Nursing assignment

Home>Homework Answsers>Nursing homework helpNURSEcase studyfollow the attachmentsa year ago17.07.202418Report issuefiles (2)NRNP6552Week8Casestudytemplate.docxNRNP6552week8casescenarios.pdfNRNP6552Week8Casestudytemplate.docxCase # (1, 2, 3 or 4) and Description of the Case Chosen:·Case 1·Case 2·Case 3·Case 4Outline 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.Write the answers to questions posed for chosen case scenario1.2.3.4.5.6.7.NRNP6552week8casescenarios.pdfNRNP6552 Week 8 Case studiesCase 1A 48-year-old Asian American woman is concerned about thin bones. Her mother was diagnosedwith osteoporosis at the age of 50 and fell at the age of 68 and fractured her hip and spent monthsin Rehab before being able to return home. The patient has no history of fractures.The patient presents to the office to have her bones checked to see if she has “thin bones”Patient has no history of previous fractures: Patient states she went through Menopause at theage of 43-44 with no major problems. Patient was diagnosed with hypothyroid at at age 40.Patient does not drink. Smokes 1ppd for 20 yrs. Husband has been out of work for 9 months dueto downsizing at his job. Pt works as an administrative assistant for a publisher but does not havehealth insurance at this time.Pt had a melanoma removed from her left cheek in 2018; No hospitalizations except forchildbirth x2Family history: Paternal Grandmother died at age 78 due to heart disease. Paternal Grandfatherdied at age 83 due to heart attack. Maternal Grandmother died at age 82 cause unknown;Maternal Grandfather died from farm accident at age of 56. Mother is 75 alive with Osteoporosisdiagnosed at age 50 and HTN diagnosed at age 63. Father is 77 alive with HTN diagnosed at age45. Pt has two daughters alive and well with no medical problems.Objective InfoHeight 5’2’ Wt 105 lbs; BMI 19.2; 128/78; HR-72/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA• CV: RRR, no murmurs, rubs or extra sounds noted; 2+ peripheral pulses, no edema noted• Breast: soft, fibrocystic changes bilaterally, without masses, dimpling or discharge• Abd: soft, +BS, no tenderness• MS: Full ROM in spine and shoulders. No tenderness, no spasms• T-Score is -1.2Questions1. What other information do you need2. What other diagnostic tests would be appropriate for this pt?3. Is this patient at high risk or low risk? What are her risk factors4. What other screenings are appropriate for this patient?5. What is the difference between a Z score and a T score?6. What would you include in patient education to prevent further loss of bone? Be specific.Case 2A 46-year-old Caucasian woman presents to the clinic complaining of breast pain. The patient state thepain is intermittent, in the right breast, the pain is sharp and has a burning sensation. She rates the painas 7/10 at it worst. The patient states the pain sometimes interferes with her sexual activity. She hastried warm compresses, ibuprofen, and support bras with little improvement. Pt is on oral birth controlpills and takes a daily vitamin.Soc hx: Pt reports she sometimes eats nutritious meals, but due to her job and family obligations shedoes eat fast food frequently. Pt states she is an assistant accountant at a local accounting firm, whichadds to her stress especially at the end of each month and during tax season. She exercises 1-2times/week by walking around the block. Sometimes the walking causes more pain in her breast. Shedrinks socially once or twice a month and has 1-2 glasses of wine at that time. She smokes 2 packs/dayfor last 22 yrs. She has tried to quit but has not been successful. Family history non-contributory.Objective InfoHeight 5’6” Wt 155 lbs; BMI 25; 140/78; HR-72/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, no murmurs, rubs or extra sounds noted; 2+ peripheral pulses, no edema noted• Breast: Macromastia breasts are soft, fibrocystic changes bilaterally noted without masses,
dimpling or discharge, no redness or inflammation noted.Questions1. What other information do you need?2. Describe the most appropriate way to perform the breast exam on this patient.3. What diagnostic tests would be appropriate for this pt?4. What are the risk factors for this patient?5. What other screenings are appropriate for this patient?6. When would you refer to a breast specialist?
