SOC-505 The Family and U.S. Society Worksheet Because family is such a major societal institution, there is a dynamic interplay between family and society. They affect one another. This assignment will help you learn this concept. Complete the worksheet by responding to the following two questions. Cite two to four scholarly sources to support your answers. Your responses should be 450-500 words each and in APA format. A Reference section will be located at the end of each question. Q.1: Describe how changes in the family have affected U.S. society since 1950. Which of those changes have been positive? Which have been negative? Explain. (450-500 words) References: Q.2: Describe how social changes in U.S. society have affected the family since 1950.Which of those changes have been positive? Which have been negative? Explain. (450-500 words) References: © 2017. Grand Canyon University. All Rights Reserved. Patient Initials: C.F Pt. Encounter Number: 1538-20200603-002 Date: 06/03/2020 Age: 69 Sex: F Allergies: NKDA Advanced Directives: FULL CODE SUBJECTIVE CC: 69 years old Hispanic female who presents to the clinic with complaining of Right foot weakness and numbness for nearly 3 weeks and that the foot is difficult to flex. Aching pain reported to bilateral feet and swelling. HPI: Patient with history of Diabetes Mellitus type II insulin dependent for 10 years. Reported some weakness to right foot and numbness for nearly 3 weeks. She states some tenderness to calf and aching pain to feet. Some swelling reported to bilateral lower extremities. She does report that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 20 pounds in the last year. Current Medications: Abilify 5 mg tablet SIG: give 1 tablet (5 mg) by oral route once daily              Amlodipine 10 mg tablet SIG: give 1 tablet (10 mg) by oral route once daily Benztropine 2 mg tablet SIG: give 1 tablet (2 mg) by oral route 2 times per day Depakote 500 mg tablet, delayed release SIG: give 1 tablet (500 mg) by oral route 2 times per day Docusate sodium 100 mg capsule SIG: give 1 capsule (100 mg) by oral route 2 times per day Enteric Coated Aspirin 81 mg tablet, delayed release SIG: give 1 tablet (81 mg) by oral route once daily Ferrous sulfate 325 mg (65 mg iron) tablet SIG: give 1 tablet (325 mg) by oral route once daily Folic acid 1 mg tablet SIG: give 1 tablet (1 mg) by oral route once daily Glipizide 10 mg tablet SIG: give 1 tablet (10 mg) by oral route 2 times per day Glucophage 1,000 mg tablet SIG: give 1 tablet (1000 mg) by oral route 2 times per day Haloperidol 10 mg tablet SIG: give 1 tablet (10 mg) by oral route once daily in the morning Lipitor 20 mg tablet SIG: give 1 tablet (20 mg) by oral route once daily.

1. SOC-505 The Family and U.S. Society Worksheet
Because family is such a major societal institution, there is a
dynamic interplay between family and society. They affect one
another. This assignment will help you learn this concept.
Complete the worksheet by responding to the following two
questions. Cite two to four scholarly sources to support your
answers. Your responses should be 450-500 words each and in
APA format. A Reference section will be located at the end of
each question.
Q.1: Describe how changes in the family have affected U.S.
society since 1950. Which of those changes have been positive?
Which have been negative? Explain. (450-500 words)
References:
Q.2: Describe how social changes in U.S. society have affected
the family since 1950.Which of those changes have been
positive? Which have been negative? Explain. (450-500 words)
References:

2. © 2017. Grand Canyon University. All Rights Reserved.
Patient Initials: C.F
Pt. Encounter Number: 1538-20200603-002
Date: 06/03/2020
Age: 69
Sex: F
Allergies: NKDA
Advanced Directives: FULL CODE
SUBJECTIVE
CC:
69 years old Hispanic female who presents to the clinic with
complaining of Right foot weakness and numbness for nearly 3
weeks and that the foot is difficult to flex. Aching pain reported
to bilateral feet and swelling.
HPI: Patient with history of Diabetes Mellitus type II insulin
dependent for 10 years. Reported some weakness to right foot
and numbness for nearly 3 weeks. She states some tenderness to
calf and aching pain to feet. Some swelling reported to bilateral
lower extremities. She does report that she has been very thirsty
lately and gets up more often at night to urinate. She has
attributed these symptoms to the extremely warm weather and
drinking more water to keep hydrated. She has gained a total of
20 pounds in the last year.
Current Medications:
Abilify 5 mg tablet SIG: give 1 tablet (5 mg) by oral route once
daily
Amlodipine 10 mg tablet SIG: give 1 tablet (10 mg) by oral
route once daily
Benztropine 2 mg tablet SIG: give 1 tablet (2 mg) by oral route
2 times per day

