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Directions: Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references. Mr. D Mr. D is a 90-year-old man who was admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction. Mr. D has a long history of comorbidities including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest. Mr. D tells the physician that he wants all measures taken to save his life. Imagine that you are the nurse assigned to provide care to Mr. D, and address the following: Considering Mr. D's advanced age, what are the benefits/risks associated with providing life-sustaining measures? What factors should you consider based on the Mr. D's age and health history? If Mr. D were your family member, how would you respond to his decision? .
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Consider the scenario below, then follow the instructions undern.docx
Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.
Mr. D
Mr. D is a 90-year-old man who was admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction. Mr. D has a long history of comorbidities including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest. Mr. D tells the physician that he wants all measures taken to save his life.
Imagine that you are the nurse assigned to provide care to Mr. D, and address the following:
Considering Mr. D's advanced age, what are the benefits/risks associated with providing life-sustaining measures?
What factors should you consider based on the Mr. D's age and health history?
If Mr. D were your family member, how would you respond to his decision?
Review the posts made by your classmates and reply to someone expanding on their idea or offering an alternative for consideration.
Please make your initial post by midweek, and respond to at least one other student's post by the end of the week. Please check the Course Calendar for specific due dates.
.
Consider the scenario then follow the instructions underneath.docx
A 90-year-old man, Mr. D, was admitted to the hospital with chest pain and diagnosed with a heart attack. He has a history of health issues including high blood pressure, diabetes, and heart failure. The doctor asked if he wants life-sustaining measures like CPR if his heart stops, and he said yes. As the nurse assigned to his care, there are benefits and risks to consider given his age and conditions. Relevant factors include his prognosis and quality of life. If he was family, his decision may warrant further discussion due to associated burdens and suffering resuscitation could involve.
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Mr. D, a 90-year-old man with a history of health issues including heart disease, was admitted to the hospital after a heart attack. He instructed doctors to perform life-saving measures if his heart stopped, but as his nurse, you have concerns given his age and existing medical conditions. Key factors to consider are the potential benefits and risks of CPR and other interventions for someone elderly with multiple comorbidities, Mr. D's quality of life, and whether aggressive treatment is in his best long-term interests.
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Mr. D, a 90-year-old man with a history of hypertension, diabetes, and congestive heart failure, was admitted to the hospital with nausea, vomiting, left arm pain, and chest pain, and was diagnosed with a myocardial infarction after an electrocardiogram. The physician asked Mr. D if he wanted life-sustaining measures like CPR and mechanical ventilation if he experienced cardiopulmonary arrest, and Mr. D stated he wanted all measures taken to save his life.
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Consider the scenario below, then follow the instructions undern.docx
Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.
Mr. D
Mr. D is a 90-year-old man who was admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction. Mr. D has a long history of comorbidities including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest. Mr. D tells the physician that he wants all measures taken to save his life.
Imagine that you are the nurse assigned to provide care to Mr. D, and address the following:
Considering Mr. D's advanced age, what are the benefits/risks associated with providing life-sustaining measures?
What factors should you consider based on the Mr. D's age and health history?
If Mr. D were your family member, how would you respond to his decision?
Review the posts made by your classmates and reply to someone expanding on their idea or offering an alternative for consideration.
Please make your initial post by midweek, and respond to at least one other student's post by the end of the week. Please check the Course Calendar for specific due dates.
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A 90-year-old man, Mr. D, was admitted to the hospital with chest pain and diagnosed with a heart attack. He has a history of health issues including high blood pressure, diabetes, and heart failure. The doctor asked if he wants life-sustaining measures like CPR if his heart stops, and he said yes. As the nurse assigned to his care, there are benefits and risks to consider given his age and conditions. Relevant factors include his prognosis and quality of life. If he was family, his decision may warrant further discussion due to associated burdens and suffering resuscitation could involve.
Consider the scenario then follow the instructions underneath it.docx
Mr. D, a 90-year-old man with a history of health issues including heart disease, was admitted to the hospital after a heart attack. He instructed doctors to perform life-saving measures if his heart stopped, but as his nurse, you have concerns given his age and existing medical conditions. Key factors to consider are the potential benefits and risks of CPR and other interventions for someone elderly with multiple comorbidities, Mr. D's quality of life, and whether aggressive treatment is in his best long-term interests.
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Mr. D, a 90-year-old man with a history of hypertension, diabetes, and congestive heart failure, was admitted to the hospital with nausea, vomiting, left arm pain, and chest pain, and was diagnosed with a myocardial infarction after an electrocardiogram. The physician asked Mr. D if he wanted life-sustaining measures like CPR and mechanical ventilation if he experienced cardiopulmonary arrest, and Mr. D stated he wanted all measures taken to save his life.
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Mr. D, a 90-year-old man, was admitted to the hospital with chest pain and diagnosed with a heart attack. Given his history of health issues including heart disease and diabetes, the doctor asked if he wanted life-saving measures like CPR if his heart stopped. Mr. D said he wanted all measures taken. As the nurse assigned to his care, you must consider the benefits and risks of life-saving efforts for someone of his age and health conditions, as well as any factors specific to his situation that should influence medical decisions and how you would respond if he were your family member.
Guidelines for write up
The document provides guidelines for writing patient write-ups, including their purpose, structure, and common mistakes to avoid. It recommends the write-up be 3-5 pages long and include sections for source of information, chief complaint, history of present illness, past medical history, family history, social history, review of systems, physical exam, labs, and assessment and plan. For the history of present illness section, it provides detailed instructions on how to construct the topic sentence, chronology, pertinent negatives, and concluding remarks. Common mistakes include omitting pertinent negatives, discussing related complaints separately, using long narrative descriptions, and incomplete assessment and plans.
