Quantitative data collection and analysis – 2025 Data can be qualitative or quantitative Qualitative data are helpful to generate a hypothesis and

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Quantitative data collection and analysis – 2025

 

Data can be qualitative or quantitative. Qualitative data are helpful to generate a hypothesis and gather information if little is known about an expected association. Focus groups, key informant interviews, and case studies are types of qualitative data collection methods used to identify common themes from which to build a hypothesis. Quantitative data collection and analysis are used to test a hypothesis and make comparisons to determine the direction and strength of a potential association. The Behavioral Risk Factor Surveillance System (BRFSS) is cross-sectional panel survey used to collect quantitative data on adult behaviors and risk factors. It is one of the largest U.S. health data collection efforts. The data can be used to analyze associations on a state or country level.

For this assignment, use the “BRFSS Web-Enabled Analysis Tool” and the “Calculation Odds Ratio” worksheet. Refer to the “Odds Ratio Interpretation” document for assistance as needed.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and public health content.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

I need this by Tuesday, (2-23-2021). I have attached 2 attachments reguired for this assignment as well as the rubric. 

Discussion: Review of Current Healthcare Issues – 2025 If you were to ask 10 people what they believe to be the most significant issue facing healthcare today you

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Discussion: Review of Current Healthcare Issues – 2025

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

  • Review the Resources and select one current national healthcare issue/stressor to focus on.
  • Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

By Day 3 of Week 1

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

Case Study: Questionable Medical History Conducted – 2025 Read the Questionable Medical History Conducted Case Study located in Chapter 10 of the textbook You are a

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Case Study: Questionable Medical History Conducted – 2025

 

Read the “Questionable Medical History Conducted Case Study,” located in Chapter 10 of the textbook. You are a health care administrator and have come across a case study from a community hospital. In order to prevent this incident from occurring in your practice setting, prepare a 10-15 slide PowerPoint educational presentation for your staff. Include the following in your presentation: 

  1. Describe the ethical issues and principles that were violated in this case.
  2. Describe the potential legal issues of concern.
  3. What tools or resources should this organization pursue in order to ensure high quality history and physical (H&P)?
  4. Explain whether negligence has occurred in this case. 
  5. Explain which requirements meet the criteria for determining negligence in court.
  6. Describe how this situation can be prevented in your practice setting.

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.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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 not required to submit this assignment to LopesWrite.

Week 3 Discussion theories in nursing – 2025 Week 3 Discussion A phenomenon is the term used to describe a perception or responses to an

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Week 3 Discussion theories in nursing – 2025

Week 3 Discussion

A phenomenon is the term used to describe a perception or responses to an event. Examples of phenomena in nursing include caring and responses to stress. Assumptions are the ideas that we take for granted. They explain the nature of the concepts in the theory, giving it structure.

Choose a middle-range theory or grand theory that, in your opinion, can be applied to research.

  • What is the phenomenon of concern in this theory?
  • What are the assumptions underpinning this theory?

Capstone Project Topic Selection and Approval – 2025 please note this is the approved topic Role of barcode guided drug delivery in reducing medication error by nurse

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Capstone Project Topic Selection and Approval – 2025

 please note this is the approved topic  (Role of barcode-guided drug delivery in reducing medication error by nurse )

In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team.

Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed.

Write a 500-750 word description of your proposed capstone project topic. Include the following:

  1. The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.
  2. The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.
  3. A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
  4. Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
  5. Significance of the topic and its implications for nursing practice.
  6. A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.

You are required to cite to a minimum of eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Plan your time accordingly to complete this assignment.

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

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

Problem/PICOT/Evidence Search (PPE) Worksheet – 2025 Directions Read over each of the following directions You must read the Assignment

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Problem/PICOT/Evidence Search (PPE) Worksheet – 2025

 

Directions

  1. Read over each of the following directions.
  2. You must read the Assignment Practice Scenario below before completing the PPE Worksheet.
  3. Download and use the required PPE Worksheet (Links to an external site.).
  4. Review the information provided in our library of how to search for journal articles here (Links to an external site.).
  5. Review the information provided in our library of how to locate and copy a journal permalink (Links to an external site.).
  6. You are required to complete the worksheet using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.). Click on the envelope at the top of the page.
  7. Complete each section of the Problem/PICOT/Evidence (PPE) Worksheet. For the Clinical PICOT Question,use the NR439 Guide for writing PICOT Questions and Examples (Links to an external site.). Use one of the templates/guides to write your Clinical PICOT Question using all of the PICOT elements. Be sure to include the PICOT letters in your question.
  8. Be sure to use the rubric to make certain you are meeting all grading criteria of the PPE Worksheet.
  9. Submit the completed PPE Worksheet on the Week 3 Assignment page.
  10. Students, A short tutorial with tips for completing the Week 3 Problem/PICOT/Evidence Search (PPE) worksheet assignment may be viewed here.  

