Safeguarding patient care assignment

/0 Comments/in /by

Safeguarding patient care assignment

This is a paper that requires the student to undertake the HSNS376 safeguarding patient care assignment. The paper also provides additional information to use in the writing of the assignment paper. Below is the assessment description to follow:

Undertake the HSNS376 safeguarding patient care assignment

Assignment 1 – Written Assignment

HSNS376/576 Assignment 1

This assessment relates to: Learning Outcomes 1-5
Assessment 1: Safeguarding patient care

This assignment examines roles, and also responsibilities nurses have about making decisions about practice aiming to keep patients safe in Australian healthcare.  As a core skill for a nurses reflection is a conscious effort to think systematically about an activity or incident that allows us to consider what was positive or challenging and if appropriate plan how it might be enhanced, improved or done differently in the future.

Case study

In 2001, 18-month-old Josie King died of dehydration and a wrongly administered narcotic while an inpatient at Johns Hopkins Hospital.  Her mother, Sorrel King, tells the story of how this happened and explains her role as a consumer (parent) in improving patient safety.

*Please note Josie’s story is a confronting and also avoidable tragic incident that occurred in a hospital. Please be aware that it may cause you distress and seek support if you need it. You can discuss with the unit coordinator, or contact UNE Student Support.

The Josie King Story

In preparation for the assessment task
View – the video of Josie’s story
Additionally, review – the associated relevant documents below

i.  Firstly, review the NMBA Registered Nurse Standards of Practice https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

ii.   Secondly, Australian Commission Safety and Quality in Health Care National Safety and Quality Health Service (NSQHS) Standards: Partnering with consumer standard and follow to the link Partnering with patients in their own care.

iii. Thirdly, Code of conduct; Code of conduct for nurses

iv. Fourthly, Code of Ethics;  Code of ethics for nurses from 1 March 2018, the International Council of Nurses Code of ethics is in effect for all nurses in Australia

Family practice issues identification and therapy models

/0 Comments/in /by

Family practice issues identification and therapy models

This is a paper that focuses on the family practice issues identification and therapy models and also recommendations for these problems. Additionally, the paper discusses the major assumptions made.

Family practice issues identification and therapy models

Family Practice Paper
I. Family description (1-2 pages)

Describe a family with whom you are working

Structure and Composition of the Family

i.    Firstly, you have to describe demographics, characteristics and roles of each family member
ii.    Then, identify strengths and resources of the family as a whole

Presenting Issues of the family

i.   Identify and describe the issues that you and the family are working on.
ii.  Draw a family genogram to illustrate the problem visually (one page attachment or figure embedded in paper.

II.  Secondly, write a literature Review on Presenting Issues (1-2 pages)   .
A.   Identify the prevalence, characteristics, and scope of one or more of the family’s primary presenting issues.
B.   Then, review research on family therapy with one or more selected issue that you are working on (or if necessary would like to or have previously worked on)
C.   Subsequently, describe efficacy or effectiveness of various family therapy approaches at resolving the problem.

III.  Thirdly, write a literature Review on Two Family therapy Models

Select two of the following therapies which you believe have potential for being effective at resolving the family problem.

Attachment Based Family therapy

Cognitive-Behavioral (Multiple strategies and also models can be found in the literature)
Communication (Satir)
Experiential (Whitaker)
Family Systems (Bowen)
Narrative (White & Epston)
Multisystemic Family Therapy
Solution-Focused (Berg)
Strategic (Haley & Madanes)
Functional Family Therapy (Alexander)
Brief Strategic Family Therapy (Szapocznik)
Multidimensional Family Therapy (Liddle)
Structural (Minuchin)
Other family therapies that you have found in the literature |

Describe the key ideas and major assumptions of each approach.
Discuss how each approach would account for the culture and values of the family.
Then, describe the assessment process including the essential information for applying each approach.
Review the evidence base for each therapy approach in relation to the presenting issue
Lastly, select one of the two approaches with a rationale for your choice.

IV. Fourthly, discuss an intervention plan (4 – 5 pages) Specify if you are able to carry out any of this approach with the family.  However, if you can begin to carry this out, describe this process; if you are not able to apply this describe how you would plan to carry this out.

Develop a plan for implementing or applying the information to the  family situation.
Then, identify the goals for treatment
Specify techniques to address the problem.
Additionally, give examples of how you would use the techniques with the family (include sample dialogue if necessary).
Lastly, describe also how you will evaluate the effectiveness of treatment (i.e. how will you know you have successfully resolved the problem the family came in to address?).

