Differential diagnosis. 2025

Janet, a 20 year-old college student, is experiencing a five-week history of itchy eyes and nasal congestion with watery nasal discharge. She also complains of a “tickling” cough, especially at night, and she has had episodes of repetitive sneezing. Janet gets frequent “colds” every spring and fall. Physical Examination Vital Signs: Temp, 98.8; BP 110/68; Pulse 72; Respirations 18 Skin: Flaking erythematous rash on the flexor surfaces of both arms Head, Eyes, Ears, Nose, and Throat: Tender over maxillary sinuses; sclera red and slightly swollen with frequent tearing; outer nares with red, irritated skin; internal nares with red, boggy, moist mucosa and one medium-sized polyp on each side; pharynx slightly erythematous, with clear postnasal drainage Lungs: Clear to auscultation and percussion Discussion Questions: 1. Provide three differential diagnoses based on Janet’s subjective and objective data and discuss your reasoning for each. 2. What additional history questions would be useful in your evaluation of Janet? 3. Discuss the pathophysiological process of your primary diagnosis. 4. Differentiate the types of hypersensitivity mechanisms. 5. As per your analysis, what type of hypersensitivity reaction is Janet experiencing? Two pages minimun.

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Respiratory Alterations 2025

Respiratory Alterations In clinical settings, patients often present with various respiratory symptoms such as congestion, coughing, and wheezing. While identifying a symptom’s underlying illness can be challenging, it is essential because even basic symptoms such as persistent coughing can be a sign of a more severe disorder. Advanced practice nurses must be able to differentiate between moderate and severe respiratory disorders, as well as properly diagnose and prescribe treatment for their patients. For this reason, you must have an understanding of the pathophysiology of respiratory disorders. Consider the following three scenarios: Scenario 1: Ms. Teel brings in her 7-month-old infant for evaluation. She is afraid that the baby might have respiratory syncytial virus (RSV) because she seems to be coughing a lot, and Ms. Teel heard that RSV is a common condition for infants. A detailed patient history reveals that the infant has been coughing consistently for several months. It’s never seemed all that bad. Ms. Teel thought it was just a normal thing, but then she read about RSV. Closer evaluation indicates that the infant coughs mostly at night; and, in fact, most nights the baby coughs to some extent. Additionally, Ms. Teel confirms that the infant seems to cough more when she cries. Physical examination reveals an apparently healthy age- and weight-appropriate, 7-month-old infant with breath sounds that are clear to auscultation. The infant’s medical history is significant only for eczema that was actually quite bad a few months back. Otherwise, the only remarkable history is an allergic reaction to amoxicillin that she experienced 3 months ago when she had an ear infection. Scenario 2: Kevin is a 6-year-old boy who is brought in for evaluation by his parents. The parents are concerned that he has a really deep cough that he just can’t seem to get over. The history reveals that he was in his usual state of good health until approximately 1 week ago when he developed a profound cough. His parents say that it is deep and sounds like he is barking. He coughs so hard that sometimes he actually vomits. The cough is productive for mucus, but there is no blood in it. Kevin has had a low-grade temperature but nothing really high. His parents do not have a thermometer and don’t know for sure how high it got. His past medical history is negative. He has never had childhood asthma or RSV. His mother says that they moved around a lot in his first 2 years and she is not sure that his immunizations are up to date. She does not have a current vaccination record. Scenario 3: Maria is a 36-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately 3 weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Maria has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. To Prepare – Review the three scenarios, as well as Chapter 27 and Chapter 28 in the Huether and McCance text. – Select one of the scenarios and consider the respiratory disorder and underlying alteration associated with the type of cough described. – Identify the pathophysiology of the alteration that you associated with the cough. – Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the disorder. Post a description of the disorder and underlying respiratory alteration associated with the type of cough in your selected scenario. Then, explain the pathophysiology of the respiratory alteration. Finally, explain how the factors you selected might impact the disorder. LEARNING RESOURCES Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby. Chapter 26, “Structure and Function of the Pulmonary System” This chapter provides information relating to the structure and function of the pulmonary system to illustrate normal pulmonary function. It focuses on gas transport to build the foundation for examining alterations of pulmonary function. Chapter 27, “Alterations of Pulmonary Function” This chapter examines clinical manifestations of pulmonary alterations and disorders of the chest wall and pleura. It covers the pathophysiology, clinical manifestations, evaluation, and treatment of obstructive lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and emphysema. Chapter 28, “Alterations of Pulmonary Function in Children” This chapter focuses on alterations of pulmonary function that affect children. These alterations include disorders of the upper and lower airways. Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine . (7th ed.) New York, NY: McGraw-Hill Education. Chapter 9, “Pulmonary Disease” This chapter begins with an overview of normal structure and function of the lungs to provide a foundation for examining various lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). ** American Lung Association. (2012). Retrieved from http://www.lung.org/ ** Asthma and Allergy Foundation of America. (2012). Retrieved from http://www.aafa.org ** Cystic Fibrosis Foundation. (2012). Retrieved from http://www.cff.org/ Instructor Requirements As advanced practice nurses, we are scholars, nurse researchers and scientists. As such, please use Peer-Reviewed scholarly articles and websites designed for health professionals (not designed for patients) for your references. Students should be using the original citation in Up to Date and go to that literature as a reference. The following are examples (not all inclusive) of resources/websites deemed inadmissible for scholarly reference: 1. Up to Date (must use original articles from Up to Date as a resource) 2. Wikipedia 3. Cdc.gov- non healthcare professionals section 4. Webmd.com 5. Mayoclinic.com – This work should have Introduction and Conclusion – It should have at least 3 current references – APA format This paper should have Introduction and Conclusion

