Advance nursing assessment

Home>Homework Answsers>Nursing homework helpfemale who presents to the office with c/o wound to her left foot2 years ago27.10.202330Report issuefiles (1)MN552WEEK9ASSIGNMENT.docxMN552WEEK9ASSIGNMENT.docxINTRODUCTIONFor this assignment, you will be given a case study. Review the information provided and answer the questions. Be sure to cite your references. Look at the case study as if the subject is a patient in your office seeking care. What are your immediate concerns? What needs to be done for them? Be thorough and succinct in your responses. Your submission must be in SOAP note format.CASE STUDYJOURNAL DETAILSIntroductionCase StudyInstructionsCase Study/SOAP Note:Julia King is a 50y/o white female who presents to the office with c/o wound to her left foot for the past few days. States she tripped and fell while barefoot, scraping the top of her foot on the pavement. She denies any other injury from the incident. Over the past 24 hours, the wound has had “smelly” drainage. Has been experiencing some numbness, tingling, and pain, but denies fever and chills. Did not seek medical attention at the time of injury. Has been using hydrogen peroxide to clean her wound. Her last tetanus shot was 15 years ago. Patient PMHx significant for DM II. States that she takes her medications when she remembers, and does not always check her blood sugar.PMHx:Asthma: no hospitalizations for exacerbation.DM IIPSHx:DeniesSHx:Smokes 1 pack of cigarettes per day for 5 years.ETOH: sociallyIllicit drugs: deniesFHx:Mother 71 y/o with a history of diabetes and obesityFather 72 y/o with a history of HTNBrother 51 alive and wellSister 48 with a history of HTN and diabetesNo family history of colon, ovarian, or uterine cancerNo history of CAD or PVDMedications:Metformin: 500mg BID po – did not take the last few daysAlbuterol MDI: 2 puffs every 6 hours prn – last used 3 days agoSingulair: 10mg po dailyAllergies:PCN: hives and facial swellingLNMP:N/AG2p2ROS:General: denies any weight changes, fatigue, or fever; + body achesSkin: denies any rashes; + wound to left footHEENT: denies headache, head injury, dizziness, lightheadedness; denies any vision changes; denies any hearing changes, tinnitus, vertigo, earache; denies any nasal congestion, discharge, nose bleeds or sinus tenderness; denies any sore throat, difficulty swallowingNeck: denies any swollen glands, painBreasts: denies any pain, dischargeRespiratory: denies any dyspnea; positive cough and wheezingCV: denies any chest pain, edemaGI: denies any nausea/vomiting/diarrhea/constipation; denies bloody stoolsPV: denies swelling in face, hands. No history of leg cramps or past clots in extremities. States has swelling in left footGU: denies frequency, urgency, burning; denies vaginal discharge, itching, soresMS: denies any weakness, numbness, erythema, twitching, or pain. No h/o of backaches or fx’s. No joint pain, tenderness, or history of head trauma. Positive for left foot painPsych: denies nervousness, depressionNeuro: denies Headache, dizziness, vertigo, syncope, weakness; + numbness to right LEHeme: denies any easy bruisingPhysical Exam:Vital signs:· 5 (tympanic), 180/100, 90, 22, O2 sat 95% on RA· Height: 5’5ʺ· Weight: 250 lb· Blood glucose: 230 (Fasting; states has not eaten yet today)Patient awake, alert, oriented x 4 with no apparent distress (NAD)Skin: warm, dry, color WNL. 4 cm lesion noted to anterior left foot with crusting and purulent drainage; + surrounding erythema extending up 7 cm proximallyHEENT: head nontraumatic, normocephalicPupils PERRLA, EOMs intact; disc margins sharp, without hemorrhages, exudates; no AV nicking notedEars: bilateral TM with good cone of light and intactNose: mucosa pink, septum midline; no sinus tenderness appreciatedMouth: mucosa pink, moist; tongue midline; tonsils 1+ without exudateNeck: supple; trachea midline; without any lymphadenopathyResp: regular and unlabored; lungs with end expiratory wheezing throughoutCV: RRR, S1 and S2 noted; no s3, s4 or murmur appreciatedAbdomen: soft, non-distended; BS + x 4; no tenderness with palpation; no CVA tenderness with percussionGenitalia: deferredRectal: deferredExtremities: warm and dry with edema to left foot; calves supple, non-tenderPV: No swelling noted to hands, feet or face. Positive swelling to left footMS: + swelling to left foot; + tenderness of 2nd–4th left metatarsals; + left pedal pulse; Cap refill < 2 sec.Neuro: alert, cooperative; thought coherent; oriented x 4; cranial nerves I-XII intactINSTRUCTIONAddress the following items:1. List your differentials for her current problems. Remember you should have at least three different differentials for each problem. Include rationale for each differential.2. At this time, what medical diagnoses are you most concerned about? Do they impact other diagnoses? If so, how?3. What diagnostic images would you order? Provide your rationale. What are you trying to rule in or out?4. What laboratory work would you order? What would you anticipate to be abnormal? Provide your rationale for each.5. What is your comprehensive plan of care? Include your rationales.MN552WEEK9ASSIGNMENT.docxINTRODUCTIONFor this assignment, you will be given a case study. Review the information provided and answer the questions. Be sure to cite your references. Look at the case study as if