2025 Professor instructions reply to two other students and include a reference that justifies your post Your reply must be

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Na Fernandez 2025

Professor instructions reply to two other students and include a reference that justifies your post. Your reply must be at least 3 paragraphs. Student post Nursing Profession Views on nursing as a career or a job and my professional objectives related to nursing. The unique roles of nurses comprise of caring for patients and assessing their reactions to health status. I believe this helps the sick in the performance of various activities that enhance their recovery. Within the nursing care environment, nurses with other healthcare workers share their functions of planning, implementing, and assessment to ensure adequate health systems that promote health, caring for the ill, and prevents illness (Masters, 2018). Nurses should always work with an intention that is beyond just getting a salary because all this task requires a lot of commitments and determination that is voluntary.Nursing is, therefore, more of a career than a job because it is a sequence of connected service opportunities. Continuing professional advancement is an expectation and expression need for the nurses in all the career stages (Barber Rioja, & Rosenfeld, 2018). It is with this regard that I aim to uphold my character of integrity and honesty. This is through ensuring that I do not copy professional evaluations and ensuring that I aspire for high levels of professional and personal conduct. Again, my professional goal is to work together with other medical professionals, and through this, I believe that I will develop my skills every day in nursing. I also aim to treat every patient individually, putting in mind that the individuals have diverse beliefs, values, and needs. I believe in the fact that in nursing, care is a priority where communication is core. I aim to provide advice and information precisely so that patients can understand and make informed decisions for the best interest of the customers. I believe that all this set of values will elevate the quality of nursing care as a way of improving the methods, judgments, and standards that direct nursing practices every day. Working in professional environments enhances skills developments that are of great significance at any stage of the career (Price & Reichert, 2017). Steps to take in preparation for an interview I believe that any skills and potential possessed by one does not mean anything without conquering a nursing interview. It becomes difficult for an individual to go to the next stage of his career, and this can be very devastating. I believe that evaluating myself is one way to ace an interview. Before the actual interview, I will formulate a list of questions and try to answer them in front of a mirror or even ask help from friends or relatives. Through this, I can find the answers to the questions I expect in the interview panel. Also, I will research the specific institution where I am to avail myself of the interview through their websites or visiting before the day of the interview. I believe this is the best way to check if my own professional and personal values rhyme with theirs, and this will put me ahead of the competition in an interview. Moreover, I will prepare my documents before the time comes. This is core because it will enable help me make sure that I do not miss out on anything that can be of help in the interview. On the day of the interview, I will ensure that I look professional. It means that I will glue to dressing modestly and avoid dresses that are flashy. Planning my day is another thing that I believe to be core. I will check the weather forecast the night before the interviews to enable me to pick appropriate attire. I will also check on the institutions’ locations and plan for the best mode of transportation that will ensure I get to the interview before time. I will also ensure that I get enough sleep before the day of the interview to ensure the optimal cognitive presentation References Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences , 7 (2), 17. Barber Rioja, V., & Rosenfeld, B. (2018). Addressing linguistic and cultural differences in the forensic interview. International Journal of Forensic Mental Health , 17 (4), 377-386. Masters, K. (2018). Role development in professional nursing practice . Jones & Bartlett Learning.

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2025 Violence does not discriminate against any social or economic position or situation It can be physical emotional or psychological and

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2 Coments Each One 150 Words (CITATION AND REFERENCE). BY 2/22 2025

