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  • With regard to the Episodic note case study provided:
    • Review this week’s Learning Resources, and consider the insights they provide about the case study.
    • Consider what history would be necessary to collect from the patient in the case study.
    • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
    • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. Nursing homework help

The Assignment

  1. Analyze the subjective portion of the note. List additional information that should be included in the documentation.
  2. Analyze the objective portion of the note. List additional information that should be included in the documentation.
  3. Is the assessment supported by the subjective and objective information? Why or why not?
  4. What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
  5. Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. Nursing homework help

 

 

 

 

 

 

 

 

In this Assessment, you will analyze an Episodic Note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. Just add in what you want to this case to make it unique to you. Do not use NA or normal.

ABDOMINAL ASSESSMENT

Subjective:

 

  • CC: “My stomach hurts, I have diarrhea and nothing seems to help.” Nursing homework help

 

  • HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.

 

  • PMH: HTN, Diabetes, hx of GI bleed 4 years ago

 

  • Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs

 

  • Allergies: NKDA

 

  • FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD

 

  • Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

 

Objective:

 

  • VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs

 

  • Heart: RRR, no murmurs

 

  • Lungs: CTA, chest wall symmetrical

 

  • Skin: Intact without lesions, no urticaria

 

  • Abd: soft, hyperactive bowel sounds, pos pain in the LLQ

 

  • Diagnostics: ?

 

Assessment:

  • Left lower quadrant pain

 

  • Gastroenteritis

PLAN:

Name: Tina Jones

Section:

 

Week 4                

Shadow Health Digital Clinical Experience Health History Documentation

 

SUBJECTIVE DATA: Include what the patient tells you, but organize the information.

 

Chief Complaint (CC):

History of Present Illness (HPI):

Medications:

Allergies:

Past Medical History (PMH):

Past Surgical History (PSH):

Sexual/Reproductive History:

Personal/Social History:

Immunization History:

Health Maintenance:

Significant Family History (Include history of parents, maternal/paternal Grandparents, siblings, and children):

 

Review of Systems: From head-to-toe, include each system that covers the Chief Complaint, History of Present Illness, and History).Remember that the information you include in this section is based on what the patient tells you. To ensure that you include all essentials in your case, refer to Chapter 2 of the Sullivan text.

 

General: Include any recent weight changes, weakness, fatigue, or fever, but do not restate HPI data here.

                HEENT:

Neck:

                Breasts:

                Respiratory:

                Cardiovascular/Peripheral Vascular:

                Gastrointestinal:

                Genitourinary:

                Musculoskeletal:

                Psychiatric:

                Neurological:

                Skin:

                Hematologic:

                Endocrine:

 

Nursing homework help

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Nursing homework help

Diversity: Module 3..

Textbook:

Andrews, M. M., Boyle, J. S., & Collins, J.W., (2020). Transcultural concepts in nursing care (8th ed.). Wolters Kluwer/LWW. Nursing homework help

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  • Chapters 7 and 8

Ackley, B.J., Ludwig, G.B,,  Flynn Makic, M.B., Martinez-Ktatz, M., &Zanotti, M.  (2020). Nursing process, clinical reasoning, nursing diagnosis, and evidence-based nursing. In Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care (12th ed.). Mosby.

  • Pages 1-15

Click here to download the article

You can read pages 1 – 15 at the following url: (no option to print and save). Click on “Look Inside Nursing homework help

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Journal Articles:

Marcelin, J.R., Siraj, D.S., Victor, R., Kotadia, S., & Maldonado, Y.A.   (2019). The impact of unconscious bias in healthcare: How to recognize and mitigate it. The Journal of Infectious Diseases, 220(2), S62-S73. https://doi.org/10.1093/infdis/jiz214

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Click here to download the article.

..

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Narayan, M.C. (2018). How to provide “Culturally Competent Care”. Home Healthcare Now,

36(1), 60. https://doi.org/10.1097/NHH.0000000000000639

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Click here to download the article

Diversity/Module3

Journal Article:

Narayan, M.C. (2018). How to provide “Culturally Competent Care”. Home Healthcare Now, 36(1). DOI:10.1097/NHH.0000000000000639

Click here to download the article.

Guiding Questions: 

Use the questions below to help focus your attention on your reading assignments.