Assignment Overview Transcript

Assignment Practice Scenario

Your Chief Nurse Executive (CNE) recognizes you are pursuing your BSN and has asked you to be a member of the nursing evidence-based practice (NEBP) committee. She has advised the members that the purpose is to conduct nursing research studies involving clinical practice problems. Increasing nurses’ awareness of quality and safety concerns will help develop an attitude of inquiry and asking questions (Sherwood & Barnsteiner, 2017). Baccalaureate nurses “collaborate in problem identification, participate in the process of search, retrieval, and documentation of evidence, and integrate evidence using credible databases and internet resources” (AACN, 2008, pp. 16-17).

The CNE has advised all members of the following areas of quality and safety clinical practice that each committee member needs to consider and choose only one as a priority area for conducting a research study. Sources of research problems come from nursing clinical practice (Houser, 2018):

QualitySafety

  • Patient satisfaction
  • Patient education
  • Falls
  • Non-pharmacological pain management

Errors. Examples include:

  • Medication
  • Patient identification
  • Communication
  • Readmissions
  • Length of stay
  • Costs

Healthcare Associated Infections (HAIs). 
Examples include:

  • Central Line Associated Blood Stream Infections (CLABSI)
  • Catheter Associated Urinary Tract Infections (CAUTI)
  • Ventilator Associated Pneumonia (VAP)
  • Surgical Site Infections (SSI)
  • Sepsis (Screening or Prevention)
  • Discharge Teaching/Coaching
  • Transitions of Care/Level of Care
  • Pressure Ulcers
  • Skin Integrity

Your CNE has requested that you select ONLY one topic area and complete the PPE Worksheet using only one topic area. The committee will collaborate and decide as a team which nursing clinical problem area will be the priority focus of their next research study. Thank you for your valuable contributions to this important NEBP committee.

Best Practices

  • For questions about this assignment, please contact your instructor.
  • Spell check for spelling and grammar errors prior to final submission. 
  • Please see the grading criteria and rubrics on this page.
  • Please use your browser’s File setting to save or print this page.

Scholarly Sources and Citations 

  • Use APA format in citations and references.

 

**Academic Integrity**

College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment. 

References

American Association of Colleges of Nurses. (2008). Executive summary: The essentials of baccalaureate education for professional nursing practice. http://www.aacnnursing.org/Education-Resources/AACN-Essentials

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones and Bartlett.

Sherwood, G., & Barnsteiner, J. (2017). Quality and safety in nursing: A competency approach to improving outcomes (2nd ed.). Wiley-Blackwell.

Quality and Safety Education for Nurses. (2018). QSEN knowledge, skills, and attitude competencies. http://qsen.org/competencies/pre-licensure-ksas/

Risk Management Analysis Part 1 – 1000 words ( 4 pages) – 2025 The purpose of this assignment is to analyze a health care risk management program Conduct

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Risk Management Analysis Part 1 – 1000 words ( 4 pages) – 2025

The purpose of this assignment is to analyze a health care risk management program.

Conduct research on approaches to risk management processes, policies, and concerns in your current or anticipated professional arena to find an example of a risk management plan. Look for a plan with sufficient content to be able to complete this assignment successfully. In a 1,000‐1,250-word paper, provide an analysis of the risk management plan that includes the following:

  1. Summary of the type of risk management plan you selected (new employee, specific audience, community‐focused, etc.) and your rationale for selecting that example. Describe the health care organization to which the plan applies and the role risk management plays in that setting.
  2. Description of the standard administrative steps and processes in a typical health care organization’s risk management program compared to the administrative steps and processes you identify in your selected example plan. (Note: For standard risk management policies and procedures, look up the MIPPA-approved accrediting body that regulates the risk management standards in your chosen health care sector, and consider federal, state, and local statutes as well.)
  3. Analysis of the key agencies and organizations that regulate the administration of safe health care in your area of concentration and an evaluation of the roles each one plays in the risk management oversight process.
  4. Evaluation of your selected risk management plan’s compliance with the standards of its corresponding MIPPA-approved accrediting body relevant to privacy, health care worker safety, and patient safety.
  5. Proposed recommendations or changes you would implement in your risk management program example to enhance, improve, or secure the aforementioned compliance standards.

