Week 6 Assignment:

http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_07/index.html

By Day 7 of Week 8

Write a 1- to 2-page summary paper that addresses the following:

• Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
• Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
• What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
• Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

To Prepare

Review the interactive media piece assigned by your Instructor. 

Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.

Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.

You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

By Day 7 of Week 8

Write a 1- to 2-page summary paper that addresses the following:

Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.

Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.

What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.

Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

PLEASE PAY ATTENTION TO THE CASE STUDY

ZERO PLAGIARISM

FIVE REFERENCES NOT MORE THAN FIVE YEARS

The practice of using herbal supplements dates back thousands of years. Today, there is a renewal in the use of herbal supplements among American consumers. However, herbal supplements are not for everyone. In fact, some herbal products may cause problems for people treatments for chronic ailments. Because they are not subject to scrutiny by the FDA or other governing agencies, the use of herbal supplements is controversial. 

Herbal supplements are products made from plants for use in the treatment and management of certain diseases and medical conditions. Many prescription drugs and over-the-counter medicines are also made from plant derivatives. These products contain only purified ingredients and, unlike herbal supplements, are closely regulated by the FDA. Herbal supplements may contain entire plants or plant parts. Herbal supplements come in all forms: dried, chopped, powdered, capsule, or liquid, and can be used in various ways. Please address the followings: 

Discuss advantages and disadvantages of dietary supplements, including adverse reactions, drug-drug interactions, drug-food interactions, and specific laboratory issues that may arise from using these products. 

Discuss the position of the FDA and other governmental agencies on over the counter herbal supplements. Support your post with at least 2 evidenced-based guidelines published within the last 5 years. 

The posts must be referenced as mentioned above and written in APA 6th edition format. 

Books: 

Teri Moser Woo & Marylou V. Robinson (4th ed.). Pharmacotherapeutics for  

Advanced Practice Nurse Prescribers. Davis   

Chapters 7, 10, 12, 13: Cultural &  

Ethnic Influences in  

Pharmacotherapeutics; Herbal &  

Nutritional Therapies;  

Pharmacoeconomics; Over-the 

Counter Medications  

Recommended reading: Adams et al.  

chapters 7,8,10,11 

      

Episodic/Focused   SOAP Note Exemplar (pls use this template)
 

Focused   SOAP Note for a patient with chest pain

 S.
  CC: “Chest pain”
 

  HPI: The patient is a 65 year old AA male who developed sudden onset of   chest pain, which began early this morning.  The pain is described as   “crushing” and is rated nine out of 10 in terms of intensity. The pain is   located in the middle of the chest and is accompanied by shortness of breath.   The patient reports feeling nauseous. The patient tried an antacid with   minimal relief of his symptoms.
 

  PMH: Positive history of GERD and hypertension is controlled
 

  FH: Mother died at 78 of breast cancer; Father at 75 of CVA.  No   history of premature cardiovascular disease in first degree relatives.
 

  SH : Negative for tobacco abuse, currently or previously; consumes   moderate alcohol; married for 39 years
 

  ROS   
General–Negative for fevers,   chills, fatigue
Cardiovascular–Negative for   orthopnea, PND, positive for intermittent lower extremity edema
Gastrointestinal–Positive for   nausea without vomiting; negative for diarrhea, abdominal pain
Pulmonary–Positive for   intermittent dyspnea on exertion, negative for cough or   hemoptysis  

 

O.

VS:   BP 186/102; P 94; R 22; T 97.8; 02 96% Wt 235lbs; Ht 70”

General–Pt appears diaphoretic and anxious

Cardiovascular–PMI is in the 5th inter-costal   space at the mid clavicular line. A grade 2/6 systolic decrescendo murmur is   heard best at the

second   right inter-costal space which radiates to the neck.

A   third heard sound is heard at the apex. No fourth heart sound or rub are   heard. No cyanosis, clubbing, noted, positive for bilateral 2+ LE edema is   noted.

Gastrointestinal–The abdomen is symmetrical   without distention; bowel

sounds   are normal in quality and intensity in all areas; a

bruit   is heard in the right para-umbilical area. No masses or

splenomegaly   are noted. Positive for mid-epigastric tenderness with deep palpation.

Pulmonary— Lungs are clear to   auscultation and percussion bilaterally 

Diagnostic   results: EKG, CXR, CK-MB (support with evidenced and guidelines)

A.

Differential   Diagnosis:

1)   Myocardial Infarction (provide supportive documentation with evidence based   guidelines).

2)   Angina (provide supportive documentation with evidence based guidelines).

3)   Costochondritis (provide supportive documentation with evidence based   guidelines).

Primary   Diagnosis/Presumptive Diagnosis: Myocardial Infarction

P. This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

Case #2: 

CASE STUDY 2: Numbness and Pain A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

To Prepare

·  You will be assigned to a specific case study for this Case Study Assignment (Please see Above)

· Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format( as in exampler above) rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

· 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 you were assigned.

· 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.

·  

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided ( ABOVE). Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 

Resource for references

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 7, “Mental Status”

       This chapter revolves around the mental status evaluation of an      individual’s overall cognitive state. The chapter includes a list of      mental abnormalities and their symptoms.

