Week 5 Patient’s Spiritual Needs: Case Analysis

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In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

  1. In 200-250 words, respond to the following:      Should the physician allow Mike to continue making decisions that seem to      him to be irrational and harmful to James, or would that mean a disrespect      of a patient’s autonomy? Explain your rationale.
  2. In 400-450 words, respond to the following: How      ought the Christian think about sickness and health? How should a      Christian think about medical intervention? What should Mike as a      Christian do? How should he reason about trusting God and treating James      in relation to what is truly honoring the principles of beneficence and      nonmaleficence in James’s care?
  3. In 200-250 words, respond to the following: How      would a spiritual needs assessment help the physician assist Mike      determine appropriate interventions for James and for his family or others      involved in his care?

Remember to support your responses with the topic study materials.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. You are required to submit this assignment to LopesWrite.

Rubric:

1. Decisions that need to be made by the physician and the father are analyzed from both perspectives with a deep understanding of the complexity of the principle of autonomy. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%

2. Decisions that need to be made by the physician and the father are analyzed with deep understanding of the complexity of the Christian perspective, as well as with the principles of beneficence and nonmaleficence. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%

3. How a spiritual needs assessment would help the physician assist the father determine appropriate interventions for his son, his family, or others involved in the care of his son is clearly analyzed with a deep understanding of the connection between a spiritual needs assessment and providing appropriate interventions. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 30%

4. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%

5. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%

6. Writer is clearly in command of standard, written, academic English. 5%

7. All format elements are correct. 5%

8. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5%

 

There are three different parts to this paper:

· Part one deals with Mike’s decision-making capabilities. 

· Part two deals with how to think issues related to sickness and health.

· Part three deals with a spiritual assessment.

 

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Soap note of Diabetes Mellitus ( to Rewrite)

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free plagiarism

APA style

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    SoapNoteChronicDisease.docx

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GI A4: shadow health

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Professional Development

  • Write a 500-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
    • What went well in your assessment?
    • What did not go so well? What will you change for your next assessment?
    • What findings did you uncover?
    • What questions yielded the most information? Why do you think these were effective?
    • What diagnostic tests would you order based on your findings?
    • What differential diagnoses are you currently considering?
    • What patient teaching were you able to complete? What additional patient teaching is needed?
    • Would you prescribe any medications at this point? Why or why not? If so, what?
    • How did your assessment demonstrate sound critical thinking and clinical decision making?

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Systems Levels (Micro-, Meso-, and Macro).

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The benefits, concerns, and challenges of a systems approach offer the practice scholar several ways to view a health problem. Select a practice problem within your unique setting and consider the following.

  • Describe the selected problem from two of the three systems levels (micro-, meso-, and macro).
  • Explain how the outcomes of one system-level effect the other level?
  • How are the systems approach beneficial in improving healthcare quality and safety?

Instructions:

Use an APA style and a minimum of 200 words. Provide support from a minimum of at least three (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 year), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply.

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be used.

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Shadow Health Mental health

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Professional Development

  • Write a 1000-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
    • What went well in your assessment?
    • What did not go so well? What will you change for your next assessment?
    • What findings did you uncover?
    • What questions yielded the most information? Why do you think these were effective?
    • What diagnostic tests would you order based on your findings?
    • What differential diagnoses are you currently considering?
    • What patient teaching were you able to complete? What additional patient teaching is needed?
    • Would you prescribe any medications at this point? Why or why not? If so, what?
    • How did your assessment demonstrate sound critical thinking and clinical decision making?

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Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem.

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Although nursing practice problems and medical practice problems are related in that they are used for medicine, there are differences between the two. A nursing practice problem is an issue encountered during nursing practice, such as during a patient assessment, related to the patient’s response to a health problem they are experiencing. There are numerous considerations to the nursing practice problems (Fuller, 1982). This ranges from the patient’s signs and symptoms to an illness to their difficulties in completing the activities of daily living due to a fractured extremity. This is due to nursing care involves the entire individual, family or community. Fuller, (1982) states that nursing practice problems, “…deal with modalities of patient care such as support, comfort, prevention of trauma, promotion of recovery, health screening, appraisal and/or assessment, health education, and coordination of health care.”

A medical practice problem is concerned with a medical condition or disease. It identifies a condition, searches for causes, establishes a prognosis, and prescribes a treatment for the condition (Chiffi & Zanotti, 2015).

Chiffi and Zanotti (2015) state, “In conclusion, medical and nursing diagnoses have different goals: a medical diagnosis identifies a variation from a norm, while a nursing diagnosis should judge the existence of a potential for enhancing self-care.”

Consider a patient with a fractured wrist. The physician will set the fracture and prescribe pain medication. These are examples of medical practice problems. The nurse will review the aftercare and medication instructions with the patient. The nurse will also review care of the splint and possibly arrange a visiting RN to help with activities of daily living.

The PICOT question is the first step in establishing or improving evidence-based practice with the goal of solving problems with patients. “Nurses use EBP to provide patients with safe, quality care and to improve outcomes” (Helbig, 2018). The PICOT is based on a nursing practice problem because it is designed to improve patient care. An example of using PICOT for evidence-based practice would be studying the frequency of oral care with the goal of reducing the incidence of ventilator associated pneumonias. It is not designed for disease research.