In addition to your textbook, you are required to support your analysis with a minimum of three peer‐reviewed references.

Mr Boyd Case Study – 2025 Mr Boyd Case Study You are a home health nurse visiting an older

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Mr Boyd Case Study – 2025

  

Mr. Boyd Case Study

You are a home health nurse visiting an older couple in the community in order to assess the couple’s functional ability and the potential for their needing assistance with ADLs. Mr. and Mrs. Boyd are 72 and 67 years old, respectively, and have been married for 45 years. They have lived in the same neighborhood since Mr. Boyd retired from his bank manager job 12 years ago. Mrs. Boyd has been a housewife since their marriage. Mr. and Mrs. Boyd have one child, a son who lives in another city about 500 miles away. There are no other family members in their community. As you sit with both of them at the kitchen table, Mrs. Boyd tells you to direct all your questions to her because Mr. Boyd has trouble understanding questions. She goes on to explain that Mr. Boyd used to garden and maintain the yard but no longer seems interested in doing anything. He sleeps a great deal, seems to be eating less and has lost 10 pounds, He is often uncommunicative when she speaks to him. She says that her husband is getting quite forgetful, has received a diagnosis of early dementia and that this worries her because he was always socially engaging and a man who could speak on several subjects. Mrs. Boyd tells you that she makes all the decisions and spends most of her time planning meals, doing housework, and attending her ladies’ church group. She says that she could really use some help with outdoor tasks because these tasks had been handled by Mr. Boyd until just recently. When you ask what she means by “recently,” Mrs. Boyd replies that a change seems to have occurred within the last 6 months. You thank Mrs. Boyd for sharing this information with you, and you indicate that most of the questions can be directed to her but that you will be asking Mr. Boyd some questions as part of the assessment. Mrs. Boyd seems concerned by this but agrees to give you an opportunity to try and ask some questions of Mr. Boyd. You begin your assessment by asking Mr. Boyd about his ADLs, and clarifying the information with Mrs. Boyd. Mr. Boyd was unable to offer any additional information and seemed overwhelmed by the questions and began to cry. Mrs. Boyd added the additional information that Mr. Boyd needs help with all of his ADL’s, showering, getting dressed and brushing his teeth. He needs reminders to eat but eats poorly about a third of his meals. He has had 2 falls recently but was not hurt. He wandered out of the house and got lost a week ago. He does not complain about pain but does seem to be massaging his legs from time to time. He has a grimace on his face at this time. Mrs. Boyd begins to cry and hold Mr. Boyd’s hand. Once you have completed your assessment on Mr. Boyd use the information from the case study to complete your Basic Nursing Care Client Assessment, and the Pain and Morse Falls assessments.

Upon completion of your Assessments on Mr. Boyd, organize the data as if you were gathering it to enter on an EHR under assessment. Create an SBAR note on one of the problem you identified through your assessment (see sample and review chapters on documentation to be sure you remember how to do this) regarding needing to call the physician about the problem. Then create a nurses note inclusive of all of the problems that you identified and would document on the HER as a nurses note (review documentation chapter and ATI documentation to refresh how to do this). Lastly you will create a plan of care for one of your client’s problems by completing the concept map that uses the Nursing Process (Review the chapters on nursing process if needed to refresh). Identify the problem your patient has (ex. At risk for falling) by using the data (subjective and objective) that supports that this is a problem. You will need to set a specific, measurable outcome (goal) to achieve with a timeframe for when you will hope to achieve the goal. Find interventions (things you do to solve the problem) in your Perry and Potter textbook in the chapters that are relevant to the problem you identified for your patient (put the page # and source for the interventions you used) and then cite your full reference on the concept map. Evaluate what you would like to have happen if the interventions you chose worked out for your patient. This is a work alone and not a team assignment. Submit everything on canvas.

