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

Assignment

Choose one of the groups  listed below (see attachment) and describe the physical, psychosocial, and cognitive changes that are associated with the group that you have chosen. Your paper should be between 3-5 pages (Not including the title and reference pages) and should include at least 4 scholarly sources besides your textbook. Your references should be in APA format (I will take points off if it is not in that format). This assignment is due at the end of week 7 and  is 10% of your grade. 

Prenatal Period

Early childhood 

Adolescence 

Middle Adulthood 

Response to 2 Peers

1. Consider your peer responses.  Are they similar or different than yours?

2. How do other’s perspectives on ethical considerations impact your view?

**When I accept the bid I will be sending you the two peer posting which to respond to. Please use their name at least twice but not excessively. Do not compare the two peers with each other only compare their individual post with mines. 250 words each with two references each, the references are not included in the word count. 

MY POST:

How often do healthcare providers encounter ethical dilemmas in end of life care?

            Medical practitioners come across moral dilemmas more frequently in their professional careers and practice (Odgers, 2019). In these situations, the no-correct response is stark evidence. This is particularly true in end-of-life treatment, where clients and families may be dealing with intense feelings, sadness, and tragedy.

What is the source of the ethical dilemma?

Communication problems, clinical confidentiality being harmed, inadequate treatment control, non-beneficial treatment, and joint decision-making can all lead to ethical dilemmas. Communication is a key model in the moral quagmire (Liu, 2017). It affects how patients perceive information about the prevailing health conditions.

What is the nurse’s role in this situation?

Immunology clinicians can help patients, close relatives, and guardians overcome ethical dilemmas by providing the best quality treatment while helping them to encounter EOL with integrity (Liu, 2017). Nurses can keep the patients in terms of the current health status while offering solace and guidance.

What legal and ethical standards must health care personnel be expected to consider in end of life care?

The medical personnel should provide full information to the patients. Another standard is confidentiality where the clinical person should disclose the details to the patient only.

The information on the health of the patient can only be disseminated to other parties with his or her consent (Tahan, 2020). Another standard is disclosure. The patient should be briefed on all matters concerns his or her health.

If you did not agree with the decision being made, can you excuse yourself from caring for the patient?

The medical practitioner can express dissatisfaction with the exercise. This can be contained in the fact that an incorrect decision may be made (Croxon, 2018). The clinical expert can decide to part ways with the therapy for it may result in a negative outcome.

Ultimately, who should make a decision about end of life care? Explain your rationale.

The patient can make a judgment about the end of life care. This is because they are the consumers of health products and dictate their preferences (Tahan, 2020). In the case, the patient feels incapable of continuing with the therapy they can request termination. The medical personnel is bound to offer guidance and facilitate the process.