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Emesis during practicum Patient complaint of nausea

This essay entails the occurence of Emesis during practicum and the Patient complaint of nausea. Emesis during practicum reflects on stting the aims and the goals to enable one to acquire the best health to the ordinary citizens

Emesis during practicum Patient complaint of nausea

Firstly, patient complaint of nausea but no emesis during practicum. The preceptor stated him is having allergy because of inflammation in one of his nares, and no elevated temperature.

Also, reflect on your practicum experience by writing your responses to the following questions:
What were the highlights of practicum to this point? Setting goals, be professionalism, and keeping up with patient’s assessment.

Secondly, what challenges did you face? Driving a long way, Client noncompliant to care, and difficult to follow directions.Recall any online content that you have studied for the practicum. Which system exams did you perform? Which skills did you use for the specific exam during the practicum? I use Otoscope to inspect the nose. How did you apply what you have learned?

Thirdly, reflect back and identify areas that you might have missed. Do you feel you are proficient and timely in performing the specific exam? If yes, great! If thats the case, what could be done to improve? How did your skills improve from the last time you performed the specific systems exam? What have you seen in the practicum environment that has not been included in the online course?

Lastly, when a person has rhinitis, the inside of the nose becomes inflamed, or swollen, causing cold-like symptoms, such as itchiness, blocked nose, runny nose, and sneezing.

In conclusion, allergic rhinitis can be causes an allergy. In other cases, it is called nonallergic rhinitis. The symptoms of nonallergic and allergic rhinitis are similar, but the causes are different.

Patient Care Delivery Systems Ethical Issues in Nursing CINHAL- MedLine to research

Please confirm if you have access to CINHAL, MedLine to research the articles and that you can provide an outline of the presentation prior to the due date of 2/20.

Confirm if you have access to CINHAL-MedLine to research

Please confirm if you have access to CINHAL, MedLine to research the articles and that you can provide an outline of the presentation prior to the due date of 2/20.
This is a 7 – 10 page PowerPoint, articles must be summarized in a separate doc and speaker notes must be added.
Please provide estimate.
Here are additional details
PROFESSIONAL PRACTICE PROJECT
NARRATED POWERPOINTS

Research and select 3 current articles written from 2006-2016, about a current professional practice topic (NOT a clinical topic), these can include the following subjects (but not limited to):
Firstly, Case Management

Secondly, Advance Nursing Practice

Thirdly, Education Preparation of Nurses

Fourthly, Health Care Delivery Systems

Further, Legality in Nursing

Also, Communication in Nursing

Additionally, Professionalism in Nursing (ie. Uniforms, organizational involvement)

Moreover, Leadership and impact on working environment

Also, Patient Care Delivery systems

Financial impact and cost containment issues

Quality Initiatives

Staffing Ratios

Ethical Issues affecting nursing

Lastly, Other topic may be considered after consultation and approval by instructor

Introduce the topic then, for each article, summarize the key points in no more than 2 paragraphs for each article. Then describe the significance of these articles (why is this important). Finally, summarize the implications these articles in current nursing practice what affect this topic has on nursing).

Researching should be conducted in such data bases as CINHAL, MedLine etc.
Student will develop narrated PowerPoints and post on Blackboard. Each student will comment on 2 student presentations.

GRADING

Reference Page APA (including grammar, punctuation, etc)
Summarization of articles (avoid long quotes)
Narrated PowerPoint:
*Include information needed to give a thorough understanding of topic, Narrative and notes to explain each slide, PP presentation completed before deadline, meets or exceeds required length (7-10 slides Significance of articles /Implication to practice
Posted comment on
Discussion board respond to 2 fellow student presentations 10% 30% 30% 25% 5%

39-year-old male with epigastric pain

This paper is on a Family Medicine 19: 39-year-old male with epigastric pain. You are to Complete only the History, Physical Exam, and Assessment sections of the Aquifer virtual case

Family Medicine 19: 39-year-old male with epigastric pain

Complete only the History, Physical Exam, and Assessment sections of the Aquifer virtual case: Family Medicine 19: 39-year-old male with epigastric pain.

Discussion Question 1
Based on your performance and the expert feedback in your HISTORY collection, describe two missed questions and also your understanding of why they were important to collect for this case history. Use specific references from your text to explain.

 

Discussion Question 2
Based on your performance and the expert feedback in your PHYSICAL EXAM collection, describe two errors in your exam performance or documentation. Use specific references from your text to explain the importance of these findings in correct assessment of this client.