7. What pharmacological and nonpharmacological therapies would you consider for this patient?Case 3A 36-year-old Hispanic woman presents to the OB clinic for her Week 24 check-up, gravida 2para 1. Patient is a full-time homemaker. Pt states she is doing well but is worried about herweight gain. Obstetric history includes a normal spontaneous vaginal delivery (NSVD) 31/2 yrsago with a viable 9 lb male infant after a 10-hour labor. No complications during pregnancy,delivery or postpartum period. She denies allergies to food, drugs or the environment. Currentmeds include Prenatal vitamins 1/day and Fe 90 mg/day. Family history significant only for diet-controlled DM in paternal grandfather and an aunt and obesity in both mother and father.Objective InfoHeight 5’2” Wt 170 lbs; BMI 31.1; 140/84 (sitting); HR-92/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, noedema noted• Breast: Soft, fibrocystic changes bilaterally noted without masses, dimpling or discharge,no redness or inflammation noted. Breast self-exam reviewed• GU: Uterus at umbilicus-approximately 24 wks size and non-tender. FHT present withDopplerQuestions1. What other information do you need?2. What diagnostic tests would be appropriate for this pt?3. What are the risk factors for this patient?4. What other screenings are appropriate for this patient?5. What management treatment would be most effective for this patient?6. What are the possible maternal and newborn complications with this health problem?Case 4A 32-year-old African American woman presents to the clinic for her 24-week check-up. Pt statesher morning sickness has resolved. However, she states she seems sad often and does notunderstand why, as she is happy about the pregnancy.HPI: Pt is 24 weeks gestation. The patient is having sad moods at least once a day. She also statesshe is tired all the time, but figures that is just part of being pregnant, but has no energy and doesnot feel like doing her usual daily chores. She finds it difficult to go to work every day. Thismoodiness started about a week ago. She tried going to bed earlier but it did not seem to help.Taking 1 prenatal vitamin every day, No known drug, food, or environmental allergies. Familyhistory is significant only for diet-controlled DM in paternal grandfather with onset in mid 40’s,Mother 58 yrs old is healthy; Father 60 yrs old with hx of DM with onset at age 45 and chronicdepression which began in early 20s.Objective InfoHeight 5’4” Wt 147 lbs; BMI 25.2; 132/78 (sitting); HR-88/min• General: Appears well nourished, hair is in disarray, with flat affect• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, noedema noted• Breast: Soft, enlarged, fibrocystic changes bilaterally noted without masses, dimpling ordischarge, no redness or inflammation noted. Breast self-exam reviewed• GU: Uterus at umbilicus- approximately 24 wks size and non-tender. FHT present withDopplerQuestions1. What other information do you need?2. What diagnostic would be appropriate for this pt?3. What are the risk factors for this patient?4. What other screenings are appropriate for this patient?5. What management treatment would be most effective for this patient?6. What are the possible maternal and newborn complications with this health problem?NRNP6552week8casescenarios.pdfNRNP6552 Week 8 Case studiesCase 1A 48-year-old Asian American woman is concerned about thin bones. Her mother was diagnosedwith osteoporosis at the age of 50 and fell at the age of 68 and fractured her hip and spent monthsin Rehab before being able to return home. The patient has no history of fractures.The patient presents to the office to have her bones checked to see if she has “thin bones”Patient has no history of previous fractures: Patient states she went through Menopause at theage of 43-44 with no major problems. Patient was diagnosed with hypothyroid at at age 40.Patient does not drink. Smokes 1ppd for 20 yrs. Husband has been out of work for 9 months dueto downsizing at his job. Pt works as an administrative assistant for a publisher but does not havehealth insurance at this time.Pt had a melanoma removed from her left cheek in 2018; No hospitalizations except forchildbirth x2Family history: Paternal Grandmother died at age 78 due to heart disease. Paternal Grandfatherdied at age 83 due to heart attack. Maternal Grandmother died at age 82 cause unknown;Maternal Grandfather died from farm accident at age of 56. Mother is 75 alive with Osteoporosisdiagnosed at age 50 and HTN diagnosed at age 63. Father is 77 alive with HTN diagnosed at age45. Pt has two daughters alive and well with no medical problems.Objective InfoHeight 5’2’ Wt 105 lbs; BMI 19.2; 128/78; HR-72/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA• CV: RRR, no murmurs, rubs or extra sounds noted; 2+ peripheral pulses, no edema noted• Breast: