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Pick one casea year ago24.07.202418Report issuefiles (2)NRNP6552Week9Casestudytemplate.docxNRNP6552week9cases.pdfNRNP6552Week9Casestudytemplate.docxCase # (1, 2, 3 or 4) and Description of the Case Chosen:·Case 1: Teresa·Case 2: Joanna·Case 3: Monica·Case 4: LauraOutline Subjective data.Identify data provided in your chosen case and any additional data needed.OutlineObjective findings.Identify findings provided in your chosen case and any additional data needed.Identify diagnostic tests, procedures, laboratory work indicated.Describe the rationale for each test or intervention with supporting references.Distinguish at least three differential diagnoses.Describe the rationales for your choice of each diagnosis with supporting references.Identify appropriate medications, treatments or other interventions associated with each differential diagnosis.Describe rationales and supporting references for each.Explain keySocial Determinants of Heath (SDoH) for your chosen case.Describe collaborative care referrals and patient education needs for your chosen case.Describe rationales and supporting references for each.NRNP6552week9cases.pdfCase #1. Teresa.History of Present Illness (HPI): Teresa is a 34-year-old Hispanic G2P2002. She presents to your officetoday at 10-weeks post-partum (PP) for her 6-week PP check. She underwent a C-section for failure toprogress following a 20-hour labor with Pitocin augmentation. She was discharged from the hospital onday 2 post-partum without complications. Teresa has had difficulty with breast feeding due todiscomfort in her suture line and terrible pain in her right breast since her discharge from the hospital.She reports occasional chills- she has not measured her temperature at home. Teresa was seen by thelactation consultant while in the hospital but “nothing is working” and her son “cries all the time”. Sheis afraid to feed her son formula as her mother-in-law wants her to “keep trying to breastfeed”. Teresatells you she feels as if she has failed her son- “it was so easy with my first baby, I know my husbandthinks I am a bad mother”.Prior medical history: None. Prior surgical history: Appendectomy (2000)Current medications: Prenatal vitamins, stool softener. Allergies: NoneOB- GYN History: NSVD (2019) healthy female 7lb 10oz; C-section healthy male 8 lbs. 8 oz as per HPI.Menarche age 12, cycle length- 5 days- frequency every 28 days- 4-5 tampons per day. No history ofsexually transmitted infections (STDs). History of abnormal pap smear in 2019 which was followed by anormal colposcopy. Last pap (during recent prenatal care) reported normal. HIV negative.LMP: First PP menstrual cycle last week. Has not resumed sexual activity PP. Contraception history:Oral contraceptives, condoms.Social history: Lives with husband, mother- in- law, and children. Stay at home mom. Denies EtOH orrecreational drug use, never smoker. Her family speaks Spanish at home; she is fluent in English.Family history: Unremarkable.Review of Systems (ROS): Negative except as noted in HPI.Physical Exam (PE)VS: BP: 110/70, P: 90, RR: 18, T: 38.4, Weight: 132 lbs.Teresa’s C-section suture line is healing well without erythema or tenderness. No vaginal discharge orlesions, no cervical motion tenderness (CMT), uterus normal size firm and non-tender. On breast exam,you do note an erythematous, swollen, and painful area to the right breast. Her physical exam isotherwise unremarkable.Case #2. Joanna.History of Present Illness (HPI): Joanna is a 28-year-old Caucasian G4P1021. She is single, living with herfather and 2-year-old daughter. She has a part-time job as a server at the local restaurant; she does nothave health insurance. Joanna presents to your office at the community health center today stating sheis pregnant and wants to receive OB care. She tells you that she has not yet been evaluated for thispregnancy as she was afraid to take time off from work and did not have enough money to pay for thevisit.Prior medical history: None. Prior surgical history: NoneCurrent medications: None. Allergies: PenicillinOB- GYN History: NSVD (2021) healthy female 6lb 8oz. Menarche age 10, cycle length- 3 days- irregularcycles since menarche- frequency every 20-30 days- 2-3 tampons per day. No history of sexuallytransmitted infections (STDs). Joanna’s OB history includes two first trimester elective terminations ofpregnancy, and 1 term female infant delivered vaginally at 37 weeks. Denies any complications duringher prior pregnancy however, she notes that her daughter experienced hypoglycemia and respiratorydistress, spending 2 weeks in the Neonatal Intensive Care Unit (NICU).LMP: Approximately 5 months ago. Contraception history: Condoms “sometimes”.Social history: Lives with her retired father and daughter. Restaurant server. Denies EtOH orrecreational drug use. Currently smoking 1 pack of cigarettes/ day (15 pack-year history). She and hermother are still paying for her daughter’s NICU stay. The child’s father is not involved in any way.Family history: Mother (deceased age 55)- Type 2 diabetes.Review of Systems (ROS): Unremarkable with exception of dysuria (“it burns when I pee”) over the past1-week. Denies fever, chills, abdominal or flank pain. Thick white vaginal discharge and “itching” for thepast month.Physical Exam (PE)VS: BP: 108/68, P: 72, RR: 18, T: 37.3, Weight 144lbsOn physical exam you palpate a fundal height of approximately 20cm with an audible fetal heart tone(FHT) of 160. On speculum exam you visualize a multiparous cervix without lesions; bluish discolorationof the cervix, vagina, and vulva is noted with a thick, white discharge. There is no cervical motiontenderness (CMT) on exam. The uterus is anteverted, non- tender, with fundus palpable at theumbilicus. Joanna’s physical exam is otherwise unremarkable.Wet mount reveals budding yeast. Urine dipstick with 1+ leukocytes, trace blood and 2+ glucose.Case #3. Monica.History of Present Illness (HPI): Monica is a 43-year-old African- American G3P2102. She is currentlyseparated from her husband of 20 years and is working full-time as a legal secretary. About 8 monthsago, Monica started having irregular periods with heavier than usual flow until she stopped havingperiods or any vaginal bleeding about 3 months ago. She is currently recovering from a “stomach flu”however, she reports daily nausea, vomiting, bloating and decreased appetite over the past 3 weeks.She is worried because she has gained 12 pounds over the last 3 months “due to menopause”. Shecomes to the clinic today to discuss menopause symptoms and hormone replacement therapy.Prior medical history: Hypertension (2010)- well controlled on current antihypertensivePrior surgical history: Cholecystectomy (2015)Current medications: Lisinopril 10mg daily. Allergies: NoneOB- GYN History: NSVD x 2 (2015, 2019) healthy female 6lb 8oz; healthy female 7lbs 6oz. First trimestermiscarriage (9 weeks) in 2014. Menarche age 15, cycle length-7 days- frequency every 28 days- 5-6 padsper day. No history of sexually transmitted infections (STDs). No history of abnormal pap (last pap 2years ago).LMP: Approximately 3 months ago. Contraception history: Condoms; past use of oral contraceptives.Social history: Lives with her elderly father, 2 daughters. Separated from her husband for 6 months.Family history: Mother deceased (age 60)- breast cancer. Father alive (age 70)- hypertension.Review of Systems (ROS): Unremarkable with exception of as noted in HPI.Physical Exam (PE)VS: BP: 130/78, P: 78, RR: 18, T: 36.1 Weight: 152 lbs.Physical exam is unremarkable with exception of a palpable 12- 14 weeks size uterus on bimanual. Youcheck a for a fetal heartbeat and obtain a heart tone of 145 via doppler. The intake nurse reports that aurine pregnancy test came back positive.Monica is in disbelief.Case #4. Laura.History of Present Illness (HPI): Laura is a 16-year-old Caucasian G1P0. She presents to your office aftermissing her second period. She is “worried” as she “always gets her period on time”. She is in highschool- about to enter the 11th grade. She lives with her grandmother and 2 older siblings. Her urinepregnancy test in clinic today is positive.Laura is sexually active with her boyfriend; they do not use condoms. He “pulls out” as birth control.She reports being treated at the health department for chlamydia and gonorrhea earlier this year. Shethinks her boyfriend was treated but he is not answering her calls since she told him about the missedperiods a few weeks ago. She reports daily nausea, vomiting and dysuria for the past 2 weeks.Prior medical history: None. Prior surgical history: NoneCurrent medications: None. Allergies: NoneOB- GYN History: Menarche age 12, cycle length-7 days- frequency