Shool requirements:

Turn it in Score must be less than 50%, must be your own work and in your own words,APA format, 

 Copy paste from websites or textbooks will not be accepted or tolerated. 

Please see College Handbook with reference to Academic Misconduct Statement.

Pick any Chronic Disease from Weeks 6-10: you can pick any of this condition,but have to be chonic not acute, cistic fibrosis,influenza,pleural effsuin,pulmonary embolism,tubercolosis,celiac disease,cirrhosis,divertiulitis,hepatitis encephalopathy,,hepatitis,pancreatic cancer,bladder cancer,prostate cancer,bph,prostatitis,cushing disease,addison disease,myasthemia gravis,priapis.ANY OF THAT CONDITIONS,JUST ONE,BUT CHONIC.

Sample:

SOAP NOTE SAMPLE FORMAT FOR MRC 

Name:  LP Date: Time: 1315   Age: 30 Sex: F SUBJECTIVE CC:   “I am having vaginal itching and pain in my lower abdomen.”  HPI:   Pt is a 30y/o AA female, who is a new patient that has recently moved to Miami.  She seeks treatment today after unsuccessful self-treatment of vaginal itching, burning upon urination, and lower abdominal pain.  She is concerned for the presence of a vaginal or bladder infection, or an STD.  Pt denies fever.  She reports the itching and burning with urination has been present for 3 weeks, and the abdominal pain has been intermittent since months ago.  Pt has tried OTC products for the itching, including Monistat and Vagisil.  She denies any other urinary symptoms, including urgency or frequency.  She describes the abdominal pain as either sharp or dull.  The pain level goes as high as 8 out of 10 at times.  200mg of PO Advil PRN reduces the pain to a 7/10.  Pt denies any aggravating factors for the pain.  Pt reports that she did start her menstrual cycle this morning, but denies any other discharge other that light bleeding beginning today.  Pt denies douching or the use of any vaginal irritants.  She reports that she is in a stable sexual relationship, and denies any new sexual partners in the last 90 days.  She denies any recent or historic known exposure to STDs.  She reports the use of condoms with every coital experience, as well as this being her only form of contraceptive.  She reports normal monthly menstrual cycles that last 3-4 days.  She reports dysmenorrhea, which she also takes Advil for.  She reports her last PAP smear was in 7/2016, was normal, and reports never having an abnormal PAP smear result.  Pt denies any hx of pregnancies.  Other medical hx includes GERD.  She reports that she has an Rx for Protonix, but she does not take it every day.  Her family hx includes the presence of DM and HTN.                 

Current Medications:  Protonix 40mg PO Daily for GERD MTV OTC PO Daily Advil 200mg OTC PO PRN for pain   

PMHx: Allergies:    NKA & NKDA 

Medication Intolerances:   Denies Chronic Illnesses/Major traumas  GERD Hospitalizations/Surgeries : Denies   

Family History :Father- DM & HTN; Mother- HTN; Older sister- DM & HTN; Maternal and paternal grandparents without known medical issues; 1 brother and 3 other sisters without known medical issues; No children.   

Social History:Lives alone.  Currently in a stable sexual relationship with one man.  Works for DEFACS.  Reports occasional alcohol use, but denies tobacco or illicit drug use.   

ROS General:  Denies weight change, fatigue, fever, night sweats Cardiovascular Denies chest pain and edema. Reports rare palpitations that are relieved by drinking water   

Skin:Denies any wounds, rashes, bruising, bleeding or skin discolorations, any changes in lesions  

Respiratory Denies cough. Reports dyspnea that accompanies the rare palpitations and is also relieved by drinking water   

Eyes Denies corrective lenses, blurring, visual changes of any kind  Gastrointestinal Abdominal pain (see HPI) and Hx of GERD.  Denies N/V/D, constipation, appetite changes   

Ears Denies Ear pain, hearing loss, ringing in ears  

Genitourinary/Gynecological Reports burning with urination, but denies frequency or urgency.  Contraceptive and STD prevention includes condoms with every coital event.  Current stable sexual relationship with one man.  Denies known historic or recent STD exposure. Last PAP was 7/2016 and normal. Regular monthly menstrual cycle lasting 3-4 days.    Nose/Mouth/Throat Denies sinus problems, dysphagia, nose bleeds or discharge  

Musculoskeletal Denies back pain, joint swelling, stiffness or pain 

Breast Denies SBE

Neurological Denies syncope, seizures, paralysis, weakness Heme/Lymph/Endo Denies bruising, night sweats, swollen glands

Psychiatric Denies depression, anxiety, sleeping difficulties 

OBJECTIVE Weight   140lb      Temp -97.7 BP 123/82 Height  5’4” Pulse 74

Respiration: 18 General Appearance Healthy appearing adult female in no acute distress. Alert and oriented; 

answers questions appropriately.  