V. Lastly, come up with conclusions and Implications

Conclusions about state of the evidence regarding the presenting issue
Additionally, write implications for future practice

 

 

Brief summary of the patient’s current health problem

/0 Comments/in /by

Brief summary of the patient’s current health problem

This is an assignment hat focuses on the brief summary of the patient’s current health problem. The paper requires adequate information on the patient’s health.

The brief summary of the patient’s current health problem

CNA772 Assignment 1

This assessment task enables you to deeply engage with the literature around the management of an acutely ill patient.  You must select a patient for the case study who has experienced either shock, acute respiratory or cardiac dysfunction.
Write a brief summary of the patient’s current health problem, relevant history. Additionally, any specific early management provided to address the primary problem prior to arriving into the emergency department. This should be sufficient to set the scene for the reader. The introduction should take up no more than one (1) to one and a half (1 ½) pages.

At all times you must maintain patient confidentiality by assigning the person a pseudonym and not disclosing personal identifying information. Please note that no patient details are required, and it is your interpretation of the management of the patient’s physiological status that is examined. There is no need to include patient’s test results unless significant to the case.  Please do not include diagrams, pictures or tables in the essay. It is your role to interpret the information, not reproduce data.  Ethics approval from health care institutions are not as you are not providing any identifying information, nor patient specifics.

The brief summary of the patient’s current health problem

To facilitate demonstrating depth of knowledge related to acutely ill patients, critically analyse the related health problem (shock, or acute respiratory or cardiac dysfunction) using evidence-based findings, limit your paper to an explanation of the physiology underlying the problem and the management provided. The management should be restrict to the key elements used to address the problem and should be linked back to the alter physiology.
Include a conclusion to the paper that draws the key elements together.  Use a minimum of 12 scholarly references to support your discussion themes ensuring that you correctly reference your work.  You must clearly demonstrate the related pathophysiology in the body of your paper.  References in the main should be no more than five years since publication.

Lastly, write clearly in an appropriate academic style and structure and back up claims by referring to academic literature and references appropriately using modified Harvard style as required by the School of Nursing.
2000 words, Times New Roman size 12, line spacing 1.5, double return before paragraphs, Harvard Author-Date for referencing, left aligned for reference list with single spacing, no need to indent first work of each paragraph, Microsoft Word Document.

Developing a professional practice portfolio for registered nurses RN BSN FNP DNP

/0 Comments/in /by

Developing a professional practice portfolio for registered nurses RN BSN FNP DNP

This is an assignment that discusses the developing a professional practice portfolio for registered nurses. The paper also discusses the standards for practice for application.

The developing a professional practice portfolio for registered nurses

Written Assignment (Individual): Developing a Professional Practice Portfolio 1,500 words Weighting 50%
AIM: According to the Registered Nurses Standards for Practice (2016), to provide safe, effective nursing care, nurses must maintain capability for practice through lifelong learning and professional development.1 In this assessment task, you will develop the skills required to create a Professional Practice Portfolio (PPP) in which you can document the evidence of capability for practice as a Registered Nurse in the future and also how the Standards for Practice are applied. This assessment item will address course learning outcomes 1 and 3.

INSTRUCTIONS:

This assessment task has two components. 1. Professional practice portfolio use • Firstly, describe a PPP and discuss the recommended components (approx. 100 words); • Present an argument that supports the use of a PPP to demonstrate professional nursing practice. Your argument should demonstrate critical thinking and analysis of why PPPs should be and the benefits and challenges of using a PPP to demonstrate capability for professional nursing practice (approx. 350 words); • Also, discuss and differentiate between ‘management’ and ‘leadership’ concepts, and describe how development of leadership and management skills could be evidenced in a professional practice portfolio (approx. 400 words). • Support your argument with at least seven scholarly sources from 2015 onwards.

1. Nursing and Midwifery Board of Australia. (2016). Registered Nurses Standards for Practice.

2. Application of Professional Standards
Standard 3 “Maintains the capability for practice” (NMBA, 2016) includes seven points about how the Registered Nurse maintains the capability for practice. The fourth point states the Registered Nurse (RN) “accepts accountability for decisions, actions, behaviours and responsibilities inherent in their role” (NMBA, 2016).

