Clinical Case Presentation

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Clinical Case Presentation

You can use the same case, but I need to add in the Soap NoteThe pathophysiology of the Diagnostic

students must post one interesting case that he/she has seen in the clinical setting via Discussion Board in the online part of this course. The case should be an unusual diagnosis, or a complex case that required in-depth evaluation on the student’s part. The case should be posted in the SOAP format, with references for the patient diagnosis, differential diagnoses (there should be at least 3), and the treatment plan. Notes will be graded as “pass/fail”. In order to receive grade points for SOAP notes, the notes must be approved by the deadlines specified on the course assignments page. The student will lose the opportunity for points on any SOAP notes not approved by the specified deadlines. The posting does not have to be written in APA format, but should be written with correct spelling and grammar. References should be in APA format. The selected references should reflect current evidence – dated within the past 5 years. See rubric in the syllabus section ..

clinical Case

CC: “Abdominal pain”

HPI: This is LR 57 y/o male Hispanic, refer abdominal pain in LLQ that started today at early in the morning, moderate intensity that radiated throughout the four quadrants, no nausea or vomiting,

Current medications: none

SH: Denies use drugs, tobacco or alcohol

Allergies: Shellfish, Iodine

ROS:

CONSTITUTIONAL: No fever, weight loss or chills

NEUROLOGIC: Denies changes in LOC.

HEENT: Denies any head injury, or change in LOC. Denies any changes in vision, diplopia or blurred vision. Denies pain in the ears. Denies loss of hearing or drainage. Denies nasal drainage, congestion. Denies throat or neck pain, hoarseness, difficulty swallowing.

Respiratory: Denies any SOB, congestion, or production of sputum.

Cardiovascular: Denies history of cardiac disease, abnormal EKG or chest pain. Denies dizziness or fatigue.

Gastrointestinal:Abdominal pain or discomfort LLQ, Denies flatulence, nausea, or vomiting.

BIOMETRICS & VS: T 98 F (oral) HR: 78 bmp RR 20 bmp

BP: 140/89 SPO2: 100 H: 5 f.9 in W: 169 Lb BMI: 25

Labs: CBC,and FOBT indicated, U/S of abdomen w/o contrast

Physical exam

GEN: No acute distress, alert, awake, and oriented times 4 (name, place, time, purpose), well nourished.

HEENT: mucous membranes moist, no pallor,no icterus

Cardiovascular: S1 and S2 RRR, no murmurs, no rubs

RESP: Clear to auscultation bilaterally, no rales/rhonchi/wheezes, no fremitus

ABD: Normal , no pulsate masses, bowel sounds present in four quadrants, Soft to touch, non distended, no rebound or guarding, no hepatosplenomegaly.

NEUROLOGIC: Cranial Nerve II through XII intact, no focal deficit. Sensation intact to bilateral upper and lower extremities. Bilateral

SKIN: Intact, no rashes, no lesions, no erythema,no dehydration sings.

GU: no inguinal hernia, no inguinal lymphadenopathy

Diagnosis:

Ulcerative Colitis

Differential Diagnosis:

Bowel obstruction : the abdominal pain occurs when the passage of normal GI contents is blocked. This usually occurs as a result of post-operative complications or simply constipation, nausea and vomiting are remarkable.

Mesenteric ischemia of the smoll intestine : The patient usually presents with rapid onset of severe periumbilical abdominal pain that is out of proportion tophysical exam findings in addition to nausea and vomiting.

Plan

mesalamine 0.5g 1 suppository rectal every 8 hours.

Teaching:

Eat small amounts of food throughout the day. Drink plenty of water (frequent consumption of small amounts throughout the day). Avoid foods rich in fiber (bran, beans, nuts, seeds and popcorn). Avoid fatty, greasy or fried foods and sauces (butter, margarine and thick cream)

Referrals: GI

Follow Up: 1 week

What are your responsibilities as an assistant nurse manager in regard to Isaac’s behavior problem?

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Nursing homework help

Isaac has worked as a staff nurse on the telemetry floor for over 15 years. He holds seniority in the unit. His patient care is satisfactory; however, his interpersonal behaviors are becoming an increasing issue for his coworkers. He throws papers around the unit, gives short answers to questions, and seems generally miserable. He tells the staff that they are lazy and stupid. He is constantly questioning their decisions. You have come from another local hospital in the role of the assistant nurse manager. Based on your observations, you have met with Isaac informally and discussed his behaviors, but they have not changed. Now three new nurses have already come to you saying that this unit is a great match for them, except for one problem. Although they have not identified Isaac by name, they have told you that one of the nurses is extremely abusive verbally, and they have been calling in sick on the days they are scheduled to work with this person.