Violence does not discriminate against any social or economic position or situation. It can be physical, emotional or psychological and usually is inflicted by a close family member (Ford-Gilboe, 2016). Characteristics that trigger providers of violence taking place is patients arriving at the emergency room with a trauma that is not related to an illness, withdrawn behavior or changes that are not normal in their everyday mood, depression, and anxiety. Other behaviors that something is wrong, is observing self-harm, suicide comments, and anything from the person’s norm (Mayo Clinic, 2017). Working in a Cardiac Unit, I have seen the abuse of a patient where the patient is abandoned or not cared for the way they should be. I see many patients where the family members (spouse, son or daughter), no longer want to be apart in their care. Once, I received a call from a daughter wanting to know if her mom has died yet. I had trouble responding because it was cold-hearted. My facility’s procedure is to report these types of abuse as soon as possible. We wait for the right time when the patient is alone to approach them with another nurse and question them about the abuse signs or abandonment noted by family members. We also inform the Charge Nurse so a message can be sent to a Social Worker and Adult Protective Services can be notified. Most of the time, once APS is involved, we do not know the outcome of the investigation. The goal is to protect a victim of abuse of any age (Mayo Clinic, 2017). Reference Ford-Gilboe, M., Wathen, C. N., Varcoe, C., MacMillan, H. L., Scott-Storey, K., Mantler, T., Hegarty, K., & Perrin, N. (2016). Development of a brief measure of intimate partner violence experiences: the Composite Abuse Scale (Revised)-Short Form (CASR-SF). BMJ Open , 6 (12), e012824. https://doi.org/10.1136/bmjopen-2016-012824 Mayo Clinic. (2017, March 1). Domestic violence: How to leave a dangerous situation. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/domestic-violence/art-20048397 National Domestic Violence Hotline. (2020). Is This Abuse? Retrieved from https://www.thehotline.org/is-this-abuse/ There are various concerns that hinder healthy living among families. Such include; domestic violence, child abuse and elder abuse. By definition domestic violence which generally involves intimate partner violence describes physical violence, sexual violence, stalking, or psychological harm by a current or former partner or spouse. Child abuse on the other hand is any act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child. Lastly elder abuse refers to an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult. (CDC, 2019). Some of the characteristics to look for while assessing domestic violence are; when an individual is fearful of their partner who is in most cases the abuser, when the abuser acts in a controlling manner, when they yell and throw things around, when the victims sustain but hide body injuries, when the victims isolate themselves, are depressed and engage in health risk behaviors like smoking, excessive drinking and even suicidal attempts. Secondly, ways of recognizing child abuse include; when the child has unexplained burns, bites, bruises, broken bones or black eyes, seems frightened by the presence of the abuser who may be a care giver, when a child becomes watchful as though preparing for something worse to happen, when the child starts abusing animals or other kids, when they show change in behavior by being rude or intentionally careless and when they get overly protective of their private parts among others. Lastly, signs of adult abuse include; poor hygiene, injuries such as bruises, cuts and broken bones, symptoms of anxiety, depression or confusion, weight loss, unexplained transactions of money and withdrawal from family members et cetera (CDC, 2019) Due to the negative impacts of health from such issues, health institutions have devised policies and procedures of reporting these types of abuse. In my facility, the purpose of the abuse policy is to identify, document and report suspected abuse, neglect and/or assault and to offer appropriate resources to patients and their families. If a healthcare professional suspects any of the above types of abuse or neglect, they are legally mandated under the state of North Dakota to report it by completing a given form specific to the type of abuse. Once completed, they are expected to notify the social worker or case manager of its completion, who will then make contact with the appropriate agency. The social worker then documents pertinent information related to the specific forms in power form. Also, while doing these necessary procedures, the professional’s first priority is ensuring safety of the patient from the suspected abuser. If the victim is a child for example, the child may be kept in the custody of the hospital for not more than 96hours and the healthcare provider must notify the juvenile court and the department of children in order that child-protective proceedings may be instituted. Conclusively, it is important to educate families on such signs of abuse and also provide them with contact information of resources that can ensure their safety in the event that any of these abuses is suspected (Falkner, 2018) References. Center for Disease Control and Prevention, (2019). Injury center: Violence prevention. Retrieved from https://www.cdc.gov>violenceprevention Falkner, A. (2018). In GCU’s Health Promotion: Health and Wellness Across the Continuum. Retrieved from https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/health-promotion_health-and-wellness-across-the-continuum_1e.php

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2025 As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders it is important to not

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Discussion: Pharmacokinetics And Pharmacodynamics 2025

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics. Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body. Photo Credit: Getty Images/Ingram Publishing When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease. For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug. To Prepare Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics. Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug. Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease. Think about a personalized plan of care based on these influencing factors and patient history in your case study. Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples. at least four references

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2025 1 Create an infographic teaching tool for the community educational project View these links on how to create infographics o

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Assignment 2025

1. Create an infographic teaching tool for the community educational project. View these links on how to create infographics: o https://www.visme.co/make-infographics/ o http://blog.hubspot.com/blog/tabid/6307/bid/34223/5-Infographics-to-Teach-You-How-to-Easily-Create-Infographics-in-PowerPoint-TEMPLATES.aspx o http://blog.hubspot.com/marketing/free-ppt-infographic-templates-designs-ht Submit an 8 X 11.5 color (one page Word or pdf. document) infographic teaching tool for your chosen community. Please also submit a reference page in APA format with at least two references you used as sources for the information on the infographic.