The developing a professional practice portfolio for registered nurses

• Secondly, choose an example from a previous or current clinical placement where you were delegated an action/responsibility by an RN/Clinical Facilitator and describe this example2. Your description should include: The context of nursing practice and health care delivery (i.e. where this occurred); who was involved; what you were delegated to do; how you enacted the delegated action/responsibility, and; the outcome of the delegated action/responsibility (approx. 200 words); • Thirdly, critically discuss how you demonstrated the application of a professional standard (within your student nurse scope of practice) and reflect upon the accountability for your decisions, actions, behaviours and responsibilities (approx. 450 words); • Support your discussion with at least three scholarly sources from 2015 onwards.

OTHER ELEMENTS: • You do not need to include an introduction or conclusion to this written assessment. • Use a heading for each of the two components of the written assessment. • Do not exceed the word limit – the word limit does not include the reference list BUT does include in-text references and quotations;

Margaret is a 40-year-old white female in for her annual examination

/0 Comments/in /by

Margaret is a 40-year-old white female in for her annual examination

Margaret is a 40-year-old white female in for her annual examination. She states she has been under increased stress in her life for the past few months. She and her husband are currently separated and considering divorce.

Margaret is a 40-year-old white female in for her annual examination

Guidelines: Support your responses with scholarly academic references using APA style format. Assigned course reading and online library resources are preferred. Weekly lecture notes are designed as overviews to the topic for the respective week and should not serve as a citation or reference.

In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and also examples; demonstrates a clear connection to the readings
In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extend meaningful discussion by building on previous postings.

Note: Review South University’s Substantive Participation Policy Criteria, Helpful Tips, ad Late Policy available by clicking on the South University Policy and Guidelines navigation tab. The late policy applies to late discussion question responses.

Discussion 1:

Margaret is a 40-year-old white female in for her annual examination. She states she has been under increased stress in her life for the past few months. She and her husband are currently separated and considering divorce. Her teenaged sons are acting out and she is working extra hours to make ends meet. Secondary to the increased stress she has started smoking again, “about a pack per day” and also states “I know that I am not eating right.”

Margaret has been on the “pill” for almost 20 years and has always liked the method. She states the she has heard that smoking and taking the pill are not good, and she is worry about that. “I really do not need birth control since I am separated but just in case I probably need something.” She states that she has been in a mutually monogamous relationship (as far as she knows) since her marriage 18 years ago. She denies a new partner since her separation.

Menarche was at 11 years, her cycles when on the pill are regular and very light. Her menstrual period should start tomorrow as she just finished her active pills. She denies a personal history of abnormal Pap smears, gynecological issues, hypertension (HTN), or diabetes. She is G2P2002, and also her pregnancies were full term and uncomplicated at ages 24 and 26. Family history is significant for both parents with HTN and mom has type 2 diabetes.

Her paternal grandfather died at age 64 years from type 2 diabetes, HTN, and also coronary artery disease. Her other grandparents died in their late 70s early 80s and she is unaware of any medical issues.

Assessment:

Margaret’s examination finds her height 5’5″, weight 172 lb (up 10 lb. from last year), current body mass index (BMI 28.6), and blood pressure (BP) 148/88. Head, eyes, ears, nose, and also throat (HEENT) are grossly within normal limits (WNL).

No thyromegaly or lymphadenopathy. Heart rate is regular and rhythm is without murmurs, thrills, or rubs. Lungs are clear to auscultation in all lobes. Breasts are without masses, nipple discharge, asymmetry, or lymphadenopathy; self breast examination techniques and frequency reviewed during examination.

Abdomen is soft, nontender, with no masses or hepatosplenomegaly; bowel sounds present in all four quadrants. Pelvic examination reveals normal vulva and negative Bartholin’s and Skene’s glands; vagina is pink, rugated, with minimal white nonodorous discharge; cervix is pink, multiparous os.

Pap smear collected during speculum examination was normal. Bimanual examination reveals a retoverted, firm, mobile, nonenlarged, nontender uterus with negative cervical motion tenderness; adnexa nontender; and also ovaries palpable bilaterally, mobile, without masses. Lower extremities were without edema or varicosities.

Firstly, what options are appropriate for this patient?

Secondly, what contraceptive options are contraindicate d?

Thirdly, what type of patient education is indicate d?

Finally, given that she has a normal pelvic exam, does that change would that influence your decision?

Documenting a Patient Phone Call for a Electronic Health Record

/0 Comments/in /by

Documenting a Patient Phone Call for a Electronic Health Record

This is a paper that focuses on Documenting a Patient Phone Call for a Electronic Health Record. The paper also provides framework on writing the report for the system.