Discussion Question 3
Based on your performance on the PHYSICAL EXAM collection, describe one key finding that you included in your list and describe a specific physical exam that you can perform at the point-of-care to further evaluate the finding. Use specific references from your text.

Discussion Question 4
Based on your performance and the expert feedback in your ASSESSMENT identification of problem categories, choose one missed/incorrect category and use specific references from your text to explain the importance of this category in arriving at correct differential diagnoses for this client.

Discussion Question 5

Based on your performance and the expert feedback in your ASSESSMENT of differential diagnoses, describe one incorrect/missed differential diagnosis and use specific references from your text to support the inclusion of the diagnosis for this client.

Today, you are working at a family medicine clinic with Dr. Medel. Together, you review her clinic schedule for the day and also she suggests that you see Mr. Cesar Rodriguez, a 39-year-old uninsured male who recently moved to the U.S. from the Dominican Republic. This is Mr. Rodriguez’s first visit to the clinic.

Molly, Dr. Medel’s medical assistant, has already escorted Mr. Rodriguez to the examination room and has arranged for a Spanish-speaking interpreter to be present for the visit, since he speaks and also comprehends very little English. Molly tells you that Mr. Rodriguez has been having “worsening abdominal pain over the past several months” and is “worried that something is wrong.”

Dr. Medel says to you, “How would you begin to think about what might be going on with Mr. Rodriguez?”

You reply, “Abdominal pain can be caused by a wide variety of conditions. I’ll need to get more information about his symptoms to form an appropriate differential diagnosis. At this point I’d have to consider several organ systems as potential etiologies of the pain.”

“Very good,” Dr. Medel responds. “Why don’t you go ahead and talk with Mr. Rodriguez and also come find me afterward. Lola, our Spanish-speaking interpreter, can help.”

As you walk down the hall, Lola, the Spanish-speaking interpreter, also,  gives you some tips on how to interview a patient with an interpreter.

You and Lola enter the room. You sit directly across from Mr. Rodriguez, with Lola sitting just off to your left and facing him. You sense that Mr. Rodriguez seems anxious about coming to the physician today. You introduce yourself and ask,
“What brings you in today?”

“Is there anything that makes the pain better or worse?”

“What worries you the most about your symptoms?”

Thinking about some of the common causes of abdominal pain, you conduct a focused review of systems:

General: Reports no weight loss, fevers, chills, or night sweats. He has had no recent illnesses. Aside from a recent move to the U.S. from the Dominican Republic, he has not traveled recently.

GI: Reports no dysphagia, regurgitation, nausea, vomiting, anorexia, early satiety, hematemesis, hematochezia, melena, diarrhea, or constipation.

GU: Reports no dysuria, hematuria, or change in frequency.

CVS/Respiratory: Reports no chest pain, cough, or shortness of breath.

MEDICAL AND FAMILY HISTORY
HISTORY
You now direct your attention to Mr. Rodriguez’ medical history.

“Do you have any chronic medical problems?”

“Have you ever been hospitalized or had any surgeries?”

“Do you take any medicines or supplements?”

“Does anyone in your family have any medical conditions—for example, heart or blood pressure problems? Diabetes?”
“Does anyone in your family have stomach problems or pain similar to yours?”

You ask Mr. Rodriguez a few more questions and discover that he works as a farm laborer. He has no known drug allergies. He smoked a few cigarettes daily but quit six months ago. Further, he drinks three to four beers per week. Also, he reports no other drug use. He has had no recent illnesses. Aside from a recent move to the U.S. from the Dominican Republic, he has not traveled recently.

You congratulate Mr. Rodriguez on quitting smoking and you thank him for answering all of your questions. Further, you review in your mind what you’ve learned from Mr. Rodriguez so far, and find yourself still wondering about why he seems a little anxious. Before you go to get Dr. Medel, you inquire, “It seems like this has really been bothering you. Is there anything else we haven’t talked about that seems important?”

CONTINUE

 

Nancy a 35-year-old female presents with an asthma exacerbation

Nancy, a 35-year-old female, presents with an asthma exacerbation. She has had asthma since she was a child and was hospitalized several times as a child but her asthma was well controlled until the past couple years.

Nancy a 35-year-old female presents with an asthma exacerbation

1.     Nancy, a 35-year-old female, presents with an asthma exacerbation. She has had asthma since she was a child and was hospitalized several times as a child but her asthma was well controlled until the past couple years. Nancy has been seen in urgent care a few times over the past year (most recently 4 months ago) and was given a prescription for an inhaled steroid (she never filled), albuterol inhaler, and oral steroids.

