Advanced Health Assessment and Diagnostic Reasoning 2025

Case #3: 38-year-old Native American pregnant female living on a reservation Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

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Complex Regional Pain Disorder White Male With Hip Pain 2025

Decision Point One Savella 12.5 mg once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks Client comes into the office to without crutches but is limping a bit. The client states that the pain is “more manageable since I started taking that drug. I have been able to get around more on my own. The pain is bad in the morning though and gets better throughout the day”. On a pain scale of 1-10; the client states that his pain is currently a 4. When asked what pain level would be tolerable on a daily basis, the client states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.”. When questioned further, the PMHNP asks what makes the pain on a scale of 1-10 different when comparing a level of 9 to his current level of 4?”. The client states that since using this drug, I can get to a point on most days where I do not need the crutches. ” The client is also asked what would need to happen to get his pain from a current level of 4 to an acceptable level of 3. He states, “If I could get to the point everyday where I do not need the crutches for most of my day, I would be happy.” Client states that he has noticed that he frequently (over the past 2 weeks) gets bouts of sweating for no apparent reason. He also states that his sleep has “not been so good as of lately.” He does complain of nausea today Client’s blood pressure and pulse are recorded as 147/92 and 110 respectively. He also admits to experiencing butterflies in his chest.  The client denies suicidal/homicidal ideation and is still future oriented Decision Point Two Continue with current medication but lower dose to 25 mg twice a day RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Client comes to office today with use of crutches. He states that his current pain is a 7 out of 10. “I do not feel as good as I did last month.” Client states that he is sleeping at night but woken frequently from pain down his right leg and into his foot Client’s blood pressure and heart rate recorded today are 124/85 and 87 respectively. He denies any heart palpitations today Client denies suicidal/homicidal ideation but he is discouraged about the recent slip in his pain management and looks sad Decision Point Three Change Savella to 25 mg orally in the MORNING and 50 mg orally at BEDTIME Guidance to Student The client has a complex neuropathic pain syndrome that may never respond to pain medication. Once that is understood, the next task is to explain to the client that pain level expectations need to realistic in nature and understand that he will always have some level of pain on a daily basis. The key is to manage it in a manner that allows him to continue his activities of daily living with as little discomfort as possible. Next, it is important to explain that medications are never the final answer but a part of a complex regimen that includes physical therapy, possible chiropractic care, heat and massage therapy, and medications. Savella is a SNRI that also possesses NMDA antagonist activity which helps in producing analgesia at the site of nerve endings. It is specifically marketed for fibromyalgia and has a place in therapy for this gentleman. Tramadol is never a good option along with other opioid type analgesics. Agonists at the Mu receptors does not provide adequate pain control in these types of neuropathic pain syndromes and therefore is never a good idea. It also has addictive properties which can lead to secondary drug abuse. Reductions in Savella can help control side effects but at a cost of uncontrolled pain. It is always a good idea to start with dose reductions during parts of the day that pain is most under control. The addition of Celexa with Savella needs to be done cautiously. Both medications inhibit the reuptake of serotonin and can, therefore, lead to serotonin toxicity or serotonin syndrome.

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analyze this case study 2025

In your Case Study Analysis related to the scenario provided, explain the following: (2 page minimum required) Explanations need to reflect the given scenario. The factors that affect fertility (STDs). Why inflammatory markers rise in STD/PID. Why prostatitis and infection happens. Also explain the causes of systemic reaction. Why a patient would need a splenectomy after a diagnosis of ITP. Anemia and the different kinds of anemia (i.e., micro and macrocytic). Scenario: A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative. Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, ­ Neuts & Lymphs, sed rate 46 mm/hr, C-reactive protein 67 mg/L CMP wnl Vital signs T 103.2 F Pulse 120 Resp 22 and PaO2 99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. Pelvic exam demonstrates copious foul-smelling green drainage with reddened cervix and + bilateral adenexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.

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Case study analysis 2025

Module 1 Assignment: Case Study Analysis A 34-year-old Hispanic-American male with end-stage renal disease received kidney transplant from a cadaver donor, as no one in his family was a good match. His post-operative course was uneventful, and he was discharged with the antirejection drugs Tacrolimus (Prograf), Cyclosporine (Neoral), and Imuran (Azathioprine). He did well for 3 months and had returned to his job as a policeman. Six months after his transplant, he began to gain weight, had decreased urine output, was very fatigued, and began to run temperatures up to 101˚F. He was evaluated by his nephrologist, who diagnosed acute kidney transplant rejection. Develop a 1- to 2-page case study analysis in which you: Explain why you think the patient presented the symptoms described. Identify the genes that may be associated with the development of the disease. Explain the process of immunosuppression and the effect it has on body systems.

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