Using 200-300 words APA format with references to support discussion

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Case Studies of Community Health topics

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Good afternoon these are about 9 case studies of Community Health. It is required by January 30. I offer # 40 if it is done correctly and on time.

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    CASESTUDIESOFCOMMUNITY.docx

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Assess the Musculoskeletal system of Tina Jones, a Digital Standardized Patient. Interview and examine the patient, and document your findings

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Please submit your post work to Canvas within 24 hours of the completion of your VCBC Experience.  Please refer to the Experiential Learning Orientation for further questions and a reminder on how to ensure your assignment is properly saved.

Please complete the Concept Notebook (Map) for the concept of Assessment linked to your clients for the day.

Rubric

205/225 Concept Notebook Rubric205/225 Concept Notebook RubricCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeRelated Concept1 ptsSatisfactoryDocumented at least 2 concepts, related to the client with a detailed explanation of each related concept and how the related concept is impacted by the main concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented at least 1 concept, 1 concept is related to the client, or only minimal explanation of each related concept and how the related concept is impacted by the main concept, or incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no related concept, did not relate the concept to the client, no explanation of each related concept and how the related concept is impacted by the main concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeExemplar1 ptsSatisfactoryDocumented at least 3 Exemplars, related to the client and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2 Exemplars, 1-2 concepts are related to the client, or incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no Exemplars , did not relate the concept to the client and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeAssessment1 ptsSatisfactoryDocumented at least 3 assessments used to find and rule out alterations with the main concept and are all related to the client, a detailed explanation of each assessment and why one would do that assessment relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2 assessments used to find and rule out alterations with the main concept and 1-2 relate to the client, minimal explanation of why one would do that assessment relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no assessments used to find and rule out alterations with the main concept and did not relate to the client, no explanation of why one would do that assessment relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeLab & Diagnostic1 ptsSatisfactoryDocumented at least 3 lab or diagnostic test used to find and rule out alterations with the main concept and all related to the client, a detailed explanation of each lab/test and why one would do that lab/test relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2 lab or diagnostic test used to find and rule out alterations with the main concept, 1-2 relate to the client, minimal explanation of each lab/test and why one would do that lab/test relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no lab or diagnostic test used to find and rule out alterations with the main concept and did not relate to the client, no explanation of each lab/test and why one would do that lab/test relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeInterventions1 ptsSatisfactoryDocumented at least 3 nursing interventions needed to care for clients with alterations to the main concept and all related to the client, a detailed explanation of each intervention and why one would perform the interventions relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2 nursing interventions needed to care for clients with alterations to the main concept, 1-2 relate to the client, minimal explanation of each intervention and why one would perform the interventions relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no nursing interventions needed to care for clients with alterations to the main concept and did not relate to the client, no explanation of each intervention and why one would perform the interventions relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeMedications1 ptsSatisfactoryDocumented at least 3 medications administered to clients to treat or prevent alterations to the main concept and all related to the client, a detailed explanation of each medication and why one would administer the medication relating o the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1-2medications administered to clients to treat or prevent alterations to the main concept, 1-2 relate to the client, minimal explanation of each medication and why one would administer the medication relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no medications administered to clients to treat or prevent alterations to the main concept and did not relate to the client, no explanation of each medication and why one would administer the medication relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomePotential Complications1 ptsSatisfactoryDocumented at least 2 potential problems that could occur if alterations to the main concept are not addressed/treated and all related to the client, a detailed explanation of each complication and how it could occur relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented 1 potential problem that could occur if alterations to the main concept are not addressed/treated, 1 concept is related to the client, minimal explanation of each complication and how it could occur relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no potential problems that could occur if alterations to the main concept are not addressed/treated, did not relate the concept to the client, no explanation of each complication and how it could occur relating to the concept, and incorrect APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeCollaborative Care1 ptsSatisfactoryDocumented at least 1 department/ancillary staff that may be needed to treat clients who have or are at risk for alterations with the main concept and is related to the client, a detailed explanation of each how that department/ancillary staff could assist the client relating to the concept, and correct APA in-text citations (if used).0.5 ptsNeeds ImprovementDocumented at least 1 department/ancillary staff that may be needed to treat clients who have or are at risk for alterations with the main concept and is related to the client, minimal explanation of each how that department/ancillary staff could assist the client relating to the concept, and incorrect APA in-text citations (if used).0 ptsUnsatisfactoryDocumented no department/ancillary staff that may be needed to treat clients who have or are at risk for alterations with the main concept, did not relate the concept to the client, no explanation of each how that department/ancillary staff could assist the client relating to the concept, and no APA in-text citations (if used).1 pts
This criterion is linked to a Learning OutcomeSpelling and Grammar1 ptsSatisfactory0- 2 mistakes in spelling or grammar.0.5 ptsNeeds Improvement3 -4 mistakes in spelling or grammar.0 ptsUnsatisfactory5 or more mistakes in spelling or grammar.1 pts
This criterion is linked to a Learning OutcomeReferences1 ptsSatisfactoryCorrect APA references.0.5 ptsNeeds ImprovementIncorrect APA references.0 ptsUnsatisfactoryNo APA references.1 pts
Total Points: 10PreviousNext

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soap note “Hypertension”

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Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

Example:

PATIENT INFORMATION

Name: Mr. W.S.

