This is discussion board: No Plegarism please, assignment will be checked with Turnitin. Will need minimum of 250 words, APA Style, double spaced, times new romans, font 12, and and minimum 3 References with intext citations.

The Medical Interview:

The medical interview serves several functions. It is used to collect information to assist in diagnosis of the present illness, to understand the patient’s values, to assess and communicate prognosis, to establish a therapeutic relationship and to reach agreement with the patient about further diagnostic procedures and therapeutic options. The interview also offers an opportunity to influence patient behaviors.

Discuss the following:

Please answer the following questions and include your rationale and evidence-based research to support your written work.

· What does it means to document accurately and appropriately?

· What are the documenting guidelines? When is it appropriate to use abbreviations?

· What is the difference between subjective and objective data?

· What does it mean to demonstrate clinical reasoning skills?

· How can you use clinical reasoning to plan the organization of a comprehensive exam?

· How will you document variations of normal and abnormal assessment findings?

· What factors influence appropriate tools and tests necessary for a comprehensive assessment?

· Reflect on personal strengths, limitations, beliefs, prejudices, and values.

· How will these impact your ability to collect a comprehensive health history?

· How can you develop strong communication skills.

· What interviewing techniques will you use to interview the patient to elicit subjective health information about their health history?

· What relevant follow-up questions will you use to evaluate patient condition?

· How will you demonstrate empathy for patient perspectives, feelings, and sociocultural background?

· What opportunities will you take to educate the patient?

Module 4 – SLP

DRAWING INFERENCES ABOUT POPULATION MEANS AND PROPORTIONS

Having developed the null and alternative hypotheses in the previous module, write a (2-3 pages) paper in which you:

1. Identify a test statistic to help you assess the evidence against the null hypothesis you developed in the previous module.
2. Explain why you have chosen the specific test statistic. Include in your discussion description of the test statistic.
3. Summarize your findings by creating a summary graph in which you display your data.
4. Discuss the total number of measurements (sample size), the possibility for measurement error, and whether it is large enough to paint an accurate picture.

SLP Assignment Expectations

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric that is linked within the course. Review it before you begin working on the assignment.

 

Health as a Human Right

Article 25 of the 1948 UDHR and the Constitution of WHO are examples of positive expressions of health as a human right.

Using South University Online Library or the Internet, search for  “health as a human right, a perspective from the WHO,” put forth in the  UDHR. Conduct a research on this topic. Your research should include key  features of the decisions, investigations, and laws you analyzed during  the research.

Your research should also include answers to the following questions:

• Analyze the purpose of Article 25 of the 1948 UDHR and the Constitution of the WHO.
• In your opinion, do these two positive laws contradict the no-duty principle in the United States? Why or why not?
• The term “the right to make informed health care decisions” is an  important health care right of patients that have the right to make  informed decisions about the direction of their care, including refusing  treatment. Give your views on this statement and support your answer  using relevant references.
• Compare and contrast the terms “the right to make informed health care decisions” and “the right to health.”
• In your opinion on life or death situations, do you think individuals should be allowed to refuse treatment? Why or why not?

After answering the above questions, read the following statement:

The Emergency Medical Treatment and Active Labor Act (EMTALA)  protects the rights of the poor and uninsured by stating that a hospital  cannot refuse emergency treatment because of the patient’s inability to  pay (patient dumping). Based on this statement, answer the following  questions:

• Explain and analyze two key duties of hospitals under EMTALA.
• What do you think would happen if a hospital administrator directed  an ambulance to take a patient to another hospital because the  individual is uninsured?
• Explain what impact this act might have on private hospitals. How  does this act impact other publicly funded programs in the state?

  

Week 5 

Discussion question worth 5 points

Discussion question due by Sunday, 11:59 pm. 

Following Case Study Question: As an NP student, needs to determine the medications for Tinea Pedis.

RX format: Medication, SIG: Instructions (Route, frequency, location, duration), Dispense #, Refills, ?

According to the ACC/AHA Guidelines, what antifungal medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format and SOAP (subjective, objective, assesment, plan) format. 

Please include patient education regarding the selected medication therapy. Please choose a medication to treat tinea pedis that would not exacerbate other patient’s symptoms. You may order labs for baseline before starting the therapy and specify which labs. 

Next to the chosen medication therapy, please choose references to support your treatment choice of medication or lab for baseline and follow up of therapy ordered. Specify when to refer the patient after therapy and why ?

WEEK 5: DISCUSSION QUESTION IN DISCUSSION BOARD

DERMATOLOGY CASE STUDY

ACC/AHA Guidelines

Chief complaint:  “ I have scaly crust in sole of feet and moist white crusts between my toes since I started using boots warm weather” for past 2 weeks. 

HPI: E.D a 45-year-old hispanic female presents to the clinic for complaint of itching in feet and scaly curst in sole of feet and moist white crusts between toes. She developed a red, itchy rash consistent with hypersensitivity reaction. She also indicates that she has noticed that her symptoms are worsening for past 2 weeks and it started after she started to use boots in warm weather. She has symptoms of red, itching rash consistent with a hypersensitivity reaction and tinea pedis. She wore about 2 weeks ago her mother’s shoes without socks and her mother has history of Tinea Pedis.

She has tried lotrimin AF cream for itching and it did not help relief her symptoms. She has not tried other remedies.

Denies associated symptoms of fever, chills, pain or any other symptoms.

PMH:

Diabetes Mellitus, type 2. Peripheral Vascular disease. Varicose Veins.

Surgeries: None

Allergies: Penicillin

Vaccination History:

She receives an annual flu shot. Last flu shot was this year

Social history:

High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.

Family history:

Both parents are alive. Father has history of DM type 2, Tinea Pedis.

mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.

ROS:

Constitutional: Negative for fever. Negative for chills.

Respiratory: No Shortness of breath. No Orthopnea

Cardiovascular: + 1 pitting leg edema. + Varicose veins.

Skin: + rash crusted white in feet and inter-digit in feet.

Psychiatric: No anxiety. No depression.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130/70 T 98.0 po P 88 R 22, non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.

NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.

LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.

HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle 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: Slow gait but steady. No Kyphosis.

SKIN: +Dryness, No open lesions. +Dry crusts in sole of feet. + moist crust in between toes.

PSYCH: Normal affect. Cooperative.

Labs:: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98

A:

Primary Diagnosis: Tinea Pedis

Secondary Diagnoses:

Atopic Dermatitis

Xerosis

Pruritus

Differential Diagnosis:

Peripheral Vascular Disease (PVD) (173.9)

P:

Medications:

Tylenol 650 mg PO Q4 hours as needed for arthritis pain

Labs: CBC with diff to evaluate for infection and baseline lab. CMP, PT/INR to evaluate status of liver and kidneys.

Referrals: may refer based on effect of medication therapy given for 2 weeks.

Follow up: return to office in 2 weeks to evaluate her symptoms.

Additional lab results:

Fungal culture confirm that she has fungal infection.

Question: As an NP student, needs to determine the medications for Tinea Pedis.

According to the ACC/AHA Guidelines, what antifungal medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format. Write her complete prescriptions using the prescription writing format and SOAP (subjective, objective, assesment, plan) format. 

Next to the chosen medication therapy, please choose references to support your treatment choice of medication or lab for baseline and follow up of therapy ordered. Specify when to refer the patient after therapy and why ? Choose a medication to treat the patient’s condition of tinea pedis that would not exacerbate other patient’s symptoms. You may order labs for baseline before start of therapy and specify which labs.