Skin Skin is normal color for ethnicity, warm, dry, clean and intact. No rashes or lesions noted. HEENT Head is norm cephalic, hair evenly distributed. Neck: Supple. Full ROM. Teeth are in good repair. Cardiovascular S1, S2 with regular rate and rhythm. No extra heart sounds.  Respiratory Symmetric chest walls. Respirations regular and easy; lungs clear to auscultation bilaterally. Gastrointestinal Abdomen flat; BS active in all 4 quadrants. Abdomen soft, suprapubic tender. No hepatosplenomegaly.    Genitourinary Suprapubic tenderness noted.  Skin color normal for ethnicity.  Irritation noted at labia majora, minora, and perineum. No ulcerated lesions noted. Lymph nodes not palpable.  Vagina pink and moist without lesions.  Discharge minimal, thick, dark red, no odor.  Cervix pink without lesions. No CMT. Uterus normal size, shape, and consistency.         Musculoskeletal Full ROM seen in all 4 extremities as patient moved about the exam room. Neurological  Speech clear. Good tone. Posture erect. Balance stable; gait normal. Psychiatric Alert and oriented. Dressed in clean clothes. Maintains eye contact. Answers questions appropriately. 

Lab Tests Urinalysis – blood noted (pt. on menstrual period), but results negative for infection Urine culture testing unavailable Wet prep – inconclusive  STD testing pending for gonorrhea, chlamydia, syphilis, HIV, HSV 1 & 2, Hep B & C    Special Tests- No ordered at this time.    

Diagnosis   Differential Diagnoses :

1-Bacterial Vaginosis (N76.0) o

2- Malignant neoplasm of female genital organ, unspecified. (C57.9) 

3-Gonococcal infection, unspecified. (A54.9) Diagnosis o Urinary tract infection, site not specified. (N39.0) Candidiasis of vulva and vagina. (B37.3) secondary to presenting symptoms (Colgan & Williams, 2011) & (Hainer & Gibson, 2011).   Plan/Therapeutics •

Plan:   o Medication : Terconazole cream 1 vaginal application QHS for 7 days for Vulvovaginal Candidiasis;   Sulfamethoxazole/TMP DS 1 tablet PO twice daily for 3 days for UTI (Woo & Wynne, 2012) o Education –  Medications prescribed:UTI and Candidiasis symptoms, causes, risks, treatment, prevention. Reasons to seek emergent care, including N/V, fever, or back pain.    STD risks and preventions.   Ulcer prevention, including taking Protonix as prescribed, not exceeding the recommended dose limit of NSAIDs, and not taking NSAIDs on an empty stomach.   o Follow-up –   Pt will be contacted with results of STD studies.    Return to clinic when finished the period for perform pap-smear or if symptoms do not resolve with prescribed TX.     

                         References 

Colgan, R. & Williams, M. (2011). Diagnosis and Treatment of Acute Uncomplicated Cystitis. American Family Physician, 84(7), 771-776. Hainer, B. & Gibson, M. (2011). Vaginitis: Diagnosis and Treatment. American Family Physician, 83(7), 807-815.  Woo, T. M., & Wynne, A. L. (2012). Pharmacotherapeutics for Nurse Practitioner Prescribers (3rd ed.). Philadelphia, PA: F.A. Davis Company.

 

Submit a paper describing a client, family member, or other individual you know who has a degenerative cognitive disorder. Possible conditions include Vascular dementia, Lewy Body disease, Alzheimer’s disease, Parkinson’s disease, AIDS-related dementia and delirium, among others. Include at least two APA citations from sources that provide information for this paper:

• Introduce the person with a brief social and medical history. What were the events leading up to the diagnosis? How did the person find out about the condition?
• Describe the disorder. What are the risk factors for the disorder?
• How is the condition diagnosed? Include any cognitive assessments, lab tests, or other medical exams.
• Describe treatment options. These may include psychotherapy, pharmacotherapy, environmental adaptations, nursing interventions, and referrals to support groups.
• Conclude with an update about the person you chose to discuss. Is this a reversible, treatable condition or an irreversible condition? What was the outcome?
• You may choose your material from the textbook or from other sources.
• It is expected that this essay will be 2-3 pages in length (not including the title page), double-spaced. Your paper should include an introduction and conclusion and proper APA citations from any source material you use, including your text.

  

1-Article Analysis

1-Article #1

Kakkos, S. K., Caprini, J. A., Geroulakos, G., Nicolaides, A. N., Stansby, G., Reddy, D. J., & Ntouvas, I. (2016). Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism. Cochrane Database of Systematic Reviews, (9). Retrieved from https://core.ac.uk/download/pdf/144577522.pdf

The paper discusses the essence of the deployment of pharmacological prophylaxis in the prevention of venous thromboembolism within the context of the medical care environment. A significant weakness in the paper is the lack of a consensus on combined modalities to make the analysis wholesome.

