DUE 8/29

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Assignment 1:  Case Study Assignments.  This assignment you will be doing in SOAP format.

               Case Study 1:  Last Name Beginning A-M

is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he’s taken Mucinex OTC the past 2 nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous

 

 

  • Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.

With regard to the case study you were assigned:

  • Review this week’s Learning Resources and consider the insights they provide.
  • Consider what history would be necessary to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
  • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

 

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

DIFFERENTIAL DIAGNOSIS FOR SKIN CONDITIONS DUE 9/23/2023 THIS CANNOT BE LATE

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TO PREPARE:

  • Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
  • Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
  • Consider which of the conditions is most likely to be the correct diagnosis, and why.
  • Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.
  • Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources.

(Photo number 4 was selected please see attachment file for photo) 

 

Possible diagnosis: Cellulitis, deep vein throm, periph vascular disease.

 

VisualDx. (2021). Clinical decision supportLinks to an external site.: For professionals. Retrieved July 16, 2021, from http://www.skinsight.com/professionals

CASE STUDY ASSIGNMENT: ASSESSMENT OF NUTRITION IN CHILDREN

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THIS CANNOT BE LATE

 

 

Overweight 5-year-old black boy with overweight parents who work full-time and the boy spends his time after school with his grandmother

 

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

For this Assignment, you will  consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

 

 

Assignment (3–4 pages, not including title and reference pages):

Assignment: Child Health Case:Include the following:

  • An explanation of the health issues and risks that are relevant to the child you were assigned.
  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
  • Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

 

  • Centers for Disease Control and Prevention. (2021, April 9). Childhood overweight & obesityLinks to an external site.. http://www.cdc.gov/obesity/childhood/This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity.

 

 

 

 

 

DUE 9/5

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Respond to peers post

 

 

 

When serving patients’ needs, nurses must be patient centered. Hence, they must use their information about their patients, such as their cultures and socioeconomic characteristics, to determine how to work with them. The information is also important in collecting patients’ health histories. People’s sexualities, gender and beliefs are important to consider ensuring that the interaction remains respectful and that professionals collect as much data as is needed from their patients.

Several cultural factors must be considered to ensure optimal care. First, it is necessary to consider the woman’s sexuality. She is a lesbian. Hence, there must be fairness and openness in the interactions. The LGBTQ community faces discrimination and may, therefore be unwilling to share information unless assured of fairness (Oblea et al., 2022). Also, sexuality may affect their reproductive hygiene and practices and may be among the factors to consider in determining the discharge source. Also, understanding spiritual factors is necessary. As a lesbian, her lifestyle violates Christian teachings. Therefore, knowing how she is connected to the universe is necessary. It is important to avoid enforcing one’s beliefs on her to avoid discrimination.

When asking questions, the professional must be sensitive to TJ and her needs. The framing of the questions should encourage respect and fairness. The questions should seek to determine if she has any illnesses, what illnesses are in her family and the impacts of any health issues on her pregnancy. Therefore, one targeted question should be whether she is sexually active with her partner. The question will help determine whether she may have been infected during sexual intercourse. Another question should be when the discharge started (Agwu, 2020). Knowing when it began may help tell how far the illness has developed. I will also ask whether there is any smell. Infections can cause discharges that smell. I will also want to know whether she is exclusive to her partner. Having other partners may increase her risk of an STI. Finally, I want to know whether she has been screened for diabetes. Diabetes may affect the medication and recommendations that may be given.

Communicating with the LGBTQ community may present the challenge of sensitivity. It is necessary to ensure one communicates in ways that do not cause bias. For instance, understanding the various pronouns that apply to different people (Brown et al., 2020). The professional should use the appropriate pronoun when addressing the patient. They should also accommodate the pregnancy. Being friendly and accommodating to the patient’s needs because of her pregnancy is necessary to ensure that she cooperates maximally.

In conclusion, different patients have different needs. The various needs and their effects should be considered to ensure patient-centered care. Professionals must accommodate all their patients’ needs. When communicating with a lesbian, their sexuality may significantly affect their communication and perception of the treatment from the professional. Therefore, it is necessary to consider how their gender and sexuality will impact how they communicate and interpret one’s communication. Therefore, in TJ’s case, I will focus on using accurate pronouns and accommodating her pregnancy with the facility to make her as comfortable as possible.