every 30 days- 2 tampons per day.History of chlamydia and gonorrhea (GC) in the past year. Last pap reported normal at the time ofchlamydia/ GC diagnosis. Has not received Human Papillomavirus (HPV) vaccine.LMP: Approximately 2 months ago. Contraception history: WithdrawalSocial history: Lives with her grandmother, siblings. Denies EtOH or recreational drug use. Currentlysmoking 1 pack of cigarettes/ dayFamily history: Mother deceased at age 42- drug overdose. Father unknown.Review of Systems (ROS): Unremarkable with exception of as noted in HPI.Physical Exam (PE)VS: BP: 110/68, P: 80, RR: 18, T: 37.1 Weight: 110 lbs. (states usual weight 120 lbs.).Physical exam is unremarkable with exception of a cloudy, yellow mucoid cervical discharge on speculumexam; friable appearance of the cervix with cervical motion tenderness (CMT). You palpate an 8-weeksize uterus on bimanual.Laura’s urine reveals 2+ ketones, 2+ nitrates, and 3+ leukocytes.NRNP6552week9cases.pdfCase #1. Teresa.History of Present Illness (HPI): Teresa is a 34-year-old Hispanic G2P2002. She presents to your officetoday at 10-weeks post-partum (PP) for her 6-week PP check. She underwent a C-section for failure toprogress following a 20-hour labor with Pitocin augmentation. She was discharged from the hospital onday 2 post-partum without complications. Teresa has had difficulty with breast feeding due todiscomfort in her suture line and terrible pain in her right breast since her discharge from the hospital.She reports occasional chills- she has not measured her temperature at home. Teresa was seen by thelactation consultant while in the hospital but “nothing is working” and her son “cries all the time”. Sheis afraid to feed her son formula as her mother-in-law wants her to “keep trying to breastfeed”. Teresatells you she feels as if she has failed her son- “it was so easy with my first baby, I know my husbandthinks I am a bad mother”.Prior medical history: None. Prior surgical history: Appendectomy (2000)Current medications: Prenatal vitamins, stool softener. Allergies: NoneOB- GYN History: NSVD (2019) healthy female 7lb 10oz; C-section healthy male 8 lbs. 8 oz as per HPI.Menarche age 12, cycle length- 5 days- frequency every 28 days- 4-5 tampons per day. No history ofsexually transmitted infections (STDs). History of abnormal pap smear in 2019 which was followed by anormal colposcopy. Last pap (during recent prenatal care) reported normal. HIV negative.LMP: First PP menstrual cycle last week. Has not resumed sexual activity PP. Contraception history:Oral contraceptives, condoms.Social history: Lives with husband, mother- in- law, and children. Stay at home mom. Denies EtOH orrecreational drug use, never smoker. Her family speaks Spanish at home; she is fluent in English.Family history: Unremarkable.Review of Systems (ROS): Negative except as noted in HPI.Physical Exam (PE)VS: BP: 110/70, P: 90, RR: 18, T: 38.4, Weight: 132 lbs.Teresa’s C-section suture line is healing well without erythema or tenderness. No vaginal discharge orlesions, no cervical motion tenderness (CMT), uterus normal size firm and non-tender. On breast exam,you do note an erythematous, swollen, and painful area to the right breast. Her physical exam isotherwise unremarkable.Case #2. Joanna.History of Present Illness (HPI): Joanna is a 28-year-old Caucasian G4P1021. She is single, living with herfather and 2-year-old daughter. She has a part-time job as a server at the local restaurant; she does nothave health insurance. Joanna presents to your office at the community health center today stating sheis pregnant and wants to receive OB care. She tells you that she has not yet been evaluated for thispregnancy as she was afraid to take time off from work and did not have enough money to pay for thevisit.Prior medical history: None. Prior surgical history: NoneCurrent medications: None. Allergies: PenicillinOB- GYN History: NSVD (2021) healthy female 6lb 8oz. Menarche age 10, cycle length- 3 days- irregularcycles since menarche- frequency every 20-30 days- 2-3 tampons per day. No history of sexuallytransmitted infections (STDs). Joanna’s OB history includes two first trimester elective terminations ofpregnancy, and 1 term female infant delivered vaginally at 37 weeks. Denies any complications duringher prior pregnancy however, she notes that her daughter experienced hypoglycemia and respiratorydistress, spending 2 weeks in the Neonatal Intensive Care Unit (NICU).LMP: Approximately 5 months ago. Contraception history: Condoms “sometimes”.Social history: Lives with her retired father and daughter. Restaurant server. Denies EtOH orrecreational drug use. Currently smoking 1 pack of cigarettes/ day (15 pack-year history). She and hermother are still paying for her daughter’s NICU stay. The child’s father is not involved in any way.Family history: Mother (deceased age 55)- Type 2 diabetes.Review of Systems (ROS): Unremarkable with exception of dysuria (“it burns when I pee”) over the past1-week. Denies fever, chills, abdominal or flank pain. Thick white vaginal discharge and “itching” for thepast month.Physical Exam (PE)VS: BP: 108/68, P: 72, RR: 18, T: 37.3, Weight 144lbsOn physical exam you palpate a fundal height of approximately 20cm with an audible fetal heart tone(FHT) of 160. On speculum exam you visualize a multiparous cervix without lesions; bluish discolorationof the cervix, vagina, and vulva is noted with a thick, white discharge. There is no cervical motiontenderness (CMT) on exam. The uterus is anteverted, non- tender, with fundus palpable at theumbilicus. Joanna’s physical exam is otherwise unremarkable.Wet mount reveals budding yeast. Urine dipstick with 1+ leukocytes, trace blood and 2+ glucose.Case #3. Monica.History of Present Illness (HPI): Monica is a 43-year-old African- American G3P2102. She is currentlyseparated from her husband of 20 years and is working full-time as a legal secretary. About 8 monthsago, Monica started having irregular periods with heavier than usual flow until she stopped havingperiods or any vaginal bleeding about 3 months ago. She is currently recovering from a “stomach flu”however, she reports daily nausea, vomiting, bloating and decreased appetite over the past 3 weeks.She is worried because she has gained 12 pounds over the last 3 months “due to menopause”. Shecomes to the clinic today to discuss menopause symptoms and hormone replacement therapy.Prior medical history: Hypertension (2010)- well controlled on current antihypertensivePrior surgical history: Cholecystectomy (2015)Current medications: Lisinopril 10mg daily. Allergies: NoneOB- GYN History: NSVD x 2 (2015, 2019) healthy female 6lb 8oz; healthy female 7lbs 6oz. First trimestermiscarriage (9 weeks) in 2014. Menarche age 15, cycle length-7 days- frequency every 28 days- 5-6 padsper day. No history of sexually transmitted infections (STDs). No history of abnormal pap (last pap 2years ago).LMP: Approximately 3 months ago. Contraception history: Condoms; past use of oral contraceptives.Social history: Lives with her elderly father, 2 daughters. Separated from her husband for 6 months.Family history: Mother deceased (age 60)- breast cancer. Father alive (age 70)- hypertension.Review of Systems (ROS): Unremarkable with exception of as noted in HPI.Physical Exam (PE)VS: BP: 130/78, P: 78, RR: 18, T: 36.1 Weight: 152 lbs.Physical exam is unremarkable with exception of a palpable 12- 14 weeks size uterus on bimanual. Youcheck a for a fetal heartbeat and obtain a heart tone of 145 via doppler. The intake nurse reports that aurine pregnancy test came back positive.Monica is in disbelief.Case #4. Laura.History of Present Illness (HPI): Laura is a 16-year-old Caucasian G1P0. She presents to your office aftermissing her second period. She is “worried” as she “always gets her period on time”. She is in highschool- about to enter the 11th grade. She lives with her grandmother and 2 older siblings. Her urinepregnancy test in clinic today is positive.Laura is sexually active with her boyfriend; they do not use condoms. He “pulls out” as birth control.She reports being treated at the health department for chlamydia and gonorrhea earlier this year. Shethinks her boyfriend was treated but he is not answering her calls since she told him about the missedperiods a few weeks ago. She reports daily nausea, vomiting and dysuria for the past 2 weeks.Prior medical history: None. Prior surgical history: NoneCurrent medications: None. Allergies: NoneOB- GYN History: Menarche age 12, cycle length-7 days- frequency every 30 days- 2 tampons per day.History of chlamydia and gonorrhea (GC) in the past year. Last pap reported normal at the time ofchlamydia/ GC diagnosis. Has not received Human Papillomavirus (HPV) vaccine.LMP: Approximately 2 