Article #2

Calder, J. D., Freeman, R., Domeij-Arverud, E., van Dijk, C. N., & Ackermann, P. W. (2016). Meta-analysis and suggested guidelines for the prevention of venous thromboembolism (VTE) in the foot and ankle surgery. Knee Surgery, Sports Traumatology, Arthroscopy, 24(4), 1409-1420. Retrieved from https://link.springer.com/article/10.1007/s00167-015-3976-y

The article discusses various methods that prove relevant to prevent venous thromboembolism. The weakness is that it uses a substantial sample to achieve its objective that may not be helpful in this study. It does not necessarily explain the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

Article #3

Liew, N. C., Alemany, G. V., Angchaisuksiri, P., Bang, S. M., Choi, G., DE, D. S., … & Suviraj, J. (2017). Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism. International angiology: a journal of the International Union of Angiology, 36(1), 1-20. Retrieved from https://europepmc.org/abstract/med/27606807

The paper explains various methods that prove relevant to prevent venous thromboembolism. An issue is the lack of a discussion of the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

Article #4

Büller, H. R., Bethune, C., Bhanot, S., Gailani, D., Monia, B. P., Raskob, G. E., … & Weitz, J. I. (2015). Factor XI antisense oligonucleotide for prevention of venous thrombosis. New England Journal of Medicine, 372(3), 232-240. Retrieved from https://www.nejm.org/doi/pdf/10.1056/NEJMoa1405760

The article explains the use of factor XI antisense oligonucleotide that proves relevant to prevent venous thromboembolism and shows that reducing levels of factor XI reduces VTE. On the contrary, it does not explain the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

Article #5

Kim, J. Y., Khavanin, N., Rambachan, A., McCarthy, R. J., Mlodinow, A. S., De Oliveria, G. S., … & Mahvi, D. M. (2015). Surgical duration and risk of venous thromboembolism. JAMA surgery, 150(2), 110-117. Retrieved from https://jamanetwork.com/journals/jamasurgery/fullarticle/1984239

The document explains various methods that prove relevant to prevent venous thromboembolism. It shows that the correlation between VTE and surgical intervention implies an increase in one increases the other. On the contrary, it fails to give a succinct explanation to the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

Article #6

Barber, E. L., & Clarke-Pearson, D. L. (2017). Prevention of venous thromboembolism in gynecologic oncology surgery. Gynecologic oncology, 144(2), 420-427. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503672/

The article explains various methods that prove relevant to prevent venous thromboembolism. The paper majorly focuses on gynecologic oncology surgery as a way of giving the necessary recommendations from the perspective of the study. On the contrary, it fails to provide a succinct explanation for the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

 

 
 

2-Article 1

Jilani, S. M., Frey, M. T., Pepin, D., Jewell, T., Jordan, M., Miller, A. M., … Reefhuis, J. (2019). Evaluation of state-mandated reporting of Neonatal Abstinence Syndrome – six states, 2013-2017. MMWR: Morbidity & Mortality Weekly Report, 68(1), 6–10. https://doi-org.lopes.idm.oclc.org/10.15585/mmwr.mm6801a2

This article is a great resource of information for my project. It offers the information on severity of the problem new generation is facing as well as it offers insight on importance of trained staff. The weak part is, that only 6 states were chosen for the survey and does not provide the reason why those states were chosen and possibly creating a bias.

Article 2 

Suarez, M. A., Horton-Bierema, W., & Bodine, C. E. (2018). Challenges and resources available for mothers in opiate recovery: A qualitative study. Open Journal of Occupational Therapy (OJOT), 6(4), 1–8. https://doi-org.lopes.idm.oclc.org/10.15453/2168-6408.1483

This article offers insight on challenges mothers with newborn face and what their children go through. While the article is mostly about mothers and their feelings it supports the idea of improving community education about the importance of starting the treatment during pregnancy.

Article 3

Mahdavi Khaki, Z., AbbasZadeh, A., Rassoli, M., & Zayeri, F. (2015). Evaluation of nursing care associated with infants born to mothers with drugs abuse and its comparison with the standards in selected hospitals in Kerman 2013-2014. Journal of Medicine & Life, 8, 295. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=edb&AN=129161724&site=eds-live&scope=site

The strength of the article is in supporting evidence of quality nursing care of newborns and the importance of nursing proficiency leading to improved outcome. Another positive factor is that it shows the drug abuse is not prevalent only in the US but also in other countries of the world. The shortcoming was in specifying what tools the nurses used to evaluate the infants signs and symptoms of drug abuse.