Documenting a Patient Phone Call for a Electronic Health Record

Learning objectives
Firstly, demonstrate professional transcription skills when documenting in an Electronic Health Record (EHR).
Secondly, document accurately in the patient record.*
Structure, Organize, and Prioritize interview data into a professional note in the patient’s electronic health record.
Thirdly, analyze communications in providing appropriate responses/feedback.*
Then, advocate on behalf of patients.*
Fourthly, apply current knowledge of electronic health records and appropriate, accurate documentation.
Lastly, demonstrate telephone techniques* (if completed in lab setting).

*Directly maps to MAERB educational competencies.

Student instructions
1.     If you have questions about this activity, please contact your instructor for assistance.
2.     You will review the chart of Alec Allard to complete this activity. Additionally, your instructor has provided you with a link to the Documenting a Patient Phone Call activity. Click on 2: Launch EHR to review the patient chart and begin this activity.

However, refer to the patient chart and any suggested resources to complete this activity.
You will complete documentation in EHR Go as instructed below. Subsequently, when you complete this activity, you will download your Progress Report in EHR Go under 3: Download Work, save the Progress Report to your device, and then upload the Progress Report to your Learning Management System (LMS).

The activity

Firstly, launch the EHR and review Alec Allard’s EHR, specifically in the Notes, Vitals, and Orders Tabs. Then read through the telephone call transcript in this document.

In the EHR, go to the Notes tab and click on the New button in the bottom right of the screen. Select the Free Text Note template. For date and time, click into the box to change the date to tomorrow and the time to 0900. Leave yourself as the author and choose the Central Clinic as the location.

See below for an example of the correct selections in the Note Choice box.

Signature assignment chronic health problem – Hypertension

/0 Comments/in /by

Signature assignment chronic health problem – Hypertension

This is an assignment that focuses on the topic Signature assignment chronic health problem-Hypertension. The paper also discusses the similarities of two EBP.

Signature assignment chronic health problem-Hypertension

G‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍uidelines:

Firstly, select a patient that you have encountered in your clinical practice with a chronic health problem. Interview the client/family members. Include the following information Setting: Community clinic, Private practice, Skilled nursing facility, Home health Clinical information: Chief complaint, HPI, PMH, PSH, FH, ROS, PE, Diagnostic Testing, Medical Decision Making, Diagnosis/Clinical Impression, Plan/Interventions, Recommendations, Education, Health promotion Ask your client/family members on areas of: Dependency with families/support systems Self-care management Adaptation/adjustment to the illness Social Isolation Body Image Cultural, racial, ethnicity, and spirituality Influences Functional Limitations Quality of Life Adherence to regimen Community Services or support Sexuality Communication Literacy Financial support Use of Research Findings and other evidence in Clinical Decision Making Choose 2 EBP resources influencing the care provided to your client. Discuss the similarities and diff‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍erences that you read for those two EBP peer reviewed articles.

Secondly, submit scholarly paper, with writing style at the graduate level, including all of the following: Reviews topic and explains rationale for its selection in the context of client care. Evaluates key concepts related to the topic. Describes multiple viewpoints if this is a controversial issue or one for which there are no clear guidelines. Assesses the merit of evidence found on this topic i.e. soundness of research Evaluates current EBM guidelines, if available. Or, recommends what these guidelines should be based on available research. Also, discuss the Standardized Procedure for this diagnosis. Discusses how the evidence did impact/would impact practice. What should be done differently based on the knowledge gained? Lastly, consider cultural, spiritual, and socioeconomic issues as applicable. This paper should be in APA Format, including citations and references Research: citations.

Client’s target heart rate using the Karvonen formula

/0 Comments/in /by

Client’s target heart rate using the Karvonen formula

This is an assignment that focuses on the topic Calculate the client’s target heart rate using the Karvonen formula. The paper also provides a case study that is related to the topic.

Calculate the client’s target heart rate using the Karvonen formula

Calculate the client’s target heart rate using the Karvonen formula
T‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍his section of your final exam provides you with an opportunity to apply all of the information you have learned throughout the course to the work that you will be doing as a certified professional. You will be presented with two client profiles, and will be asked to design a 12-week periodized program for each client. In addition to describing the logistics of the program, you will also be asked to explain why you have designed the program the way that you have. Approach these clients as you would approach a real-life situation. Your client should be able to take your program and put it into practice without having to contact you for explanation of what to do or why to do it. Before you finalize your submission, make sure your program passes the following tests:

1. Firstly, is the training program that you are designing appropriate, safe, and effective for the client, given the client’s physical abilities and primary goals?