She had eczema as a child and also received allergy shots for many years. Her asthma symptoms flared again 2 weeks ago and she has been using her albuterol 4–5 times/day. Nancy reports that she is very short of breath when climbing stairs or when walking to the mailbox. She has had nighttime coughing spells every day during the past week and has had to prop up on pillows to breathe. She indicates that she has had similar previous flares in the past and she “just wants more albuterol and steroid pills.”

Firstly, Classify Nancy’s asthma using (and citing) the most current EBP guidelines.

Which of the four categories (intermittent, persistent – mild, persistent – moderate, persistent – severe) does she fall under?

Explain your justification.

Secondly, Is Nancy’s asthma being manage d properly? Explain your answer.

Thirdly, Would you refill her albuterol inhaler and steroid pill prescriptions as she requested?

Fourthly, Incorporate the pathophysiology of the three core defects of asthma into your discussion for all of these questions.

Furthermore, What is the value in performing this spirometry on Nancy when she already has a known diagnosis of asthma?

Moreover, Interpret her spirometry by defining and analyzing each indice (FEV1, FVC, FEV1/FVC ratio) individually.

Lastly, Explain the significance of “atopy” and “one continuous airway” applying Nancy’s scenario.

 

Harry CASE STUDY

2.     Harry, a 42-year-old Caucasian male, present ed with a BP of 172/104 three weeks ago and was place d on lisinopril/hctz 20/12.5 – 1 tablet daily. He returned today and his BP is 148/88. He complains of a persistent, dry, hacky cough that is annoying him significantly.

a.     Explain the pathophysiology of his cough and lisinopril. How would you address this?

b.    Explain the location within the RAAS and the mechanism of action for lowering blood pressure for each of the following four antihypertensive drug classes: renin inhibitor, ACE, ARB, and aldosterone inhibitor. A brief paragraph for each will suffice.

c.     Discuss how the RAAS impacts African-Americans differently than other ethnicities. According to the EBP guidelines, which two drug classes are use d specifically in the treatment of African-Americans for hypertension?

3.     Harry was also start ed on atorvastatin 40mg three weeks ago and complains of severe weakness and muscle pain in his legs and shoulders. His urine is “tea colored.” His CK (creatine kinase) is 2,000.

a.     Identify Harry’s diagnosis and explain his weakness, muscle pain in legs and shoulders, elevated CK, and tea-colored urine from a pathophysiological perspective.

b.    Explain from a pathophysiological perspective the difference in mechanism of action between a hydrophilic and lipophilic statin as they relate to myalgias. As an FNP, how does this knowledge help you? Give two examples of hydrophilic and lipophilic statins.

Examination of the developing a curriculum for a nursing program

This is an assignment that focuses on the examination of the development of a curriculum for a nursing program. The paper also analyzes the factors that impact the design of a nursing curriculum.

Examination of the development of a curriculum for a nursing program

Nurse educator are responsible for many area of evaluation, including students, curriculum, and program evaluation. Additionally, they have a responsibility to the internal and external stakeholders when it comes to the evaluation process. There are two types of evaluation: summative and formative evaluation. Formative evaluation takes place during the learning process (Billings & Halstead, 2012). Summative evaluation refers to the outcomes of the learning when the learning environment has ended (Billings & Halstead, 2012.)

OVERVIEW
Create a 15 page curriculum evaluation that incorporates the curriculum analysis and course design you created for Assessments 1 and 2.By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Assessment criteria

·        Competency 1: Examine the development of a curriculum for a nursing program.
o   Describe how evidence-based nursing concepts, theories, and best practices can be applied to improve curriculum development.
·        Competency 2: Analyze factors that impact the design of a nursing curriculum.
o   List criteria that are important to consider in curriculum evaluation.
·        Competency 3: Select an appropriate organizing/curriculum framework for the design of nursing curriculum.
Explain the importance of ongoing curriculum evaluation, including why it is important and for whom it is important.
Then, explain how and why pilot testing can be used in curriculum evaluation.

o   Identify the appropriate accreditation body for a selected curriculum and describe appropriate accreditation evaluation criteria.
·        Competency 4: Select a curriculum evaluation process that facilitates continuous quality improvement.
o   Provide examples of both short-term and long-term evaluations for process improvement, and explain why both types are important to curriculum development.
·        Competency 5: Communicate in a manner that is scholarly, professional, and consistent with the expectations of a nursing education professional.
o   Apply academic writing skills to incorporate faculty feedback in the creation of a complete, succinct, professionally flowing curriculum design evaluation.
o   Write effectively using appropriate spelling, grammar, punctuation and mechanics, and APA style and formatting.