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Three differential diagnoses a

Week 1 discussion

Discussion Questions

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, post a response to one question in the Discussion Area by the due date assigned. You may respond to your classmates’ postings for either question.

To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

You are a Family Nurse Practitioner working in a community health center. You are seeing a 14-year-old adolescent patent for an annual visit. The patient’s mother is also present during the visit and notes that the patient’s grades in school have been declining. Her son is also hanging out with a group of kids that she has concerns about. The mother has concerns for what is going on with her son. Answer the following questions using course resources (texts) and two other evidence-based sources (current guidelines and/or scholarly articles that are within a 3-5 year time frame).

What are the components of an annual exam for an adolescent patient?

Is the mother required to be present during your exam?

Describe 1 health promotion idea that you would discuss with your middle adolescence patient. Why is this idea important?

What are some screening tools that might be of importance in this situation? (hint: do you suspect drug or alcohol abuse here?)

Week 2 discussion

A fifteen-year-old female presents to your clinic complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately, she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema, and her father has high blood pressure. She is the only child. She denies smoking and illegal drug use. On examination, she is in no acute distress and her vital signs are: T 98.6, BP 120/80, pulse 80, and respirations 20. Her head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is decreased air movement and high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.

What is the chief complaint?

Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?

What treatment plan would you consider utilizing current evidence based practice guidelines?

Week 3 discussion

In week 3 you learned about other common adolescent health conditions. Review the following case study and answer the following questions:

An 18 year old white female presents to your clinic today with a 2 week history of intermittent abdominal pain. She also is positive for periodic cramping and diarrhea as well as low grade fever. She also notes reduced appetite. She notes that She admits smoking ½ PPD for the last 2 years. Denies any illegal drug or alcohol use. Does note a positive history of Crohn’s Disease. Based on the information provided answer the following questions:

What are the top 3 differentials you would consider with the presumptive final diagnosis listed first?

What focused physical exam findings would be beneficial to know?

What diagnostic testing needs completed if any to confirm diagnosis?

Using evidence based treatment guidelines note a treatment plan.

Week 4 discussion

Discussion

This week’s content addressed common chronic diseases. Please review the case study below and answer the following questions:

A sixty-year-old baker presents to your clinic, complaining of increasing shortness of breath and nonproductive cough over the last month. She feels like she can’t do as much activity as she used to do without becoming tired. She even has to sleep upright in her recliner at night to be able to breathe comfortably. She denies any chest pain, nausea, or sweating. Her past medical history is significant for high blood pressure and coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is married and is retiring from the local bakery soon. She denies any tobacco, alcohol, or drug use. Her mother died of a stroke, and her father died from prostate cancer. She denies any recent upper respiratory illness, and she has had no other symptoms. On examination, she is in no acute distress. Her blood pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory rate is 16. With auscultation, she has distant air sounds and she has late inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2 are distant and an S3 is heard over the apex.

What is the chief complaint?

Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?

What treatment plan would you consider utilizing current evidence based practice guidelines?

Week 5 discussion

Discussion Questions

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, go to the Discussion Area and post a response to one question in the Discussion Area by the due date assigned. You may respond to your classmates’ posts for either question.

To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

As a family nurse practitioner you are working in a rural health clinic. You are evaluating a 16-year-old adolescent patient who comes in complaining of having a difficulty concentrating in school. On exam you also note that the patient is very thin and frail in appearance and is asking you for diet pills.

What are some initial areas for concern? What screening tools can help lead you closer to your diagnosis?

Describe 1 health promotion strategy you can discuss with the patient.

Be sure to address the following in your plan of care: pharmacological and non-pharmacological (OTC) interventions, labs, follow-up, teaching, and referral/s.

Your work should integrate course resources (text/s) as well as a minimum of two (2) other evidence-based guidelines and/or articles published within 3-5 years.

Week 6 discussion

This week’s content discussed common psychiatric disorders in the Adult and Older Adult client. Often times a secondary diagnosis is masked due to their psychiatric disorder. Review the following case study and answer the following questions.

Mr. White is a 72-year-old man, with a history of hypertension, COPD and moderate dementia, who presents with 4 days of increased confusion, nighttime restlessness, visual hallucinations, and urinary incontinence. His physical exam is unremarkable except for tachypnea, a mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score from a baseline of 18 to 12 today.

Mr. White’s presentation is most consistent with an acute delirium (acute change in cognition, perceptual derangement, waxing and waning consciousness, and inattention).

What is the most likely diagnosis to frequently cause acute delirium in patients with dementia?

What additional testing should you consider if any?

What are treatment options to consider with this patient?

Week 7 discussion

Assignment 1: Discussion

This week’s content addressed common techniques and testing that can be prescribed by the Nurse Practitioner. Review ONE of the following videos and post for the class what you have learned this week:

Watch the following video on suturing

Suture Skills Course – Learn Best Suture Techniques

Watch the following video on EKG rhythms

Skillstat

Submission Details:

Post your response to the Discussion Area by the due date assigned. Respond to atleast two posts by the end of the week.

Week 8 discussion

Complete The Growth and Development APEA module. Pick one of the following topics that were reviewed: Newborn assessment, Nutrition, Child, Adolescent, or Immunization. Please choose on that has not been previously covered by a peer.

What is an area that you may have forgotten?

Explain the specific growth and development concept in detail and describe strategies that you will undertake to assist in retaining that information?

Submission Details:

Post your response to the Discussion Area by the due date assigned. Respond to atleast two posts by the end of the week.

Week 9 discussion

This week’s content will focus on health literacy which is a common barrier towards achieving optimal health care. Please review the following information from the Agency for Healthcare Research and Quality website https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/index.html Evaluate these tools to discover ways that will help reduce the barriers that hinder healthcare literacy

What are your initial thoughts after reviewing the AHRQ website?

What are some strategies you can incorporate in everyday practice to assist with health literacy?

Week 10 discussion

Evidence-Based Clinical Intervention

By the due date assigned, submit your Evidence-Based Clinical Intervention to the Discussion Area.

Your Evidence-Based Clinical Intervention should be submitted in a Microsoft Word document following APA style and should include the following:

The medical problem/diagnosis/disease.

Typical presenting signs and symptoms including:

Onset, Characteristics, Location, Radiation, Timing, Setting, Aggravating factors, Alleviating factors, Associated symptoms, Course since onset, Usual age group affected

Concomitant disease states associated with the diagnosis

The pathophysiology of the problem.

Three differential diagnoses and the usual presenting signs and symptoms in priority sequence with rationales.

Reference to at least two current journal articles that show evidence-based practice as how to best treat this disorder related to the primary differential.

The expected outcomes of the intervention.

Algorithms if available.

A typical clinical note in SOAP format.

Respond to at least two of your classmates’ Evidence-Based Clinical Interventions using the lessons and vocabulary found in the reading. Support your answers with examples and research. Your responses should clarify your understanding of the topic. They should be your own, original, and free from plagiarism. Follow the APA format for writing style, spelling and grammar, and citation of sources.

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