2. Secondly, could you defend your program from a legal standpoint? Who would be held liable if your client was injured during training because of either lifting too much weight or exceeding a certain heart rate?

3. Is your program justifiable from a business standpoint? Are you professional with your current clients? Would they refer their friends, family, or colleagues to you based on the guidance that you provide in your program design?

4. Imagine that YOU are the paying client. Would you feel that your money was well spent if you were handed the training program/dietary recommendations?

Case Study 1 Calculations:

Calculate the client’s target heart rate using the Karvonen formula. Training Program: Design a full 12-week periodized training program for the client described in the Client Profile. Be very specific as you design the training program. This is an opportunity for you to demonstrate your full comprehension of the information and concepts discussed throughout the course. List the types of exercise, duration, sets, reps, rest intervals, and so on. Include the following in your case study submission:

A description of your professional responsibilities as discussed in the stages of the drawing-in process (Unit 12) Discussion of any fitness tests, methods of evaluation, and data collection used to assess. Also, evaluate the client’s needs. Specific conditions that you ha‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍ve identified in the client profile. A fully detailed 12-week comprehensive and periodized training program including specific exercises, sets, repetitions, suggested rest times, etc. Use an integrated approach in your program recommendations. Specific and detailed nutritional strategies and an explanation as to how the strategies will assist the client in meeting energy needs. Explanation for your chosen assessment, programming, and nutritional recommendations.

Calculate the client’s target heart rate using the Karvonen formula

(Be sure to reference course concepts when discussing rationale for your recommendations. Keep in mind that a client should be able to take your program and put it into practice without having to contact you to clarify what you intended by your recommendations or to explain parts of your program. Don’t forget your explanation for WHY you listed and recommended what you did. Reference the concepts and theories covered in the course.

For example: if you are developing a program for a beginner client without any resistance training experience, explain how your program addresses the lack of experience. Additionally, initial need for foundational development, process by which you would safely progress the client, etc. Tying your program to course concepts is a critical component of your case study. Lastly, review the Client Profile below. Client Profile: Jamie Summers Age: 53 Gender: Female Resting Heart Rate: 90 bpm Height: 5’5″ Weight: 165 lb Body Fat Percentage: 35%

Background and Goals: Jamie is a working mother of three teenagers. She has not been consistently active for many years. Also, she was recently diagnosed with high blood pressure. This is likely caused by her high-stress corporate job and physical inactivity. She also has an affinity for processed and sugary foods.

Investigation of a problem related to a PICOT question SOAP NOTE

/0 Comments/in /by

Investigation of a problem related to a PICOT question SOAP NOTE

This is an assignment that discusses the Investigation of a problem related to a PICOT question. The paper also involves creation of a power point for presentation.

Investigation of a problem related to a PICOT question

A‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍ssignment Criteria:

Develop a PowerPoint presentation that includes the following criteria:

1. Firstly, describe the problem related to the PICOT question.

2. Secondly, state the PICOT question and describe the components

3. Describe the intervention.

4. Summarize the evidence that supports the intervention.

5. Provide a brief summary of the pilot project.

6. Lastly, discuss the implementation process for the intervention and include a timeline. 7. Describe how the intervention will be evaluated. Include measurement tools and a timeline. 8. Consequently, explain the implications of the intervention on practice and the science of nursing. 9. Once the PPT is created,

Presentation

For presentation clarification, include presenter’s notes in the click to add section to explain the slide.The PowerPoint presentation should not be more than 10-12 slides and 10-12 minutes in length. Additionally, be complete and concise. Use bulleted statements not complete sentences or paragraphs. 12. Use APA format for PPT, which always includes a title slide, a reference slide, and APA requirements. Resources found in APA Documents/Resources. 13. A minimum of four (4) references will also be required for this assignment. References should be from scholarly peer-reviewed journals (check Ulrich’s Periodical Directory) and be less than five (5) ye‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍ars old. Include the following slides: • Slide 1: Title-develop a title slide. This should include the title of the presentation, student name, and the university name. Use APA format (does not need to be in Times New Roman for a PPT).