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NUR3045 Module 1 Quiz – Chapter 3 2017 2025

Question 1 Statistics for 2008 to 2009 indicated that 20 . 7% of children lived in poverty . What health implications can be drawn from this statistic? Select all that apply . 1. These children run a higher risk of poor overall health status. 2. Public health clinics can provide preventive care. 3. Medicaid assistance can enable these children to receive health care. 4. Increased funding for children’s health has resulted from these statistics. Question 2 Which criterion limits access to health care? 1. No public transportation 2. Employment opportunities 3. Transition programs for newly arrived legal residents 4. Advocacy groups for immigrants Question 3 A patient in the Emergency Department is concerned about the cost of treatment because of no financial income . What areas would the nurse include when assessing this patient? Select all that apply . 1. Preventive care 2. Nutritional status 3. Number of accidents 4. Shelter 5. Status of current immunizations Question 4 While taking the health history, a Black Hispanic patient tells the nurse about having difficulty finding employment . The nurse realizes that which is a factor that causes income disparity within this segment of the population? 1. Shift to labor requiring higher technological skills 2. Increase in the real minimum wage potential 3. Increase in traditional labor skills for these groups 4. Shift of skilled jobs to unskilled labor Question 5 The nurse notes that a larger number of foreign-born patients are being seen in the hospital . From which countries are the majority of foreign-born legal permanent residents? Select all that apply . 1. Mexico 2. China 3. India 4. Europe 5. South America Question 6 A patient explains how a former job has been outsourced to another country . What impact has globalization had on the economy? 1. Increased income inequality for some groups in the United States 2. Improved income for all minority groups in the United States 3. Increased membership in labor unions 4. Decreased immigration Question 7 Legal permanent residents tend to initially settle in urban areas . What can be inferred from this? 1. Employment may be found but will probably be in lesser-paying jobs. 2. Unemployment will not be a concern. 3. Employment is easy to obtain in urban areas. 4. Income earning potential is higher. Question 8 A foreign-born patient tells the nurse about preparing for the naturalization exam . What kinds of questions will be on this exam? Select all that apply . 1. Questions about the Constitution 2. Parts of the US government 3. Who makes federal laws 4. The number of justices on the Supreme Court 5. Words of the US national anthem Question 9 While shifts in the population profile are occurring, what is an important consideration to address in health care? 1. Cultural health needs of varying groups must be considered. 2. Health care needs to be streamlined for consistent care delivery. 3. More physicians need to be trained to deliver health care. 4. Health care providers need to be younger to care for an aging population. Question 10 According to the 2010 Census, the percentage of the 65+ population of White non-Hispanics is at 13% . How will health planning needs be affected by this percentage? 1. This population will have greater demands on the health care system as it ages. 2. Planning needs for other segments of the population can be revised downwards. 3. There is no need to increase manufacture of childhood immunizations. 4. Cultural accommodations for other minority groups can be decreased. Question 11 A patient tells the nurse that she lives in Section 8 housing . The nurse realizes that eligibility for this program is determined by: 1. Low-income guidelines 2. Family size 3. Geographic address 4. Employment history Question 12 A patient, an immigrant from another country, is waiting to be seen in the Emergency Department . What difficulties is this patient dealing with since coming to a new country? Select all that apply . 1. Learning a new language 2. Adapting to a new climate 3. Eating new foods 4. Fitting in with the new culture 5. Rejecting old customs in favor of new ones Question 13 The nurse is comparing the patient population at a health care organization with the US Bureau of the Census population statistics . Which statement would the nurse use to make this comparison? 1. The percentage of US citizens who were people of color in 2010 was 36.3% of the population. 2. The percentage of Black Americans dropped considerably between 2000 and 2010. 3. People of color are the majority population within the United States. 4. People of color as a percentage of the overall US population are decreasing. Question 14 Prior to completing an admission assessment, a foreign-born patient provides the nurse with a green card . What does this green card represent? Select all that apply . 1. Proof of legal permanent residency 2. All rights of a US citizen with exceptions 3. Inability to vote 4. Restrictions to become a citizen 5. Automatic US citizenship Question 15 When determining health care needs for a patient population, the health care organization analyzes the percentage of races represented within the organization with those of the US Census . What was the change in the White population between the 2000 and 2010 censuses? 1. 2.7% 2. 1.2% 3. 0.3% 4. 3.8% Question 16 While completing demographics for a new admission, the nurse notes that there are separate categories for race and Hispanic origin . What influenced this change to occur in demographic data reporting? 1. Federal guidelines written in 1997 separated race and Hispanic origin as two separate concepts. 2. The number of people identified as non-White was increasing out of proportion to the population. 3. Identifies which health plans the patient is eligible to enroll in 4. Better differentiates categories within the African-American group Question 17 How might immigration contribute to income inequality in the United States? 1. Many immigrants’ willingness to do jobs for less money than native-born residents 2. Being the primary income earners in the family 3. Advocating for higher minimum wages 4. A willingness to join labor unions as in previous immigrant trends Question 18 Which characteristic would the nurse assess in a family experiencing multi-generational poverty? 1. Repeated cycles of decreased educational opportunities leading to poorer income potential and poorer health outcomes 2. Members not wishing to improve their life circumstances 3. Decreased interest by lawmakers in reducing poverty circumstances 4. Increased government efforts to provide money to improve incomes Question 19 The health care administrator is comparing the 2000 Census Bureau data with patient demographic data . Which cultural group represented 12 . 5% of the population in 2000? 1. Hispanic or Latino 2. Asian 3. African American 4. American Indian and Alaskan Native Question 20 What does the nurse identify as reasons why income influences health? Select all that apply . 1. Increases access to health care 2. Enables people to live in better neighborhoods 3. Enables people to afford better housing 4. Enables people to live in areas without environmental hazards 5. Reduces despair