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2025 Question 1 1 out of 1 points Mrs Rosen is a 49 year old patient

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(Multiple Choice) NURS 6630 Final Exam (2020)…. 2025

Question 1 1 out of 1 points Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? . All of the above • Question 2 0 out of 1 points An elderly woman with a history of Alzheimer’s disease, coronary artery disease, and myocardial infarction had a fall at home 3 months ago that resulted in her receiving an open reduction internal fixation. While assessing this patient, the PMHNP is made aware that the patient continues to experience mild to moderate pain. What is the PMHNP most likely to do? . Order an X-ray because it is possible that she dislocated her hip. • Question 3 1 out of 1 points The PMHNP is caring for a patient who reports excessive arousal at nighttime. What could the PMHNP use for a time-limited duration to shift the patient’s brain from a hyperactive state to a sleep state? . Benzodiazepines • Question 4 1 out of 1 points A patient addicted to heroin is receiving treatment for detoxification. He begins to experience tachycardia, tremors, and diaphoresis. What medication will the PMHNP prescribe for this patient? . Clonidine (Catapres) • Question 5 1 out of 1 points The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? . It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels. • Question 6 1 out of 1 points A patient with hypersexual disorder is being assessed for possible pharmacologic treatment. Why does the PMHNP prescribe an antiandrogen for this patient? . It will block testosterone. • Question 7 1 out of 1 points Which statement best describes a pharmacological approach to treating patients for impulsive aggression? . Opioid antagonists can be used to reduce drive. • Question 8 1 out of 1 points A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? . ADHD is often not the focus of treatment in adults with comorbid conditions. • Question 9 1 out of 1 points A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe? . Duloxetine (Cymbalta) • Question 10 1 out of 1 points Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) medication for their son. Which medication would the PMHNP start? ll of the above could potentially treat their son’s symptoms. • Question 11 1 out of 1 points Which of the following is a true statement regarding the use of stimulants to treat attention deficit hyperactivity disorder (ADHD)? . Signal strength output is increased by dialing up the release of dopamine (DA) and norepinephrine (NE). • Question 12 1 out of 1 points Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs,” he says. Which statement best describes the neurobiological parallels between food and drug addiction? . There is decreased activation of the prefrontal cortex. • Question 13 1 out of 1 points A 72-year-old male patient is in the early stages of Alzheimer’s disease. The PMHNP determines that improving memory is a key consideration in selecting a medication. Which of the following would be an appropriate choice? . All of the above • Question 14 1 out of 1 points A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side effects with the patient? . The medication can affect your blood pressure. • Question 15 1 out of 1 points The parents of a 7-year-old patient with ADHD are concerned about the effects of stimulants on their child. The parents prefer to start pharmacological treatment with a non-stimulant. Which medication will the PMHNP will most likely prescribe? . Strattera • Question 16 1 out of 1 points The PMHNP is assessing a patient who has expressed suicidal intent and is now stating that he is hearing voices and sees people chasing him. The PMHNP identifies these symptoms to be associated with which of the following? . “Bath salt” intoxication • Question 17 1 out of 1 points An 80-year-old female patient diagnosed with Stage II Alzheimer’s has a history of irritable bowel syndrome. Which cholinergic drug may be the best choice for treatment given the patient’s gastrointestinal problems? . Donepezil (Aricept) • Question 18 1 out of 1 points A 63-year-old patient presents with the following symptoms. The PMHNP determines which set of symptoms warrant prescribing a medication? Select the answer that is matched with an appropriate treatment. . Impairment in the ability to learn and retain new information is most problematic, and an appropriate treatment option would be donepezil. • Question 19 1 out of 1 points The PMHNP is caring for a patient with chronic insomnia who is worried about pharmacological treatment because the patient does not want to experience dependence. Which pharmacological treatment approach will the PMHNP likely select for this patient for a limited duration, while searching and correcting the underlying pathology associated with the insomnia? . Non-benzodiazepine hypnotics • Question 20 1 out of 1 points The PMHNP is performing a quality assurance peer review of the chart of another PMHNP. Upon review, the PMHNP reviews the chart of an older adult