Interview someone you know (could be face-to-face or virtual) on their diet. Follow the diet history/diet recall and use this information to write an ADIME note. Have the person you’re interviewing fill out the evaluation sheet and give it to you 

Due: Sunday night at 11:59pm Mountain Time

In this assignment, you will identify argument and fallacy forms.

Step 1: Consider the scenario:

Scientists from the Coalition of Concerned Scientists claim that fresh water is going to be the scarcest resource on the planet in 50 years. This claim, though alarming, is based only on a single study performed in the Appalachian Mountains over a span of 10 years. The study involved testing the percentage and availability of fresh, drinkable water along the mountain range once every April for 10 years. The study has many citizens concerned this could mark the beginning of a slippery slope, and many are beginning to think irrationally about how to maintain an abundance of clean water. As a well-respected environmental blogger, many have come to you looking for answers, and while you may not have the solutions they want, you do believe you can prove that the Coalition of Concerned Scientists study is riddled with fallacies.

Step 2: Examine the presence of fallacy.

Create content for a two to three-page (minimum) blog entry aimed at easing the anxiety of your readership, address the following statements:

• What type of argument is being presented? How does that differ or coincide with the fallacy form?
• What fallacy or fallacies are present in the Coalition of Concerned Scientists’ claim? What are the ramifications of the fallacy or fallacies within this scenario?
• By what criteria can you distinguish between arguments and fallacies? In the case of the Coalition of Concerned Scientists study, what improvements would transform this into a viable argument?
• Are there any logical fallacies present in the scenario? If so, explain. How can you discern logical fallacies within an argument?

Step 3: When you have completed your assignment, save a copy for yourself in an easily accessible place.

Cite any sources in APA format.

For this assignment, you are going to put it all together.  The last two assignments have highlighted various portions of your diet. Now, what would your healthy, well-balanced diet look like?  What foods would it include? 

This assignment includes two parts. You are to write a report that covers both.  You should have a title page and include references if you need them.

Part I.

During weeks 1 and 2, you recorded and analyzed your dietary intake for 3 24-hr periods.  Now modify your intake to meet the following dietary recommendations. In order to make the changes, you will need to use Cronometer (https://cronometer.com/).  This is a web-based diet analysis program that is available on the computer, cellphone, or tablet. This will be the first time you use this program for this class, so set up an account and log in.

Your new diet analysis must meet these goals.  These should look familiar.  They are recommendations we have discussed throughout the class.

1. Calorie intake is within 200 calories of the calorie level recommended by the diet analysis program. Be sure you selected the correct activity for your daily activities.
2. All nutrients meet or exceed the target or limit.  Be sure not to exceed the upper limit for the nutrient.
3. The source of calories from carbohydrates is >55% and the source of calories from fat is <25%.

Screenshot the results of your analysis.  You need to submit this file in the assignment area along with your Word file.

Once you have modified your diet, fill in the table below. Be sure to copy and paste the table into your report.  You can add more lines by placing your cursor in the last cell and hit the “tab” button.  This will add another line to the table.  You may not have the same number of foods in each column.

Foods I deleted from my diet:

Foods I changed the amount in my diet:

New Foods I added to my diet:

           Answer the following questions in a short written essay. This summary should be at least one page, double-spaced, 12 point font, and 1” margins.

1. Was making the changes an easy task?
2. Are the changes realistic?
3. Is there a particular type of food you found yourself adding and/or deleting?

Part II. 

In the next two pages, you may do one of two things.  Whichever one you pick, your summary should be at least two pages, double-spaced, 12 point font, and 1” margins.  Use references where needed.

1. Relate the changes you made in your diet to five things you learned in the class.  There is no right or wrong. Be sure to explain your response in detail. Do make the five items obvious such as a new paragraph for each item.
2. Implement one of the following and describe your experience.  Your discussion should include the obstacles and successes you faced implementing the change

• Take all your vitamins and minerals through food for a week.
• Obtain all protein through food for a week.
• Increase your whole grains intake for a week.

Situation: Patient “CP” is an 18-year-old male who was admitted at 1900 today. His mother visited him at his college dormitory and was very concerned with his health; he seemed weak and had lost weight since she last saw him. She took him to see his primary care provider, and the provider admitted him and has ordered a tube feeding. I placed an 8-Fr, 42-inch feeding tube in his right nares about an hour ago, and x-ray just called and confirmed placement in the stomach. The pump is in his room. He is up to the bathroom prn; otherwise bed rest.

Background: CP was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously. He reports fatigue and has recently lost 6 kg (13.2 lb) after he registered at the local college and moved to live in a dormitory. CP’s mom was here earlier, but she is a single parent and has two younger boys, so she had to go home.

Assessment: CP is awake and alert. His heart rate and rhythm are regular at 80–85/min. Breath sounds are fine with a respiratory rate at 18/min. His color is a bit pale. Blood pressure is 118/78 mm Hg. He reports no pain and states he’s not had much appetite the past few weeks. His belly is flat and nontender. Bowel sounds are normoactive.

Recommendation: CP is due for vital signs and assessment. The tube feeding just arrived, and you will need to start it on the pump. He needs 720 kilocalories over 8 hours overnight. His regular diet is high calorie, high fat, but he wasn’t too hungry this evening; just had a bit of his chocolate shake. You will need to give his pancreatic enzymes orally before you start the tube feeding. You should also assess his diet and reinforce patient education on nutrition.