months ago. Contraception history: WithdrawalSocial history: Lives with her grandmother, siblings. Denies EtOH or recreational drug use. Currentlysmoking 1 pack of cigarettes/ dayFamily history: Mother deceased at age 42- drug overdose. Father unknown.Review of Systems (ROS): Unremarkable with exception of as noted in HPI.Physical Exam (PE)VS: BP: 110/68, P: 80, RR: 18, T: 37.1 Weight: 110 lbs. (states usual weight 120 lbs.).Physical exam is unremarkable with exception of a cloudy, yellow mucoid cervical discharge on speculumexam; friable appearance of the cervix with cervical motion tenderness (CMT). You palpate an 8-weeksize uterus on bimanual.Laura’s urine reveals 2+ ketones, 2+ nitrates, and 3+ leukocytes.NRNP6552Week9Casestudytemplate.docxCase # (1, 2, 3 or 4) and Description of the Case Chosen:·Case 1: Teresa·Case 2: Joanna·Case 3: Monica·Case 4: LauraOutline Subjective data.Identify data provided in your chosen case and any additional data needed.OutlineObjective findings.Identify findings provided in your chosen case and any additional data needed.Identify diagnostic tests, procedures, laboratory work indicated.Describe the rationale for each test or intervention with supporting references.Distinguish at least three differential diagnoses.Describe the rationales for your choice of each diagnosis with supporting references.Identify appropriate medications, treatments or other interventions associated with each differential diagnosis.Describe rationales and supporting references for each.Explain keySocial Determinants of Heath (SDoH) for your chosen case.Describe collaborative care referrals and patient education needs for your chosen case.Describe rationales and supporting references for each.NRNP6552week9cases.pdfCase #1. Teresa.History of Present Illness (HPI): Teresa is a 34-year-old Hispanic G2P2002. She presents to your officetoday at 10-weeks post-partum (PP) for her 6-week PP check. She underwent a C-section for failure toprogress following a 20-hour labor with Pitocin augmentation. She was discharged from the hospital onday 2 post-partum without complications. Teresa has had difficulty with breast feeding due todiscomfort in her suture line and terrible pain in her right breast since her discharge from the hospital.She reports occasional chills- she has not measured her temperature at home. Teresa was seen by thelactation consultant while in the hospital but “nothing is working” and her son “cries all the time”. Sheis afraid to feed her son formula as her mother-in-law wants her to “keep trying to breastfeed”. Teresatells you she feels as if she has failed her son- “it was so easy with my first baby, I know my husbandthinks I am a bad mother”.Prior medical history: None. Prior surgical history: Appendectomy (2000)Current medications: Prenatal vitamins, stool softener. Allergies: NoneOB- GYN History: NSVD (2019) healthy female 7lb 10oz; C-section healthy male 8 lbs. 8 oz as per HPI.Menarche age 12, cycle length- 5 days- frequency every 28 days- 4-5 tampons per day. No history ofsexually transmitted infections (STDs). History of abnormal pap smear in 2019 which was followed by anormal colposcopy. Last pap (during recent prenatal care) reported normal. HIV negative.LMP: First PP menstrual cycle last week. Has not resumed sexual activity PP. Contraception history:Oral contraceptives, condoms.Social history: Lives with husband, mother- in- law, and children. Stay at home mom. Denies EtOH orrecreational drug use, never smoker. Her family speaks Spanish at home; she is fluent in English.Family history: Unremarkable.Review of Systems (ROS): Negative except as noted in HPI.Physical Exam (PE)VS: BP: 110/70, P: 90, RR: 18, T: 38.4, Weight: 132 lbs.Teresa’s C-section suture line is healing well without erythema or tenderness. No vaginal discharge orlesions, no cervical motion tenderness (CMT), uterus normal size firm and non-tender. On breast exam,you do note an erythematous, swollen, and painful area to the right breast. Her physical exam isotherwise unremarkable.Case #2. Joanna.History of Present Illness (HPI): Joanna is a 28-year-old Caucasian G4P1021. She is single, living with herfather and 2-year-old daughter. She has a part-time job as a server at the local restaurant; she does nothave health insurance. Joanna presents to your office at the community health center today stating sheis pregnant and wants to receive OB care. She tells you that she has not yet been evaluated for thispregnancy as she was afraid to take time off from work and did not have enough money to pay for thevisit.Prior medical history: None. Prior surgical history: NoneCurrent medications: None. Allergies: PenicillinOB- GYN History: NSVD (2021) healthy female 6lb 8oz. Menarche age 10, cycle length- 3 days- irregularcycles since menarche- frequency every 20-30 days- 2-3 tampons per day. No history of sexuallytransmitted infections (STDs). Joanna’s OB history includes two first trimester elective terminations ofpregnancy, and 1 term female infant delivered vaginally at 37 weeks. Denies any complications duringher prior pregnancy however, she notes that her daughter experienced hypoglycemia and respiratorydistress, spending 2 weeks in the Neonatal Intensive Care Unit (NICU).LMP: Approximately 5 months ago. Contraception history: Condoms “sometimes”.Social history: Lives with her retired father and daughter. Restaurant server. Denies EtOH orrecreational drug use. Currently smoking 1 pack of cigarettes/ day (15 pack-year history). She and hermother are still paying for her daughter’s NICU stay. The child’s father is not involved in any way.Family history: Mother (deceased age 55)- Type 2 diabetes.Review of Systems (ROS): Unremarkable with exception of dysuria (“it burns when I pee”) over the past1-week. Denies fever, chills, abdominal or flank pain. Thick white vaginal discharge and “itching” for thepast month.Physical Exam (PE)VS: BP: 108/68, P: 72, RR: 18, T: 37.3, Weight 144lbsOn physical exam you palpate a fundal height of approximately 20cm with an audible fetal heart tone(FHT) of 160. On speculum exam you visualize a multiparous cervix without lesions; bluish discolorationof the cervix, vagina, and vulva is noted with a thick, white discharge. There is no cervical motiontenderness (CMT) on exam. The uterus is anteverted, non- tender, with fundus palpable at theumbilicus. Joanna’s physical exam is otherwise unremarkable.Wet mount reveals budding yeast. Urine dipstick with 1+ leukocytes, trace blood and 2+ glucose.Case #3. Monica.History of Present Illness (HPI): Monica is a 43-year-old African- American G3P2102. She is currentlyseparated from her husband of 20 years and is working full-time as a legal secretary. About 8 monthsago, Monica started having irregular periods with heavier than usual flow until she stopped havingperiods or any vaginal bleeding about 3 months ago. She is currently recovering from a “stomach flu”however, she reports daily nausea, vomiting, bloating and decreased appetite over the past 3 weeks.She is worried because she has gained 12 pounds over the last 3 months “due to menopause”. Shecomes to the clinic today to discuss menopause symptoms and hormone replacement therapy.Prior medical history: Hypertension (2010)- well controlled on current antihypertensivePrior surgical history: Cholecystectomy (2015)Current medications: Lisinopril 10mg daily. Allergies: NoneOB- GYN History: NSVD x 2 (2015, 2019) healthy female 6lb 8oz; healthy female 7lbs 6oz. First trimestermiscarriage (9 weeks) in 2014. Menarche age 15, cycle length-7 days- frequency every 28 days- 5-6 padsper day. No history of sexually transmitted infections (STDs). No history of abnormal pap (last pap 2years ago).LMP: Approximately 3 months ago. Contraception history: Condoms; past use of oral contraceptives.Social history: Lives with her elderly father, 2 daughters. Separated from her husband for 6 months.Family history: Mother deceased (age 60)- breast cancer. Father alive (age 70)- hypertension.Review of Systems (ROS): Unremarkable with exception of as noted in HPI.Physical Exam (PE)VS: BP: 130/78, P: 78, RR: 18, T: 36.1 Weight: 152 lbs.Physical exam is unremarkable with exception of a palpable 12- 14 weeks size uterus on bimanual. Youcheck a for a fetal heartbeat and obtain a heart tone of 145 via doppler. The intake nurse reports that aurine pregnancy test came back positive.Monica is in disbelief.Case #4. Laura.History of Present Illness (HPI): Laura is a 16-year-old Caucasian G1P0. She presents to your office aftermissing her second period. She is “worried” as she “always gets her period on time”. She is in highschool- about to enter the 11th grade. She lives with her grandmother and 2 older siblings. Her urinepregnancy test in clinic today is positive.Laura is