patient in long-term care facility who has chronic insomnia. The chart indicates that the patient has been receiving hypnotics on a nightly basis. What does the PMHNP find problematic about this documentation? . Hypnotics have prolonged half-lives that can cause drug accumulation in the elderly. • Question 21 1 out of 1 points The PMHNP is evaluating a 30-year-old female patient who states that she notices pain and a drastic change in mood before the start of her menstrual cycle. The patient states that she has tried diet and lifestyle changes but nothing has worked. What will the PMHNP most likely do? . Prescribe desvenlafaxine (Pristiq), 50 mg daily • Question 22 1 out of 1 points The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain? . Imipramine (Tofranil) • Question 23 1 out of 1 points The PMHNP is assessing a patient she has been treating with the diagnosis of chronic pain. During the assessment, the patient states that he has recently been having trouble getting to sleep and staying asleep. Based on this information, what action is the PMHNP most likely to take? . Order hydroxyzine (Vistaril), 50 mg PRN or as needed • Question 24 1 out of 1 points The PMHNP is attempting to treat a patient’s chronic insomnia and wishes to start with an initial prescription that has a half-life of approximately 1–2 hours. What is the most appropriate prescription for the PMHNP to make? . Triazolam (Halcion) • Question 25 1 out of 1 points A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe? . Naltrexone • Question 26 1 out of 1 points The PMHNP has been asked to provide an in-service training to include attention to the use of antipsychotics to treat Alzheimer’s. What does the PMHNP convey to staff? . Both “A” & “C.” • Question 27 1 out of 1 points A 14-year-old patient is prescribed Strattera and asks when the medicine should be taken. What does the PMHNP understand regarding the drug’s dosing profile? . The patient will have one or two doses a day. • Question 28 1 out of 1 points Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions? . Alcoholism • Question 29 1 out of 1 points Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options? . “Naltrexone may be an appropriate option to discuss.” • Question 30 1 out of 1 points The PMHNP is caring for a patient with chronic insomnia who would benefit from taking hypnotics. The PMHNP wants to prescribe the patient a drug with an ultra-short half-life (1–3 hours). Which drug will the PMHNP prescribe? . Triazolam (Halcion) • Question 31 1 out of 1 points A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know how he can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority? . Prescribe lidocaine 5% • Question 32 1 out of 1 points The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient? . Matching the patient’s symptoms with the malfunctioning brain circuits and neurotransmitters that might mediate those symptoms • Question 33 1 out of 1 points The PMHNP is caring for a patient who openly admitted to drinking a quart of vodka daily. Prior to prescribing this patient disulfiram (Antabuse), it is important for the PMHNP to: . Evaluate the patient’s willingness to abstain from alcohol • Question 34 1 out of 1 points A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that which of the following medications may be beneficial in augmenting stimulant medication? . Guanfacine ER (Intuniv) • Question 35 1 out of 1 points An adult patient presents with a history of alcohol addiction and attention deficit hyperactivity disorder (ADHD). Given these comorbidities, the PMHNP determines which of the following medications may be the best treatment option? . Atomoxetine (Strattera) • Question 36 1 out of 1 points The PMHNP prescribes an obese patient phentermine (Adipex-p)/topiramate ER (Topamax) (Qsymia), Why is topiramate (Topamax) often prescribed with phentermine (Adipex-P)? . Phentermine (Adipex-P) works by suppressing appetite while topiramate (Topamax) acts by inhibiting appetite. • Question 37 0 out of 1 points The PMHNP evaluates a patient presenting with symptoms of dementia. Before the PMHNP considers treatment options, the patient must be assessed for other possible causes of dementia. Which of the following answers addresses both possible other causes of dementia and a rational treatment option for Dementia? . Possible other causes: hypothyroidism, Cushing’s syndrome, multiple sclerosis Possible treatment option: memantine • Question 38 1 out of 1 points The PMHNP is assessing a patient who presents with elevated levels of brain amyloid as noted by positron emission tomography (PET). What other factors will the PMHNP consider before prescribing medication for this patient, and what medication would the PMHNP want to avoid given these other factors? . Both “A” & “B” • Question 39 1 out of 1 points The PMHNP is discussing dopamine D2 receptor occupancy and its association with aggressive behaviors in patients with the student. Why does the PMHNP prescribe a standard dose of atypical antipsychotics? . The doses are based on achieving 60% D2 receptor occupancy. &

