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Click on M120/HSC1531 Section 02 Medical Terminology (5.5 Weeks) – Online Plus – 2021 Spring Quarter Term 1, then click on Module 06 – Digestive System and Review of Body Systems  and then click on Module 06 Exam Study Guide, study for the exam, and then click on Module 06 Final Exam and complete the exam. 

Jane is a 19 year old college freshman who plays on her school’s soccer team. She presents to college health clinic with complaint of sore throat, fever, fatigue, aches and pains that started abruptly yesterday. She denies cough, runny nose, sinus congestion, nausea/ vomiting, and abdominal pain. A review of her record reveals that her immunizations are up to date. She has a benign PMH / FH. She has no drug allergies. Medications include OCPs.

VS: BP-110/64, T-101.6, HR- 88, R- 16

Physical Exam Findings

HEENT: PERRL, Sclera clear, conjunctiva pink without discharge; ear canals clear bilaterally, no swelling or exudate. TMs pearly grey bilaterally with clearly visible landmarks; nares clear bilaterally with no swelling, erythema or discharge visible; Pharynx erythematous with white tonsillar exudates bilaterally.

Neck: Supple with tender swollen anterior cervical lymph nodes bilaterally.

1. What additional history items are important?
2. In addition to the HEENT/neck findings given above, what additional physical exam items are important to perform and record?
3. Apply the Centor criteria. What did you get and what does that mean?
4. A diagnosis of GABHS pharyngitis is confirmed. What is your treatment plan?

Please refer to the Grading Rubric for details on how this activity will be graded.

• S Question 1
• O Question 2
• A Question 3
• P Question 4

Grading Rubric:

ote: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Clinical Case Study – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsSubjective DataIncludes all relevant subjective data necessary for differentiation of the client’s problem. Data is presented in systematic, organized manner consistently.

20 pointsIncludes most subjective data with omission of two minor details or one major detail. Most data is presented in systematic, organized manner.

17 pointsIncludes subjective data but omits four minor details or two major details. Some data is presented in a systematic, organized manner.

15 pointsOmits more than four minor details or more than two major details of the subjective data. Data is not presented in a systematic, organized manner.

Lacking most or all subjective data.

Submits assignment late.

13 points20Objective DataObjective data is complete and consistently presented in an organized manner.

20 pointsObjective data is complete and presented in an organized manner most of the time.

17 pointsObjective data is not complete or is not presented in an organized manner.

15 pointsObjective data is not complete and is not presented in an organized manner.

Lacking most or all objective data.

Submits assignment late.

13 points20AssessmentAssessment, including differential and/or diagnosis (if appropriate), is complete and appropriate to client Diagnostics are complete and appropriate to client.

20 pointsAssessment, including differential and/or diagnosis (if appropriate), is complete but some may not be appropriate for client.

17 pointsAssessment, including differential and/or diagnosis (if appropriate), is not complete but is appropriate.

15 pointsAssessment, including differential and/or diagnosis (if appropriate), is not complete or appropriate, or it is not evident.

Submits assignment late.

13 points20PlanPlan includes all relevant measures 95% to 100% Pharmacologic Non-pharmacologic Education Referral Follow-up.

20 pointsPlan includes all relevant measures 89% to 94% Pharmacologic Non-Pharmacologic Education Referral Follow-up.

17 pointsPlan includes four of the five relevant measures, but the four are complete.

15 pointsPlan is not complete and/or covers only three relevant measures.

Plan and relevant measures are not evident.

Submits assignment late.

13 points20Professional ApplicationCase incorporates four evidence-based practice articles.

10 pointsCase incorporates three evidence-based practice articles.

8 pointsDoes not include an evidence-based practice article but has two or more advanced practice articles.

7 pointsDoes not include evidence-based practice article but has one advanced practice article or does not include evidence-based practice article or advanced practice article.

6 points10Organization, APA, Grammar, and SpellingWell organized content that is clear and concise. Correct APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

There are no spelling, punctuation, or word-usage errors.

10 pointsOrganized content that is informative and supportive of purpose. Correct and consistent APA formatting of references, and cites all references used. No more than one to two unique APA errors.

There are minimal to no grammar, punctuation, or word-usage errors.

8 pointsPoor organization and flow of ideas may distract from the content. Three to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

7 pointsIllogical flow of ideas.

Many APA formatting errors, or no attempt to format in APA.

The writer struggles with limited vocabulary and has difficulty conveying meaning–noting just the broadest of meanings.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

6 points10Total Points100 

   Read the following case study and answer the reflective questions.  Please provide  rationales for your answers.  Make sure to provide a citation for your answers.

 CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter,  her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income  neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and  worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring  of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to  the United States as a registered nurse and met her husband, a drug company representative. The  older couple moved to the United States when their daughter became a U.S. citizen and petitioned  them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come  to the United States. The Arahans found life in the United States different from that in their home country, but their  adjustment was not as difficult because both were healthy and spoke English fluently. Most of their  time was spent taking care of their two grandchildren and the house. As the grandchildren grew older,  the older couple found that they had more spare time. The daughter and her husband advanced in  their careers and spent a great deal more time at their jobs. There were few family dinners during  the week. On weekends, the daughter, her husband, and their children socialized with their own  friends. The couple began to feel isolated and longed for a more active life. Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where  they still had relatives and friends. However, political and economic issues would have made it  difficult for them to live there. Besides, they had become accustomed to the way of life in the United  States with all the modern conveniences and abundance of goods that were difficult to obtain in their  country. However, they also became concerned that they might not be able to tolerate the winter  months and that minor health problems might worsen as they aged. They wondered who would take  care of them if they became very frail and where they would live, knowing that their daughter had  only saved money for their grandchildren’s college education. They expressed their sentiments to  their daughter, who became very concerned about how her parents were feeling. This older couple had been attending church on a regular basis, but had never been active in other  church-related activities. The church bulletin announced the establishment of parish nursing with  two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic.  Here, they met one of the registered nurses, who had a short discussion with them about the services  offered. The registered nurse had spent a great deal of her working years as a community health 

Two recommendations for nursing education that will help create change in the health care industry are interprofessional education and defining core competencies. Following these recommendations would show an increase in initial care-based knowledge and more effective communication in work settings.

Interprofessional education is extremely important to the industry and would help develop better working relationships and a better understanding of professional roles. Shared learning environments with students from various disciplines will encourage graduates to work more effectively in teams and decrease the number of miscommunications among the team (IOM, 2011).

There are several higher-level competencies that are not a primary focus during early education, including them in the program curriculum could better prepare nurses in areas such as evidence-based practice, medical management, patient safety, and clinical judgment. It can be difficult for students just graduating to apply their knowledge with these competencies. Incorporating knowledge and action would put out a more highly educated and better-prepared workforce (IOM, 2011).

IOM (Institute of Medicine). 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.

Case Study 1 & 2 

Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

Case Study 1 & 2 Lyme Disease and Peripheral Vascular Disease 

The answers must be in your own words with reference to journal or book where you found the evidence to your answer. Do not copy paste or use a past students work as all files submitted in this course are registered and saved in turn it in program.

Answers must be scholarly and be 3-4 sentences in length with rationale and explanation. No Straight forward / Simple answer will be accepted.  

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.

All answers to case studies must have reference cited in text for each answer and minimum of 2 Scholarly References (Journals, books) (No websites)  per case Study

Lyme Disease Case Study # 1

A 38-year-old male had a 3-week history of fatigue and lethargy with intermittent complaints of headache, fever, chills, myalgia, and arthralgia. According to the history, the patient’s symptoms began shortly after a camping vacation. He recalled a bug bite and rash on his thigh immediately after the trip. The following studies were ordered: Studies Result

Lyme disease test: Elevated IgM antibody titers against Borrelia burgdorferi (normal: low)

Erythrocyte sedimentation rate (ESR):30 mm/hour (normal: ≤15 mm/hour) 

Aspartate aminotransferase (AST): 32 units/L (normal: 8-20 units/L) 

Hemoglobin (Hgb); 12 g/dL (normal: 14-18 g/dL) 

Hematocrit (Hct); 36% (normal: 42%-52%) 

Rheumatoid factor (RF): Negative (normal: negative) 

Antinuclear antibodies (ANA): Negative (normal: negative) 

Diagnostic Analysis:

Based on the patient’s history of camping in the woods and an insect bite and rash on the thigh, Lyme disease was suspected. Early in the course of this disease, testing for specific immunoglobulin (Ig) M antibodies against B. burgdorferi is the most helpful in diagnosing Lyme disease. An elevated ESR, increased AST levels, and mild anemia are frequently seen early in this disease. RF and ANA abnormalities are usually absent. 

Critical Thinking; Questions

1. What is the cardinal sign of Lyme disease? (always on the boards) 

2. At what stages of Lyme disease are the IgG and IgM antibodies elevated?

3. Why was the ESR elevated?

4. What is the Therapeutic goal for Lyme Disease and what is the recommended treatment.

Peripheral Vascular Disease Case Studies #2

A 52-year-old man complained of pain and cramping in his right calf caused by walking two blocks. The pain was relieved with cessation of activity. The pain had been increasing in frequency and intensity. Physical examination findings were essentially normal except for decreased hair on the right leg. The patient’s popliteal, dorsalis pedis, and posterior tibial pulses were markedly decreased compared with those of his left leg. 

Studies Results

Routine laboratory work: Within normal limits (WNL) 

Doppler ultrasound systolic pressures Femoral: 130 mm Hg; popliteal: 90 mm Hg; posterior tibial: 88 mm Hg; dorsalis pedis: 88 mm Hg (normal: same as brachial systolic blood pressure) 

Arterial plethysmography: Decreased amplitude of distal femoral, popliteal, dorsalis pedis, and posterior tibial pulse waves

Femoral arteriography of right leg: Obstruction of the femoral artery at the midthigh level 

Arterial duplex scan: Apparent arterial obstruction in the superficial femoral artery Diagnostic Analysis:

With the clinical picture of classic intermittent claudication, the noninvasive Doppler and plethysmographic arterial vascular study merely documented the presence and location of the arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography to document the location of the vascular occlusion. The patient underwent a bypass from the proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.

Critical Thinking Questions:

1. What was the cause of this patient’s pain and cramping? 

2. Why was there decreased hair on the patient’s right leg? 

3. What would be the strategic physical assessments after surgery to determine the adequacy of the patient’s circulation? 

4. What would be the treatment of intermittent Claudication for non-occlusion?