  1. How does culture influence adult development?
  1. What are the influences of culture on caregiving in the African American culture?
  1. How does gender and specific religious beliefs and practices influence health and illness during crisis or transitions?
  1. How does socioeconomic factors, including income level, influence the interactions of older adults?
  1. What nursing interventions are based on the patients’ cultural values and individual preferences?
  1. What is the importance of cultural values, beliefs and practices related to mental health nursing care?
  1. How do you make a nursing diagnosis and directions on how to plan nursing care?  Nursing homework help

 

Nursing Diagnosis Website

https://nurseslabs.com/nursing-diagnosis/#h-problem-focused-nursing-diagnosis

Diversity/ Module 3 DB

Overview

For this discussion, first, read chapter 7 in your textbook, Transcultural Concepts in Nursing Care.

Use the Critical Thinking Activity #5 on page 234 in your textbook to respond to the following questions:

  1. Explain the difference between gang membership in El Salvador and the United States.
  1. What are the cultural factors that are important to consider when you are planning nursing care for a patient like Jose?
  1. For an example, how do you view body tattoos?
  1. What are the issues related to political asylum, immigration, and the like?
  1. How would you assist Jose to meet his developmental needs?
  1. What might be the problems he will encounter in the U.S. society?
  1. What might be the problems he will encounter in the U.S. healthcare system?

Points: 30

Due Dates:

  • Initial Post: Fri, April 8 by 11:59 p.m. Eastern Standard Time (EST) of the US.
  • Response Post: Sun, April 10 by 11:59 p.m. Eastern Standard Time (EST) of the US – (the response posts cannot be done on the same day as the initial post).

References:

  • Initial Post: Minimum of two (2) total references: one (1) from required course materials and one (1) from peer-reviewed references.
  • Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

  • Initial Post: Minimum 200 words excluding references (approximately one (1) page)
  • Response posts: Minimum 100 words excluding references.

 

Note: Since it is difficult to edit the APA reference in the Blackboard discussion area, you can copy and paste APA references from your Word document to the Blackboard discussion area.  Points will not be deducted because of format changes in spacing.

 

Instructions

To be successful, complete the following steps in order:

STEP 1. Review the overview.

STEP 2. Click here to download the rubric.

STEP 3. Create a new Word document, type your initial post.

STEP 4. Copy the initial post from the Word document.

STEP 5. Click on “DISCUSSIONS” section located on the left-hand side of your screen in Blackboard.

STEP 6. Post in the discussion forum titled “M3 A5 DB: BIAS AND STEREOTYPING”

 

Got questions? Please post them to the ‘QUESTION & ANSWER FORUM’ in Blackboard. Nursing homework help

 

Nursing homework help

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Nursing homework help

As you will learn throughout the program, the diagnosis of a variety of psychiatric illnesses is not always an easy or straightforward process. Multiple observations and assessment methods are often employed to reach a diagnosis. This approach can include the use of standardized assessment instruments.  This then aids you in defining a treatment plan and choosing specific treatment plans to use in the care of your clients.  Nursing homework help

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You are tasked with identifying a standardized assessment instrument/tool to measure the disorders listed for each week. You will keep these instruments in the form of a “portfolio” that you can use in your clinical practice to assess clients who present with a variety of symptoms.

Instructions:

Instrument/ Tool criteria:

For each assessment, you are tasked with selecting, you will identify an instrument and:

  1. List what DSM diagnosis the tool/instrument is used for.
  2. Identify an assessment/diagnosis instrument.
  3. Appraise a scholarly, peer-reviewed article that addresses the use of the instrument to support your choice as an evidence-based instrument for practice.
  4. Evaluate the instrument’s appropriateness for diagnosing the condition it is designed to assess or if the developers of the instrument reported that the instrument is only part of a comprehensive assessment for the disorder.
  5. Describe whether or not the instrument can be used to measure patient response to therapy/treatment or if it is strictly for assessment and diagnosis.
  6. Discuss the psychometrics/scoring of the instrument, including reliability and validity.
  7. Discuss any limitations associated with the use of the instrument.
  8. Include a link to view the assessment if possible.

Student Example Anxiety and Related Disorders

Week 7

 

Instrument: Social Phobia Inventory (SPIN)

 

Article: Psychometric properties of the Social Phobia Inventory

 

Appropriateness for Dx: This tool is meant for screening of individuals with social phobia and assignment of a severity score (Connor et al., 2000). The tool was created in congruence with DSM-4 but is consistent with the DSM-5 diagnosis of social anxiety disorder, minus some minor changes (Substance Abuse and Mental Health Service Administration [SAMHSA], 2016). Although the study is outdated, Duke University School of Medicine (2020) acknowledges that the tool is still relevant and utilized by their Anxiety and Traumatic Stress Program. Nursing homework help

 

Response to Therapy/Treatment: The SPIN is appropriate for testing treatment response and through studies has proven sensitive to symptom changes over time. Changes in scores are able to determine treatment efficiency (Connor et al., 2000).