sexually active with her boyfriend; they do not use condoms. He “pulls out” as birth control.She reports being treated at the health department for chlamydia and gonorrhea earlier this year. Shethinks her boyfriend was treated but he is not answering her calls since she told him about the missedperiods a few weeks ago. She reports daily nausea, vomiting and dysuria for the past 2 weeks.Prior medical history: None. Prior surgical history: NoneCurrent medications: None. Allergies: NoneOB- GYN History: Menarche age 12, cycle length-7 days- frequency every 30 days- 2 tampons per day.History of chlamydia and gonorrhea (GC) in the past year. Last pap reported normal at the time ofchlamydia/ GC diagnosis. Has not received Human Papillomavirus (HPV) vaccine.LMP: Approximately 2 months ago. Contraception history: WithdrawalSocial history: Lives with her grandmother, siblings. Denies EtOH or recreational drug use. Currentlysmoking 1 pack of cigarettes/ dayFamily history: Mother deceased at age 42- drug overdose. Father unknown.Review of Systems (ROS): Unremarkable with exception of as noted in HPI.Physical Exam (PE)VS: BP: 110/68, P: 80, RR: 18, T: 37.1 Weight: 110 lbs. (states usual weight 120 lbs.).Physical exam is unremarkable with exception of a cloudy, yellow mucoid cervical discharge on speculumexam; friable appearance of the cervix with cervical motion tenderness (CMT). You palpate an 8-weeksize uterus on bimanual.Laura’s urine reveals 2+ ketones, 2+ nitrates, and 3+ leukocytes.NRNP6552Week9Casestudytemplate.docxCase # (1, 2, 3 or 4) and Description of the Case Chosen:·Case 1: Teresa·Case 2: Joanna·Case 3: Monica·Case 4: LauraOutline Subjective data.Identify data provided in your chosen case and any additional data needed.OutlineObjective findings.Identify findings provided in your chosen case and any additional data needed.Identify diagnostic tests, procedures, laboratory work indicated.Describe the rationale for each test or intervention with supporting references.Distinguish at least three differential diagnoses.Describe the rationales for your choice of each diagnosis with supporting references.Identify appropriate medications, treatments or other interventions associated with each differential diagnosis.Describe rationales and supporting references for each.Explain keySocial Determinants of Heath (SDoH) for your chosen case.Describe collaborative care referrals and patient education needs for your chosen case.Describe rationales and supporting references for each.NRNP6552week9cases.pdfCase #1. Teresa.History of Present Illness (HPI): Teresa is a 34-year-old Hispanic G2P2002. She presents to your officetoday at 10-weeks post-partum (PP) for her 6-week PP check. She underwent a C-section for failure toprogress following a 20-hour labor with Pitocin augmentation. She was discharged from the hospital onday 2 post-partum without complications. Teresa has had difficulty with breast feeding due todiscomfort in her suture line and terrible pain in her right breast since her discharge from the hospital.She reports occasional chills- she has not measured her temperature at home. Teresa was seen by thelactation consultant while in the hospital but “nothing is working” and her son “cries all the time”. Sheis afraid to feed her son formula as her mother-in-law wants her to “keep trying to breastfeed”. Teresatells you she feels as if she has failed her son- “it was so easy with my first baby, I know my husbandthinks I am a bad mother”.Prior medical history: None. Prior surgical history: Appendectomy (2000)Current medications: Prenatal vitamins, stool softener. Allergies: NoneOB- GYN History: NSVD (2019) healthy female 7lb 10oz; C-section healthy male 8 lbs. 8 oz as per HPI.Menarche age 12, cycle length- 5 days- frequency every 28 days- 4-5 tampons per day. No history ofsexually transmitted infections (STDs). History of abnormal pap smear in 2019 which was followed by anormal colposcopy. Last pap (during recent prenatal care) reported normal. HIV negative.LMP: First PP menstrual cycle last week. Has not resumed sexual activity PP. Contraception history:Oral contraceptives, condoms.Social history: Lives with husband, mother- in- law, and children. Stay at home mom. Denies EtOH orrecreational drug use, never smoker. Her family speaks Spanish at home; she is fluent in English.Family history: Unremarkable.Review of Systems (ROS): Negative except as noted in HPI.Physical Exam (PE)VS: BP: 110/70, P: 90, RR: 18, T: 38.4, Weight: 132 lbs.Teresa’s C-section suture line is healing well without erythema or tenderness. No vaginal discharge orlesions, no cervical motion tenderness (CMT), uterus normal size firm and non-tender. On breast exam,you do note an erythematous, swollen, and painful area to the right breast. Her physical exam isotherwise unremarkable.Case #2. Joanna.History of Present Illness (HPI): Joanna is a 28-year-old Caucasian G4P1021. She is single, living with herfather and 2-year-old daughter. She has a part-time job as a server at the local restaurant; she does nothave health insurance. Joanna presents to your office at the community health center today stating sheis pregnant and wants to receive OB care. She tells you that she has not yet been evaluated for thispregnancy as she was afraid to take time off from work and did not have enough money to pay for thevisit.Prior medical history: None. Prior surgical history: NoneCurrent medications: None. Allergies: PenicillinOB- GYN History: NSVD (2021) healthy female 6lb 8oz. Menarche age 10, cycle length- 3 days- irregularcycles since menarche- frequency every 20-30 days- 2-3 tampons per day. No history of sexuallytransmitted infections (STDs). Joanna’s OB history includes two first trimester elective terminations ofpregnancy, and 1 term female infant delivered vaginally at 37 weeks. Denies any complications duringher prior pregnancy however, she notes that her daughter experienced hypoglycemia and respiratorydistress, spending 2 weeks in the Neonatal Intensive Care Unit (NICU).LMP: Approximately 5 months ago. Contraception history: Condoms “sometimes”.Social history: Lives with her retired father and daughter. Restaurant server. Denies EtOH orrecreational drug use. Currently smoking 1 pack of cigarettes/ day (15 pack-year history). She and hermother are still paying for her daughter’s NICU stay. The child’s father is not involved in any way.Family history: Mother (deceased age 55)- Type 2 diabetes.Review of Systems (ROS): Unremarkable with exception of dysuria (“it burns when I pee”) over the past1-week. Denies fever, chills, abdominal or flank pain. Thick white vaginal discharge and “itching” for thepast month.Physical Exam (PE)VS: BP: 108/68, P: 72, RR: 18, T: 37.3, Weight 144lbsOn physical exam you palpate a fundal height of approximately 20cm with an audible fetal heart tone(FHT) of 160. On speculum exam you visualize a multiparous cervix without lesions; bluish discolorationof the cervix, vagina, and vulva is noted with a thick, white discharge. There is no cervical motiontenderness (CMT) on exam. The uterus is anteverted, non- tender, with fundus palpable at theumbilicus. Joanna’s physical exam is otherwise unremarkable.Wet mount reveals budding yeast. Urine dipstick with 1+ leukocytes, trace blood and 2+ glucose.Case #3. Monica.History of Present Illness (HPI): Monica is a 43-year-old African- American G3P2102. She is currentlyseparated from her husband of 20 years and is working full-time as a legal secretary. About 8 monthsago, Monica started having irregular periods with heavier than usual flow until she stopped havingperiods or any vaginal bleeding about 3 months ago. She is currently recovering from a “stomach flu”however, she reports daily nausea, vomiting, bloating and decreased appetite over the past 3 weeks.She is worried because she has gained 12 pounds over the last 3 months “due to menopause”. Shecomes to the clinic today to discuss menopause symptoms and hormone replacement therapy.Prior medical history: Hypertension (2010)- well controlled on current antihypertensivePrior surgical history: Cholecystectomy (2015)Current medications: Lisinopril 10mg daily. Allergies: NoneOB- GYN History: NSVD x 2 (2015, 2019) healthy female 6lb 8oz; healthy female 7lbs 6oz. First trimestermiscarriage (9 weeks) in 2014. Menarche age 15, cycle length-7 days- frequency every 28 days- 5-6 padsper day. No history of sexually transmitted infections (STDs). No history of abnormal pap (last pap 2years ago).LMP: Approximately 3 months ago. Contraception history: Condoms; past use of oral contraceptives.Social history: Lives with her elderly father, 2 daughters. Separated from her husband for 6 months.Family history: Mother deceased (age 60)- breast cancer. Father alive (age 70)- hypertension.Review