please pay attention to my case study

4 references

zero plagiarism

Subjective: 

• CC: “I have bumps on my bottom that I want to have checked out.” 

• HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed. 

• PMH: Asthma 

• Medications: Symbicort 160/4.5mcg 

• Allergies: NKDA 

• FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD 

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

Objective: 

• VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs 

• Heart: RRR, no murmurs 

• Lungs: CTA, chest wall symmetrical 

• Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia 

• Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, negMcBurney 

• Diagnostics: HSV specimen obtained 

Assessment: 

• Chancre 

Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.

• Analyze the subjective portion of the note. List additional information that should be included in the documentation.
• Analyze the objective portion of the note. List additional information that should be included in the documentation.
• Is the assessment supported by the subjective and objective information? Why or why not?
• Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?
• 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.

In this Lab Assignment, 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.

 

1) Minimum 3 full pages 

2)¨**********APA norms, please use headers 

            All paragraphs must be narrative and cited in the text- each paragraphs

            Bulleted responses are not accepted

            Dont write in the first person.)

3) It will be verified by Turnitin and SafeAssign 

4) Minimum 4 references not older than 5 years. 

5) Identify your answer with the numbers, according to the three parts of this question.

6) The lines of your answer will be counted. Please make sure you meet the requirements.

 

 ____________________________________________________________

Mandatory Dicrections:

Taking into account files 1 and 2  answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

Read File 1 (This is the main case)

Use the chart you completed and questions you answered in File 2 as the basis for your responses in this assignment.

___________________________________________________________

Taking into account files 1 and 2  answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

1) At least 17 lines respond to the following: 

Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.

2) At least 36 lines respond to the following: 

How ought the Christian think about sickness and health? 

How should a Christian think about medical intervention? What should Mike as a Christian do? 

How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?

3) At least 17 lines respond to the following: 

How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

 

The ACA or the AHCA: Imperfect Solutions to Increasing Access to Health Care?

This week’s discussion focuses on the federal government’s role in protecting the public’s health using the ACA and current efforts to “repeal and replace” the ACA. Please note that the government’s role in protecting the public’s health did not begin with the ACA. In the late 1800s, Lilian Wald brought health care to the community. And in 1965, Congress passed bills authorizing Medicare and Medicaid. Since 1965, Congress has expanded government-sponsored health care to pregnant women and children.

Topic 1

• Compare the current provisions in the ACA with those in the failed first version of the AHCA.
• Share your opinions about why the AHCA failed in the first attempt at passage.

Instructions
For this assignment, complete the following:

• Review the Toulmin-model outline (Week 2 Lesson) and your completed Week 1 Assignment (Pro-Position Proposal). Assess any feedback provided by the professor and/or your peers.
• Compose a position paper representing the pro side of your topic. (See the Pro-Paper Template). The paper should include approximately 6 developed paragraphs:
  • Introduction (with thesis statement)
  • Context paragraph
  • 3 body paragraphs (focusing on 3 pros)
  • Conclusion
• Apply a formal tone appropriate for academic audiences, maintaining an objective 3rd person point of view – no 1st person (I, me, my, we, our, us, mine) or 2nd person (you, your). Avoid contractions, clichés, and slang terminology.
• Use the provided template to assist in formatting the title page and headers.
• Incorporate at least 3 scholarly sources into the paper. Cite all sources in APA format, both parenthetically and on a reference page.
• Before submission, proofread and edit carefully for spelling, punctuation, and grammar. Not every error will be flagged automatically in word-processing programs, and some that are flagged as errors are actually correct.

Writing Requirements (APA format)

• Length: 2-3 pages (not including title page or references page)
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 3 academic articles)

Grading
This activity will be graded using the Pro-Position Paper Grading Rubric.

Course Outcomes (CO): 3, 6

Due Date: By 11:59 p.m. MT on Sunday

 

Ms. X., aged 55 years, has been complaining of severe fatigue and “indigestion.” Her son is quite concerned and decides to take her to the emergency department. On arrival she appears very anxious, and her facial skin is cool and clammy; her blood pressure is 90/60, and the pulse is around 90, weak, and irregular. She is given oxygen, an intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myocardial infarction involving the left ventricle. Her son provides information that indicates Ms. X is a long-time smoker, has a stressful job as a high school teacher, is recently separated after 20 years of marriage, and is fearful of losing the family home. She has also seemed to be more fatigued and stopped going to the gym about 18 months ago. She has begun to rely on “fast foods” like pizza and fried chicken and cooks infrequently. Her father had died of a heart attack at age 50. She had also noticed more fatigue and intermittent leg pain when walking or climbing stairs at work. Generalized atherosclerosis is suspected.