2 assignments on Psychopharmacology – 2025 Therapy for Patients With Sleep Wake Disorders From negative changes in mood to problems concentrating sleep wake disorders

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2 assignments on Psychopharmacology – 2025

  

Therapy for Patients With Sleep/Wake Disorders

From negative changes in mood to problems concentrating, sleep/wake disorders can have a tremendous impact on patients’ lives. When patients suffer from these disorders, they often seek medical care with the intent of receiving medications to manage symptoms. However, many of the medications used to treat sleep/wake disorders may be addictive, making thorough patient assessments and close follow-up care essential. To prescribe appropriate therapies with patient safety in mind, you must understand not only the pathophysiology of these disorders but also the pharmacologic agents used to treat them.

This week, as you study therapies for individuals with sleep/wake disorders, you examine the assessment and treatment of patients with these disorders. You also explore ethical and legal implications of these therapies.

Learning Objectives

Students will:

· Synthesize concepts related to the psychopharmacologic treatment of patients

· Assess patient factors and history to develop personalized therapy plans for patients with sleep/wake disorders

· Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring therapy for sleep/wake disorders

· Synthesize knowledge of providing care to patients presenting for sleep/wake disorders

· Analyze ethical and legal implications related to prescribing therapy for patients with sleep/wake disorders

  

Learning Resources

Required Readings (click to expand/reduce)

https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cat06423a&AN=wal.DSM5&site=eds-live&scope=site

https://ezp.waldenulibrary.org/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocview%2F2422903356%3Faccountid%3D14872

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/

https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_Narcolepsy.pdf

https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_NightWakingsChildren.pdf

https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6470

https://ezp.waldenulibrary.org/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocview%2F1720529955%3Faccountid%3D14872

Medication Resources (click to expand/reduce)

https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?source=deepLink&institution=SZMC%5ESZMC%5ET43537

Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments.

   

· alprazolam

· amitriptyline

· amoxapine

· amphetamine

· desipramine

· diazepam

· doxepin

· eszopiclone

· flunitrazepam

· flurazepam

· hydroxyzine

·  imipramine

· lemborexant

· lorazepam

· melatonin

· methylphenedate

· modafinil

· armodafinil

· carnitine

· clomipramine

· clonazepam

· nortriptyline

· pitolisant

· ramelteon

· sodium oxybate

· solriamfetol

· SSRI’s

· temazepam

· trazodone

· triazolam

· trimipramine

· wellbutrin

· zaleplon

· zolpidem

Required Media (click to expand/reduce)

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/DT/week_11/index.html

Required Media (click to expand/reduce

  

Assignment 1: Short Answer Assessment

As a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

Photo Credit: Getty Images/Collection Mix: Sub

To Prepare

· Review the Learning Resources for this week.

· Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.

· Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health.

To complete:

Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?

2. List 4 predictors of late onset generalized anxiety disorder.

3. List 4 potential neurobiology causes of psychotic major depression.

4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.

5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific. 

Assignment 2: Assessing and Treating Patients With Sleep/Wake Disorders

Sleep disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health, safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with psychopharmacologic treatments, however, many of these drugs can have negative effects on other aspects of a patient’s health and well-being. Additionally, while psychopharmacologic treatments may be able to address issues with sleep, they can also exert potential challenges with waking patterns. Thus, it is important for the psychiatric nurse practitioner to carefully evaluate the best psychopharmacologic treatments for patients that present with sleep/wake disorders.

Reference: Mayo Clinic. (2020). Sleep disorders. https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018

To prepare for this Assignment:

· Review this week’s Learning Resources, including the Medication Resources indicated for this week.

· Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with sleep/wake disorders.

The Assignment: 5 pages

Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

NOTE

FOR THIS ASSIGNMENT, YOU WILL WORK WITH :

DECISION 1: TRAZADONE 50-100 MG DAILY AT BEDTIME.

DECISION 2: DECREASE TRAZADONE TO 25 MG AT BEDTIME

DECISION 3 : CONTINUE TRAZADONE AND ENCOURAGE SLEEP HYGIENE.

Case study – 2025 A 58 year old obese white male presents to ED with chief complaint of fever chills pain and swelling in

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Case study – 2025

A 58-year-old obese white male presents to ED with chief complaint of fever, chills, pain, and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg po q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 6.7 mg/dl.