Article 4

MacMullen, N. J., Dulski, L. A., & Blobaum, P. (2014). Evidence-based interventions for Neonatal Abstinence Syndrome. Pediatric Nursing, 40(4), 165–203. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=103762898&site=eds-live&scope=site

This research article is somewhat weak support for my work, but supportive evidence of proper assessment and nursing intervention leads to improved outcome. It shows what kind of assessment and grading tool was used and how effective it was in the assessment of the abstinence syndrome.

Article 5

Cook, C. L., Dahms, S. K., & Meiers, S. J. (2017). Enhancing care for infants with neonatal abstinence syndrome: An evidence-based practice approach in a rural midwestern region. Worldviews on Evidence-Based Nursing, 14(5), 422–423. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12217

This article provides excellent support to prove that quality of education and introduction of the evidence-based practice will improve the recognition of the NAS, reporting and provide education to families. The authors offer ways to educate the staff and provide adequate resources for the staff to use as needed.

Article 6

Lucas, K., & Knobel, R. (2012). Implementing practice guidelines and education to improve the care of infants with Neonatal Abstinence Syndrome. Retrieved from http://ovidsp.dc2.ovid.com.lopes.idm.oclc.org/sp-3.33.0b/ovidweb.cgi?&S=CPIKFPHLBGEBAABJJPDKPHBHCKDLAA00&Link+Set=S.sh.22%7c7%7csl_10&Counter5=SS_view_found_article%7c00149525-201202000-00011%7cyrovft%7covftdb%7cyrovftm&Counter5Data=00149525-201202000-00011%7cyrovft%7covftdb%7cyrovftm

Approval of standardized assessment tool by nursing staff has proven to be effective for identifying and diagnosing the infants with NAS. It also shows how subjective assessment can lead to poor outcomes. The possible weakness of the article is in using only one assessment tool (Finnegan’s) not showing which tool is better.

 

3-Hi a, you have an interesting topic, but what I do not see the relevance of the articles and nursing related interventions. Since I do not know your picot, and I do not work in your field, I am wondering how that information will improve nursing care. I had to change my topic for the final project due to the same issue- it was more medical related than nursing. Can you elaborate more on how the above information is related to nursing? Lenka

 

 

Include the following in your paper:  

1. Background information on the health condition. a. Scope of the problem—-the population at risk.  b. How many Americans are affected by this health condition? c. Geographic region the problem is mostly found, if any.d. Brief explanation of the health condition. e. How is the health condition treated?  2. Discuss the health disparity of the health condition. a. Each of the conditions listed is considered to be a health disparity in the US. b. Research how the condition is a disparity and why. c. Who is affected?d. Is there anything being done to address health disparities in this country. –i. Look up “healthy People 2020”e. What can nursing do? what is nursing’s role is health disparities?3. Nursing Education, health promotion and disease prevention.  a. Discuss what you, the nurse, can do to address this aspect of nursing.  

  

Description

Part I: HIV/AIDS has affected millions of people in the United States and the world since the 1980s. On a global scale, large numbers of people with HIV/AIDS are not receiving the needed treatment. Congress created The Ryan White Care Act of 1990 to assist public hospitals struggling financially from caring for uninsured men and women living with HIV/AIDS. There were four Titles written into The Ryan White Care Act of 1990. In recent years the Titles have moved into five Parts, Part A-F focusing on a variety of topics.

In 2014, the Affordable Care Act gave insurance access to many of the uninsured population. Over the past few decades, countries like England and Canada have a lower percentage of HIV/AIDS cases. Is this due to their healthcare structure? In 4 pages, discuss the following.

a. Explain the purpose of each of the five Parts in The Ryan White Care Act.

b. Explain other viewpoints or opposing viewpoints of the Act.

c. Describe your stance on if there is a need for the Ryan White Care Act with the Affordable Care Act. Think about other countries. 

d. This portion of your assignment will require you to research and examine information from various sources. Use a minimum of three credible sources for your paper, with three being an academic source from the Rasmussen College Online Library (don’t forget to include in-text citations throughout your paper with paraphrasing or quoting)

e. Make sure to include your APA formatted reference page.

Part II: Based on your research you decide which one of the previous communication tools would be most effective to communicate your findings. Keep in mind the position and facility you selected and create a memo, a PowerPoint, detailed meeting agenda, or an information sheet. In the first paragraph, slide, or bullet please justify the reason you picked communication format. 

a. In the first paragraph, slide, or bullet please justify the reason you picked the particular communication format.

b. Use feedback from your instructor to guide you through the communication tool you decided to use.

c. Make sure to use audience specific language and tone.