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SOAP NOTE on a patient with Hypothyroidism

This is an assignment that focuses on creation of SOAP NOTE on a patient with Hypothyroidism. The paper will also focus on the social history and also medical history.

Creation of SOAP NOTE on a patient with Hypothyroidism

Topic
Firstly, create a 2 page SOAP NOTE on a patient who has Hypothyroidism. You would will also need to create ALL of the INFORMATION that goes in the SOAP Note that would be associated with a person who has Hypothyroidism. Please write your plan as Nurse Practitioner who works in primary care. I have uploaded an EXAMPLE of the Typhon Documentation that out instructor requires for us to upload every week for clinicals, so it can assist you with writing this SOAP Note.
INSTRUCTIONS:

Subjective (S):
CC: chief complaint – What are they being seen for? This is the reason that the patient sought care, stated in their own words/words of their caregiver, or paraphrased.
HPI: history of present illness – use the “OLDCART” approach for collecting data and documenting findings.  [O=onset, L=location, D=duration, C=characteristics, A=associated/aggravating factors, R=relieving factors, T=treatment, S=summary]
The HPI would flow better if you use oldcart information in paragraph form using complete sentences

PMH: past medical history – This should also include past illness/diagnosis, conditions, traumas, hospitalizations, and surgical history. Include dates if possible.
Allergies: State the offending medication/food and the reactions.
Medications: Names, dosages, and routes of administration.

Creation of SOAP NOTE on a patient with Hypothyroidism

Social history: Related to the problem, educational level/literacy, smoking, alcohol, drugs, HIV risk, sexually active, caffeine, work and other stressors. Cultural and spiritual beliefs that impact health and illness. Financial resources.
Family history: Additionally, use terms like maternal, paternal and the diseases and the ages they were deceased or diagnosed if known.
Health Maintenance/Promotion – Required for all SOAP notes: Immunizations, exercise, diet, etc. However, remember to use the United States Clinical Preventative Services Task Force (USPSTF) guidelines for age appropriate indicators. This should reflect what the patient is presently doing regarding the guidelines.

ROS: review of systems – [Refer to your course modules and also the Bickley Etext (Bates Guide) as a guide when conducting your ROS to make sure you have not missed any important symptoms, particularly in areas that you have not already thoroughly explored while discussing the history of present illness.]
Additionally, ROS would be easier to read if you don’t run all systems together. Start each system on a new line.

You would also want to include any pertinent negatives or positives that would help with your differential diagnosis. For acute episodic (focused) visits (i.e. sprained ankle, sore throat, etc.) you may be omitting certain areas such as GYN, Rectal, GI/Abd, etc.
General: May include if patient has had a fever, chills, fatigue, malaise, etc.

Nurse Manager of a 32 bed general surgical ward in a metropolitan hospital

You are the Nurse Manager of a 32 bed general surgical ward in a metropolitan hospital in a major city. As a result of a restructuring of the hospital networks in the local Area Health Service you have been asked to combine the 32 general surgical ward with a new 12 bed, short stay surgical ward which has been built adjacent to your ward.

Nurse Manager of a 32 bed general surgical ward in a metropolitan hospital

You are the Nurse Manager of a 32 bed general surgical ward in a metropolitan hospital in a major city. As a result of a restructuring of the hospital networks in the local Area Health Service you have been asked to combine the 32 general surgical ward with a new 12 bed, short stay surgical ward which has been built adjacent to your ward.

Please answer the questions that follow in relation to this case analysis.

Firstly,  Develop a business plan (approx. 1000 words)

Secondly,  Identify the steps required in developing a nursing service business plan and explain why they are important.

Thirdly, Name the documents and data would you need to collect and analyse to develop a service profile.

Fourthly, Examine the service demand for the new service level.

Further, Explain the type of workload methodology that might be useful for determining the supply of nurses to staff the new service level.

Briefly discuss any skill-mix or staff education issues which might need to be taken into account for the new combined service.