Slide 2: Purpose of presentation-verbiage is in the assignment instructions above. • Slide 3: Describe the problem related to the PICOT question. (Describe the problem identified and the need within the organization. Convince the audience that this is a problem that requires attention). • Slide 4: State the PICOT question and explain each of the components • Slide 5: Describe the intervention • Slide 6: Summarize the evidence that supports the intervention. However, convince the audience that the review of the literature was diligent and thorough in the search for the best evidence available on the clinical practice-based problem/topic.

Slides

Slide 7: Describe the pilot project • Slide 8: Discuss the implementation process of intervention and include a timeline • Slide 9: Explain the evaluation process and include measurement tools and a timeline • Slide 10: Conclusion: Include a summary of the main points covered and the importance of implementing the intervention. • Slide 11: Lastly, put references in APA format (please include in-text citations on the slides). Reference‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍ should be in APA format

58-year-old male with shortness of breath

/0 Comments/in /by

58-year-old male with shortness of breath

This paper focuses on a Family Medicine 28: 58-year-old male with shortness of breath. While working with your family medicine preceptor you are scheduled to see Mr. John Barley, a 58-year-old male who has sought medical attention

Family Medicine 28: 58-year-old male with shortness of breath

Family Medicine 28: 58-year-old male with shortness of breath

While working with your family medicine preceptor you are scheduled to see Mr. John Barley, a 58-year-old male who has sought medical attention only rarely in the past 10 years. He comes to the office today because of progressively worsening cough and shortness of breath during the previous month.

Before you and your preceptor Dr. Wilson enter the room to meet Mr. Barley, you think about the definition of dyspnea:

TEACHING POINT
Dyspnea Definition
Dyspnea is defined as an uncomfortable awareness of breathing.
Any problem in the mechanical system of breathing can trigger dyspnea, including (but not limited to):
Firstly, blockage in the nose
Secondly, fluid in the alveoli
Thirdly, irritation of the diaphragm

PATIENT HISTORY 1

Dr. Wilson greets Mr. Barley, introduces you, and then excuses himself to go see another patient. He states he will be back for you to present Mr. Barley’s case to him.
You sit down across from Mr. Barley and say, “Hi, Mr. Barley. Thanks for letting me work with you.” Mr. Barley says, “Sure, anyone working with Dr. Wilson is OK by me.”
You begin eliciting the history:

“I understand you have a cough and shortness of breath. Can you tell me more about it?”
“OK. Have you noticed anything else that seems to be related to the cough? Things like weight loss, chest pain, and fever?”
“Have you had any nausea, vomiting, or diarrhea?”
“Do you have shortness of breath when you are active and when you are at rest?”
“Have you had in the past, or currently have, exposures to things that can cause cough, like chemicals, and smoking?”
“Do you have any trouble lying flat when you sleep?”

You learn that he has not traveled recently, which could have exposed him to an unusual form of pneumonia.

He also has not been exposed to tuberculosis. From other questions, you learn that Mr. Barley has no leg swelling or paroxysmal nocturnal dyspnea (PND). You know that he has had no orthopnea.

As a farmer, he is active during the day. Deconditioning is not likely.
Wondering if his shortness of breath is due to a panic disorder, you ask him a series of questions and note that his symptoms are not associated with paresthesia, choking, nausea, chest pain, derealization feeling, trembling or shaking, dizziness, palpitations, sweating, chills, or flushes.

PATIENT HISTORY 2

HISTORY
Now that you have a good understanding of the history of the present illness, you continue the interview by turning to past medical, social, and family histories.
You say, “I think I have a clear idea about what brought you in today. Let me ask you now about your health in general.”
“Any serious illnesses in the past?”
“I’d like to ask about your personal life. Tell me about your home life.”
“Tell me about your immediate family health history.”
You say, “So I understand that you have had a cough with white phlegm for the past two winters and that you have been experiencing shortness of breath with exertion. Additionally, you may have been exposed to some chemical irritants at your farm, but you have been careful about this. You also smoke cigarettes.”

INSTRUCTIONS

Assignment
Complete only the History, Physical Exam, and Assessment sections of the Aquifer virtual case: Family Medicine 28: 58-year-old male with shortness of breath.

Discussion Question 1
Based on your performance and the expert feedback in your HISTORY collection, describe two missed questions and 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, further, 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. Lastly, 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 also use specific references from your text to support the inclusion of the diagnosis for this client.

Submission Details:
• Post your initial response to the Discussion Area by Day 3. • Please make sure you are using scholarly references and they should not be older than 5 years. Your posts/references must be in APA format. Finally, please follow the discussion rubric to make sure you have addressed the discussion criteria.