REQUIREMENTS 

Write a 6-10 page paper recommending treatment and care for patient regarding cystic fibrosis. Rubric will be attached. APA citations needed. At least 4 citations, only 1 being from an online source. Also include pathophysiology, nursing process, patient teaching, diagnostic tests, etc.  

Case 3

• 16-year-old white pregnant teenager living in an inner-city neighborhood.

What are the barriers to interpersonal communication?

            As a clinician, interpersonal communication barriers when dealing with a 16-year-old white pregnant teenager are many. They include fatigue, anxiety and embarrassment, age difference between clinician and patient, and the patient’s values and beliefs (Bosworth, 2010). For one, pregnant adolescent patients might have a problem concentrating due to fatigue. Thus, gathering information from such a patient might be a difficult task for any clinician. When patients are not entirely concentrated on giving the correct information, accurately diagnosing and treating them will be a huge ask. Adolescent patients tend to be anxious or embarrassed about their condition, especially if it is an unplanned pregnancy. No one would feel comfortable getting undressed in front of a stranger, much less a teenage mom-to-be. Thus, anticipating embarrassment and finding a way to minimize it can help ease an uncomfortable situation.

            Also, everyone has their assumptions based on their culture or beliefs. A 16-year-old white pregnant teenager can genuinely believe that only a female nurse can attend to her and that men would not do a thorough job. The clinician should consider such assumptions before attending to the patient. This goes hand in hand with those adolescent patients who believe that junior staff can properly treat them. The age difference between the clinician and the patient can sometimes be an issue, especially if the patient feels she will not communicate comfortably with an older attendant. Lastly, a 16-year-old white pregnant teenager is most likely to be anxious or embarrassed about her condition. Teenagers may be hesitant to openly discuss their condition in the present of a parent, and my also feel guilty and worried about what their peers might think of them. Thus, the privacy and confidentiality of this interaction will be of utmost importance. 

What are the procedures and examination techniques that will be used during the physical exam of your patient?

            The 16-year-old white pregnant teenager will be taken through a geriatric assessment. However, since teenagers may hesitate to talk freely in the presence of their parent, the clinician should ask for permission on the patient’s behalf for the parents to be absent while the interview is being conducted. Also, the clinician should avoid any painful or intrusive procedures and do as much as possible with the patient still dressed and seated. The patient should also be asked if they prefer certain things done and whether there are specific movements they feel uncomfortable doing. For this patient, the first step will be to arrange for privacy, quiet, and any special needs since the physical examination will be affected by the environment’s quality. It will also be essential to make sure the patient is calm, relaxed, and adequately draped or gowned. The next step will be to conduct a general inspection and check for vital signs, and an eye and ear examination will follow this. An ophthalmo-otoscopy will then be undertaken before connecting the otoscope to the nasal speculum and examining the nares. A mouth examination will then follow before evaluating the face to examine symmetry and other details concerning motor divisions of the V and VI cranial nerves. For a young mother, a complete examination may be easier if it is divided into multiple sessions rather than taking the patient through hours of exhaustive tasks. The procedure will yield a more relevant and complete list of psychosocial issues, functional problems, or medical problems. Results will be thoughtfully integrated with the patient’s pathophysiology and history (Ball et al., 2015). 

Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are.

           The Subjective, Objective, Assessment, and Plan (SOAP) is an acronym used in nursing to document patient’s data in a structured way. It provides clinicians with a framework for evaluating patients’ information. Also, it offers a cognitive outline that aids in clinical reasoning. Using the framework, nurses are able to assess, diagnose, and treat patients in an informed and reasoned manner. This paper aims to discuss S.O.A.P. approach in documenting patients’ data. 

           The subjective (S) stands for the patent’s experiences, personal views, and feelings. The component included here is chief complaint (CC), history of present illness (H.P.I.), and review of systems (R.O.S.). The patient chief complaint is a short statement of the patient purpose to visit the hospital. History of present illness describes the patient current situation or condition since the time that the symptoms for the disease started showing. It describes the condition in a narrative form. The review of systems compiles the pertinent and negative symptoms (Jenkins &David, 2019). 

           The Objective assessment (O) entails the documentation of information that the clinician observes from the current patients’ condition. This documentation covers vital signs, physical evaluation findings, imaging results, laboratory information, and other diagnostics data. Simultaneously, the assessment section entails the synthesis of evidence documented in the ‘subjective’ and ‘objective’ sections. This section records the assessment of the patient’s situation, how the problem behaves, and any changes in the condition. It is at this stage that the decision-making process is discussed in more in-depth details (Jenkins & David, 2019). Lastly, the plan (P) section documents what is supposed to address the patient’s concerns. This includes things like doing ordering referrals, additional testing, and consultations with other health care providers. Also, it documents the goals therapy, drugs, and procedures performed on the patient (Jenkins & David, 2019).  

Reference

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination . St. Louis, MO.

Bosworth, H. (Ed.). (2010). Improving patient treatment adherence: A clinician’s guide. Springer Science & Business Media.

Jenkins, M. L., & Davis, A. (2019). Transforming Nursing Documentation. Studies in health technology and informatics, 264, 625-628.