soft, fibrocystic changes bilaterally, without masses, dimpling or discharge• Abd: soft, +BS, no tenderness• MS: Full ROM in spine and shoulders. No tenderness, no spasms• T-Score is -1.2Questions1. What other information do you need2. What other diagnostic tests would be appropriate for this pt?3. Is this patient at high risk or low risk? What are her risk factors4. What other screenings are appropriate for this patient?5. What is the difference between a Z score and a T score?6. What would you include in patient education to prevent further loss of bone? Be specific.Case 2A 46-year-old Caucasian woman presents to the clinic complaining of breast pain. The patient state thepain is intermittent, in the right breast, the pain is sharp and has a burning sensation. She rates the painas 7/10 at it worst. The patient states the pain sometimes interferes with her sexual activity. She hastried warm compresses, ibuprofen, and support bras with little improvement. Pt is on oral birth controlpills and takes a daily vitamin.Soc hx: Pt reports she sometimes eats nutritious meals, but due to her job and family obligations shedoes eat fast food frequently. Pt states she is an assistant accountant at a local accounting firm, whichadds to her stress especially at the end of each month and during tax season. She exercises 1-2times/week by walking around the block. Sometimes the walking causes more pain in her breast. Shedrinks socially once or twice a month and has 1-2 glasses of wine at that time. She smokes 2 packs/dayfor last 22 yrs. She has tried to quit but has not been successful. Family history non-contributory.Objective InfoHeight 5’6” Wt 155 lbs; BMI 25; 140/78; HR-72/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, no murmurs, rubs or extra sounds noted; 2+ peripheral pulses, no edema noted• Breast: Macromastia breasts are soft, fibrocystic changes bilaterally noted without masses,
dimpling or discharge, no redness or inflammation noted.Questions1. What other information do you need?2. Describe the most appropriate way to perform the breast exam on this patient.3. What diagnostic tests would be appropriate for this pt?4. What are the risk factors for this patient?5. What other screenings are appropriate for this patient?6. When would you refer to a breast specialist?
7. What pharmacological and nonpharmacological therapies would you consider for this patient?Case 3A 36-year-old Hispanic woman presents to the OB clinic for her Week 24 check-up, gravida 2para 1. Patient is a full-time homemaker. Pt states she is doing well but is worried about herweight gain. Obstetric history includes a normal spontaneous vaginal delivery (NSVD) 31/2 yrsago with a viable 9 lb male infant after a 10-hour labor. No complications during pregnancy,delivery or postpartum period. She denies allergies to food, drugs or the environment. Currentmeds include Prenatal vitamins 1/day and Fe 90 mg/day. Family history significant only for diet-controlled DM in paternal grandfather and an aunt and obesity in both mother and father.Objective InfoHeight 5’2” Wt 170 lbs; BMI 31.1; 140/84 (sitting); HR-92/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, noedema noted• Breast: Soft, fibrocystic changes bilaterally noted without masses, dimpling or discharge,no redness or inflammation noted. Breast self-exam reviewed• GU: Uterus at umbilicus-approximately 24 wks size and non-tender. FHT present withDopplerQuestions1. What other information do you need?2. What diagnostic tests would be appropriate for this pt?3. What are the risk factors for this patient?4. What other screenings are appropriate for this patient?5. What management treatment would be most effective for this patient?6. What are the possible maternal and newborn complications with this health problem?Case 4A 32-year-old African American woman presents to the clinic for her 24-week check-up. Pt statesher morning sickness has resolved. However, she states she seems sad often and does notunderstand why, as she is happy about the pregnancy.HPI: Pt is 24 weeks gestation. The patient is having sad moods at least once a day. She also statesshe is tired all the time, but figures that is just part of being pregnant, but has no energy and doesnot feel like doing her usual daily chores. She finds it difficult to go to work every day. Thismoodiness started about a week ago. She tried going to bed earlier but it did not seem to help.Taking 1 prenatal vitamin every day, No known drug, food, or environmental allergies. Familyhistory is significant only for diet-controlled DM in paternal grandfather with onset in mid 40’s,Mother 58 yrs old is healthy; Father 60 yrs old with hx of DM with onset at age 45 and chronicdepression which began in early 20s.Objective InfoHeight 5’4” Wt 147 lbs; BMI 25.2; 132/78 (sitting); HR-88/min• General: Appears well nourished, hair