Developing a cost centre budget (approx. 1000 words)

Also, Discuss the benefits of having the Nurse Manager develop a cost centre budget for a specific area of responsibility. Flexible, zero-based and output-based budgeting are three alternative budgeting methods that could be adopted by the Nurse Manager to develop a budget plan for this new combined service.

Which method would you consider most appropriate and why?

Remember, your answer should compare and contrast the different methodologies and include discussion of the merits, weaknesses and applications of each model.

In the context of developing a cost centre expenditure budget: Provide an outline the three main areas of expenditure (line items). They will be consider  for the expenditure budget. Also, give examples of the issues to be consider for each area of expenditure prior to starting calculations.

Identify and discuss the cost centre reports generated within your organisation. They will provide a baseline for the budget calculations.

Develop a sample Salaries and Wages budget (approx. 300 words)

Develop a sample Salaries and Wages budget for this profile. Make notes on all your calculations to demonstrate your thinking. Explain the assumptions that you make to underpin your decisions

Literature search of Nursing PICOT question

This is an assignment that focuses on a literature search of a suitable PICOT question. This should be identified from module 1. Additionally, the references used shall be rated using the provided links in the assessment.

Literature search of a suitable PICOT question.

INSTRUCTIONS

Complete the assignment, using this Word file as a worksheet. Type your answers directly on this sheet. Use APA style and include citations to support your work.
Include your PICOT question from Module 1. Identify in parenthesis each part of the question (the (P) (I) (C) (O) and (T), if a time element is included).
QUESTIONS

Firstly, perform a literature search for the PICOT question identified from your assignment that you completed for Module 1. Use Chapter 3 and the PubMed Search Example document as a guide to conduct your search. Then, write 1-2 paragraphs discussing your approach and steps taken to perform the literature search. Also, include the names of the databases you used to perform your literature search.
Provide a list of 10 references related to your chosen PICOT question.

Secondly, for each of the 10 references, rate the level of evidence. Use a specific evidence rating scale. See the following examples:
·       https://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford
·       http://www.abiebr.com/set/1-introduction-and-methodology/determining-levels-evidence
The resources in Appendix B may be helpful.  Additionally, provide a rationale for the rating you chose.
Lastly, complete an Evaluation Table Template for the ten references as presented in Appendix C.

Thirdly, discuss in 1-2 paragraphs any difficulties you experienced in performing the literature search and rating the evidence. Subsequently, synthesize and critique the quality of the research evidence on your topic. Lastly, comment on your level of comfort in performing a literature search.
References

Make sure to conduct a research as indicated. All resources to be in a clear citation and referencing style and format. In this case, use APA style.

PICO principles elements identification and research

This is an assignment that discusses the PICO principles elements identification and research. The paper also discusses the potential impact of the procedures.

The PICO principles elements identification and research

1. Study Design [35] 1.1 Briefly describe the research question that this paper aimed to address (no more than 250 words). [2]
1.2 i) Firstly, apply the PICO (population (P), intervention (I), comparison (C) and outcome(s) (O)) principle, to identify each of the P-I-C-O elements of the study. [5]
ii) What is the primary outcome of this research? Justify your answer. [2]
1.3 The authors describe the study as a “Single blind randomized clinical trial.” i) State the randomization procedure the authors used in this study. [2]
ii) Also, describe the “blindness” status in this study. [2]
iii) Then, discuss any potential impact of these two procedures on the validity of the study results. [4]

iv) Secondly, propose an alternative randomization approach which is different from what had been used in this article. [3]
1.4 From a research terminology view point, is this i) an experimental/observational, ii) prospective/retrospective and iii) cross-sectional/longitudinal study? Please justify your answer. [6]
1.5 Thirdly, briefly propose a different study design (other than a randomized clinical trial) to compare the effectiveness of two different doses of fluoride toothpaste in improving oral health. Comparing the study design that you have proposed to the one proposed by the authors, list two strengths and two weaknesses of the design you have suggested. [9]