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2025 NOTE Please no plagiarism 3 to 5 pages this is for school admission I

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FAMILY NURSE ENTRACE ESSAY 2025

NOTE: Please no plagiarism, 3 to 5 pages, this is for school admission, I am already a practicing baccalaureate prepared nurse, and finally I am pursuing a Family Nurse Practitioner now. How to answer the essay question The essay question needs to address the following topics: · Why have you chosen to pursue nursing as a career? · What qualities and attributes do you believe you possess that will enable you to perform effectively as a student and later as a practicing baccalaureate prepared nurse? · How can nursing address and improve global healthcare needs?

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2025 One of the responsibilities of the medical administrator is handling sorting and distributing the incoming mail In 1 to

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Foundations Of Medical Administration Module 2 2025

One of the responsibilities of the medical administrator is handling, sorting, and distributing the incoming mail. In 1 to 2 pages address the following: Identify four kinds of mails that may be received at a typical medical office. Identify how to manage the privacy of incoming mail (electronic and paper). Identify steps for handling all type of mail marked urgent. Identify system(s) that should be created to ensure all mail is properly distributed.

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2025 Need help to reply three post DO NOT JUST REPEAT SAME INFORMATION DO

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W8 REPLY 2025

Need help to reply three post. DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION. 1- Each reply should be at least 200 words. 2- One scholarly reference ( NO MAYO CLINIC/ AHA) 3- APA style needs to be followed. 4- Each response should have reference at the end 5- Reference should be within last 5 years

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2025 Chief complaint I m here for a medication refill because I ran out of my medicines

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Discussion Board 2025

Chief complaint: “I’m here for a medication refill because I ran out of my medicines”. HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home. She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway. PMH: Primary Hypertension, Previous history of MI 1 year ago Surgeries: 1 year ago-Left Anterior Descending (LAD) cardiac stent placement Allergies : Penicillin Vaccination History: Up-to-date Social history: High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago. Family history: Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52. ROS: Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks. Psychiatric: Non-contributory. Physical examination: Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored HEENT : Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK : Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS : + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART : Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN : No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY : No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL : + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH : Normal affect. Cooperative. SKIN : No rashes. Positive for dry skin. Labs : Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98. A: Primary Diagnosis: Congestive Heart Failure (CHF) Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA) Differential Diagnosis: Peripheral Vascular Disease (PVD) Plan: Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index. Additional lab results : Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 % BNP – not available. As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease). Questions: 1. According to the ACC/AHA guidelines, what medications should this patient be prescribed? 2. Does he need medication(s) given his history of MI?

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2025 Chief complaint I m here for a medication refill because I ran out of my medicines

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Discussion Case Study Apa Style Two References. 2025

Chief complaint: “I’m here for a medication refill because I ran out of my medicines”. HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home. She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway. PMH: Primary Hypertension, Previous history of MI 1 year ago Surgeries: 1 year ago-Left Anterior Descending (LAD) cardiac stent placement Allergies : Penicillin Vaccination History: Up-to-date Social history: High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago. Family history: Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52. ROS: Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks. Psychiatric: Non-contributory. Physical examination: Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored HEENT : Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK : Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS : + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART : Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN : No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY : No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL : + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH : Normal affect. Cooperative. SKIN : No rashes. Positive for dry skin. Labs : Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98. A: Primary Diagnosis: Congestive Heart Failure (CHF) Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA) Differential Diagnosis: Peripheral Vascular Disease (PVD) Plan: Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index. Additional lab results : Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 % BNP – not available. As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease). Questions: 1. According to the ACC/AHA guidelines, what medications should this patient be prescribed? 2. Does he need medication(s) given his history of MI?

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