At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.

Consider the following scenario:

A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.

To Prepare

· Review the scenario provided, as well as Chapter 25 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.

· Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact diagnosis and prescription of treatment for the patient in the scenario.

Assignment

Post a description of how you would diagnose and prescribe treatment for the patient in the scenario. Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

• Chapter 23, “Structure and Function of the      Cardiovascular and Lymphatic Systems”

This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow.

• Chapter 24, “Alterations of Cardiovascular Function”

This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.

• Chapter 25, “Alterations of Cardiovascular Function in      Children”

This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart diseases from acquired cardiovascular disorders.

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

• Chapter 10, “Cardiovascular Disorders: Heart Disease”

This chapter begins by exploring the normal structure and function of the heart. It then examines the etiology, pathophysiology, and clinical manifestations of five heart disorders: arrhythmias, congestive heart failure, valvular heart disease, coronary artery disease, and pericardial disease.

Jacobsen, R. C., & Gratton, M. C. (2011). A case of unrecognized prehospital anaphylactic shock.Prehospital Emergency Care, 15(1), 61–66.

Retrieved from the Walden Library databases.

 
 

This article provides information relating to the diagnosis and management of anaphylactic shock. It also explores difficulties encountered when diagnosing uncommon clinical presentations of anaphylactic shock.

 

•  In 2-3 pages: 
• Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.
• Explain your responsibilities when having a DEA number.
• Explain how you apply for a DEA number.
• Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements.
• Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

 

Assignment:

Create a Power Point Presentation to discuss the following

Sgt. Eddie Johns leaned back against the chair in the outpatient orthopedic clinic. His head was killing him! He wasn’t sure which was worse, the “morning after” headache or not being able to sleep at night. At least when he had a few beers under his belt so he could catch a few hours of sleep. It had been like this since he was air evacuated back stateside from Afghanistan after the roadside bomb went off. He was thankful that he had only broken his leg in a couple of places and gotten a bad bump on the head. They called that traumatic brain injury but he didn’t know what that was and really didn’t believe them anyway. He was still thinking just fine. His friend Joe wasn’t so lucky! How was Joe going to learn to walk on those artificial legs? He was still in the hospital in Washington, DC. That was pretty far from his home. Eddie wished he could visit Joe. They had been in the same platoon for 9 months. But, Eddie was glad that he had been able to come back to his own home town for outpatient treatment. It took an hour to get here but at least he could see his girl almost every day. Sure he had moved back in with his mom but it was easier to have someone to help him get around and cook for him. It was a bummer that he couldn’t work right now. He guessed it didn’t matter much since he really didn’t have a job to go back to. He had been replaced at the plant. They said they would find something for him to do once he could get around more easily. Eddie sure hoped the doc would take the pins out of his leg today and give him a clearance to work.

• How would the use of the Roy Adaptation Model assist the nurse in planning the continuation of care for Sgt. Johns?
• Describe the influence of Roy’s Theory in guiding the nurse’s actions in promoting Sgt. Johns adjusted self-concept.
• From the perspective of the Roy Adaptation Model, why is it important for the nurse to listen to Sgt. Johns’ “story” in his own words and not just base her interactions on information from the chart, fellow colleagues, or his family?
• Based on Neuman System’s Model, identify at least 4 stressors from the case study. Create a plan of care based on Neuman Systems Model for Sgt. Johns. 

Your PowerPoint should include at least 1 outside reference and your book. The presentation should be 10 to 15 slides in length.

Assignment Instructions

Ethical Standards of Practice

This assignment will assess knowing of the following CAHIIM Competencies:

Domain VI. Leadership

                VI.H. Ethics

1. Comply with ethical standards of practice.   3. Assess how cultural issues affect health, healthcare quality, cost and HIM

Assignment Instructions

Part 1:

Review the case study at the end of chapter 5.  Which ethical standards in this chapter apply to this case and how?  What impact would the implementation of the system have on the facility if it is implemented without proper privacy and security controls?  Can policies and procedures be established to help ensure compliance?

Part 2:

Locate the website of two medical billing and coding companies that use staff based in other countries. Describe their training practices on topics such as ICD-10-CM coding, and English language and culture, comparing similarities and differences. What impact could using these companies have on ethical standards of practice? The following are suggested sites to begin with; you may find others as well:

Supporting Materials

• HIMA200 Assignment – Ethical Standards of Practice.docx (16 KB)

  You are a health information manager in a hospital setting. Your facility has purchased an electronic health record (EHR) system. During the testing period, you and your staff discover that the EHR system does not comply with applicable federal privacy and security standards. Pressure is mounting to deploy the system in the near future. What ethical issues should you consider? How should you proceed?

 

Unit II Case Study

Analyze the case study found on p. 198 (“Maria’s Story”) in your textbook by addressing the assigned questions below. While analyzing the case, be sure to identify the major problems and issues.

 Draft a response or strategy for addressing the major problems and issues.

 Make recommendations to improve the patient’s health.

 Discuss any negative consequences that may occur if the patient’s health issue is not addressed.

Your response should be at least two pages in length. Include at least one reference to support your work in APA style. You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.

Information about accessing the Blackboard Grading Rubric for this assignment is provided below.