3. Depakote 500 mg tablet, delayed release SIG: give 1 tablet (500
mg) by oral route 2 times per day
Docusate sodium 100 mg capsule SIG: give 1 capsule (100 mg)
by oral route 2 times per day
Enteric Coated Aspirin 81 mg tablet, delayed release SIG: give
1 tablet (81 mg) by oral route once daily
Ferrous sulfate 325 mg (65 mg iron) tablet SIG: give 1 tablet
(325 mg) by oral route once daily
Folic acid 1 mg tablet SIG: give 1 tablet (1 mg) by oral route
once daily
Glipizide 10 mg tablet SIG: give 1 tablet (10 mg) by oral route
2 times per day
Glucophage 1,000 mg tablet SIG: give 1 tablet (1000 mg) by
oral route 2 times per day
Haloperidol 10 mg tablet SIG: give 1 tablet (10 mg) by oral
route once daily in the morning
Lipitor 20 mg tablet SIG: give 1 tablet (20 mg) by oral route
once daily
Lisinopril 10 mg tablet SIG: give 1 tablet (10 mg) by oral route
once daily
Lorazepam 1 mg tablet SIG: give 1 tablet (1 mg) by oral route 2
times per day
Metoprolol tartrate 50 mg tablet SIG: give 1 tablet (50 mg) by
oral route 2 times per day with meals
Sertraline 100 mg tablet SIG: give 2 tablets (200 mg) by oral
route once daily in the morning
Singulair 10 mg tablet give 1 tablet (10 mg) by oral route once
daily in the evening
Toujeo Solostar 300 unit/ml (1.5 ml) subcutaneous insulin pen
SIG: inject 65 units by subcutaneous route once daily
PMH
Schizoaffective disorder with major depression.
DM type II insulin dependent.
COPD with heavy smoker
HTN with CVD

4. Chronic anemia
Hyperlipidemia
Osteoarthritis of multiple sites like cervical and knees
Constipation. GERD
Obese
Sx Hx of cesarean section.
Medication Allergy: NKDA
Medication Intolerances:
None
Chronic Illnesses/Major traumas:
Screening Hx/Immunizations Hx:
Hospitalizations/Surgeries:
Family History:
Type 2 DM present in older brother and maternal grandfather.
Both were diagnosed in their late forties. Brother takes both,
pills and shots.
Mother alive and well
Father has COPD
Two other siblings alive and well
All 2 children are alive and well
A. Surgery History:
C-section 10 years ago.
Health Maintenance:
Flu vaccine 10/2019
Pneumonia 23 06/2018
PCV 13 11/2019
Menarche at age 12

5. Last pap smear 6 years ago
G2PAA0
B. Lifestyle Patterns (include spiritual beliefs, behaviors, and
traditional practices)
Widowed who lives in a single family home
She is Catholic, has not being able to go to church in 2 months
due to COVID-19 virus.
Smokes 1 pack per day. Denies illegal drug uses or alcohol
Does not exercise. Enjoy to watch TV
Social History: The patient has smoked a pack of cigarettes a
day for the past 13 years
ROS
General
The patient denies fever, chills, positive weight gained
Cardiovascular
Denies chest pain, palpitations, and difficulty breathing while
lying down
Skin
No ulcers, no bruises, no redness
Respiratory
Denies a cough, and wheezing. Reported mild SOB with
activity
Eyes
Wears glasses. Denies blurred, double or any loss vision.
Gastrointestinal
Denies nausea, vomiting, abdominal bloating or pain, diarrhea,
or food intolerance, but admits occasional episodes of
constipation
Ears
External ears normal. Ears without pain, hearing lost, ringing or
any discharge
Genitourinary/Gynecological