is in disarray, with flat affect• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, noedema noted• Breast: Soft, enlarged, fibrocystic changes bilaterally noted without masses, dimpling ordischarge, no redness or inflammation noted. Breast self-exam reviewed• GU: Uterus at umbilicus- approximately 24 wks size and non-tender. FHT present withDopplerQuestions1. What other information do you need?2. What diagnostic would be appropriate for this pt?3. What are the risk factors for this patient?4. What other screenings are appropriate for this patient?5. What management treatment would be most effective for this patient?6. What are the possible maternal and newborn complications with this health problem?NRNP6552Week8Casestudytemplate.docxCase # (1, 2, 3 or 4) and Description of the Case Chosen:·Case 1·Case 2·Case 3·Case 4Outline 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.Write the answers to questions posed for chosen case scenario1.2.3.4.5.6.7.NRNP6552week8casescenarios.pdfNRNP6552 Week 8 Case studiesCase 1A 48-year-old Asian American woman is concerned about thin bones. Her mother was diagnosedwith osteoporosis at the age of 50 and fell at the age of 68 and fractured her hip and spent monthsin Rehab before being able to return home. The patient has no history of fractures.The patient presents to the office to have her bones checked to see if she has “thin bones”Patient has no history of previous fractures: Patient states she went through Menopause at theage of 43-44 with no major problems. Patient was diagnosed with hypothyroid at at age 40.Patient does not drink. Smokes 1ppd for 20 yrs. Husband has been out of work for 9 months dueto downsizing at his job. Pt works as an administrative assistant for a publisher but does not havehealth insurance at this time.Pt had a melanoma removed from her left cheek in 2018; No hospitalizations except forchildbirth x2Family history: Paternal Grandmother died at age 78 due to heart disease. Paternal Grandfatherdied at age 83 due to heart attack. Maternal Grandmother died at age 82 cause unknown;Maternal Grandfather died from farm accident at age of 56. Mother is 75 alive with Osteoporosisdiagnosed at age 50 and HTN diagnosed at age 63. Father is 77 alive with HTN diagnosed at age45. Pt has two daughters alive and well with no medical problems.Objective InfoHeight 5’2’ Wt 105 lbs; BMI 19.2; 128/78; HR-72/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA• CV: RRR, no murmurs, rubs or extra sounds noted; 2+ peripheral pulses, no edema noted• Breast: soft, fibrocystic changes bilaterally, without masses, dimpling or discharge• Abd: soft, +BS, no tenderness• MS: Full ROM in spine and shoulders. No tenderness, no spasms• T-Score is -1.2Questions1. What other information do you need2. What other diagnostic tests would be appropriate for this pt?3. Is this patient at high risk or low risk? What are her risk factors4. What other screenings are appropriate for this patient?5. What is the difference between a Z score and a T score?6. What would you include in patient education to prevent further loss of bone? Be specific.Case 2A 46-year-old Caucasian woman presents to the clinic complaining of breast pain. The patient state thepain is intermittent, in the right breast, the pain is sharp and has a burning sensation. She rates the painas 7/10 at it worst. The patient states the pain sometimes interferes with her sexual activity. She hastried warm compresses, ibuprofen, and support bras with little improvement. Pt is on oral birth controlpills and takes a daily vitamin.Soc hx: Pt reports she sometimes eats nutritious meals, but due to her job and family obligations shedoes eat fast food frequently. Pt states she is an assistant accountant at a local accounting firm, whichadds to her stress especially at the end of each month and during tax season. She exercises 1-2times/week by walking around the block. Sometimes the walking causes more pain in her breast. Shedrinks socially once or twice a month and has 1-2 glasses of wine at that time. She smokes 2 packs/dayfor last 22 yrs. She has tried to quit but has not been successful. Family history non-contributory.Objective InfoHeight 5’6” Wt 155 lbs; BMI 25; 140/78; HR-72/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, no murmurs, rubs or extra sounds noted; 2+ peripheral pulses, no edema noted• Breast: Macromastia breasts are soft, fibrocystic changes bilaterally noted without masses,
dimpling or discharge, no redness or inflammation noted.Questions1. What other information do you need?2. Describe the most appropriate way to perform the breast exam on this patient.3. What diagnostic tests would be appropriate for this pt?4. What are the risk factors for this patient?5. What other screenings are appropriate for this patient?6. When would you refer to a breast specialist?
