Requirements: 1. Using a patient seen in their clinical setting, students will give an oral presentation (via Kaltura) using the 6-step learner-centered SNAPPS model to mimic a real life presentation to the preceptor by: · Briefly summarizing the relative history and findings; · Narrowing the differential to three relevant possibilities using the pertinent positive and negative findings; · Analyzing the differential by comparing and contrasting the possibilities; · Probing the preceptor by asking questions about uncertainties, difficulties, or alternative approaches; · Identifying a treatment plan for the patient; and · Select a case-related issue for self-directed learning 2. In addition to the oral presentation, the student will submit the written findings of their research for the case-related, self-directed learning topic that was identified in the presentation. 3. The written portion of this assignment will be submitted on the “SNAPPS Template for Written Assignment” using appropriate evidence-based, scholarly references and using appropriate APA reference and in-text citations. 4. The oral presentation must be submitted to the Week 5 discussion board before Sunday, 11:59 p.m. MT. The written portion of the assignment must be submitted on the template provided to the assignment box before Sunday, 11:59 p.m. MT.  If any of the required items are missing or are submitted after the deadline, late penalties will be applied according to the Late Assignment Policy as discussion in the Syllabus. Preparing the presentation and paper The oral presentation part of this assignment should be prepared using the following guidelines: · Students will present a patient seen in their clinical setting for a single, problem-focused (acute) visit. · The oral presentation will be recorded and should mimic a presentation that would be given to the preceptor · The oral presentation must be recorded in VoiceThread or Kaltura · The presentation should be a maximum of 5-7min. · The presentation should be shared with the class for viewing by posting a link in the Week 5 discussion board BEFORE Sunday 11:59pm MT. · Students should ensure that the publishing options in VoiceThread are set to allow everyone viewing privileges. · To help organize your data in preparation for the presentation, it is recommended that students use the “SNAPPS TEMPLATE FOR ORAL PRESENTATION”. This document is only a guide and is not required. It should NOT be submitted to the discussion board or assignment box. · Students should refer to the SNAPPS videos in the Week 1 lesson as an example of the oral presentation · As part of the patient presentation, the student must provide the following: 1. Chief complaint with pertinent HPI, ROS and PE findings 2. Identification of the differential 3. An analysis of the differential with arguments for or against each diagnosis ranked in order from most likely to least likely 4. Probing questions that were asked of the preceptor or areas of uncertain.

1. Requirements:
1. Using a patient seen in their clinical setting, students will
give an oral presentation (via Kaltura) using the 6-step learner-
centered SNAPPS model to mimic a real life presentation to the
preceptor by:
· Briefly summarizing the relative history and findings;
· Narrowing the differential to three relevant possibilities using
the pertinent positive and negative findings;
· Analyzing the differential by comparing and contrasting the
possibilities;
· Probing the preceptor by asking questions about uncertainties,
difficulties, or alternative approaches;
· Identifying a treatment plan for the patient; and
· Select a case-related issue for self-directed learning
2. In addition to the oral presentation, the student will submit
the written findings of their research for the case-related, self-
directed learning topic that was identified in the presentation.
3. The written portion of this assignment will be submitted on
the “SNAPPS Template for Written Assignment” using
appropriate evidence-based, scholarly references and using
appropriate APA reference and in-text citations.
4. The oral presentation must be submitted to the Week 5
discussion board before Sunday, 11:59 p.m. MT. The written
portion of the assignment must be submitted on the template
provided to the assignment box before Sunday, 11:59 p.m. MT.
If any of the required items are missing or are submitted after
the deadline, late penalties will be applied according to the Late
Assignment Policy as discussion in the Syllabus.
Preparing the presentation and paper
The oral presentation part of this assignment should be prepared
using the following guidelines:
· Students will present a patient seen in their clinical setting for
a single, problem-focused (acute) visit.

