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CASE STUDY – 2025 Subjective Mark a 48 year old male presents to the office with mild to moderate chest pressure with radiation to his
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CASE STUDY – 2025
Subjective
Mark, a 48 year-old male, presents to the office with mild-to-moderate chest pressure with radiation to his back. Mark reports that he was awakened from sleep at 0700 with chest pressure. Initially described as soreness across his anterior chest and through to his back. He rates his pain +6/10. He felt as though if he could just belch, he would feel better. His wife drove him to the office to be here when it opened at 0900. She tried to convince Mark to go to the emergency room, but he emphatically refused, insisting on going to the office first. Upon arrival to the office, you take Mark back to an examination room and instruct the receptionist to call 911.
Past medical/surgical history: Diabetes mellitus type 2
Family history: He has a family history of premature coronary artery disease. His father died of acute myocardial infarction (AMI) at age 45. One brother died of AMI at age 49.
Social history: He has smoked for 25 years but has reduced his smoking to 1 pack per day since his brother’s death 2 years ago. He has put on 25 pounds in the past 2 years and is generally sedentary
Medications: Metformin XR 500mg daily, Last A1C was 7.4
Allergies: Latex
Objective
General: Anxious and shows Levine’s sign as you enter the office room. He is slightly diaphoretic.
Vital signs: BP 192/96, P: 102, RR-22, T-98.8, SpO2 is 90%
ECG: ST segment depression and T wave inversion in leads II and III
CV: Heart tones are muffled with an S3 gallop. Hands and feet are cool to touch. Radial pulses are 2+. Pedal and posterior tibial pulses are 1+. Neck vein distention of 5cm with HOB at 90 degrees.
Respiratory: Rhonchi in upper lobes bilaterally and a non-productive cough
Abdomen: Positive bowel sounds in all 4 quadrants, soft, non-tender, no masses felt.
The provider sent the patient immediately to the Emergency Department. Upon arrival and within 2 hours of arrival for care, troponin was 6 ng/dl, Chemistry panel: Na, K, CL were WNL, BUN 20, Creatinine 0.8, serum glucose 189.
Question answers should be based on evidence found in readings and from peer-reviewed literature. At least two sources must be used and cited in APA format for each question. Only one source can be a textbook. Resources should generally be within 5 years unless you are explaining the pathophysiology of a disease or providing pertinent background information.
Discussion Questions:
Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief – 2025 It may seem to you that healthcare has been a national topic of debate among political leaders for as long
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Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief – 2025
It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.
Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.
As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.
In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.
To Prepare:
The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)
Part 1: Agenda Comparison Grid
Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:
Part 2: Agenda Comparison Grid Analysis
Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:
Part 3: Fact Sheet or Talking Points Brief
Using the information recorded on the template in Parts 1 and 2, develop a 1-page Fact Sheet or Talking Points Brief that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. You can use Microsoft Word or PowerPoint to create your Fact Sheet or Talking Point Brief. Be sure to address the following:
Discussion – 2025 Discussion Legal and Ethical Considerations for Group and Family Therapy Considering the Health Insurance Portability and Accountability
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Discussion – 2025
Discussion: Legal and Ethical Considerations for Group and Family Therapy
Considering the Health Insurance Portability and Accountability Act (HIPPA), the idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric mental health nurse practitioner does. In your role, learning how to provide this type of therapy within the limits of confidentiality is essential. For this Discussion, consider how limited confidentiality and other legal and ethical considerations might impact therapeutic approaches for clients in group and family therapy.
To prepare:
Review this week’s Learning Resources and consider the insights they provide on group and family therapy.
View the media, Legal and Ethical Issues for Mental Health Professions, Volume I, and reflect on legal and ethical considerations for group and family therapy and individual therapy.
Post an explanation of how legal and ethical considerations for group and family therapy differ from those for individual therapy.
Then, explain how these differences might impact your therapeutic approaches for clients in group and family therapy.
Support your rationale with evidence-based literature.
Link to download the media Legal and Ethical Issues for Mental Health Professions:
https://waldenu.kanopy.com/product/legal-and-ethical-issues-mental-health-pro
W#6 – Advance health – 2025 Discussion 1 Men s Health Planning This discussion will allow you to examine several different preventive
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W#6 – Advance health – 2025
Discussion 1: Men’s Health Planning
This discussion will allow you to examine several different preventive guidelines related to men’s health.
Choose only ONE of the following topics and respond to the thread corresponding to the question you select.
Please include at least three scholarly sources within your initial post.
Topic 1: Colorectal Cancer Screening
A 47-year-old man presents to your clinic for a routine physical. He considers himself to be “fairly healthy” and doesn’t routinely go to the doctor. His last physical was five years ago. In reviewing his chart, you see that his BMI is 30, he exercises twice a week at the local gym, and he does not take any medication. Part of your discussion during today’s visit is about screening for colorectal cancers. He did endorse some constipation in the review of systems. He noted an uncle in his family history who was diagnosed at age 54 with colon cancer. You begin to talk about colorectal screening, and the patient interrupts you and tells you that he is only 47 and that he should not have to worry about it until he is 50.
1. What are the recommendations and source(s) for the colorectal cancer screening test?
2. The patient thinks he does not have to worry about “being screened” until age 50. Is he correct? Why or why not? What age would you recommend screening for this patient and why? Does his family history come into play here?
3. What age would you recommend screening for this patient and why? Does his family history come into play here?
4. What are the screening options for this patient, and which would you recommend? Why?
Topic 2: Prostate Cancer Screening
Your patient is an otherwise healthy, white 55-year-old man who presents for his annual physical. He has a history of hypertension and takes Losartan 50 mg daily. His family history is negative for cardiovascular disease or cancer. His review of systems is negative. The patient is a paramedic and exercises regularly. The patient’s BMI is 23. He states that one of his friends was diagnosed with prostate cancer and asks if he needs to be screened.
1. Which screening guidelines would you utilize?
2. Keeping the guideline you used in mind, explain and provide rationales for whether you would change your recommendations if:
a) The patient had a family history of prostate cancer.
b) The patient was African American.
c) The patient was 76 years old.
Topic 3: Testicular Cancer Screening
A 35-year-old African American male is being seen for a pre-employment physical. His father was recently treated for prostate cancer. His BMI is 24, and his past medical history was negative except for an appendectomy 15 years ago. He states he is too young to be screened for prostate cancer, but he wants to be screened for testicular cancer.
1. What are the primary risk factors for testicular cancer?
2. What are the screening options for testicular cancer, and which guidelines did you utilize?
3. Is screening recommended for this patient, and how would you counsel this patient?
– Please include at least three scholarly sources within your post.
– Minimum 400 words.
TURNITIN ASSIGNMENT.