity to check your knowledge of budgeting basics and as well as the value of financial resource management. The information gained from completing this formative will promote success with the Interdisciplinary Plan Proposal. Completing this activity also demonstrates your engagement in the course, requires just a few minutes of your time, and is not graded.

Demonstration of Proficiency

· Competency 1: Explain strategies for managing human and financial resources to promote organizational health.

· Explain organizational resources, including a financial budget, needed for the plan to be a success and the impacts on those resources if nothing is done, related to the improvements sought by the plan.

· Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.

· Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific objective related to improving patient or organizational outcomes.

· Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.

· Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.

· Explain a change theory and a leadership strategy, supported by relevant evidence, that are most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.

· Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

· Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Reference

Mulvale, G., Embrett, M., & Shaghayegh, D. R. (2016). 'Gearing up' to improve interprofessional collaboration in primary care: A systematic review and conceptual framework. 
BMC Family Practice, 
17.

Professional Context

This assessment will allow you to describe a plan proposal that includes an analysis of best practices of interprofessional collaboration, change theory, leadership strategies, and organizational resources with a financial budget that can be used to solve the problem identified through the interview you conducted in the prior assessment.

Scenario

Having reviewed the information gleaned from your professional interview and identified the issue, you will determine and present an objective for an interdisciplinary intervention to address the issue.

Note: You will not be expected to implement the plan during this course. However, the plan should be evidence-based and realistic within the context of the issue and your interviewee's organization.

Instructions

For this assessment, use the context of the organization where you conducted your interview to develop a viable plan for an interdisciplinary team to address the issue you identified. Define a specific patient or organizational outcome or objective based on the information gathered in your interview.

The goal of this assessment is to clearly lay out the improvement objective for your planned interdisciplinary intervention of the issue you identified. Additionally, be sure to further build on the leadership, change, and collaboration research you completed in the previous assessment. Look for specific, real-world ways in which those strategies and best practices could be applied to encourage buy-in for the plan or facilitate the implementation of the plan for the best possible outcome.

Using the 
Interdisciplinary Plan Proposal Template [DOCX]
 Download Interdisciplinary Plan Proposal Template [DOCX]will help you stay organized and concise. As you complete each section of the template, make sure you apply APA format to in-text citations for the evidence and best practices that inform your plan, as well as the reference list at the end.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

· Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes.

· Explain a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.

· Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.

· Explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if the improvements described in the plan are not made.

· Communicate the interdisciplinary plan, with writing that is clear, logically organized, and professional, with correct grammar and spelling, using current APA style.

Additional Requirements

·
Length of submission: Use the provided template. Remember that part of this assessment is to make the plan easy to understand and use, so it is critical that you are clear and concise. Most submissions will be 2–4 pages in length. Be sure to include a reference page at the end of the plan.

·
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.

·
APA formatting: Make sure that in-text citations and reference list follow current APA style.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The 
Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

discussion post

/in /by

Evaluate the potential complications and long-term effects associated with thermal injuries and burns, such as wound infections, contractures, hypertrophic scarring, and psychological distress. How can nurse practitioners recognize and manage these complications to optimize patient outcomes and facilitate physical and emotional recovery?

Team Poster of Evidence-Based Practice Project

/in /by

 choose a research question, review the relevant literature, examine the question’s potential significance to nursing, and pragmatically examine the feasibility of studying the research question. Draft a PICOT Question. Review Chapter 2 for more information. 

SOAP NOTE

/in /by

 

This Soap Note Case Study it shoudl be in  (iron deficiency anemia diseases)