6. Has experienced increased frequency and volumes of urination,
but denies pain during urination, blood in the urine, or urinary
incontinence
SOAP NOTE
Nose/Mouth/Throat
Oral mucosa moist, denies swallowing issues
Musculoskeletal
Reported leg cramp, weakness and numbness to right leg/foot.
Reported swelling and aching feet
Breast
Unremarkable
Neurological
Has never had a seizure and denies recent headaches.
Heme/Lymph/Endo
No cervical, clavicular, or posterior auricular lymphadenopathy.
Psychiatric
Denies increase of depression symptoms. No hallucination or
suicidal thoughts.
OBJECTIVE
Weight 257.3 LBS BMI 42.1
Temp 97.6
BP 137/81
Height 5’ 5”
Pulse 64
Resp 18
PHYSICAL EXAMINATION
General Appearance
The patient is awake, alert, oriented x3. She is forgetful at
times, but usually keeps very oriented. No acute distress noted.
The patient is using the walker for ambulation, but sometimes
she uses a cane.

7. Skin
The patient has bilateral psoriasis of elbows.
HEENT
Head: Denies blurred, double or any loss vision. Ears without
pain, hearing lost, ringing or any discharge. Nose without
bleeding or discharge. Throat: Mouth and throat without any
acute disorder. Denies hoarseness, difficulty swallowing and
throat or neck pain.
Cardiovascular
S1, S2. Regular rate and rhythm. No murmur. No extra
sounds.
Respiratory
No respiratory distress, no wheezing, no use of accessory
muscles for respiration. Breath sounds normal. SOB in exertion
Gastrointestinal
Abdomen symmetric, soft, non-tender, and non-distended,
bowel sounds presents and normal in all abdominal quadrants,
no hepatosplenomegaly, no abdominal bruits, or mass noted.
Percussion with normal tympanic and dull areas according to
the normal exam. Murphy’s sign negative, no ascites.
Breast
Normal assessment
Genitourinary
No CVA tenderness. No inguinal hernias, no suprapubic pain.
Perineum intact without lesion
Musculoskeletal
The patient is able to move all the extremities, ambulate with
assistive device, but usually very independent. No tremor noted
at this time. Swelling noted to bilateral lower extremities
Neurological
The patient is awake, alert, and oriented x3 as mentioned
before. No cranial nerve deficit noted. No neurofocal
manifestation found during the physical assessment

8. Psychiatric
The patient is very cooperative. No anxiety, no suicidal idea.
She is very calm.
Laboratory/Test:
Triglycerides 235 (H) A1C 6.9
Urinalysis: WNL
EKG: 64 bpm sinus rhythm:
Special Tests: CBC, CMP, A1C, BNP, Lipid panel, Cardiac
Enzymes, U/A, D-DIMER, Thyroid Panel, Liver Panel
EKG, Echocardiogram, Arterial and Venous Doppler, Chest X-
ray, ABI
Diagnosis
Primary Diagnosis:
Diabetes Mellitus Type II with Diabetic Polyneuropathy ICD-
10: E11.42
Symptoms of diabetes mellitus are those of hyperglycemia. The
mild hyperglycemia of early DM is in most of the cases
asymptomatic, delaying the diagnosis of the disease for many
years. Significant hyperglycemia causes glycosuria that leads
to urinary frequency, polyuria, and polydipsia that may progress
to orthostatic hypotension and dehydration. Severe patient
dehydration makes the patient feel weak, fatigue and even could
show symptoms of mental status changes. Disease’s symptoms
could come and go as plasma glucose levels fluctuate.
Polyphagia may accompany hyperglycemia, but, is not typically
the main patient concern. Hyperglycemia is also a possible
cause of weight loss, nausea, vomiting, and blurred vision.
Hyperglycemia could also predispose the patients to infection

