Case Study #2 2025

Assignment Details Case Study #2 Date: November 12, 2016, 2:00 pm Location: XYZ Family Practice You are an NP student in this practice. Your next patient is the following: “I had to come in today because I have been coughing for a long time” Amanda Smith (69 year old, black female) is a retired postal worker. During the visit, she is coughing continually. She states the cough started 5 days ago intermittently but 2 days ago it became constant. Her chart indicates that she has been a patient of the practice for 5 years, gets care regularly and her HTN has been controlled for 4 years. Social History Married – 2 adult children A & W Non-Smoker now. Smoke 1 pack a day for 15 years. Quit x5 years ago No alcohol or drug use Baptist, attends church regularly and is a member of the choir Family History Mother – Deceased at age 27 from traumatic accident Father – Deceased age 78 related to renal failure secondary to diabetes type II Siblings – one brother age 61 A & W Medical/Surgical/Health Maintenance Hx Measles, mumps and chicken pox as a child. Tetanus/Diptheria/Pertussis – Last dose 2 years ago Influenza – Last dose 9 months ago Pneumococcal vaccine at age 65 Zostivax at age 60 Chronic diagnoses – HTN x 5 years Takes HCTZ 25 mg daily ROS General Usual weight has been maintained Fever for 5 days up to 101 Skin Dry skin, uses emollient frequently HEENT Wears reading glasses Dentition fair. Partial upper denture Neck No swelling or stiffness Chest Substernal pain on cough Respiratory Began coughing 4 days ago. Started mild, intermittent and non-productive. Two days ago became constant and productive of frothy sputum. Keeps her awake at night. No relief with OTC cough syrup. She states she is short of breath today. CV No CP at rest or when not coughing PV Some swelling of feet and ankles at end of day, relieved by elevating feet GI Decreased appetite for one week No change in bowel habits GU No frequency, hesitancy, nocturia or change in bladder habits Genitalia No changes MS Stiffness in hands and legs on awakening. Relieved with activity Psych No depression, anxiety, or memory change Neurologic No numbness, weakness, headache, change in mentation, or paralysis Hematologic No past anemia Endocrine No change in weight, thirst, heat/cold intolerance. Your physical exam reveals: Temp 101.4, Resp 30 labored, no retractions, BP 135/92, HR 110, Pulse Ox 90 Wt 130 lbs General appearance – Alert in all spheres, in mild respiratory distress, able to answer questions with short sentences, tripod breathing HEENT – Eyes ,ear, nose, head wnl Mouth -mucosa dry Pharynx – tonsils present not enlarged, normal pink color Lymph – no enlargement Skin – Dry and scaly legs and arms. Tenting of skin noted Heart- regular rhythm at 110 bpm, no murmurs or extra sounds Lungs – normal breath sound without crackles, bronchophony or egophony Abdomen – no mass, tenderness, rigidity Extremities – Hands – no swelling, Feet/legs – +1 edema feet to ankle level Pedal pulses – wnl Differential diagnoses: CAP Acute bronchitis Congestive heart failure Influenza Plan – transfer to acute care setting for further work-up Assignment Details: The “Elevator Consult” In this activity, you will practice giving a synopsis of your patient to your preceptor. In practice, you may often give this type of report if you are sending a patient for a consultation and your phone the specialist to discuss the patient. This report should be concise and clear. The receiver should, within one minute (slightly less for simple cases, slightly more for complex cases) have a picture of the patient in his/her head. You will report on ONLY items pertaining to the acute problem in this case. Do not include extraneous material or material not directly impacting the decision-making regarding this problem. Remember, this is a FOCUSED visit and assessment to evaluate a focused concern. The history and physical exam applies techniques relevant to the specific complaint for the patient at that visit. Your report should be similarly focused, providing only information that relates specifically to the presenting problem. Please review the grading rubric under Course Resources in the Grading Rubric section.

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Assignment: Evidence-Based Project, Part 5: Recommending An Evidence-Based Practice Change 2025

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes. In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach. To Prepare: Reflect on the four peer-reviewed articles you critically appraised in Module 4. Reflect on your current healthcare organization and think about potential opportunities for evidence-based change. The Assignment: (Evidence-Based Project) Part 5: Recommending an Evidence-Based Practice Change Create an 8- to 9-slide PowerPoint presentation in which you do the following: Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.) Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered. Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking. Add a lessons learned section that includes the following: A summary of the critical appraisal of the peer-reviewed articles you previously submitted An explanation about what you learned from completing the evaluation table (1 slide) An explanation about what you learned from completing the levels of evidence table (1 slide) An explanation about what you learned from completing the outcomes synthesis table (1 slide) 3 to 5 references with 5 years.

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Research Paper #2 – Ethical Challenges In “Obamacare/Trumpcare” And Healthcare Reforms DUE **03/22/2020** 2025

-INDIVIDUAL ASSIGNEMENT——- Ethical Challenges in an Era Where “Obamacare/Trumpcare” and/or Healthcare Reform Dominate Identify and discuss any conflicts that exist between ethics and healthcare reform that has been brought upon the execution of the affordable care act aka Obamacare/Trumpcare. Also, explain how nurses should negotiate such conflicts. Consider how nurses have historically handled conflicts between ethics and their profession in a time where health care reform was obsolete. What happens to those patients that still don’t have insurance? Word Length: 1500-2000 words *****APA Format******* Minimum (5) Peer Reviewed Articles/journals, the oldest being no more than 5 years old.

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Assignment 2025

What do you think of when you read the term “mental disorder?” Do you envision someone who is acting wild and out of control, or a perpetually sad person who can’t function? In reality, extremes such as these describe only a small fraction of people with psychological illnesses. Many affected people go through life with few others knowing of their condition and contribute to the world in much the same way as others. In this assignment, you will select a disorder you would like to learn more about. Assignment Details Perform the following tasks: . · Select a psychological disorder you would like to research. · Research the most appropriate treatment for the disorder. · Include at least two sources in your research. Include references and a bibliography. Your resources should include this week’s readings, in addition to the external research you conduct using outside sources. The LIRN is an excellent place to find information. · Once you have completed your research, compose a paper detailing what you have learned. Include the following information: Summarize the disorder,  including symptoms and behaviors Describe the most appropriate treatment for the disorder

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