1. What are your responsibilities as an assistant nurse manager in regard to Isaac’s behavior problem?

2. What is the next step in dealing with Isaac’s behaviors?

3. How will you, as the manager, have Isaac develop more effective people skills?

This is your first position as a nurse manager. The holidays are rapidly approaching, and the hospital policy states that each unit will negotiate holiday coverage individually. You are already getting requests via e-mail and on Post-it notes for holiday time. Several staff members have come to you stating that they “never” seem to get their requests for holidays. Discussion among the staff members is creating dissension and conflict.

1. Discuss the potential impact of this problem on you and the unit staff.

2. Describe a minimum of one positive consequence and one negative consequence of this conflict.

3. Select a model of conflict resolution and explain how you, as a nurse manager, might resolve this conflict.

In the last century, what historical, social, political, and economic trends and issues have influenced today’s health-care system? 

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1. In the last century, what historical, social, political, and economic trends and issues have influenced today’s health-care system?

2. What is the purpose and process of evaluating the three aspects of health care: structure, process, and outcome?

3. How does technology improve patient outcomes and the health-care system?

4. How can you intervene to improve quality of care and safety within the health-care system and at the bedside?

2. Select one nonprofit organization or one government agencies that influences and advocates for quality improvement in the health-care system. Explore the Web site for your selected organization/agency and answer the following questions: •

What does the organization/agency do that supports the hallmarks of quality? •

What have been the results of their efforts for patients, facilities, the health-care delivery system, or the nursing profession? •

How has the organization/agency affected facilities where you are practicing and your own professional practice?

Essentials of Nursing Leadership & Management
6th Edition

Sally A. Weiss  MSN, EdD, RN, CNE, ANEFRuth M. Tappen  EdD, RN, FAAN

ISBN-13: 978-0-8036-3663-7

What are your responsibilities as an assistant nurse manager in regard to Isaac’s behavior problem?

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Nursing homework help

Isaac has worked as a staff nurse on the telemetry floor for over 15 years. He holds seniority in the unit. His patient care is satisfactory; however, his interpersonal behaviors are becoming an increasing issue for his coworkers. He throws papers around the unit, gives short answers to questions, and seems generally miserable. He tells the staff that they are lazy and stupid. He is constantly questioning their decisions. You have come from another local hospital in the role of the assistant nurse manager. Based on your observations, you have met with Isaac informally and discussed his behaviors, but they have not changed. Now three new nurses have already come to you saying that this unit is a great match for them, except for one problem. Although they have not identified Isaac by name, they have told you that one of the nurses is extremely abusive verbally, and they have been calling in sick on the days they are scheduled to work with this person.

1. What are your responsibilities as an assistant nurse manager in regard to Isaac’s behavior problem?

2. What is the next step in dealing with Isaac’s behaviors?

3. How will you, as the manager, have Isaac develop more effective people skills?

This is your first position as a nurse manager. The holidays are rapidly approaching, and the hospital policy states that each unit will negotiate holiday coverage individually. You are already getting requests via e-mail and on Post-it notes for holiday time. Several staff members have come to you stating that they “never” seem to get their requests for holidays. Discussion among the staff members is creating dissension and conflict.

1. Discuss the potential impact of this problem on you and the unit staff.

2. Describe a minimum of one positive consequence and one negative consequence of this conflict.

3. Select a model of conflict resolution and explain how you, as a nurse manager, might resolve this conflict.

–APA Format.

-Introduction or abstract page

-Summary or Conclusion page

–Four Pages Minimum, not included Introduction or abstract, Conclusion or Summary , and Bibliographic pages.

–Completely unacceptable Copy and Paste from Internet, or other resources.

– Bibliographic have to be in APA Format, minimum 3 references citations with 3 years old  or less.

Select a current health-related case involving research ethics.

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Nursing homework help

In the best-selling book, The Immortal Life of Henrietta Lacks (Skloot, 2010), the author highlights the true story of an African-American woman who died in 1951 from cervical cancer. What makes her story unique is that prior to her death, cells from her tumor were removed and successfully grown in a petri dish. This was the first time scientists were able to successfully replicate cells outside the body, and it is estimated that billions of Lacks’ cells have been used in medical research. However, Henrietta Lacks was never asked for permission to take a sample and her family was never made aware of the widespread use of her cells. Although the culturing of her cells has been pivotal for advancing research, strong ethical concerns later arose about using these cells without patient or family approval.

This week’s readings describe historical examples of unethical research, such as a study of syphilis among African-American men in which treatment was withheld and a study in which live cancer cells were injected into elderly patients. Today, stricter controls that seek to protect study participants are placed on researchers, but breaches still occur. Careful attention must be given toward preventing unethical behavior. In this Discussion, you explore ethical considerations and issues in research.

· Select a current health-related case involving research ethics. (If none come to mind, browse the Internet to familiarize yourself with recent cases.)

