1) . Plot out on an Excel or other type of spreadsheet the required immunizations per CDC recommendations for the following patient. Immunizations should include all immunizations the patient should have received up to this point.

DO NOT COPY AND PASTE FROM THE CDC WEBSITE OR ANY OTHER SOURCE. THIS MUST BE YOUR OWN WORK, ALL COPY/PASTES WILL RECEIVE A ZERO.

– A 18 year old male patient entering college in the Fall who will be staying in a dormitory. Start with infancy and up to this current day. Create what you think would be the appropriate record.

2.)  Write two paragraph homelessness in America and the vulnerability. Find a video on YouTube and attach it as your reference. 

3.)  

Greg is a nurse serving a community-based group home for individuals with developmental and mental health disabilities. He is responsible to provide nursing services for 14 residents in three group homes. To best serve his clients, as well as the larger community of disabled residents, he has taken several courses related to the needs of those with disabilities.
 

1.Greg has learned that the historical view of those with disabilities has evolved. In current frameworks, it is viewed as important to differentiate among the concepts of impairment, disability, and handicap. In this framework, the concept of a person’s limited ability to perform an activity in an expected way is best described as a(n): Give a rationale and a reference (50 words)

1. Impairment
2. Disability
3. Handicap
4. Deficit

2.Most of Greg’s clients require assistance in multiple functional areas. This assistance is necessary, in part, because of environmental and social barriers that affect their quality of life. A common barrier to proper health care is poor access to transportation services. This is an example of what type of barrier? Give a rationale and a reference (50 words)

1. Psychological
2. Geographic
3. Cultural
4. Organizational

3.Many of Greg’s clients experience limitations in their ability to function on some level. According to U.S. Census Bureau definitions, the client who requires assistance with money management, paying bills, etc., is said to have a limitation in: Give a rationale and a reference (50 words)

1. Functional activities
2. Activities of daily living
3. Instrumental activities of daily living
4. Financial management

4. Greg has served in his current position since 1990. During this period of time, he has become convinced of the importance of the advocacy role of community health nurses and he has participated in efforts to pass landmark legislation protecting the rights of those with disabilities. This legislation, which resulted in the formalized expectation of “reasonable accommodations,” is referred to as the: Give a rationale and a reference (50 words)

1. Americans with Disabilities Act
2. Individuals with Disabilities Education Act
3. Ticket to Work Act
4. Work Incentives Improvement Act

Case study Guidelines

1. Answer the questions asked with rationale
2. No more or less than 200 words total. (give or take 10      words)
3. Use at least one reference using APA citation      guidelines
4. No more than 1-2 spelling and grammar mistakes
5. Original post ( Do not copy another student’s work)

• What population is under consideration?
  • What was the specific intervention that was used? Is this a new intervention or one that was already used?
  • What were the author’s claims?
• Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?
• Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article. Support your position with evidence-based literature.

 Here are the instructions for my Discussion Question for this week. This is a case study and at the end there are 3 questions to answer. 

Week 8: Discussion Part one

Initial Visit: Meet the Family 

Background: Field Family: Mother: Michelle age 25, Father: Mike age 27, Daughter: Jennifer age 5, Son: Rey age 18 months. Maternal Grandmother: Mary age 48, Paternal Grandfather: Tom age 52. 

Setting:Rural U.S.

Office: Rural, NP owned, Family Practice Clinic

Today is a busy day in your rural family practice clinic. You are reviewing the chart of your next appointment and realize that there is very little information and that you are scheduled to do well-child exams on a male age 18 months and female age 5 years, who appear from last names to be siblings. Your office schedules 20 minutes each for well-child exams. Upon entering the room, you note a Caucasian woman who appears in her early 30s who sits focused on paperwork, a male toddler climbing on the exam table to reach up and take the otoscope off of the wall, while a preschool-aged appearing female is sitting at your computer pretending to type on the keyboard.  

As you introduce yourself, the mother stands abruptly and grabs the toddler off of the exam table, smacking his hand and causing him to cry, while simultaneously yelling “I told you to stop it!” She states, “I am so sorry. They usually behave. I am Michelle, and this is Rey and Jennifer.” You then inquire as to the reason for their visit, as you always do. The mother reports they recently moved to the area to live with her parents due to a recent separation from her husband, and she is there to have a physical exam before they lose her husband’s health insurance benefits. She reports that the children are currently healthy and have a regular pediatrician back at home.  

