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.

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

Change Proposal

In a Microsoft Word document of 4-5 pages formatted in APA style, develop a change proposal for a new technology that will contribute to a safer patient environment.
In your paper address each of the following criteria:

• Describe how the change proposal for the new technology will:
  • impact patient safety.
  • be measured to assess the impact of your change.
  • be communicated to staff and implemented.
• Examine human factors related to change and resistance to change.

On a separate reference page, cite all sources using APA format. Please note that the title and reference pages should not be included in the total page count of your paper.

• Use this APA Citation Helper as a convenient reference for properly citing resources.
• This handout will provide you the details of formatting your essay using APA style.
• You may create your essay in this APA-formatted template.

Learning styles represent the different approaches to learning based   on preferences, weaknesses, and strengths. For learners to best   achieve the desired educational outcome, learning styles must be   considered when creating a plan. Complete “The VARK   Questionnaire,” located on the VARK website, and then complete   the following:

1. Click “OK” to receive your questionnaire   scores.
2. Once you have determined your preferred learning     style, review the corresponding link to view your learning   preference.
3. Review the other learning styles: visual, aural,     read/write, kinesthetic, and multimodal (listed on the VARK     Questionnaire Results page).
4. Compare your current preferred     learning strategies to the identified strategies for your preferred     learning style.
5. Examine how awareness of learning styles     has influenced your perceptions of teaching and learning.

In a paper (750‐1,000 words), summarize your analysis of this   exercise and discuss the overall value of learning styles. Include the following:

1. Provide a summary of your learning style according the VARK   questionnaire.
2. Describe your preferred learning strategies.     Compare your current preferred learning strategies to the identified     strategies for your preferred learning style.
3. Describe how     individual learning styles affect the degree to which a learner can     understand or perform educational activities. Discuss the importance     of an educator identifying individual learning styles and     preferences when working with learners.
4. Discuss why     understanding the learning styles of individuals participating in     health promotion is important to achieving the desired outcome. How     do learning styles ultimately affect the possibility for a     behavioral change? How would different learning styles be     accommodated in health promotion?

Cite to at least three peer‐reviewed or scholarly sources to   complete this assignment. Sources should be published within the last   5 years and appropriate for the assignment criteria.

Prepare this assignment according to the guidelines found in the APA   Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the   rubric prior to beginning the assignment to become familiar with the   expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please   refer to the directions in the Student Success Center.

WEEK 12

Reflect on the various settings in which family nurse practitioners are able to work. Currently in primary care, specifically community health centers, there is a significant need to hire more advanced practice nurses to meet the care needs of patients in both rural and urban populations. Read the article attached below and examine what role does the Community Nursing Practice Model have in achieving better access, care delivery and outcomes to patients living in underserved communities. Identify 1 (one) MSN Essential most correlates to this discussion related to community nursing practice.

Nurse Practitioners in Community Health Settings Today Article: http://clinicians.org/images/upload/wessel_nurse_practitioners.pdf

I have also attached additional information pertaining to community health from the Center for Disease Control (CDC).

CDC Community Health Improvement Navigator: https://www.cdc.gov/chinav/