2. · The oral presentation will be recorded and should mimic a
presentation that would be given to the preceptor
· The oral presentation must be recorded in VoiceThread or
Kaltura
· The presentation should be a maximum of 5-7min.
· The presentation should be shared with the class for viewing
by posting a link in the Week 5 discussion board BEFORE
Sunday 11:59pm MT.
· Students should ensure that the publishing options in
VoiceThread are set to allow everyone viewing privileges.
· To help organize your data in preparation for the presentation,
it is recommended that students use the “SNAPPS TEMPLATE
FOR ORAL PRESENTATION”. This document is only a guide
and is not required. It should NOT be submitted to the
discussion board or assignment box.
· Students should refer to the SNAPPS videos in the Week 1
lesson as an example of the oral presentation
· As part of the patient presentation, the student must provide
the following:
1. Chief complaint with pertinent HPI, ROS and PE findings
2. Identification of the differential
3. An analysis of the differential with arguments for or against
each diagnosis ranked in order from most likely to least likely
4. Probing questions that were asked of the preceptor or areas of
uncertainties
5. Novice level plan management (diagnosis, medication,
education and follow-up instructions)
· The student states the self-directed learning topic that they
will investigate further. (NOTE: A self-directed learning topic
is something that you want to know more about that relates to
the condition, but is not the condition itself).
The written portion of this assignment should be prepared using
the following guidelines:
· The student’s findings of the self-directed learning topic must
be completed on the “SNAPPS WRITTEN ASSIGNMENT
TEMPLATE”

3. · The report should be between 5-7 paragraphs in
length, discussing something learned from the student’s
research about the self-directed learning topic.
· Correct grammar, punctuation, and spelling should be
observed.
· In-text citations and reference page should be written in APA
format and scholarly evidence-based medicine (EBM)
references must be used.
SNAPPS WRITTEN ASSIGNMENT TEMPLATE
What is the self-directed learning issue that was identified in
your oral presentation?
Research the self-directed learning issue and provide a summary
of your findings which is fully supported by appropriate,
scholarly, EBM references.

4. REFERENCES
Running head: SNAPPS
1
CASE STUDY: SNAPPS
4

5. SNAPPS PRESENTATION
NR 511
Chamberlain University
Devita Price
June 9, 2019
According to Allan & Arroll (2014), physical interventions
are effective for reducing the risk of spreading or getting Upper
Respiratory Infections (URIs). The authors reached this
conclusion after examining a Cochrane systematic review study
that used sixty-seven studies to establish the effectiveness of
using physical interventions to prevent upper respiratory tract
infections. Among the sixty-seven studies were cluster RCTs,
RCTs, case-control studies, and retrospective and prospective
cohort studies. However, most researchers still recommend
more research to be carried out on the specific interventions to
establish their effectiveness accurately.
URIs can be defined as viral infections that causes
inflammation affecting the nose and throat. Symptoms may last
up to ten days or longer and may cause pandemics. URIs
remain to be the most common medical problems that people
face in their everyday life. It includes infections of the
pharynx, trachea, nose, bronchi, paranasal, and sinuses. The

6. most common symptoms include fever, sneezing, coughing,
sore throat, stuffy , running nose, vomiting, loss of appetite,
and watery eyes. Most URIs have overlapping clinical
presentations, which requires accuracy to be able to determine
the correct mucosal part that has been affected (Allan & Arroll,
2014).
The transmission of URIs takes place through droplet, aerosol,
direct contact with already infected secretions and subsequent
passage to the eyes and nares. Therefore, it can be concluded
that they are most commonly transmitted in crowded places and
that it is possible for many people to become infected at the
same time. As mentioned earlier, they are not very serious
illnesses, but they can cause other medical complications.
Therefore, their treatment is necessary to ensure that they will
not pose any medical threat in the future. There has been
increasing evidence that single measures are not very effective.
In this case, they recommend the use of physical interventions
(Allan & Arroll, 2014).
The physical interventions have various advantages over the
other methods. The first advantage is that they can be instituted
rapidly. These interventions do not necessarily need the
attention of a medical provider to help in their implementation
procedures. They are simple and can be carried out by anyone.
The second advantage is that they are free of any infective
agent. They do not cause any allergic reactions unlike drugs,
which may have effects on some people. Over the counter drugs
may not be very effective and may add to the problem. These
two aspects give the physical interventions an upper hand over
other method (Torner, 2015).
According to Allan & Arroll (2014), physical interventions
include hygienic practices such as handwashing, use of hand-
wipes, masks, gowns, alcohol-based disinfectants, and other
disinfectants. In fact, according to their study, they concluded
that exercising can reduce both the duration and severity of
URIs. Other physical intervention such as isolation, distancing,
barriers proved to be effective. The authors revealed that URIs