HPI: The mother denies any recent illnesses in either child and reports they are here for their check-up. She does report that since moving in with her parents recently, it has been difficult to get the children to go to bed at night and stay in bed and expresses extreme frustration with this. She reports that they are eating three meals per day and two snacks, one at bedtime and one in the afternoon between lunch and dinner. They do brush their teeth twice a day, ride in car seats in the car, and play vigorously both indoors and outdoors at home. She also verbalizes extreme concern of their impending loss of health insurance. 

PMH: Jennifer: Full-term gestation, born cesarean section, weight. 7lb 4 oz. There were no complications in pregnancy, but the mother did smoke 1 PPD throughout pregnancy. There were no hospitalizations—NKDA. The daily medication was chewable children’s multivitamin with iron. Rey: Born at 34 weeks gestation via cesarean section, weight. 5lb 1 oz. The mother developed preeclampsia and gestational diabetes. The mother quit smoking when she found out she was pregnant. Rey has allergies per mother and sometimes takes Cetrizine syrup half a teaspoon once daily, PRN congestion, and a children’s chewable multivitamin daily.  

Immunizations: The mother has no immunization records with her at this timeon either child. She reports some immunizations given, but cannot remember last date.  

Social History:Both children currently live with their mother and maternal grandparents for the last 8 weeks. Their father is involved but lives 2 hours away in the state capital where he works. Jennifer will be starting kindergarten this fall in the community’s elementary school. 

Family History: They are maternal and paternal smokers. The mother has been one since age 16 at 1PPD until 18 months ago. The father continues to smoke. There were no diseases reported in either parent. Mother has a history with gestational diabetes and preeclampsia.  MGM has a history of hyperlipidemia, Type 2 DM, and Hypertension. They are Latin American in descent, emigrated from Cuba in the 1970s. MGF has a history of hypertension, hyperlipidemia, and an MI with stenting 2 years ago.  The mother has two siblings; one who died in an MVA 5 years ago at the age of 18 a younger brother, and an older sister who is 32 and lives in a large urban city in the Midwest with her family, and she is in good health. Other family members died of old age. She is unaware of paternal familial health history.

Please  answer the following questions):

1.- What would you like to focus on during your visit today?

2.- Would a family assessment tool be appropriate? 

3.- What other historical information would you like to have at this visit?

 Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle. less than 10% turnitin.

this is a sample of the “SOAP NOTE TEMPLATE ” the assignment should be similar to it

those 2 diseases are together not seperate.

  

PATIENT INFORMATION

Name: Mr. W.S.

Age: 65-year-old

Sex: Male

Source: Patient

Allergies: None

Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime

PMH: Hypercholesterolemia

Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago.

Surgical History: Appendectomy 47 years ago.

Family History: Father- died 81 does not report information

 Mother-alive, 88 years old, Diabetes Mellitus, HTN

Daughter-alive, 34 years old, healthy

Social Hx: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone.

SUBJECTIVE:

Chief complain: “headaches” that started two weeks ago

Symptom analysis/HPI:

The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness. He states that he has been under stress in his workplace for the last month.

Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.

ROS:

CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures. 

HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing.

Respiratory: Patient denies shortness of breath, cough or hemoptysis.

Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal

dyspnea.

Gastrointestinal: Denies abdominal pain or discomfort. Denies flatulence, nausea, vomiting or

diarrhea.

Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence.

MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound.

Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus.

Objective Data

CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 0/10.

General appearance: The patient is alert and oriented x 3. No acute distress noted. NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5.

HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Maxillary sinuses no tenderness. Nasal mucosa moist without bleeding. Oral mucosa moist without lesions,.Lids non-remarkable and appropriate for race.

Neck: supple without cervical lymphadenopathy, no jugular vein distention, no thyroid swelling or masses.

Cardiovascular: S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary refill < 2 sec.

Respiratory: No dyspnea or use of accessory muscles observed. No egophony, whispered pectoriloquy or tactile fremitus on palpation. Breath sounds presents and clear bilaterally on auscultation.