of Systems (ROS): Unremarkable with exception of as noted in HPI.Physical Exam (PE)VS: BP: 130/78, P: 78, RR: 18, T: 36.1 Weight: 152 lbs.Physical exam is unremarkable with exception of a palpable 12- 14 weeks size uterus on bimanual. Youcheck a for a fetal heartbeat and obtain a heart tone of 145 via doppler. The intake nurse reports that aurine pregnancy test came back positive.Monica is in disbelief.Case #4. Laura.History of Present Illness (HPI): Laura is a 16-year-old Caucasian G1P0. She presents to your office aftermissing her second period. She is “worried” as she “always gets her period on time”. She is in highschool- about to enter the 11th grade. She lives with her grandmother and 2 older siblings. Her urinepregnancy test in clinic today is positive.Laura is sexually active with her boyfriend; they do not use condoms. He “pulls out” as birth control.She reports being treated at the health department for chlamydia and gonorrhea earlier this year. Shethinks her boyfriend was treated but he is not answering her calls since she told him about the missedperiods a few weeks ago. She reports daily nausea, vomiting and dysuria for the past 2 weeks.Prior medical history: None. Prior surgical history: NoneCurrent medications: None. Allergies: NoneOB- GYN History: Menarche age 12, cycle length-7 days- frequency every 30 days- 2 tampons per day.History of chlamydia and gonorrhea (GC) in the past year. Last pap reported normal at the time ofchlamydia/ GC diagnosis. Has not received Human Papillomavirus (HPV) vaccine.LMP: Approximately 2 months ago. Contraception history: WithdrawalSocial history: Lives with her grandmother, siblings. Denies EtOH or recreational drug use. Currentlysmoking 1 pack of cigarettes/ dayFamily history: Mother deceased at age 42- drug overdose. Father unknown.Review of Systems (ROS): Unremarkable with exception of as noted in HPI.Physical Exam (PE)VS: BP: 110/68, P: 80, RR: 18, T: 37.1 Weight: 110 lbs. (states usual weight 120 lbs.).Physical exam is unremarkable with exception of a cloudy, yellow mucoid cervical discharge on speculumexam; friable appearance of the cervix with cervical motion tenderness (CMT). You palpate an 8-weeksize uterus on bimanual.Laura’s urine reveals 2+ ketones, 2+ nitrates, and 3+ leukocytes.12Bids(56)Miss DeannaDr. Ellen RMMISS HILLARY A+Sheryl HoganProf. TOPGRADEEmily ClareDr. Sarah Blakefirstclass tutorDoctor.NamiraDr. Freya WalkerPROF_ALISTERMUSYOKIONES A+Dr CloverDiscount AssigngrA+de plusProWritingGuruDr. Everleigh_JKColeen AndersonIsabella HarvardBrilliant GeekShow All Bidsother Questions(10)Hmong HistoryAfrican American philosophy paper6Week 6 Discussion: HRM 500improving thisAPPLEassignmentOrganizational Behavior Week 5 DiscussionIdentify a company in your local or generalized area that you would classify as a monopoly. Explain the key reasons why you classified the company as a monopoly, and state how the company operates relative to at least two (2) characteristics of that partiThyrmodynamicsInternational BUSNESS

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Home>Homework Answsers>Nursing homework help7 months ago27.11.20248Report issuefiles (1)Wk1RES.AllegoryoftheOrchard.docxWk1RES.AllegoryoftheOrchard.docxAllegory of the OrchardThe Allegory of the Orchard presents barriers and challenges of underserved, vulnerable, or marginalized populations and communities. These barriers and challenges highlight the importance of understanding the impact of political determinants of health on such groups. This allegory encourages an identification, understanding, analysis, and response to these factors as members of the healthcare community.For this Discussion, consider the role of the political determinants of health on underserved, vulnerable, or marginalized populations and communities. How might advocates address the health disparities to promote equity and access to high quality healthcare?ResourcesBe sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.WEEKLY RESOURCESRequired ResourcesReadings· Dawes, D. E. (2020).The political determinants of health. Johns Hopkins University Press.· “Foreword (pp. ix–xi)· Chapter 1, “The Allegory of the Orchard: The Political Determinants of Health Inequalities” (pp. 1–17)· Porche, D. J. (2023).Health policy: Applications for nurses and other healthcare professionals(3rd ed.). Jones & Bartlett Learning.· Chapter 1, “Policy Overview” (pp.1–20)· Chapter 6, “Healthcare Systems” (pp. 81–92)· Walden University Oasis: Writing Center. (n.d.).Citations: OverviewLinks to an external site..https://academicguides.waldenu.edu/writingcenter/apa/citations· Walden University Oasis: Writing Center. (n.d.).Common assignments: Discussion postLinks to an external site.. https://academicguides.waldenu.edu/writingcenter/assignments/discussionpostMedia· Satcher Health Leadership Institute. (2021, April 19).The allegory of the orchard: The political determinants of health by Daniel E. DawesLinks to an external site.[Video]. https://www.youtube.com/watch?v=mux1c73fJ78Note:The approximate length of this media piece is 6 minutes.· Satcher Health Leadership Institute. (2021, April 19).The allegory of the orchard—part II: The political determinants of health by Daniel E. Dawes, part 2Links to an external site.[Video]. https://www.youtube.com/watch?v=8gTbPog_J9sNote:The approximate length of this media piece is 7 minutes.· Satcher Health Leadership Institute. (2021, February 2).The political determinants of health: Jessica’s storyLinks to an external site.[Video]. https://www.youtube.com/watch?v=cmMutvgQIcUNote:The approximate length of this media piece is 5 minutes.·Document:Welcome to the DNP ProgramDownload Welcome to the DNP Program(PPT)·Document:Welcome to the DNP Program NarrativeDownload Welcome to the DNP Program Narrative(Word document)To Prepare:· View and read the Learning Resources regarding The Allegory of the Orchard.· Consider the role of political determinants of health on disparities in health for some groups.· Consider if advocates should be more concerned with policies that promote equality or equity.· Explore your role, as a nurse, in addressing these determinants in our policy advocacy efforts.By Day 3 of Week 1Posta response detailing the following:UseThe Allegory of the Orchardto discuss how the political determinants of health negatively impact the health outcomes of a group of patients for whom you care. Why are you, as a nurse, the right person to become politically involved in addressing these determinants?RESPOND TO THIS DISCUSSION POSTK N RThe Allegory of the OrchardThe Allegory of the Orchard vividly illustrates how political determinants of health influence underserved, vulnerable, or marginalized populations, perpetuating health disparities. These determinants laws, policies, and governance significantly shape access to resources and opportunities, affecting health outcomes. For homeless patients frequently utilizing the emergency department (ED) for care, the interplay between social determinants of health (SDOH) and political barriers presents unique challenges. As nurses, our professional role extends beyond direct patient care; it includes advocacy for equitable health policies. This discussion will explore the negative impacts of political determinants on homeless individuals’ health outcomes and why nurses are uniquely positioned to drive policy changes that promote equity and access.Political Determinants of Health and Their Impact on Homeless PatientsThe Allegory of the Orchard highlights how political determinants of health laws, policies, and governance contribute to health disparities in vulnerable populations. Homeless patients, who frequently utilize EDs for basic care, are disproportionately affected by political determinants of health. Policies that limit funding for affordable housing, mental health services, and addiction recovery programs perpetuate the challenges faced by these individuals (Dawes, 2020).A lack of supportive policies addressing the root causes of homelessness perpetuates this cycle. For example, policies that restrict Medicaid expansion exacerbate chronic illnesses and mental health conditions among homeless populations (Formosa et al., 2021). Additionally, these patients often lack access to preventive care and consistent follow-up, which leads to frequent ED visits and poor health outcomes (Rhodes et al., 2021). Political determinants, therefore, act as significant barriers to achieving equitable health outcomes for homeless individuals (Satcher Health Leadership Institute, 2021).The Nurse’s Role in Addressing Political Determinants of HealthAs a nurse, I am uniquely positioned to address the political determinants of health affecting homeless patients. Nurses are on the frontlines of