7. are more likely to happen during the antigenic shifts in the
virus, which is the changing of a virus to create a new subtype.
These shifts mainly take place when the viruses cross from
animal species to humans. When physical interventions are
used, they interrupt the process and curb the spread from
already infected people.
According to Mukerji (2015), revealed that masks and
respirator interventions are cost-effective when compared to
control measures or none. However, they could not determine
the most cost-effective one between the mask and the respirator
interventions. For that, they recommend more research. Both
mask and respirator interventions are effective in controlling
infection transmissions in community settings and even
healthcare facilities. This translates to the fact that physical
interventions are economically effective compared to medical
interventions in controlling and managing URIs.
References
Allan, G. M., & Arroll, B. (2014). Prevention and treatment of

8. the common cold: making sense of the evidence. Canadian
Medical Association Journal, 186(3), 190-199.
Mukerji, S. (2015). Review of economic evaluations of mask
and respirator use for protection against respiratory infection
transmission. BMC Infectious Diseases, 15(1).
Torner, N. (2015). Effectiveness of non-pharmaceutical
measures in preventing pediatric influenza: a case–control
study. BMC Public Health, 15(1).
SNAPPS ORAL PRESENTATION TEMPLATE
This template should only be used to organize your oral
presentation, IT SHOULD NOT BE SUBMITTED.
SUMMARIZE
Using a patient seen in the practicum setting, summarize the
H&P into an organized and concise format.
CC
Irregular menses, increase fatigue and feeling dizzy when
standing up too fast
HPI statement using OLDCARTS data
24-year old obese African American female presents with a
chief complaint of irregular and heavy menses, increased
fatigue and feeling dizzy when standing up too fast. She does
report that her menses typically last 7 days and heavy on days
2-6 with multiple clots. Her cycles c typically come every 28-30
days. However, she states that recently she has had some
spotting between cycles and states her menses has been coming
increasingly sooner. She is sexually active and denies uterine
pain or pain during intercourse but states she notices spotting
after. She reports that her current form of birth control is
condom usage. Her last menstrual period was 2 weeks ago and
states she is currently spotting. She reports history of Anemia

9. after delivery of her child 2 years ago, that was treated with
OTC iron supplements. She is not currently on any medications.
O--- Irregular period started four months ago, increased fatigue
started one a month ago, feeling dizzy when standing up too fast
started one week ago.
L--- generalized fatigue
D--- some of the symptoms are intermittent (like feeling dizzy
when standing too fast). And some are constant (like the
irregular menses and fatigue).
C--- On day one, there is spotting. On day 2 through day 4, she
states she must wear both a sanitary napkin and tampon and
states she must change both every 1-2 hours, she reports passing
multiple clots during this time. On day 5 and 6, she changes
both sanitary napkin and tampon every 2-4 hours. On day 7,
there is spotting again.
A--- intermittent spotting noted after intercourse.
R—There are no relieving factors noted by the patient at this
time.
T--- There are no identifiable treatments noted by the patient at
this time.
S--- The severity has increased. When the fatigue started, she
was able to function daily and take care of her daughter. Now
she is unable to care for her children without the assistance of
her mother daily. The dizziness
Pertinent ROS
Constitutional: No current fever, chills, or body aches
Respiratory: No symptoms
Gastrointestinal: Denies abd pain, hx of appendix removal
Genitourinary: No symptoms
Hematology/Lymphatics: no swollen lymph glands, Hx of
anemia after baby 2 years ago.
Neurologic: No Headache

