1) Minimum 6 full pages  (Follow the 3 x 3 rule: minimum three paragraphs per part)

             Part 1: Minimum 1 page

             Part 2: minimum 1 page

             Part 3: Minimum 3 pages

             Part 4: minimum 1 page

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraph

          Bulleted responses are not accepted

          Don’t write in the first person 

          Don’t copy and paste the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

Part 3: Minimum 5 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.do

__________________________________________________________________________________

Part 1: Pathophysiology

Identify a common perceptual, neurological, or cognitive issue 

1. discuss contributing factors. 

2. Outline steps for prevention or health promotion for the patient and family.

Part 2: Pathophysiology

1. Discuss characteristic findings for a stroke 

2. Discuss how it affects the lives of patients and their families. 

3. Discuss the nurse’s role in supporting the patient’s psychological and emotional needs. 

4. Provide an example.

Part 3: Pathophysiology

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

1. Temperature: 37.1 degrees C
2. BP 123/78 HR 93 RR 22 Pox 99%
3. Denies pain
4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

1. WBC: 19.2 (1,000/uL)
2. Lymphocytes 6700 (cells/uL)
3. CT Head shows no changes since previous scan
4. Urinalysis positive for moderate amount of leukocytes and cloudy
5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Questions:

 1.Describe the clinical manifestations present in Mr. M.

2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. 

a. Explain why these should be considered and what data is provided for support.

3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why. (Write in the first person) 

4. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. 

a. Discuss the impact it can have on his family.

5. Discuss what interventions can be put into place to support Mr. M. and his family.

6. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

1. Chronic pain: Treatment options and efficacy
2. CRF: Prevention/treatment in diabetic patients
3. Rheumatoid arthritis: Risks/benefits of latest treatments
4. IBS: diagnosis and treatment

• Select three relevant and appropriate scholarly articles that address the topic you chose.
• Present a thorough literature review of the three articles by summarizing, synthesizing, and evaluating the materials.
• Incorporate citations into your body paragraphs; incorporate the essential and most relevant supporting evidence eloquently and appropriately.
• Present your writing in a clear, organized manner.
• Demonstrate understanding of the content presented in the articles.
• Use proper APA format with proper citations. Review APA Citations Here

In this assignment, you will examine the clinical manifestations, pathophysiology, and developmental considerations for Type 1 and Type 2 diabetes mellitus.  Consider the developmental implications of Type 1 diabetes on children and Type 2 diabetes on adults.

Step 1 Locate at least one professional, evidence-based resource to support your response.

 Step 2 Download the worksheet Endocrine Disorders Attached.

 Step 3 Complete the worksheet.

• In the header row of the table, enter names of the disorders.
• In the remaining rows of the table, enter a description of the disorder, the clinical manifestations, the underlying pathophysiology, and developmental considerations (consider the age of onset with respect to the physiological, psychological, and social implications of the disease).  
• Be sure to cite all sources used to complete the worksheet and provide a reference using proper APA formatting.

PLEASE CHECK THE GRANDING  RUBRIC 

Below is the template you are to follow whendeveloping your management plan. Also, always be sure to complete the EMRon the case. Use this template with each case. It is not aSOAP format as that is not required. Points will be deducted for not utilizingthe template.

THIS SECTION IS 30 POINTS!!! Follow the bullet points below.Copy and answer each bullet point on a word document and cut and paste yourresponses to the management section!

•  Primary Diagnosis and ICD-10 code: Also include any procedural codes.
• 3-5 Differential Diagnoses- Why? What made you select each one as a DDX? How did you rule out? This would be a good area to include references.
• Additional laboratory and diagnostic tests: It may be necessary to establish or evaluate a condition. Some tests, such as MRI, may require prior authorization from the patient’s insurance carrier. 
• Consults: referrals to specialists, therapists (physical, occupational), counselors, or other professionals. If you are sending it to the hospital, what orders would you write for a direct admit? 
• Therapeutic modalities: pharmacological and nonpharmacological management. 
• Health Promotion: Address risk factors as appropriate. Consider age-appropriate preventive health screening.
• Patient education: Explanations and advice given to patient and family members. 
• Disposition/follow-up instructions: when the patient is to return sooner, and when to go to another facility such as the emergency department, urgent care center, specialist, or therapist.
• References (minimum of 3, timely, that prove this plan follows the current standard of care).

        Identifyingdata (ID):lb  a 76-year-old AfricanAmerican female that resides in an apartment on the second floor.

Chief complaint (CC): “I am having pain in my knees and I amready to do something about it. That is why they sent me to you. My knees havebeen getting worse over the past couple of years. They hurt when I walk formore than a block and when I climb stairs. “

                Historyof present illness (HPI)

Analysis of symptom/complaint:

·       Lb complains of pain in her knees that staredabout five years ago but has gotten worse over time. The location of her painis inside her knees, and the pain in her right knee is worse. The pain in herright knee radiates down to her ankle. Ms. Johnson describes the pain in her knees as stiff and achy. They arestiff in the morning for about 15-20 minutes. Cold weather and exercise makesher knee pain worse. She hasn’t found anything that helps with the pain. Ms.Johnson states that her pain level is usually about a 4 or 5 out of 10, andsometimes it is a 7 or 8 out of 10. Associated symptoms with the pain areswelling in her knees and sometimes her finger knuckles.

has trouble getting around duethe pain in her knees. Ms. Johnson states, “I have to walk up the stairs to getto it. Thank goodness I don’t live on the 3^rd floor. It’s gettingharder and harder to get up those stairs. My daughter usually has to come helpme.”

a.         Include significant chronic health disordersthat impact on the current chief complaint. 

Ms. Johnson has a past medicalhistory of peptic ulcer disease with GI bleed from Ibuprofen use, chronickidney disease, and hypertension.

2.           Allergies:Ms. Johnson denies allergies to medication, food, pollens and pet dander(environmental).

3.           Immunizations:  Up to date

4.           Pastmedical history (PMH) –

a.         Pastmedical disorders/illnesses

Hypertension (for the last 20 years)

Chronic Kidney Disease

Peptic Ulcer Disease with GIbleed from Ibuprofen 4 years ago.

b.         Pastsurgical history (PSH)

No past surgical history

Injuries/disabilities

Patientreports no injuries or disabilities.

·       d.            Other hospitalizations B.

Medications

Amlodipine10mg tab ,1tab po daily

Lisinopril10mg tab,1 tab Po daily

Simvastatin20mg tab

Hydrochlorothiazide25mg tab

Acetaminophenprn headacge

Mulivitamindsily

The paper has to be 5 full pages (Excluding the Title page, Abstract, and References) a total of 8 pages 

The paper is divided as follows:

A) The Title of the paper 

B) The Abstract

C) What is the specific concept (Page One)

D) Nursing assessments for the specific concept (Page Two)

E) Patient problems/ nursing diagnoses related to the specific concept (Page Three)

F) Specific, realistic, and measurable goals attributed to patient care of the specific concept (Page Four)

G) Nursing intervention for patient care of the specific concept (Page Five) 

H) References 

PAPER MUST BE IN (APA FORMAT 7)

The paper must NOT have any plagiarism 

The paper must have good spelling, grammar, punctuation, and sentence structure.  

Each subject talked about must be a complete page of the paper

The final paper must be turned in no later than April 27 at 10 AM