 

Psychometrics: The tool is self-administered and consists of 17 separate statements regarding problems a patient may exhibit if they have social phobia. The statement is then rated on how much it has bothered the individual in the last week, from ‘not at all’ (0) to ‘extremely’ (4). Any score over 21 is considered clinically significant. In the study, the assessment tool was able to effectively separate individuals with and without social phobia. Validity is strong in regard to detecting the severity of illness and is sensitive to symptom reductions during treatment. The scale shows significant correlation with the Liebowitz Social Anxiety Scale Test, The Brief Social Phobia Scale and The Fear Questionnaire social phobia subscale (Connor et al., 2000).

 

Limitations: Limitations exist in the tool’s alignment with DSM-4 instead of the more recent edition, although differences are very minor (SAMHSA, 2016). With a cutoff score of 19, sensitivity and specificity were good, but some individuals consider the cutoff score to be 15, in which these measures are weaker (Connor et al., 2000). Nursing homework help

 

References

 

Connor, K., Davidson, J., Churchill, E., Sherwood, A., Foa, E., & Wisler, R. (2000).

Psychometric properties of the Social Phobia Inventory. British Journal of Psychiatry, 176, 379-386.

 

Nursing homework help

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Nursing homework help

Assignment

 

(Note from me: you have already help with the main part of the assignment. The part that I want you to work on now is to help me responds to two post from to different colleagues. I have attached their post so read it and give a respond to their post. Just a page or less will be fine as long as it meets the discussion) Nursing homework help

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COVID19 is our first Pandemic of the century.  This lethal global pandemic has led to health, societal, individual, familial, and economic changes.  Using the surveillance tools available on this ever-changing pandemic, track how this pandemic has changed within a state or country since the start of the pandemic.  Compare it to another state or country.  Grade  (A-F) the response and explain your answer with evidence. Post your answer to the discussion board Nursing homework help

 

  • Respond to at least (2) of your colleague’s postings over the course of the week to continue the dialogue.

 

 

 

 

 

 

 

 

 

DISCUSSION POSTER 1

 

I decided to compare COVID-19 data between the United States and Kazakhstan. According to Johns Hopkins University & Medicine (2022), Kazakhstan has 1,393,904 confirmed cases; 19,012 deaths; and 9,168,000 of its people fully vaccinated, which is approximately 49.52% of the population. Over the past month, there have been 2,091 new cases reported and 45 new deaths as a result of the virus (Johns Hopkins University & Medicine, 2022). In the United States, there are 80,155,397 confirmed cases; 982,565 deaths, and 66.38% of the population fully vaccinated (Johns Hopkins University & Medicine, 2022). Over the past month, there have been 902,685 new cases and 25,980 new deaths recorded (Johns Hopkins University & Medicine, 2022).

I think it is difficult to compare these two countries due to population differences. With a population of approximately 329.5 million in the U.S. and 18.75 million in Kazakhstan (Data Commons, 2020), I think there are many factors that could have affected COVID-19 responses by both of these countries. If I had to “grade” Kazakhstan’s response to the pandemic, I would give them a B. I think it is actually impressive that 49.52% of the population is vaccinated. Although Kazakhstan is a large country, majority of it is rural and the population is largely dispersed throughout its region. Geographically, there are a lot of transit opportunities between shared borders, which include both Russia and China, which is why I also think it is impressive that the number of new cases over the last month is not as high as I would otherwise expect it to be. I do think more of the population could be vaccinated, but I do not think access to vaccines are as readily available as they are in the United States.

I would grade the U.S.’s response to the pandemic as a C+. I think the response was heavily delayed initially, lots of information had to be pieced together and it was unclear whether or not the information was withheld or simply unknown given the circumstances; however, I do think more of the population can and should be vaccinated. I think for the majority, there are many opportunities for individuals to get vaccinated and even boosted, however, we are still seeing a good portion of the population protesting against vaccines and ignoring vital statistical data. I think I may be biased because I lived here and wish we could have led by example in this situation, but we are constantly battling other challenges as a society on top of this pandemic, which I why I think it is difficult to judge the overall response. There are just so many factors at play.  Nursing homework help

References

Data Commons. (2020). United States of America. Data Commons Place Explorer. https://datacommons.org/place/country/USA?utm_medium=explore&mprop=count&popt=Person&hl=en

Data Commons. (2020). Kazakhstan. Data Commons Place Explorer. https://datacommons.org/place/country/KAZ?utm_medium=explore&mprop=count&popt=Person&hl=en

John’s Hopkins University & Medicine. (2022). Kazakhstan. Coronavirus Resource Center. https://coronavirus.jhu.edu/region/kazakhstan