care, witnessing firsthand the challenges and inequities that patients face (Winnett, 2022). For instance, my experiences caring for homeless patients in the ED have revealed how inadequate discharge planning and limited access to social services contribute to recurring health crises (Winnett, 2022). Nurses bring credibility and trust to advocacy efforts, making them powerful agents of change. Through professional organizations and legislative advocacy, nurses can lobby for policies that promote equity, such as increased funding for affordable housing initiatives (Porche, 2023). Advocacy for expanded Medicaid coverage is also essential to ensuring homeless populations receive the necessary preventive care (Formosa et al., 2021). Equity-focused policies recognize the need to allocate resources based on the unique challenges faced by vulnerable populations, such as the homeless (Dawes & Gonzalez, 2023). The importance of advocating for equity rather than equality, aligning resources with the specific needs of underserved groups, is further emphasized (Satcher Health Leadership Institute, 2021). By leveraging their expertise and commitment to patient care, nurses can drive systemic changes that address political determinants of health and promote equity.ConclusionThe Allegory of the Orchard underscores the profound influence of political determinants of health on underserved populations. Homeless individuals face significant health disparities due to systemic barriers, which perpetuate cycles of poor health and reliance on emergency services. Nurses, equipped with firsthand knowledge and advocacy skills, are well-suited to champion policies that address these inequities. By focusing on equity and advocating for systemic change, nurses can play a critical role in reducing health disparities and improving access to high-quality care for marginalized populations.ReferencesDawes, D. E. (2020).The political determinants of health. Johns Hopkins University Press.Dawes, D., & Gonzalez, J. (2023). The politics of population health.Milbank Quarterly, 101(S1), 224–241.https://doi.org/10.1111/1468-0009.12603Links to an external site.Formosa, E. A., Kishimoto, V., Orchanian-Cheff, A., & Hayman, K. (2021). Emergency department interventions for homelessness: A systematic review.CJEM, 23(1), 111–122.https://doi.org/10.1007/s43678-020-00008-4Links to an external site.Porche, D. J. (2023).Health policy: Applications for nurses and other healthcare professionals(3rd ed.). Jones & Bartlett Learning.Rhodes, H. M., Simon, H. L., Hume, H. G., Strief, D., Knutson, A., Webber, M. C., & Robertshaw, D. C. (2021). Safety-Net Accountable Health Model Partnership drives inpatient connection to outpatient social services, reducing readmissions in a population experiencing homelessness.Professional Case Management, 26(3), 150–155.https://doi.org/10.1097/NCM.0000000000000466Links to an external site.Satcher Health Leadership Institute. (2021).The allegory of the orchard: The political determinants of health by Daniel E. Dawes[Video]. YouTube.https://www.youtube.com/watch?v=mux1c73fJ78Links to an external site.Satcher Health Leadership Institute. (2021).The allegory of the orchard—Part II: The political determinants of health by Daniel E. Dawes, Part 2[Video]. YouTube.https://www.youtube.com/watch?v=8gTbPog_J9Links to an external site.Winnett, R. (2022). The experiences of hospital social workers who care for homeless patients: An interpretive phenomenological analysis.Social Work in Health Care, 61(1), 52–68.https://doi.org/10.1080/00981389.2022.2033379Links to an external site.image2.pngimage1.jpegWk1RES.AllegoryoftheOrchard.docxAllegory of the OrchardThe Allegory of the Orchard presents barriers and challenges of underserved, vulnerable, or marginalized populations and communities. These barriers and challenges highlight the importance of understanding the impact of political determinants of health on such groups. This allegory encourages an identification, understanding, analysis, and response to these factors as members of the healthcare community.For this Discussion, consider the role of the political determinants of health on underserved, vulnerable, or marginalized populations and communities. How might advocates address the health disparities to promote equity and access to high quality healthcare?ResourcesBe sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.WEEKLY RESOURCESRequired ResourcesReadings· Dawes, D. E. (2020).The political determinants of health. Johns Hopkins University Press.· “Foreword (pp. ix–xi)· Chapter 1, “The Allegory of the Orchard: The Political Determinants of Health Inequalities” (pp. 1–17)· Porche, D. J. (2023).Health policy: Applications for nurses and other healthcare professionals(3rd ed.). Jones & Bartlett Learning.· Chapter 1, “Policy Overview” (pp.1–20)· Chapter 6, “Healthcare Systems” (pp. 81–92)· Walden University Oasis: Writing Center. (n.d.).Citations: OverviewLinks to an external site..https://academicguides.waldenu.edu/writingcenter/apa/citations· Walden University Oasis: Writing Center. (n.d.).Common assignments: Discussion postLinks to an external site.. https://academicguides.waldenu.edu/writingcenter/assignments/discussionpostMedia· Satcher Health Leadership Institute. (2021, April 19).The allegory of the orchard: The political determinants of health by Daniel E. DawesLinks to an external site.[Video]. https://www.youtube.com/watch?v=mux1c73fJ78Note:The approximate length of this media piece is 6 minutes.· Satcher Health Leadership Institute. (2021, April 19).The allegory of the orchard—part II: The political determinants of health by Daniel E. Dawes, part 2Links to an external site.[Video]. https://www.youtube.com/watch?v=8gTbPog_J9sNote:The approximate length of this media piece is 7 minutes.· Satcher Health Leadership Institute. (2021, February 2).The political determinants of health: Jessica’s storyLinks to an external site.[Video]. https://www.youtube.com/watch?v=cmMutvgQIcUNote:The approximate length of this media piece is 5 minutes.·Document:Welcome to the DNP ProgramDownload Welcome to the DNP Program(PPT)·Document:Welcome to the DNP Program NarrativeDownload Welcome to the DNP Program Narrative(Word document)To Prepare:· View and read the Learning Resources regarding The Allegory of the Orchard.· Consider the role of political determinants of health on disparities in health for some groups.· Consider if advocates should be more concerned with policies that promote equality or equity.· Explore your role, as a nurse, in addressing these determinants in our policy advocacy efforts.By Day 3 of Week 1Posta response detailing the following:UseThe Allegory of the Orchardto discuss how the political determinants of health negatively impact the health outcomes of a group of patients for whom you care. Why are you, as a nurse, the right person to become politically involved in addressing these determinants?RESPOND TO THIS DISCUSSION POSTK N RThe Allegory of the OrchardThe Allegory of the Orchard vividly illustrates how political determinants of health influence underserved, vulnerable, or marginalized populations, perpetuating health disparities. These determinants laws, policies, and governance significantly shape access to resources and opportunities, affecting health outcomes. For homeless patients frequently utilizing the emergency department (ED) for care, the interplay between social determinants of health (SDOH) and political barriers presents unique challenges. As nurses, our professional role extends beyond direct patient care; it includes advocacy for equitable health policies. This discussion will explore the negative impacts of political determinants on homeless individuals’ health outcomes and why nurses are uniquely positioned to drive policy changes that promote equity and access.Political Determinants of Health and Their Impact on Homeless PatientsThe Allegory of the Orchard highlights how political determinants of health laws, policies, and governance contribute to health disparities in vulnerable populations. Homeless patients, who frequently utilize EDs for basic care, are disproportionately affected by political determinants of health. Policies that limit funding for affordable housing, mental health services, and addiction recovery programs perpetuate the challenges faced by these individuals (Dawes, 2020).A lack of supportive policies addressing the root causes of homelessness perpetuates this cycle. For example, policies that restrict Medicaid expansion exacerbate chronic illnesses and mental health conditions among homeless populations (Formosa et al., 2021). Additionally, these patients often lack access to preventive care and consistent follow-up, which leads to frequent ED visits and poor