9. such as bacterial or fungal. The disease is usually diagnosed by
typical symptoms and signs and confirmed by measurement of
plasma glucose. Measurement after eight to twelve hours fast
(FPG) or two after ingestion of a concentrated glucose solution.
OGTT is more sensitive for diagnosing DM and impaired
glucose tolerance, but, is less convenient and reproducible than
FPG. It is rarely used routinely, except for diagnosing
gestational diabetes and for research purposes as well.
Differential Diagnoses-:
Hansen's Disease (Leprosy) ICD-10 A30.9: Patient can
complain of numbness of affected areas of the skin. Also,
muscle weakness or paralysis, especially in the hands and feet
could be found. Enlarged nerves could be present as well.
Peripheral Artery Disease (PAD) ICD-10 I73.9: The most
common symptoms of PAD involving the lower extremities are
cramping, pain or tiredness in the leg or hip muscles while
walking or climbing stairs. Typically, this pain goes away with
rest and returns when you walk again.
Venous Insufficiency ICD-10I87.2 When your veins have
trouble sending blood from your limbs back to the heart, it’s
known as venous insufficiency. In this condition, blood doesn’t
flow back properly to the heart, causing blood to pool in the
veins in your legs. Symptoms of venous insufficiency include:
swelling of the legs or ankles, weak legs, aching, pain that gets
worse when you stand and gets better when you raise your legs
Heart Failure Unspecified ICD-10 I50.9- Reflected with
swelling to lower extremities, weakness and shortness of breath
in exertion.
A/P
1. Diabetes mellitus, type 2, insulin-dependent, obesity and
polyneuropathy: Will request blood sugar log to monitor blood
sugar level for any adjustment needed in the medication, also
we will continue with the Toujeo. We will continue monitoring
also the hemoglobin A1c for any adjustment needed in the

10. treatment. Oriented the patient to do the foot care to prevent
any skin lesion because of the high risk. Also, we will continue
with oral medication that she had before which is metformin and
Glipizide. We will continue with NCS diet. Encourage portion
control. Will add Gabapentin 300 mg capsule SIG: give 1
capsule (300 mg) by oral route 3 times per day
2. Health maintenance. We discuss treatment with patient. We
will continue monitoring the chronic disease, lab work to
prevent any progression of her disease. We will continue
monitoring the patient compliance with the medications,
especially with the insulin administration. We will continue
monitoring the patient's behavior. We will continue instructing
the patient on fall precaution, how to prevent falls. We will
continue with no-concentrated-sugar, low-sodium, low-fat, low-
cholesterol diet. Will request patient to bring blood sugar log
and b/p and weekly weight reading to next visit (in 2 weeks).
Educated about smoking cessation .
3. Hypertension, coronary artery disease, hyperlipidemia. -
Will continue with current treatment. Will continue using
Cardiology as needed for consultation. We will continue
providing the patient with Lisinopril, metoprolol and
amlodipine and also low sodium diet. So, we will continue
monitoring the patient's lipid panel for any adjustment needed
in the medications in the meantime. We are going to continue
Lipitor 20 mg orally daily for the patient due to the cholesterol
is normal and LFT is WNLs. Low sodium, fat/cholesterol diet.
4. Schizoaffective disorder with major depression: We will
continue current treatment that patient has. We will order psych
evaluation to obtain a base line of the diseases. We will
continue monitoring patient behavior for any adjustment needed
in medication. We will continue monitoring Depakote level,
even when this medication is used as mood stabilizer, just to

11. prevent high dose. We will continue benztropine top prevent
side effects of other antipsychotics.
5. EKG, Echocardiogram, ABI and Chest X- ray and Labs – To
evaluate Heart function and rhythm- ejection fraction- vascular
disease, electrolytes imbalance or deficiencies and check lungs.
Patient Initials:
Pt. Encounter Number:
Date:
Age:
Sex:
Allergies:
Advanced Directives:
SUBJECTIVE
CC:
HPI: Describe the course of the patient’s illness:
Onset:
Location:
Duration:
Characteristics:
Aggravating Factors:
Relieving Factors:
Treatment:
Current Medications:
PMH

12. Medication Intolerances:
Chronic Illnesses/Major traumas:
Screening Hx/Immunizations Hx:
Hospitalizations/Surgeries:
Family History:
Social History:
ROS
General
Cardiovascular
Skin
Respiratory
Eyes
Gastrointestinal
Ears
Genitourinary/Gynecological
Nose/Mouth/Throat

13. Musculoskeletal
Breast
Neurological
Heme/Lymph/Endo
Psychiatric
OBJECTIVE
Weight BMI
Temp
BP
Height
Pulse
Resp
PHYSICAL EXAMINATION
General Appearance
Skin
HEENT
Cardiovascular
Respiratory
Gastrointestinal
Breast
Genitourinary
Musculoskeletal

14. Neurological
Psychiatric
Lab Tests
Special Tests
Diagnosis
· Primary Diagnosis-
Evidence for primary diagnosis should be documented in
your Subjective and
Objective exams.
o Differential Diagnoses- Include three diagnoses
PLAN including education
o Plan:
Further testing
Medication
Education
Non-medication treatments
· Referrals
Follow-up visits
References