John’s Hopkins University & Medicine. (2022). United States. Coronavirus Resource Center. https://coronavirus.jhu.edu/region/united-sta

 

 

 

 

DISCUSSION POSTER 2

 

COVID-19 is a pandemic that will linger across countries for many years. It has had a generational impact on child development, mental health, healthcare, and community settings alike. It will take years to recover across the globe, and we can only hope moving forward, that in the future we are better equipped to handle such a treacherous pandemic. Comparing Italy to the United States, they are actually quite similar. The Italian prime minister was ridiculed for not taking the pandemic seriously. For instance, a state of emergency was declared January of 2020, yet allowed the normalcy of life to continue. That was a misconception that unfortunately cost countless lives. As February came about, it became clear that COVID-19 was not contained and red zone regulations were implemented within eleven cities. A failed tactic that shortly lead to a country wide lockdown. By March, it was chaos, yet they had finally secured mask mandates, travel restrictions, and physical distancing in times of essential travel. Information was scant and people yearned for knowledge on the spread, cases, hospitalization, and mortality rate within their cities.

 

Fulfilling the need for more information, Italian researchers collaborated and created, an interactive web tool to help citizens stay in the know. Italy has a universal health system interwoven between state and government officials. Healthcare workers were deemed the most likely to spread COVID-19 due to a lack of PPE. A crisis call sent out requesting help to address unsafe working conditions for doctors, nurses, and medics was met with complete silence. No grants. No funding. No help. To date, Italy continues to struggle with COVID. Statista is another tool that shows up to date positive cases within the Italian population. As of today there remains 1.2 million positive cases, with 487 individuals in the ICU and 9.5 thousand hospitalized. I give Italy a D for not taking it more seriously, not implementing lockdown precautions sooner for the safety of their communities, and failing to act in appropriate crisis management to equip healthcare workers with adequate PPE. They have yet to utilize survelliance tools to identify the ongoig spread and strategies to reduce it. By not addressing the lack of PPE they have only allowed COVID to remain fluent.  Nursing homework help

 

The U.S mimicked Italy at a much slower rate. From January until March of 2020 it was pure chaos. Not much information was known and dread gripped communities. It was not until March that all states began declaring a state of emergency allowing governors to execute policies such as: the closure of non-essential businesses, the introduction of mask mandates for all individuals, and school closures. (Bergquist et al,. 2020). Something that was done differently, was reduce the incarcerated population, execute no visitors policies in health care related facilities, and mandatory symptom monitoring. Similar to Italy, the United States had a travel policy for essential workers to flatten the curve and slow the spread. Financially, the U.S had a crisis management plan that allowed for distribution of money and allocated resources to the socioeconomic struggling families. A few examples being, the Coronavirus Preparedness and Response Supplemental Appropriations Act, Coronavirus Aid, Relief and Economic Security (CARES) Act,and Paycheck Protection Program to protect small businesses. At one point, it aided in making mortgage or rent payments. We also had accessibility to technology to, fast track testing strategies and generate a vaccine. Early on in the pandemic tracking apps helped mitigate exposure and positive cases.

 

Healthcare shifted slightly as telemedicine became more available to treat simple ailments and those with COVID were referred to the hospital for additional evaluation and treatment. The American healthcare system maintained PPE to the best of its ability, unlike Italy. We also had overwhelmed hospitals, ICU beds, and increased fatalities. I feel The United States got lucky in managing COVID-19. With a non-universal healthcare system, grants, and statewide influence from governors, COVID-19 was a trial by error scenario that after two years appeared to have been done well. I would give us a C. The reason being, the guidelines frequently shifted and with news outlets increasing confusion there needed to be better surveillance tools. Italy did not have enough and we had too many unofficial data tools reporting false or inaccurate epidemiological information. Also, in the future it truly needs to not be political. I feel it could have been managed much more efficiently had it been uninvolved in politics. Something I feel elongated the ability to find resolution.

 

Bergquist, S., Otten, T., &Sarich, N. (2020). COVID-19 pandemic in the United States. Health policy and technology, 9(4), 623–638. https://doi.org/10.1016/j.hlpt.2020.08.007

Covid‐19 in Italy: Modelling, communications, and collaborations. (2022). Significance, 19(2), 19–21. https://doi.org/10.1111/1740-9713.01629

Ortenzi, F., Albanese, E., &Fadda, M. (2020). A Transdisciplinary Analysis of COVID-19 in Italy: The Most Affected Country in Europe. International journal of environmental research and public health, 17(24), 9488. https://doi.org/10.3390/ijerph17249488