health outcomes (Rhodes et al., 2021). Political determinants, therefore, act as significant barriers to achieving equitable health outcomes for homeless individuals (Satcher Health Leadership Institute, 2021).The Nurse’s Role in Addressing Political Determinants of HealthAs a nurse, I am uniquely positioned to address the political determinants of health affecting homeless patients. Nurses are on the frontlines of care, witnessing firsthand the challenges and inequities that patients face (Winnett, 2022). For instance, my experiences caring for homeless patients in the ED have revealed how inadequate discharge planning and limited access to social services contribute to recurring health crises (Winnett, 2022). Nurses bring credibility and trust to advocacy efforts, making them powerful agents of change. Through professional organizations and legislative advocacy, nurses can lobby for policies that promote equity, such as increased funding for affordable housing initiatives (Porche, 2023). Advocacy for expanded Medicaid coverage is also essential to ensuring homeless populations receive the necessary preventive care (Formosa et al., 2021). Equity-focused policies recognize the need to allocate resources based on the unique challenges faced by vulnerable populations, such as the homeless (Dawes & Gonzalez, 2023). The importance of advocating for equity rather than equality, aligning resources with the specific needs of underserved groups, is further emphasized (Satcher Health Leadership Institute, 2021). By leveraging their expertise and commitment to patient care, nurses can drive systemic changes that address political determinants of health and promote equity.ConclusionThe Allegory of the Orchard underscores the profound influence of political determinants of health on underserved populations. Homeless individuals face significant health disparities due to systemic barriers, which perpetuate cycles of poor health and reliance on emergency services. Nurses, equipped with firsthand knowledge and advocacy skills, are well-suited to champion policies that address these inequities. By focusing on equity and advocating for systemic change, nurses can play a critical role in reducing health disparities and improving access to high-quality care for marginalized populations.ReferencesDawes, D. E. (2020).The political determinants of health. Johns Hopkins University Press.Dawes, D., & Gonzalez, J. (2023). The politics of population health.Milbank Quarterly, 101(S1), 224–241.https://doi.org/10.1111/1468-0009.12603Links to an external site.Formosa, E. A., Kishimoto, V., Orchanian-Cheff, A., & Hayman, K. (2021). Emergency department interventions for homelessness: A systematic review.CJEM, 23(1), 111–122.https://doi.org/10.1007/s43678-020-00008-4Links to an external site.Porche, D. J. (2023).Health policy: Applications for nurses and other healthcare professionals(3rd ed.). Jones & Bartlett Learning.Rhodes, H. M., Simon, H. L., Hume, H. G., Strief, D., Knutson, A., Webber, M. C., & Robertshaw, D. C. (2021). Safety-Net Accountable Health Model Partnership drives inpatient connection to outpatient social services, reducing readmissions in a population experiencing homelessness.Professional Case Management, 26(3), 150–155.https://doi.org/10.1097/NCM.0000000000000466Links to an external site.Satcher Health Leadership Institute. (2021).The allegory of the orchard: The political determinants of health by Daniel E. Dawes[Video]. YouTube.https://www.youtube.com/watch?v=mux1c73fJ78Links to an external site.Satcher Health Leadership Institute. (2021).The allegory of the orchard—Part II: The political determinants of health by Daniel E. Dawes, Part 2[Video]. YouTube.https://www.youtube.com/watch?v=8gTbPog_J9Links to an external site.Winnett, R. (2022). The experiences of hospital social workers who care for homeless patients: An interpretive phenomenological analysis.Social Work in Health Care, 61(1), 52–68.https://doi.org/10.1080/00981389.2022.2033379Links to an external site.image2.pngimage1.jpegBids(57)Dr. Ellen RMDr. Aylin JMProf Double RDr. Sarah Blakefirstclass tutorMUSYOKIONES A+Dr ClovergrA+de plusSheryl HoganProWritingGuruDr. Everleigh_JKColeen AndersonIsabella HarvardBrilliant GeekWIZARD_KIMPROF_ALISTERTeacher A+ WorkAshley EllieMadam MichelleAmerican TutorShow All Bidsother Questions(10)Reading ReflectionPayment Link6531 wk JOURNALEvidence discussion boardquizAssignment 2: Required Assignment 1—Financial Statement Analysis: Average Payment Period Ratiomath-calculus from Ohio University SyllabusJoe is thinking about expanding his businessCreating Training Toolsmadam-professor only

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Home>Homework Answsers>Nursing homework helpAPAAssignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement DisordersFor this Assignment, you will complete a focused SOAP note for a patient in a case study who has either a schizophrenia spectrum, other psychotic, or medication-induced movement disorder.To PrepareReview this       week’s Learning Resources. Consider the insights they provide about       assessing, diagnosing, and treating schizophrenia spectrum, other       psychotic, and medication-induced movement disorders.Review the      Focused SOAP Note template, which you will use to complete this      Assignment. There is also a Focused SOAP Note Exemplar provided as a guide      for Assignment expectations.Review the      video,Case Study: Sherman Tremaine. You will use this case as      the basis of this Assignment. In this video, a Walden faculty member is      assessing a mock patient. The patient will be represented onscreen as an      avatar.Consider what      history would be necessary to collect from this patient.Consider what      interview questions you would need to ask this patient.The AssignmentDevelop a focused SOAP note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:Subjective:What details      did the patient provide regarding their chief complaint and symptomology      to derive your differential diagnosis? What is the duration and severity      of their symptoms? How are their symptoms impacting their functioning in      life?Objective:What      observations did you make during the psychiatric assessment?Assessment:Discuss      the patient’s mental status examination results. What were your      differential diagnoses? Provide a minimum of three possible diagnoses with      supporting evidence, and list them in order from highest priority to      lowest priority. Compare theDSM-5-TRdiagnostic criteria      for each differential diagnosis and explain whatDSM-5-TRcriteria      rules out the differential diagnosis to find an accurate diagnosis.      Explain the critical-thinking process that led you to the primary      diagnosis you selected. Include pertinent positives and pertinent      negatives for the specific patient case.Plan:What is      your plan for psychotherapy? What is your plan for treatment and      management, including alternative therapies? Include pharmacologic and      nonpharmacologic treatments, alternative therapies, and follow-up      parameters, as well as a rationale for this treatment and management      plan. Also incorporate one health promotion activity and one patient      education strategy.Reflection      notes:What      would you do differently with this patient if you could conduct the      session again? Discuss what your next intervention would be if you      were able to follow up with this patient. Also include in your reflection      a discussion related to legal/ethical considerations (demonstrate critical      thinking beyond confidentiality and consent for treatment!), health      promotion, and disease prevention, taking into consideration patient factors      (such as age, ethnic group, etc.), PMH, and other risk factors (e.g.,      socioeconomic, cultural background, etc.).Provide at      least three evidence-based, peer-reviewed journal articles or      evidenced-based guidelines that relate to this case to support your      diagnostics and differential diagnoses. Be sure they are current (no more      than 5 years old).Medication ReviewReview the FDA-approved use of the following medicines related to treating schizophrenia-spectrum and other psychotic disorders:PsychosisSchizoaffective    disorderalprazolam (adjunct)amisulpridearipiprazoleasenapineblonanserincarbamazepine (adjunct)chlorpromazineclonazepam (adjunct)clozapinecyamemazineflupenthixolfluphenazinehaloperidoliloperidonelamotrigine (adjunct)lorazepam (adjunct)loxapinelurasidonemesoridazinemolindoneolanzapinepaliperidoneperospironeperphenazinepimozidepipothiazinequetiapinerisperidonesertindolesulpiridethioridazinethiothixenetrifluoperazinevalproate (divalproex) (adjunct)ziprasidonezotepinezuclopenthixolamisulpridearipiprazoleasenapinecarbamazepine (adjunct)chlorpromazineclozapinecyamemazineflupenthixolhaloperidoliloperidonelamotrigine (adjunct)l-methylfolate (adjunct)loxapinelurasidonemesoridazinemolindoneolanzapinepaliperidoneperospironeperphenazinepipothiazinequetiapinerisperidonesertindolesulpiridethioridazinethiothixenetrifluoperazinevalproate (divalproex) (adjunct)ziprasidonezotepinezuclopenthixolSchizophreniaCataplexy syndromeCatatoniaExtrapyramidal side    effectsamisulpridearipiprazoleasenapinecarbamazepine (adjunct)chlorpromazineclozapinecyamemazineflupenthixolhaloperidoliloperidonelamotrigine (adjunct)l-methylfolate (adjunct)loxapinelurasidonemesoridazinemolindoneolanzapinepaliperidoneperospironeperphenazinepipothiazinequetiapinerisperidonesertindolesulpiridethioridazinethiothixenetrifluoperazinevalproate (divalproex) (adjunct)ziprasidonezotepinezuclopenthixolSeasonal affective disorderbupropionSedation-inductionhydroxyzinemidazolamclomipramineimipraminesodiuSadock, B. J., Sadock, V. A., & Ruiz, P. (2015).Kaplan & Sadock’s synopsis of psychiatry(11th ed.). Wolters Kluwer. (For review as needed)Chapter 7, “Schizophrenia      Spectrum and Other Psychotic Disorders”Chapter 29.2,      “Medication-Induced Movement Disorders”Chapter 29.3, “α2-Adrenergic      Receptor Agonists, α1-Adrenergic Receptor Antagonists:      Clonidine, Guanfacine, Prazosin, and Yohimbine”Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015).Rutter’s child and adolescent psychiatry(6th ed.). Wiley Blackwell.· Chapter 43, “Pharmacological, Medically-Led and Related Disorders”· Chapter 57, “Schizophrenia and Psychosis”Zakhari, R. (2021).The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.· Chapter 9, “Psychotic Disorders and Delusions”REQUIRED MEDIAhttps://www.youtube.com/watch?v=ipW5AcbFzzEhttps://www.youtube.com/watch?v=63lHuGMbscUNRNP6675WEEK5AssignmentDETAILS.docxWAL_NRNP6675_05_A_EN-CC.zip3 years ago21.09.202220Report issueAnswer(1)Brainy Brian4.8(904)5.0(213)ChatPurchase the answer to view itNOT RATEDSOAPNote.docxSOAPNote2.PDF3 years agoplagiarism checkPurchase $30Bids(88)Dr. Sophie Milesabdul_rehman_Emily ClareWIZARD_KIMProf Double RSheryl HoganDr. Adeline ZoeJahky BCreative GeekTutor Cyrus KenProf. TOPGRADERihAN_MendozaQuality AssignmentsAshley EllieColeen AndersonBrainy BrianNightingaleMUSYOKIONES A+ProWritingGuruPROF_ALISTERother Questions(10)taxationFor homework help1234Can you Help in Writing This paperLLAWSOC 315 Week 3 Learning Team Assignment Outline of Diversity Action Plan Written Reportmarketing homeworkRES 320 Week 1-5 Entire GRADE A++ 100%PSY 428 Week 5 Learning Team Assignment Environmental Proposal and Presentation Baderman Island (ppt)PSY 103 Learning Experiencelaw help

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Home>Homework Answsers>Nursing homework helpBenchmark – Human Experience Across the Health-Illness ContinuumView RubricDue Date:Apr 07, 2019 23:59:59Max Points:100Details:The benchmark assesses the following competency:Benchmark: 5.1. Understand the human experience across the health-illness continuum.Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).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. Refer to theLopesWrite Technical Support articlesfor assistance.Benchmark – Human Experience Across the Health-Illness Continuum1Unsatisfactory0.00%2Less than Satisfactory75.00%3Satisfactory79.00%4Good89.00%5Excellent100.00%80.0 %Content30.0 %Health-Illness Importance to Health and Patient Care (Benchmarked: 5.1. Understand the human experience across the health-illness continuum.)A discussion on the importance of the health-illness continuum is not presented.A partial summary on the importance of the health-illness continuum is presented. The summary does not fully include the relation of the continuum to health and the human experience in patient care. There are significant inaccuracies. More evidence or information is needed.A general discussion on the importance of the health-illness in relation to health and the human experience in patient care is presented. The discussion generally establishes that the health-illness continuum is important to patient care. There are some inaccuracies. More information or rationale is needed.A discussion on the importance of the health-illness in relation to health and the human experience in patient care is presented. The discussion demonstrates that the health-illness continuum is important to patient care. Some rationale is needed for clarity.A discussion on the importance of the health-illness continuum in relation to health and the human experience in patient care is presented. The discussion demonstrates that the health-illness continuum is important to patient care. Strong rationale is offered for support.30.0 %Refection on Personal State of Health and the Health Illness ContinuumReflection on personal overall state of health is omitted.A partial summary of personal overall state of health is included. The summary is not informative. Behaviors supporting or detracting from health and well-being are omitted or incomplete.A general discussion of personal overall state of health is included. Overall the discussion demonstrates some insight into some behaviors supporting or detracting from health and well-being. The author does not clearly establish where personal health falls on the health-illness continuum.A discussion of personal state of health is included. The discussion demonstrates personal insight into overall behaviors supporting or detracting from health and well-being. The author establishes where personal health falls on the health-illness continuum.A well-developed discussion of personal state of health is included. The discussion demonstrates strong personal insight into behaviors supporting or detracting from health and well-being. The author clearly establishes where personal health falls on the health-illness continuum.20.0 %Resources Supporting WellnessOptions and resources available to help the author move toward wellness on the health-illness continuum are omitted.Partial options and resources available that would help the author move toward wellness on the health-illness continuum are presented. It is unclear how this will assist in moving the author toward wellness.General options and resources available that would help the author move toward wellness on the health-illness continuum are presented. More information is needed to establish how this will assist in moving the author toward wellness.Options and resources available that would reasonably help the author move toward wellness on the health-illness continuum are presented. The author establishes how these resources will assist in moving toward wellness.Options and resources available that would be extremely helpful to help the author move toward wellness on the health-illness continuum are presented. The author clearly establishes how these will assist in moving toward wellness. Insight into wellness as it pertains to the health illness continuum is demonstrated.15.0 %Organization and Effectiveness5.0 %Thesis Development and PurposePaper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.15.0 %Organization and Effectiveness5.0 %Argument Logic and ConstructionStatement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.15.0 %Organization and Effectiveness5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.Writer is clearly in command of standard, written, academic English.5.0 %Format2.0 %Paper Format (use of appropriate style for the major and assignment)Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present.Template is fully used; There are virtually no errors in formatting style.All format elements are correct.3.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct.Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.100 %Total Weightage6 years ago06.04.201915Report issueAnswer(1)kim woods4.6(27k+)4.7(2k+)ChatPurchase the answer to view itNOT RATEDorder_116297_298293.doc6 years agoplagiarism checkPurchase $15Bids(58)Prof Double RGreat-WritersGradesMaestroAmanda SmithnicohwilliamYourStudyGuruRanju LewisTutor RisperDiscount WriterProf SheizRosie SeptemberReem HasanansRohanKATHERINE BECKSkristine tutorAngelina MayMichelle OwensUNDISPUTED GEEKThe grAdebrilliant answersother Questions(10)Global Warning Cause and Mitigation Paperneed essay HWDue in 6 hours… original work, not too complicated prefer closer to 250 wordsBUS 302 Management ConceptsInterview a Manager: What makes a good ManagerPhysics DQFive questions for Islam religion class to be answered in 500 words APA formatFOR BONIETA 123INFO620 Week 5 Assignment Enterprise Database Systems Assignments Chapter 15 and 16discussion

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