7. What pharmacological and nonpharmacological therapies would you consider for this patient?Case 3A 36-year-old Hispanic woman presents to the OB clinic for her Week 24 check-up, gravida 2para 1. Patient is a full-time homemaker. Pt states she is doing well but is worried about herweight gain. Obstetric history includes a normal spontaneous vaginal delivery (NSVD) 31/2 yrsago with a viable 9 lb male infant after a 10-hour labor. No complications during pregnancy,delivery or postpartum period. She denies allergies to food, drugs or the environment. Currentmeds include Prenatal vitamins 1/day and Fe 90 mg/day. Family history significant only for diet-controlled DM in paternal grandfather and an aunt and obesity in both mother and father.Objective InfoHeight 5’2” Wt 170 lbs; BMI 31.1; 140/84 (sitting); HR-92/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, noedema noted• Breast: Soft, fibrocystic changes bilaterally noted without masses, dimpling or discharge,no redness or inflammation noted. Breast self-exam reviewed• GU: Uterus at umbilicus-approximately 24 wks size and non-tender. FHT present withDopplerQuestions1. What other information do you need?2. What diagnostic tests would be appropriate for this pt?3. What are the risk factors for this patient?4. What other screenings are appropriate for this patient?5. What management treatment would be most effective for this patient?6. What are the possible maternal and newborn complications with this health problem?Case 4A 32-year-old African American woman presents to the clinic for her 24-week check-up. Pt statesher morning sickness has resolved. However, she states she seems sad often and does notunderstand why, as she is happy about the pregnancy.HPI: Pt is 24 weeks gestation. The patient is having sad moods at least once a day. She also statesshe is tired all the time, but figures that is just part of being pregnant, but has no energy and doesnot feel like doing her usual daily chores. She finds it difficult to go to work every day. Thismoodiness started about a week ago. She tried going to bed earlier but it did not seem to help.Taking 1 prenatal vitamin every day, No known drug, food, or environmental allergies. Familyhistory is significant only for diet-controlled DM in paternal grandfather with onset in mid 40’s,Mother 58 yrs old is healthy; Father 60 yrs old with hx of DM with onset at age 45 and chronicdepression which began in early 20s.Objective InfoHeight 5’4” Wt 147 lbs; BMI 25.2; 132/78 (sitting); HR-88/min• General: Appears well nourished, hair is in disarray, with flat affect• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, noedema noted• Breast: Soft, enlarged, fibrocystic changes bilaterally noted without masses, dimpling ordischarge, no redness or inflammation noted. Breast self-exam reviewed• GU: Uterus at umbilicus- approximately 24 wks size and non-tender. FHT present withDopplerQuestions1. What other information do you need?2. What diagnostic would be appropriate for this pt?3. What are the risk factors for this patient?4. What other screenings are appropriate for this patient?5. What management treatment would be most effective for this patient?6. What are the possible maternal and newborn complications with this health problem?NRNP6552Week8Casestudytemplate.docxCase # (1, 2, 3 or 4) and Description of the Case Chosen:·Case 1·Case 2·Case 3·Case 4Outline 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.Write the answers to questions posed for chosen case scenario1.2.3.4.5.6.7.NRNP6552week8casescenarios.pdfNRNP6552 Week 8 Case studiesCase 1A 48-year-old Asian American woman is concerned about thin bones. Her mother was diagnosedwith osteoporosis at the