• ·Chapter 23, “Neurologic System”

       The authors of this chapter explore the anatomy and physiology of the      neurologic system. The authors also describe neurological examinations and      potential findings.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 4, “Affective Changes”
This chapter outlines how to identify the potential cause of affective changes in a patient. The authors provide a suggested approach to the evaluation of this type of change, and they include specific tools that can be used as part of the diagnosis.

Chapter 9, “Confusion in Older Adults”
This chapter focuses on causes of confusion in older adults, with an emphasis on dementia. The authors include suggested questions for taking a focused history as well as what to look for in a physical examination.

Chapter 13, “Dizziness”
Dizziness can be a symptom of many underlying conditions. This chapter outlines the questions to ask a patient in taking a focused history and different tests to use in a physical examination.

Chapter 19, “Headache”
The focus of this chapter is the identification of the causes of headaches. The first step is to ensure that the headache is not a life-threatening condition. The authors give suggestions for taking a thorough history and performing a physical exam.

Chapter 31, “Sleep Problems”
In this chapter, the authors highlight the main causes of sleep problems. They also provide possible questions to use in taking the patient’s history, things to look for when performing a physical exam, and possible laboratory and diagnostic studies that might be useful in making the diagnosis.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

• Chapter 2, “The Comprehensive History      and Physical Exam” (“Cranial Nerves and Their Function” and      “Grading Reflexes”) (Previously read in Weeks 1, 2, 3, and 5)

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical examination objective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Neurologic system: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Neurologic system: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Mental status: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Bearden , S. T., & Nay, L. B. (2011). Utility of EEG in differential diagnosis of adults with unexplained acute alteration of mental status. American Journal of Electroneurodiagnostic Technology, 51(2), 92–104.

This article reviews the use of electrocenographs (EEG) to assist in differential diagnoses. The authors provide differential diagnostic scenarios in which the EEG was useful.

Athilingam, P ., Visovsky, C., & Elliott, A. F. (2015). Cognitive screening in persons with chronic diseases in primary care: Challenges and recommendations for practice. American Journal of Alzheimer’s Disease & Other Dementias, 30(6), 547–558. doi:10.1177/1533317515577127

Sinclair , A. J., Gadsby, R., Hillson, R., Forbes, A., & Bayer, A. J. (2013). Brief report: Use of the Mini-Cog as a screening tool for cognitive impairment in diabetes in primary care. Diabetes Research and Clinical Practice, 100(1), e23–e25. doi:10.1016/j.diabres.2013.01.001

Roalf, D. R., Moberg, P. J., Xei, S. X., Wolk, D. A., Moelter, S. T., & Arnold, S. E. (2013). Comparative accuracies of two common screening instruments for classification of Alzheimer’s disease, mild cognitive impairment, and healthy aging. Alzheimer’s & Dementia, 9(5), 529–537. doi:10.1016/j.jalz.2012.10.001. Retrieved from http://www.alzheimersanddementia.com/article/S1552-5260(12)02463-6/abstract 

Understanding family structure and style is essential to patient and family care. Conducting a family interview and needs assessment gathers information to identify strengths, as well as potential barriers to health. This information ultimately helps develop family-centered strategies for support and guidance.

This family health assessment is a two-part assignment. The information you gather in this initial assignment will be utilized for the second assignment in Topic 3.

Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following:

1. Values/Health Perception
2. Nutrition
3. Sleep/Rest
4. Elimination
5. Activity/Exercise
6. Cognitive
7. Sensory-Perception
8. Self-Perception
9. Role Relationship
10. Sexuality
11. Coping

Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview.

Upon completion of the interview, write a 750-1,000-word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment.

Include the following in your paper:

1. Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment.
2. Summarize the overall health behaviors of the family. Describe the current health of the family.
3. Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified.
4. Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

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.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Quantitative Research

Write a fully developed and detailed APA essay addressing each of the following points/questions. There is no required word count; be sure to completely answer all the questions for each question in detail. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least one (1) source using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page are required. Review the rubric criteria for this assignment.

Conduct a literature search to select a quantitative research study related to the problem identified in Module 1 and conduct an initial critical appraisal. Respond to the overview questions for the critical appraisal of quantitative studies, including:

• Is this quantitative research report a case study, case control study, cohort study, randomized control trial or systematic review?
• Where does the study fall in the hierarchy of evidence in terms of reliability and risk of bias?
• Why was the study done? (Define the problem and purpose.)
• Were the steps of the study clearly identified?
• What was the sample size?
• Are the measurements of major variables reliable and valid? Explain.
• How were the data analyzed?
• Were there any untoward events during the conduct of the study?
• How do the results fit with previous research in the area? (This may be reflected in the literature review.)
• What does this research mean to clinical practice?

Additionally, be sure to include the rapid appraisal questions for the specific research design of the quantitative study that you have chosen. These can be found in Chapter 5 of the textbook (Melnyk and Fineout-Overholt, 2015). 

This critical appraisal should be written in complete sentences (not just a numbered list) using APA format. 

Provide a reference for the article according to APA format and a copy of the article.

Assignment Expectations:

Length: Clearly and fully answer all questions; attach a copy of the article
Structure: Include a title page and reference page in APA format. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of one (1) scholarly source for the article is required for this assignment.
Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

SEE ATTACHMENT FOR INITIAL STUDY