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Final Project I Submission: Malpractice 2025

You have been working on this project for weeks, and now it is time to submit your final version. This should be a complete, polished artifact that contains all of the required critical elements and incorporates the feedback you received from your instructor on Milestones One and Two. This is your opportunity to shine! Final Submission: Malpractice Case Analysis In Module Seven , you will submit your final project. It should be a complete, polished artifact containing all of the critical elements of the final product. It should reflect the incorporation of feedback gained throughout the course. To complete this assignment, review the FINAL PROJECT RUBRIC WHICH HAS THE INSTRUCTIONS FOR THE FINAL SUBMISSION. THE first 2 milestone projects previously done are attached below and should be added/merged to the final project as one cohesive project.

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Nursing Standardized Simulation (Mary Cohen) 2025

SCENARIO OVERVIEW: Mary Cohen is a 50-year-old white female with a history of gallstones and episodic abdominal pain. She presented to the emergency department this afternoon after experiencing right upper quadrant abdominal pain approximately one hour after eating a fatty meal. She was diagnosed with Cholecystitis and admitted for probable cholecystectomy.  Health histories and physical assessments: Gastrointestinal system  SIMCARE CENTER™ activities: a-Head-to-toe assessments Please keep in mind you will also be required to recognize a variety of signs and symptoms linked to abnormalities in these skills. Questions 1. What is Cholecystitis and the common signs and symptoms associated with it? 2. Describe nursing education that should accompany a patient with Cholecystitis. 3. What medications can be used to treat and/or alleviate Cholecystitis? PLEASE USE APA FORMAT AND INCLUDE REFERENCES LESS THAN 5 YEARS OLD

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