Age: 65-year-old

Sex: Male

Source: Patient

Allergies: None

Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime

PMH: Hypercholesterolemia

Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago.

Surgical History: Appendectomy 47 years ago.

Family History: Father- died 81 does not report information

Mother-alive, 88 years old, Diabetes Mellitus, HTN

Daughter-alive, 34 years old, healthy

Social Hx: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone.

SUBJECTIVE:

Chief complain: “headaches” that started two weeks ago

Symptom analysis/HPI:

The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness.He states that he has been under stress in his workplace for the last month.

Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.

ROS:

CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures.

HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing.

Respiratory:Patient denies shortness of breath, cough or hemoptysis.

Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal

dyspnea.

Gastrointestinal:Denies abdominal pain or discomfort.Denies flatulence, nausea, vomiting or

diarrhea.

Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence.

MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound.

Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus.

Objective Data

CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 0/10.

General appearance: The patient is alert and oriented x 3. No acute distress noted.NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5.

HEENT:Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Maxillary sinuses no tenderness. Nasal mucosa moist without bleeding. Oral mucosa moist without lesions,.Lids non-remarkable and appropriate for race.

Neck: supple without cervical lymphadenopathy, no jugular vein distention, no thyroid swelling or masses.

Cardiovascular:S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary refill < 2 sec.

Respiratory:No dyspnea or use of accessory muscles observed. No egophony, whispered pectoriloquy or tactile fremitus on palpation. Breath sounds presents and clear bilaterally on auscultation.

Gastrointestinal:No mass or hernia observed. Upon auscultation, bowel sounds present in all four quadrants, no bruits over renal and aorta arteries. Abdomen soft non-tender, no guarding, no reboundno distention or organomegaly noted on palpation

Musculoskeletal:No pain to palpation. Active and passive ROM within normal limits, no stiffness.

Integumentary:intact, no lesions or rashes, no cyanosis or jaundice.

Assessment

Essential (Primary) Hypertension (ICD10 I10): Given the symptoms and high blood pressure (156/92 mmhg), classified as stage 2. Once the organic cause of hypertension has been ruled out, such as renal, adrenal or thyroid, this diagnosis is confirmed.

Differential diagnosis:

Ø Renal artery stenosis(ICD10 I70.1)

Ø Chronic kidney disease(ICD10 I12.9)

Ø Hyperthyroidism (ICD10 E05.90)

Plan

Diagnosis is based on the clinical evaluation through history, physical examination, and routine laboratory tests to assess risk factors, reveal identifiable causes and detect target-organ damage, including evidence of cardiovascular disease.

These basic laboratory tests are:

· CMP

· Complete blood count

· Lipid profile

· Thyroid-stimulating hormone

· Urinalysis

· Electrocardiogram

Ø Pharmacological treatment:

The treatment of choice in this case would be:

Thiazide-like diuretic and/or a CCB

· Hydrochlorothiazide tab 25 mg, Initial dose: 25 mg orally once daily.

 

Ø Non-Pharmacologic treatment:

· Weight loss

· Healthy diet (DASH dietary pattern): Diet rich in fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and trans l fat

· Reduced intake of dietary sodium: <1,500 mg/d is optimal goal but at least 1,000 mg/d reduction in most adults

· Enhanced intake of dietary potassium

· Regular physical activity (Aerobic): 90–150 min/wk

· Tobacco cessation

· Measures to release stress and effective coping mechanisms.

Education

· Provide with nutrition/dietary information.

· Daily blood pressure monitoring at home twice a day for 7 days, keep a record, bring the record on the next visit with her PCP

· Instruction about medication intake compliance.

· Education of possible complications such as stroke, heart attack, and other problems.

· Patient was educated on course of hypertension, as well as warning signs and symptoms, which could indicate the need to attend the E.R/U.C. Answered all pt. questions/concerns. Pt verbalizes understanding to all

Follow-ups/Referrals

· Evaluation with PCP in 1 weeks for managing blood pressure and to evaluate current hypotensive therapy. Urgent Care visit prn.

· No referrals needed at this time

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Focused Exam: Cough Assignment

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Review this week’s Learning Resources and consider the insights they provide related to ears, nose, and throat.

  • Review the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation within the Shadow Health platform. Review the examples also provided.
  • Review the DCE (Shadow Health) Documentation Template for Focused Exam: Cough found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
  • Review the Week 5 Focused Exam: Cough Rubric provided in the Assignment submission area for details on completing tReview the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation within the Shadow Health platform. Review the examples also provided.
    Review the DCE (Shadow Health) Documentation Template for Focused Exam: Cough found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
    Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

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