1. List the high-risk factors for atherosclerosis in this patient’s history.
2. Describe how atherosclerosis causes myocardial infarction.
3. It is suspected that the indigestion reported in the history was really angina. Explain how this pain may have occurred.
4. Explain each of the admitting signs.
5. What is “atypical” in Ms. X’s symptoms? How does this affect treatment and prognosis?
6. What information do serum enzyme and electrolyte levels provide?
7. What purpose does the ECG serve? It is determined that Ms. X. has a large infarct in the anterior left ventricle.
8. Ms. X. is showing increasing PVCs on the ECG. State the cause and describe the effect if these continue to increase in frequency.
9. On day 6 after admission Ms. X is preparing to go home with her son and they receive instructions on lifestyle modifications that are desirable if Ms. X is to avoid another MI. What measures should be included in such a discussion?
10. Discuss how stress could have played a factor in Ms. X’s MI and her future post discharge.
11. Ms. X’s condition becomes less stable and she remains in the hospital. On the seventh day following admission, she is found unconscious on the floor of her bathroom. Her pulse is weak and elevated, and her skin is moist with pallor evident. Her BP is 50 systolic. A diagnosis of cardiogenic shock is made, and resuscitation efforts are started.
12. Explain why Ms. X. has experienced cardiogenic shock at this time.
13. Describe the effects of cardiogenic shock on the organs of the body.
14. What problems will occur if decompensated shock occurs? How is compensation limited in this situation?
15. Ms. X dies shortly later. What is the cause of death in this case?

 Please refer to the Grading Rubric for details on how this activity will be graded 

 

Case Study Rubric

Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Case Study Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsContent of Case StudyThe writer demonstrates a well-articulated understanding of the case study subject matter in a clear, complex, and informative manner. The case study content and theories are well developed and linked to the course content, assignment requirements, and practical experience. The case study includes relevant material that fulfills all objectives of the assignment.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

30 pointsThe writer demonstrates an understanding of the subject matter, and the components of the case study are accurately represented with evidence-based practice, ethics, theory, and/or role content. Course materials and scholarly resources are present to support required concepts. The paper includes relevant material that fulfills all objectives of the case study.

Cites two references.

26 pointsThe writer demonstrates a moderate understanding of the subject matter, as evidenced by components of the case study and use of evidence-based practice, theory, or role-development. Course content is present but missing depth and/or development.

Cites only one reference.

23 pointsAbsent application to evidence-based practice, theory, or role development.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Significant content of case study is vague, inaccurately portrayed, or missing.

No references cited.

Submits assignment late.

20 points30Analysis and Synthesis of Case Study Content and MeaningThrough critical analysis, the submitted case study provides an accurate, clear, concise, and complete summary of the scenario.

Information from scholarly resources is synthesized, providing new information or insight related to the context of the assignment by providing both supportive and alternative information or viewpoints.

All instruction requirements noted.

30 pointsCase study is complete, providing evidence of further synthesis of course content via scholarly resources.

Information is synthesized to help fulfill the case study requirements. The content supports at least one viewpoint.

Submission provides clarification of the assignment by correctly answering all posed questions within the instructions.

All instruction requirements noted.

26 pointsLacks clarification or new information. Scholarly reference supports the content without adding any new information or insight. Case study content may be confusing or unclear, and the summary may be incomplete.

Most instruction requirements are noted.

23 pointsSubmission is primarily a summation of the assignment without further synthesis of course content or analysis of the scenario.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Missing some instruction requirements.

Submits assignment late.

20 points30Application of KnowledgeThe summary of the case study provides information validated via scholarly resources that offer a multidisciplinary approach to the scenario provided.

The student’s application in practice is accurate and plausible, and additional scholarly resource(s) supporting the application are provided.

All questions posed within the assignment are answered correctly in a well-developed manner, applying knowledge with citations for validation.

All instruction requirements noted.

30 pointsA summary of the study, findings, and knowledge gained from the assignment is presented.

Student indicates how the information will be used within their professional practice.

All questions posed within the assignment are answered within the case study. The answer to one question may be vague and/or limited in development, but as a whole all answers are correct.

All instruction requirements noted.

26 pointsObjective criteria are not clearly used, allowing for a more superficial application of knowledge between the assignment and the broader course content.

One question is answered incorrectly and/or two case study answers are vague or limited in development but remain correct.

Student’s indication of how they will apply this new knowledge to their clinical practice is vague.

Most instruction requirements are noted.

23 pointsThe application of knowledge is significantly lacking.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Student’s indication of how they will apply this new knowledge to their clinical practice is not practical or feasible.

Application of knowledge is incorrect and/or student fails to explain how the information will be used within their personal practice.

Multiple questions are not answered or are answered incorrectly (e.g., two questions answered incorrectly, or three case study answers are vague or limited in development but remain correct).

Missing some instruction requirements.

Submits assignment late.

20 points30OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work. Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references, and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors, or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

2 points5To