Gastrointestinal: No mass or hernia observed. Upon auscultation, bowel sounds present in all four quadrants, no bruits over renal and aorta arteries. Abdomen soft non-tender, no guarding, no rebound no distention or organomegaly noted on palpation

Musculoskeletal: No pain to palpation. Active and passive ROM within normal limits, no stiffness.

Integumentary: intact, no lesions or rashes, no cyanosis or jaundice.

Assessment 

Essential (Primary) Hypertension (ICD10 I10): Given the symptoms and high blood pressure (156/92 mmhg), classified as stage 2. Once the organic cause of hypertension has been ruled out, such as renal, adrenal or thyroid, this diagnosis is confirmed.

Differential diagnosis:

Ø Renal artery stenosis (ICD10 I70.1)

Ø Chronic kidney disease (ICD10 I12.9)

Ø Hyperthyroidism (ICD10 E05.90)

Plan

Diagnosis is based on the clinical evaluation through history, physical examination, and routine laboratory tests to assess risk factors, reveal identifiable causes and detect target-organ damage, including evidence of cardiovascular disease.

These basic laboratory tests are:

· CMP

· Complete blood count

· Lipid profile

· Thyroid-stimulating hormone

· Urinalysis

· Electrocardiogram

Ø Pharmacological treatment: 

The treatment of choice in this case would be:

Thiazide-like diuretic and/or a CCB

· Hydrochlorothiazide tab 25 mg, Initial dose: 25 mg orally once daily. 

Ø Non-Pharmacologic treatment: 

· Weight loss

· Healthy diet (DASH dietary pattern): Diet rich in fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and trans l fat

· Reduced intake of dietary sodium: <1,500 mg/d is optimal goal but at least 1,000 mg/d reduction in most adults

· Enhanced intake of dietary potassium

· Regular physical activity (Aerobic): 90–150 min/wk

· Tobacco cessation

· Measures to release stress and effective coping mechanisms.

Education

· Provide with nutrition/dietary information.

· Daily blood pressure monitoring at home twice a day for 7 days, keep a record, bring the record on the next visit with her PCP

· Instruction about medication intake compliance. 

· Education of possible complications such as stroke, heart attack, and other problems.

· Patient was educated on course of hypertension, as well as warning signs and symptoms, which could indicate the need to attend the E.R/U.C. Answered all pt. questions/concerns. Pt verbalizes understanding to all

Follow-ups/Referrals

· Evaluation with PCP in 1 weeks for managing blood pressure and to evaluate current hypotensive therapy. Urgent Care visit prn.

· No referrals needed at this time.

References

Domino, F., Baldor, R., Golding, J., Stephens, M. (2017). The 5-Minute Clinical Consult 2017 (25th ed.). Print (The 5-Minute Consult Series).

Codina Leik, M. T. (2014). Family Nurse Practitioner Certification Intensive Review (2nd ed.). ISBN 978-0-8261-3424-0

 

 

An important role of nursing is to provide health promotion and disease prevention. Review the 2020 Topics and Objectives on the Healthy People website. Choose a topic of interest that you would like to address, in conjunction with a population at-risk for the associated topic. Submit the topic and associated group to your instructor for approval.

Create a 15-20-slide PowerPoint presentation for your topic and focus group. Include speaker notes and citations for each slide, and create a slide at the end for References.

Address the following:

1. Describe the approved topic and associated population your group has selected. Discuss how this topic adversely affects the population. How does health disparity affect this population?
2. Explain evidence-based approaches that can optimize health for this population. How do these approaches minimize health disparity among affected populations?
3. Outline a proposal for health education that can be used in a family-centered health promotion to address the issue for the target population. Ensure your proposal is based on evidence-based practice.
4. Present a general profile of at least one health-related organization for the selected focus topic. Present two resources, national or local, for the proposed education plan that can be utilized by the provider or the patient.
5. Identify interdisciplinary health professionals important to include in the health promotion. What is their role? Why is their involvement significant?

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style

Note: The topic for the presentation is breast cancer in American women .

I would like you to do answer only question 2 and leave the rest. Do it Power point please. 5-7 slices including references.