GENITALIA ASSESSMENT

Subjective:

• CC: “I have bumps on my bottom that I want to have checked out.”
• HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.
• PMH: Asthma
• Medications: Symbicort 160/4.5mcg
• Allergies: NKDA
• FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD
• Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

• VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs
• Heart: RRR, no murmurs
• Lungs: CTA, chest wall symmetrical
• Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia.
• Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, negMcBurney
• Diagnostics: HSV specimen obtained

Assessment:

• Chancre

The Lab Assignment

Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.

• Analyze the subjective portion of the note. List additional information that should be included in the documentation.
• Analyze the objective portion of the note. List additional information that should be included in the documentation.
• Is the assessment supported by the subjective and objective information? Why or why not?
• Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?
• Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

Week 4 Discussion

TASK

Post your initial response to the topic below.

Functional Wellness

·  Identify two strategies you can implement to provide comfort to maintain function with an ethnically diverse older adult with a chronic disease?

·  These strategies can be nutrition, ADLs, exercise, etc.

As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the  University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

Chapter 4 – The International Flow of Funds and Exchange Rates

1. China is said to be a “Currency Manipulator.”  What does this mean? Do you agree? Why and why not?
2. Spot market, Forward Markets and Futures Markets are common foreign exchange rate market options for managing business risks associated with exchange rate fluctuation with international business partners. How do you decide which mechanism is best for your business?
3. Select a current global business event relating to The International Flow of Funds or Exchange Rates from a news source, such as electronic newspapers, New York Times, International Business Times, Economic Times, or CNN News. Provide a brief summary of the article, relating it to the material you have read in chapter 4. Include an explanation of what you learned in this article and if you agree with the author’s perspective

For or this discussion watch the video Emotional Hygiene and then answer the following questions in your initial post, and then, reply to one other student. See the Course Items Module for specific discussion instructions.

• Why does society view physical health more important than psychological health? Why do you think society views emotional health differently than physical illness?

 Discuss the purpose of strategic planning in a health care environment. Explain what factors affect future planning in an organization and what tools can be used for future planning. 

Using 200-300 words APA format with at least two references. Sources must be published within the last 5 years.