Instructions: Response must be at least 500 words per case study, so 1,000 words in total in current 7th ed APA forma. Must include at least 4 academic references cited. Must be grammatically correct.

Integumentary Function:
K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.

Case Study Questions

1. Name the most common triggers for psoriasis and explain the different clinical types.
2. There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.
3. Included in question 2
4. A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking?
5. What others manifestation could present a patient with Psoriasis?

Sensory Function:
C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.

Case Study Questions

1. Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.
2. With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.
3. Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.

  

Mr. Reynolds, age 65, is slowly recovering from a recent heart attack. He has a history of emphysema but is having more difficulty breathing. He dislikes medications and any form of therapy.

Question 1

Using normal anatomy and physiology, discuss how impaired ventilation can interfere with cardiac recovery and function.

Answers may vary.

Question 2

Based on the patient’s medical history and his feelings about recovery programs, in conjunction with the patient’s need for medications and other therapies, discuss the need for medication and participation in recovery programs and possible strategies and the roles of other professionals in support of his recovery from the heart attack and to manage his respiratory condition.

JL, a 50-year-old woman, fell and broke the left tibia at the ankle. She is in the emergency department, waiting for the fracture to be immobilized. The leg hurts and she notes that the ankle is swelling. A diagnosis of a simple fracture and sprain (damage to ligaments) is made.

Question 1

What is the cause of pain and swelling? What can JL expect in the days to come as inflammation resolves and healing begins?

Answers may vary.

Question 2

What is the rationale for immobilizing the fractured bone?

Answers may vary.

Question 3

She is told to come back to the fracture clinic in 24 hours to have her cast checked. What could happen to the inflamed tissue if the edema increases in the casted area?

Answers may vary.

Question 4

She reports feeling fatigued and anorexic, and has a low-grade temperature. What is the cause of these symptoms?

Ms. W. is a 55-year-old patient who consulted her physician because of recurrent epigastric pain and nausea and two recent episodes of vomiting, in which the emesis was dark-colored and granular in appearance. Her history includes heavy alcohol use, cigarette smoking, and persistent headaches. She has not followed all her physician’s previous recommendations but has been controlling her headaches by taking two aspirins every few hours. Following tests, a bleeding gastric ulcer was diagnosed.

Question 1

Discuss the factors contributing to Ms. W.’s condition.

Answers may vary.

Question 2

Discuss synergism, antagonism and potentiation as they apply to this case.

Answers may vary.

Question 3

Discuss the potential effects of increased bleeding from the ulcer.

Answers may vary.

Question 4

Discuss issues related to patient compliance.

 

Assignment:

Determine a work area in your organization that you would like to use for assignments in this course. Focusing on one area will help you organize your work for any future assignment.  

1. Construct a presentation using PowerPoints® with voice over and create a twelve-step project charter for your workflow redesign. This should be about a health care system component (Example of a system component could be the admission process into an emergency room) and frame the project in a quality-improvement modality by establishing a plan for improvement. In your text book page 228-229 list the twelve questions that must be answered for this assignment.
2. Construct a PowerPoint® presentation of a workflow design for the same health care system component using appropriate Yourdon symbols and conventions.
3. Include these steps to create your workflow redesign:
   1. identify process to be mapped;
   2. identify and involve individuals who perform the tasks;
   3. map the current state; assess current state workflow;
   4. identify opportunities for improvement;
   5. identify data to measure redesign outcomes;
   6. map future “to be” process; test new workflows and processes;
   7. train on new workflows and processes;
   8. go live with the new workflows and processes;
   9. and analyze data and refine workflows and processes

The PowerPoints® should include a title page, the twelve-step project charter and then your workflow redesign for the same health care component, then a reference page.

 PLEASE FOLLOW INSTRUCTION BELOW

ZERO PLAGIARISM/SEE RUBRIC DETAILS  ATTACHED

FIVE REFERENCES/ 7TH APA WRITING FORMAT

Before embarking on any professional or academic activity, it is important to understand the background, knowledge, and experience you bring to it. You might ask yourself, “What do I already know? What do I need to know? And what do I want to know?” This critical self-reflection is especially important for developing clinical skills such as those for advanced practice nursing.  

The Psychiatric-Mental Health Nurse Practitioner (PMHNP) Clinical Skills List and Clinical Skills Self-Assessment Form provided in the Learning Resources can be used to celebrate your progress throughout your practicum and identify skills gaps. The list covers all necessary skills you should demonstrate during your practicum experiences.

Just as you did in PRAC 6635, for this Assignment, you assess where you are now in your clinical skill development and make plans for this practicum. Specifically, you will identify strengths and opportunities for improvement regarding the required practicum skills. In this practicum experience, when developing your goals and objectives, be sure to keep assessment and diagnostic reasoning in mind.

To Prepare

• Review the resources and clinical skills in the PMHNP Clinical Skills List document. It is recommended that you print out this document to serve as a guide throughout your practicum.  
• Review the “Developing SMART Goals” resource on how to develop goals and objectives that follow the SMART framework. 
• Review the resources on nursing competencies and nursing theory and consider how these inform your practice. 
• Download the Clinical Skills Self-Assessment Form to complete this Assignment. 

Assignment

Use the PMHNP Clinical Skills Self-Assessment Form to complete the following:   

• Rate yourself according to your confidence level performing the procedures identified on the Clinical Skills Self-Assessment Form.  
• Based on your ratings, summarize your strengths and opportunities for improvement.   
• Based on your self-assessment and theory of nursing practice, develop 3–4 measurable goals and objectives for this practicum experience. Include them on the designated area of the form.