age of 50 and fell at the age of 68 and fractured her hip and spent monthsin Rehab before being able to return home. The patient has no history of fractures.The patient presents to the office to have her bones checked to see if she has “thin bones”Patient has no history of previous fractures: Patient states she went through Menopause at theage of 43-44 with no major problems. Patient was diagnosed with hypothyroid at at age 40.Patient does not drink. Smokes 1ppd for 20 yrs. Husband has been out of work for 9 months dueto downsizing at his job. Pt works as an administrative assistant for a publisher but does not havehealth insurance at this time.Pt had a melanoma removed from her left cheek in 2018; No hospitalizations except forchildbirth x2Family history: Paternal Grandmother died at age 78 due to heart disease. Paternal Grandfatherdied at age 83 due to heart attack. Maternal Grandmother died at age 82 cause unknown;Maternal Grandfather died from farm accident at age of 56. Mother is 75 alive with Osteoporosisdiagnosed at age 50 and HTN diagnosed at age 63. Father is 77 alive with HTN diagnosed at age45. Pt has two daughters alive and well with no medical problems.Objective InfoHeight 5’2’ Wt 105 lbs; BMI 19.2; 128/78; HR-72/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA• CV: RRR, no murmurs, rubs or extra sounds noted; 2+ peripheral pulses, no edema noted• Breast: soft, fibrocystic changes bilaterally, without masses, dimpling or discharge• Abd: soft, +BS, no tenderness• MS: Full ROM in spine and shoulders. No tenderness, no spasms• T-Score is -1.2Questions1. What other information do you need2. What other diagnostic tests would be appropriate for this pt?3. Is this patient at high risk or low risk? What are her risk factors4. What other screenings are appropriate for this patient?5. What is the difference between a Z score and a T score?6. What would you include in patient education to prevent further loss of bone? Be specific.Case 2A 46-year-old Caucasian woman presents to the clinic complaining of breast pain. The patient state thepain is intermittent, in the right breast, the pain is sharp and has a burning sensation. She rates the painas 7/10 at it worst. The patient states the pain sometimes interferes with her sexual activity. She hastried warm compresses, ibuprofen, and support bras with little improvement. Pt is on oral birth controlpills and takes a daily vitamin.Soc hx: Pt reports she sometimes eats nutritious meals, but due to her job and family obligations shedoes eat fast food frequently. Pt states she is an assistant accountant at a local accounting firm, whichadds to her stress especially at the end of each month and during tax season. She exercises 1-2times/week by walking around the block. Sometimes the walking causes more pain in her breast. Shedrinks socially once or twice a month and has 1-2 glasses of wine at that time. She smokes 2 packs/dayfor last 22 yrs. She has tried to quit but has not been successful. Family history non-contributory.Objective InfoHeight 5’6” Wt 155 lbs; BMI 25; 140/78; HR-72/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, no murmurs, rubs or extra sounds noted; 2+ peripheral pulses, no edema noted• Breast: Macromastia breasts are soft, fibrocystic changes bilaterally noted without masses,
dimpling or discharge, no redness or inflammation noted.Questions1. What other information do you need?2. Describe the most appropriate way to perform the breast exam on this patient.3. What diagnostic tests would be appropriate for this pt?4. What are the risk factors for this patient?5. What other screenings are appropriate for this patient?6. When would you refer to a breast specialist?