the subject is a patient in your office seeking care. What are your immediate concerns? What needs to be done for them? Be thorough and succinct in your responses. Your submission must be in SOAP note format.CASE STUDYJOURNAL DETAILSIntroductionCase StudyInstructionsCase Study/SOAP Note:Julia King is a 50y/o white female who presents to the office with c/o wound to her left foot for the past few days. States she tripped and fell while barefoot, scraping the top of her foot on the pavement. She denies any other injury from the incident. Over the past 24 hours, the wound has had “smelly” drainage. Has been experiencing some numbness, tingling, and pain, but denies fever and chills. Did not seek medical attention at the time of injury. Has been using hydrogen peroxide to clean her wound. Her last tetanus shot was 15 years ago. Patient PMHx significant for DM II. States that she takes her medications when she remembers, and does not always check her blood sugar.PMHx:Asthma: no hospitalizations for exacerbation.DM IIPSHx:DeniesSHx:Smokes 1 pack of cigarettes per day for 5 years.ETOH: sociallyIllicit drugs: deniesFHx:Mother 71 y/o with a history of diabetes and obesityFather 72 y/o with a history of HTNBrother 51 alive and wellSister 48 with a history of HTN and diabetesNo family history of colon, ovarian, or uterine cancerNo history of CAD or PVDMedications:Metformin: 500mg BID po - did not take the last few daysAlbuterol MDI: 2 puffs every 6 hours prn – last used 3 days agoSingulair: 10mg po dailyAllergies:PCN: hives and facial swellingLNMP:N/AG2p2ROS:General: denies any weight changes, fatigue, or fever; + body achesSkin: denies any rashes; + wound to left footHEENT: denies headache, head injury, dizziness, lightheadedness; denies any vision changes; denies any hearing changes, tinnitus, vertigo, earache; denies any nasal congestion, discharge, nose bleeds or sinus tenderness; denies any sore throat, difficulty swallowingNeck: denies any swollen glands, painBreasts: denies any pain, dischargeRespiratory: denies any dyspnea; positive cough and wheezingCV: denies any chest pain, edemaGI: denies any nausea/vomiting/diarrhea/constipation; denies bloody stoolsPV: denies swelling in face, hands. No history of leg cramps or past clots in extremities. States has swelling in left footGU: denies frequency, urgency, burning; denies vaginal discharge, itching, soresMS: denies any weakness, numbness, erythema, twitching, or pain. No h/o of backaches or fx’s. No joint pain, tenderness, or history of head trauma. Positive for left foot painPsych: denies nervousness, depressionNeuro: denies Headache, dizziness, vertigo, syncope, weakness; + numbness to right LEHeme: denies any easy bruisingPhysical Exam:Vital signs:· 5 (tympanic), 180/100, 90, 22, O2 sat 95% on RA· Height: 5'5ʺ· Weight: 250 lb· Blood glucose: 230 (Fasting; states has not eaten yet today)Patient awake, alert, oriented x 4 with no apparent distress (NAD)Skin: warm, dry, color WNL. 4 cm lesion noted to anterior left foot with crusting and purulent drainage; + surrounding erythema extending up 7 cm proximallyHEENT: head nontraumatic, normocephalicPupils PERRLA, EOMs intact; disc margins sharp, without hemorrhages, exudates; no AV nicking notedEars: bilateral TM with good cone of light and intactNose: mucosa pink, septum midline; no sinus tenderness appreciatedMouth: mucosa pink, moist; tongue midline; tonsils 1+ without exudateNeck: supple; trachea midline; without any lymphadenopathyResp: regular and unlabored; lungs with end expiratory wheezing throughoutCV: RRR, S1 and S2 noted; no s3, s4 or murmur appreciatedAbdomen: soft, non-distended; BS + x 4; no tenderness with palpation; no CVA tenderness with percussionGenitalia: deferredRectal: deferredExtremities: warm and dry with edema to left foot; calves supple, non-tenderPV: No swelling noted to hands, feet or face. Positive swelling to left footMS: + swelling to left foot; + tenderness of 2nd–4th left metatarsals; + left pedal pulse; Cap refill < 2 sec.Neuro: alert, cooperative; thought coherent; oriented x 4; cranial nerves I-XII intactINSTRUCTIONAddress the following items:1. List your differentials for her current problems. Remember you should have at least three different differentials for each problem. Include rationale for each differential.2. At this time, what medical diagnoses are you most concerned about? Do they impact other diagnoses? If so, how?3. What diagnostic images would you order? Provide your rationale. What are you trying to rule in or out?4. What laboratory work would you order? What would you anticipate to be abnormal? Provide your rationale for each.5. What is your comprehensive plan of care? Include your rationales.Bids(73)Miss DeannaDr. Ellen RMMISS HILLARY A+abdul_rehman_Emily ClareSTELLAR GEEK A+Sheryl HoganProf Double RDoctor.NamiraProWritingGuruYoung NyanyaProf. TOPGRADEDr M. MichelleAshley EllieColeen AndersonPremiumBrainy BrianPROF_ALISTERQuality AssignmentsElprofessoriShow All Bidsother Questions(10)Mth D6mmHuman Growth1. Build a custom interviewHigh-level computer languagesHypothesis testingPlagiarismUnit III Reflection PaperBus 475 Business and Society Assignment 2Create a program that allows the user to input a list of first names into one array and last names into a

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