10. Pertinent PE
Vitas & Measurements
T: 37.1, HR 90, RR 20, BP 101/52, SpO2 96%, BMI 36.2
GEN: A/O X3 In no acute distress, appears stated age,
overweight
PULM: Clear to auscultation, no retractions
CARDIO: Tachy with Regular rhythm, no Carotid Bruits, PP
equal 2+ x4,
Cap refill less than 3 secs, brittle nails noted with cold
fingertips.
ABD: Non tender, BS qual x4, no CVA tenderness
Neuro/{SYCH: sluggish mood noted, no focal deficits.
NARROW
Based on the H&P key findings, identify an appropriate
differential.
I have narrowed my differential to Anemia secondary to
increase blood loss from heavy menstrual cycle. Next, I will
analyze my differentials to show you why I came to this
conclusion.
ANALYZE
Analyze the differential by comparing and contrasting the
possibilities. Use pertinent positive and negative findings to
argue for or against each diagnosis in your differential. Rank
your diagnoses in order of most likely to least likely.

11. 1. My top differential is Iron Deficiency Anemia. The most
likely cause of this would be to the increase in blood loss over
the past four months. The duration of her symptoms and the fact
that this was a gradual onset with worsening symptoms supports
this differential over the remaining differentials. 12% of women
aged 12 to 49 have iron deficient anemia. Anemia occurs when
there are less red blood cells in the body then needed. Carrying
oxygen to the body tissues, is the job of the red blood cells.
Iron is used by the body to build red blood cells. Low Iron
levels due to blood loss is a common cause of anemia. Heavy
Menstruation puts women at ran increased risk for low iron
levels. Positive signs of anemia fatigue, tachy, pale conjunctiva,
brittle nails.
Negative, no SOB noted
2. Another differential would be Dysfunctional uterine bleeding
due to the increasing heavy bleeding, blood clots, spotting
between periods, shifts in time between periods, and fatigue.
This is caused by an imbalance of the female hormones estrogen
and progesterone. When a menstrual cycle in which no egg is
released, is the most common cause of this. Without an egg, the
body does not produce progesterone causing the lining of the
uterus to thicken by estrogen.
3. Endometriosis can also be a differential due to the heavy
menstrual cycle. However, this seems unlikely as the patient is
not complaining of abdominal pain or pain with intercourse
4. Rarely, Uterine fibroids can also be a differential due to the
bleeding between periods. However, this is also unlikely as the
patient denies abdominal or pelvic pain, pain during
intercourse, or difficulty urinating.
PROBE
Verbalize any knowledge gaps, points of confusion or dilemmas
that you have regarding your understanding of the case by

12. identifying questions that you would (or did) ask your
preceptor.
I was unsure about the actual differentials for this patient as
they all require more testing to be 100% diagnosed. I
questioned my preceptor and she explained how the risk of not
treating the patient for Iron deficiency anemia until the lab
results could be harmful to the patient. The harm to the patient
would be to large when the patient could have already started
treatment.
PLAN
At a novice level, propose an appropriate plan to confirm and/or
manage the problem.
1. Fatigue, increased HR, heavy and irregular menstrual cycle
with dizziness when getting up too fast.
Ordered: Labs---CBC with type and screen, CMP, HCG
-Ferrus sulfate 325mg Daily, Folic acid 1mg daily (will increase
both BID if Hbg lower than 9).
-Abdominal/ trans vaginal Ultrasound
-Referral to OBGYN
Return to the office if symptoms persist. Instructions on rising
slowly and maintaining safelty measures. Go to the nearest ER
of symptoms worsen
SELF-DIRECTED LEARNING
Identify one issue for self-directed learning.
Then knowledge gaps that I had with this patient is treating a
diagnosis that you have no “actual” proof of.
Therefore, I have chosen Iron Deficiency anemia as my self-
directed learning assignment.

13. In the written portion of this assignment, you will present your
findings.