· As you review the case that you have selected, reflect on the ethical principles discussed in “What Are the Major Ethical Issues in Conducting Research?” article found in this week’s Learning Resources. Which principles were breached in the case you have identified?

Post a description of the case that you selected and the ethical issues involved. Analyze the ethical principles that were breached by the researchers or organizations in your selected case as well as the possible cause of the breach(es). Suggest how the research might have been conducted differently to avoid or minimize the ethical problems. Discuss how research can be done on sensitive issues while still protecting the rights of the research subjects.

· A synthesis of what the studies reveal about the current state of knowledge on the question that you developed

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Nursing homework help

This is a continuation of the Course Project presented in Week 2.

Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

· Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.

· Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.

· Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.

· Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

To complete:

Write a 3- to 4-page literature review that includes the following:

· A synthesis of what the studies reveal about the current state of knowledge on the question that you developed

o Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.

· Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry

· Your literature review summary table with all references formatted in correct APA style

Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

identifying quality technology tools that increase the ability of nurses to provide safe, effective care.

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Nursing homework help

With so much attention focused on health care reform, it is important that nurses be given the opportunity to use high-quality technology tools. These tools can increase access to vital medical information, promote effective communication among health care professionals, and improve the patient experience. By actively seeking out and adopting these tools, nurses can greatly enhance the quality and safety of care that they provide.

This Discussion focuses on identifying quality technology tools that increase the ability of nurses to provide safe, effective care.

· Review the various technology tools described in this week’s Learning Resources.

· Identify a recently adopted information, education, or communication technology tool in your specialty area. Reflect on how it is used and how its use impacts the quality of care.

· Consider how your identified technology tool might impact nursing practice if it were more widely used. What are some barriers preventing increased usage? How could wider implementation be facilitated?

Post a description of a current or new information, education, or communication technology tool that is being used in your specialty area and assess its impact on the quality of care. Highlight the effect that increased use of this technology would have on nursing practice and discuss the barriers that are slowing or hindering its adoption. Summarize how adoption of the technology tool could be facilitated.

Analyze the health status of a specific minority group.

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Analyze the health status of a specific minority group. Select a minority group that is represented in the United States (examples include American Indian/Alaskan Native, Asian American, Black or African American, Hispanic or Latino, Native Hawaiian, or Pacific Islander).

In an essay of 750-1,000 words, compare and contrast the health status of the minority group you have selected to the national average. Consider the cultural, socioeconomic, and sociopolitical barriers to health. How do race, ethnicity, socioeconomic status, and education influence health for the minority group you have selected? Address the following in your essay:

  1. What is the current health status of this minority group?
  2. How is health promotion defined by this group?
  3. What health disparities exist for this group?
  4. Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.

Cite a minimum of three references in the paper.

You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:

  1. Minority Health: http://www.cdc.gov/minorityhealth/index.html
  2. Racial and Ethnic Approaches to Community Health (REACH): http://www.cdc.gov/chronicdisease/resources/publications/aag/reach.htm
  3. Racial and Ethnic Minority Populations: http://www.samhsa.gov/specific-populations/racial-ethnic-minority

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Select a global health issue impacting the international health community

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Select a global health issue impacting the international health community. Briefly describe the global health issue and its impact on the larger health care system (i.e., continents, regions, countries, states, and health departments). How can health care delivery systems work collaboratively to address global health concerns?Who are some of the stakeholders that may work on these issues?  Readings within your text covering international/global health and the following websites will assist you in answering these questions:

  1.U.S. Centers for Disease Control and Prevention (CDC) Global Health website: http://www.cdc.gov/cogh/index.htm

2.U.S. Department of Health & Human Services (HHS) Global Health website: http://www.globalhealth.gov/index.html

3.Families USA – Why Global Health Matters—Here and Abroad website: http://www.familiesusa.org/

4.World Health Organization (WHO) website: http://www.who.int

describes data quality characteristics by researching four articles on data quality.

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Nursing homework help

Create a Power Point Presentation that describes data quality characteristics by researching four articles on data quality.  Describe the five common dimensions of data quality and how EHR data is used as a source of longitudinal data for population studies.

Your presentation should meet the following structural requirements:

  • Be 7-8 slides in length, not including the cover or reference slides.
  • Be formatted according to the APA Writing style.
  • Provide support for your statements with in-text citations from a minimum of four (4) scholarly articles. Two (2) of these sources may be from the class readings, textbook, or lectures, but two (2) must be external.
  • Presentation notes are required for each slide and should be put in the notes section to support the slide content. These can be part of the presentation or delivered as a separate document. If you opt for the former, be aware that the presentation cannot be submitted in PDF format, which does not make notes visible to the instructor.
  • Utilize the following headings to organize the content in your work:
    • Introduction
    • Assessment
    • Recommendations
    • Conclusion