 

References

Oblea, P. N., Bathan, N. Q., Gaa, C. A., Lustik, M. B., Tartavoulle, T. M., Nguyen-Wu, E. D., & Siaki, L. A. (2022). Outcomes of LGBTQ culturally sensitive training among civilian and military healthcare personnel. Journal of Public Health, fdac145. https://doi.org/10.1093/pubmed/fdac145

Brown, C., Frohard-Dourlent, H., Wood, B. A., Saewyc, E., Eisenberg, M. E., & Porta, C. M. (2020). “It makes such a difference”: An examination of how LGBTQ youth talk about personal gender pronouns. Journal of the American Association of Nurse Practitioners, 32(1), 70-80. DOI: 10.1097/JXX.0000000000000217

Agwu, A. (2020). Sexuality, sexual health, and sexually transmitted infections in adolescents and young adults. Topics in Antiviral Medicine, 28(2), 459. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482983/

DUE 9/3

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·         Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.

·         Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

·         Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

To prepare:

·         Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

·         By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.

·         Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.

·         Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

·         Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

 

 

 

 

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter”

DUE 9/1

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Respond to your peer

 

 

Ojebode – Main post week 1

Intercultural communication and culturally competent care are crucial when working with patients of minority racial and ethnic identity. The assigned case is a 38-year-old Native American pregnant female who lives on a reservation. The nurse should aim to build trust and collaborate with the patient to obtain as much information as possible. All this should be done in a culturally competent approach which includes communication techniques that are adapted to the patient. The health history of the patient can be obtained by collaborating and building trust by using culturally competent approaches.

When communicating with this patient, listening without interrupting, asking for elaboration, and using plain language would be the appropriate techniques. Listening without interruption allows the patient to express herself appropriately and shows respect for the patient’s views and opinions. Secondly, the nurse should show cultural humility by showing respect for the patient’s culture and willingness to learn more (Stubbe, 2020). This can be achieved through requesting for elaboration about patient experiences, beliefs, and perspectives. The approach indicates genuine interest in the patient’s culture and ensures trust-building. Using plain language is essential in reducing any language barriers. For all patients, it is necessary to use plain language to ensure patients understand the information and make informed decisions. Therefore, I would create rapport, listen without interrupting, and show genuine interest in learning more about this Native patient and her perspective.

The patient is present with several risk factors which must be assessed. First, her age is a risk factor in her pregnancy. Pregnancy in a 38-year-old should be considered a high-risk pregnancy. Older women are at increased risk of preeclampsia, birth defects, and miscarriages (Glick et al, 2021). Additionally, living in a reservation also presents significant environmental risks. A large proportion of people living in reservations live in a poor environment with inadequate housing and sanitation resources (Crepelle, 2019). Therefore, assessment of the patient’s environment and living situation is necessary. Additionally, Native American women, especially those living in reservations experience higher rates of sexual violence (Edwards et al., 2022). This is a psychosocial issue that should be considered and a risk factor to be evaluated in this patient. Access to healthcare services is also a crucial area of assessment for the patient. Because of pregnancy, it is essential to ask about access to medical services and the patient’s diet.

The Protocol for Responding to & Assessing Patients’ Assets, Risks & Experiences (PRAPARE) is a risk assessment tool that can be used with this patient. The PRAPARE is a questionnaire targeting social determinants of health and focusing on personal characteristics, social and emotional health, financial resources, and family and home conditions (NACHC & AAPCHO, 2022). The tool focuses on the current state of the patient, her ability to access adequate healthcare and basic health resources, and her current emotional and social state. It is useful in assessing a patient’s stability and ability to maintain a health management plan.

The following targeted questions would be used with the patient:

  1. What is your current work situation?
  2. Who do you live with?
  3. Have you been able to access medical services when needed from where you live?
  4. Have you received any vaccine shots during your pregnancy?
  5. What food do you typically eat at home?

 

References

Crepelle, A. (2019). The reservation water crisis. Tulane Environmental Law Journal, 32(2), 157-188. https://www.jstor.org/stable/26661936Links to an external site.

Edwards, K. M., Siller, L., Leader Charge, D., Bordeaux, S., & Leader Charge, L. (2022). Dating violence, sexual assault, and sexual harassment victimization among girls on an Indian reservation: An examination of rates and risk and protective factors. Violence Against Women, 28(3-4), 761-779. https://doi.org/10.1177/10778012211012091Links to an external site.

Glick, I., Kadish, E., & Rottenstreich, M. (2021). Management of pregnancy in women of advanced maternal age: Improving outcomes for mother and baby. International Journal of Women’s Health, 751-759. https://doi.org/10.2147/IJWH.S283216Links to an external site.

National Association of Community Health Centers, Inc (NACHC) & Association of Asian Pacific Community Health Organizations (AAPCHO). (2022). Protocol for Responding to & Assessing Patients’ Assets, Risks & Experiences (PRAPARE). https://prapare.org/

Stubbe, D. E. (2020). Practicing cultural competence and cultural humility in the care of diverse patients. Focus, 18(1), 49-51. https://doi.org/10.1176/appi.focus.20190041Links to an external site.