7. What pharmacological and nonpharmacological therapies would you consider for this patient?Case 3A 36-year-old Hispanic woman presents to the OB clinic for her Week 24 check-up, gravida 2para 1. Patient is a full-time homemaker. Pt states she is doing well but is worried about herweight gain. Obstetric history includes a normal spontaneous vaginal delivery (NSVD) 31/2 yrsago with a viable 9 lb male infant after a 10-hour labor. No complications during pregnancy,delivery or postpartum period. She denies allergies to food, drugs or the environment. Currentmeds include Prenatal vitamins 1/day and Fe 90 mg/day. Family history significant only for diet-controlled DM in paternal grandfather and an aunt and obesity in both mother and father.Objective InfoHeight 5’2” Wt 170 lbs; BMI 31.1; 140/84 (sitting); HR-92/min• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, noedema noted• Breast: Soft, fibrocystic changes bilaterally noted without masses, dimpling or discharge,no redness or inflammation noted. Breast self-exam reviewed• GU: Uterus at umbilicus-approximately 24 wks size and non-tender. FHT present withDopplerQuestions1. What other information do you need?2. What diagnostic tests would be appropriate for this pt?3. What are the risk factors for this patient?4. What other screenings are appropriate for this patient?5. What management treatment would be most effective for this patient?6. What are the possible maternal and newborn complications with this health problem?Case 4A 32-year-old African American woman presents to the clinic for her 24-week check-up. Pt statesher morning sickness has resolved. However, she states she seems sad often and does notunderstand why, as she is happy about the pregnancy.HPI: Pt is 24 weeks gestation. The patient is having sad moods at least once a day. She also statesshe is tired all the time, but figures that is just part of being pregnant, but has no energy and doesnot feel like doing her usual daily chores. She finds it difficult to go to work every day. Thismoodiness started about a week ago. She tried going to bed earlier but it did not seem to help.Taking 1 prenatal vitamin every day, No known drug, food, or environmental allergies. Familyhistory is significant only for diet-controlled DM in paternal grandfather with onset in mid 40’s,Mother 58 yrs old is healthy; Father 60 yrs old with hx of DM with onset at age 45 and chronicdepression which began in early 20s.Objective InfoHeight 5’4” Wt 147 lbs; BMI 25.2; 132/78 (sitting); HR-88/min• General: Appears well nourished, hair is in disarray, with flat affect• HEENT:  Normocephalic, no lumps/lesions• Neck: supple without adenopathy , no thyromegaly.• Lungs: Eupneic, CTA-bilaterally• CV: RRR, soft systolic murmur Grade II/VI, no rubs noted; 2+ peripheral pulses, noedema noted• Breast: Soft, enlarged, fibrocystic changes bilaterally noted without masses, dimpling ordischarge, no redness or inflammation noted. Breast self-exam reviewed• GU: Uterus at umbilicus- approximately 24 wks size and non-tender. FHT present withDopplerQuestions1. What other information do you need?2. What diagnostic would be appropriate for this pt?3. What are the risk factors for this patient?4. What other screenings are appropriate for this patient?5. What management treatment would be most effective for this patient?6. What are the possible maternal and newborn complications with this health problem?12Bids(64)Dr. Ellen RMMISS HILLARY A+nicohwilliamDr. Aylin JMSheryl HoganProf Double REmily ClareDr. Sarah BlakeProWritingGurufirstclass tutorDr. Freya WalkerPROF_ALISTERDemi_RoseFiona DavaMUSYOKIONES A+Dr CloverJudithTutorDiscount AssigngrA+de plusDr. Everleigh_JKShow All Bidsother Questions(10)Globalization Argumentative PaperMandatory DiscussionManaging Employees Performance 5Research Proposal Paper for Paula HogI need help with this assignment can someone help me please4x-2=12

what is this translated into wordsIntroduction to Critical Thinking case study for Justice Studies studentsLawDeliverable Length: 1,500–1,750 words Details: Weekly tasks or assignments (Individual or Group Projects) will be due by Monday and late submissions will be assigned a late penalty in accordance with the late penalty policy found in the syllabus. NOTE: Ameasure of crime

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