The PICO principles elements identification and research

2. This question focuses on the “Subjects” section of the paper: [9]
2.1) The authors used “DMFS>=5“ as an inclusion criterion to recruit “caries-active adolescents”. Identify “DMFS” variable’s type (qualitative/quantitative, categorical/binary/ordinal/nominal/continuous/discrete). [6]
2.2) Fourthly, provide 3 possible values that the variable DMFS can take. [3]
3. This question focuses on Table 1, which summarizes the baseline caries condition of the subjects in the two arms. [21]
3.2) The second row of Table 1 (extract shown below) shows the DiFS different at the baseline for the two arms. Assume DiFS is a normally distributed variable for this question. Use the table below to answer the following questions: [13]

3.2.1) Then, determine the DiFS range for the 5000ppm group that 70% of the participants (roughly 73 out of 104) fall into. [4]

3.2.2) For the 5000ppm group, if another random sample of 104 participants was selected from the same population, what is the chance that the average DiFS of this new sample will be over 16 surfaces? Show your calculation and interpret the results. [5]

3.2.3) Use your own words to explain the terminology: “Standard Error” and “Standard Deviation”. [4]

4. Using the results from Table 3, conduct a statistical test to answer the following question: Does the “Prevented Fraction in Progression” in Compliance B group outperform the Prevented Fraction in Compliance A Group? Write down the null and alternative hypotheses, state the statistical method used, conduct the analysis, report the estimates, and write a paragraph regarding your interpretation. Set the type one error to be 0.05. [8]

The PICO principles elements identification and research

5. For this question, note that details of the sample size calculations are given under the “Statistical Methods” section of the article. [27]
5.1 Also, list 4 key elements, and their values, as used by the authors for the sample size calculation. [4]
5.2 Then, explain in your own words what “Type I errors (alpha)” and “Type II errors” are in statistics, using the sample size determination context given by the authors. [6]
5.3 What is the sample size by the sample size calculation? What is the total sample size adopted by the authors in this study? Additionally, are these two numbers the same or different (which is bigger)? Give a reason why this might be the case. [4]

5.4. Consider a situation when a study failed to recruit the sample size originally planned for (for example, if in the current study PI could only recruit 80 subjects). Explain the potential impact of using this smaller sample size on the data analysis. [4]
5.5 In general terms, briefly describe the effect on the sample size if the power was increased to 99%. [2]
5.6. Lastly, consider the situation that the authors want to plan a new follow-up study, and have recruited you as the trial statistician. You are to also conduct a new sample size calculation with alpha (2-sided) changed to 20%, from the original study design, and other elements remaining the same. Finally, show your calculation (pen/paper or a screen shot if using online sample size calculation tool). Give advice to PI how many subjects should he/she recruit? [7]

RNs LPNs UAPs working night shift on a medical unit

You are working the night shift on a medical unit and have been assigned charge nurse responsibilities. Further, you are working with four RNs, one LPN, and two UAPs.

You are working the night shift on a medical unit

Case Study: You are working the night shift on a medical unit and have been assigned charge nurse responsibilities. You are working with four RNs, one LPN, and two UAPs. A client becomes pulseless and is not breathing, and the nurse assigned to the client’s care calls a code. The nurse is occupied at this client’s bedside for 1.5 hours until the resuscitation effort is completed, and the client is transferred to the intensive care unit. This nurse also has four other assigned clients. In addition to the nurse assigned to care for the client requiring resuscitation, two of the other nurses working on your unit are assisting in the code.

Review the case study and write an essay (suggested length of 2–3 pages, excluding title page and reference page) in which you do the following:

Discuss what tasks could you delegate to the UAPs?
The LPN working on the unit is a new graduate and has been employed for only 4 weeks. How would you collaborate with this nurse when delegating tasks for completion?

Discuss how you will maintain the safety of the other clients on your unit while three nurses are occupied with the client requiring resuscitation?

Explain how might effective delegation to other team members contribute to care of the clients on the unit? (Remember, this is not a question about the patient that is code. How you will handle the unit while you are short staff).

More details;