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This document provides information on cardiovascular disorders and two case studies involving patients presenting with chest discomfort.
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Subjective – The “history” section
HPI: include symptom dimensions, chronological narrative of patient’s complains, information obtained from other sources (always identify source if not the patient).
Pertinent past medical history.
Pertinent review of systems, for example, “Patient has not had any stiffness or loss of motion of other joints.”
Current medications (list with daily dosages).
Objective – The physical exam and laboratory data section
Vital signs including oxygen saturation when indicated.
Focuses physical exam.
All pertinent labs, x-rays, etc. completed at the visit.
Assessment/Problem List – Your assessment of the patient’s problems
Assessment: A one sentence description of the patient and major problem
Problem list: A numerical list of problems identified
All listed problems need to be supported by findings in subjective and objective areas above. Try to take the assessment of the major problem to the highest level of diagnosis that you can, for example, “low back sprain caused by radiculitis involving left 5th LS nerve root.”
Provide at least 2 differential diagnoses for the major new problem identified in your note.
Plan – Your plan for the patient based on the problems you’ve identified
Develop a diagnostic and treatment plan for each differential diagnosis.
Your diagnostic plan may include tests, procedures, other laboratory studies, consultations, etc.
Your treatment plan should include: patient education, pharmacotherapy if any, other therapeutic procedures. You must also address plans for follow-up (next scheduled visit, etc.).
Also see your Bates Guide to Physical Examination for excellent examples of complete H & P and SOAP note formats.
Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved. Page 1
BATES’ VISUAL GUIDE TO PHYSICAL EXAMINATION
OSCE 1: Chest Pain
This video format is designed to help you prepare for objective structured clinical examinations, or
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You are going to observe and participate in a clinical encounter of a patient who comes to the office
with a complaint of chest pain.
As you observe the encounter, you will be asked to answer questions while the image on the screen
freezes. Such questions will allow you to practice history taking and physical examination skills as well as
your clinical reasoning skills in developing an assessment or differential diagnosis and a plan—that is, an
appropriate next diagnostic workup.
You will have time to record your findings and receive feedback.
Health History
Tell me your special concerns today.
I’m a little worried because I have been having sharp pains in my chest for the last two weeks.
What findings might be important to look for as you observe this patient?
Level of distress.
Labored breathing.
Skin color: central and peripheral cyanosis.
Respiratory rate.
Two weeks ago I was reading a story in the paper about a car crash, when I noticed sharp pains in my
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This document summarizes common clinical presentations related to mobility issues, falls, dizziness, and blackouts in elderly patients. It outlines important history, exam findings, and investigations for different causes. Specific conditions discussed include orthostatic hypotension, vertigo including benign paroxysmal positional vertigo (BPPV), and osteoporosis. The role of a multidisciplinary team in developing comprehensive management plans is emphasized. Examples are provided of potential case discussions focusing on problem lists, differential diagnoses, and coordinated care plans.
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The document provides guidance on effective communication techniques for assisting victims of traffic accidents. It begins with introducing the aims of establishing effective communication and learning useful phrases. It then covers procedures for basic and advanced life support, including assessing airways, breathing, circulation, and vital signs. Neurological examinations and exploring patient injuries are discussed. Useful medical terminology and references are also provided.
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The document provides guidance on effective communication techniques for assisting victims of traffic accidents. It begins with introducing the aims of establishing effective communication and learning useful phrases. It then covers procedures for basic and advanced life support, including assessing airways, breathing, circulation, and vital signs. Neurological examinations and exploring the patient's medical history are discussed. The document concludes with references.
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This document discusses coronary artery disease (CAD) and its treatment through angiography. CAD is caused by a buildup of plaque in the coronary arteries that supply the heart with blood. When plaque builds up, it reduces blood flow to the heart and can cause chest pain known as angina. Angiography is a medical imaging technique used to visualize the blood vessels by injecting contrast dye and taking X-rays. It is commonly used to diagnose and develop treatment plans for patients with CAD. The document then provides details on a nursing care plan for managing acute chest pain, one of the most common symptoms of CAD seen in hospitals. The plan includes assessing pain levels, providing comfort measures, administering medications, and educating the patient
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Cardiovascular disease (CVD) refers to conditions that affect the heart or blood vessels. CVD is the leading cause of death globally and can be prevented by addressing behavioral risk factors like smoking, poor diet, obesity, and alcohol use. Long-term stress can increase risk of CVD by raising blood pressure and cholesterol over time. Building social support systems and engaging in regular exercise can help manage stress levels and reduce CVD risk.
Lecture presentation amls_lesson03_cardiovascular
This document provides information on cardiovascular disorders and two case studies involving patients presenting with chest discomfort.
The first case involves an elderly male patient at a nursing home with chest pain and difficulty breathing. After assessment, the patient is diagnosed with a spontaneous pneumothorax.
The second case involves a young male camper with chest pain that has worsened over 36 hours. Additional information reveals recent recreational drug use. Assessment findings include subcutaneous emphysema and early repolarization on ECG. He is diagnosed with pneumomediastinum from increased intrathoracic pressure from holding in marijuana smoke.
Both cases demonstrate use of the AMLS assessment pathway to evaluate patients with chest discomfort and identify differential diagnoses
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Nursing mnemonics provide concise summaries of important clinical information. The document presents three mnemonics: DAD BOND CLASH summarizes the medical management of heart failure in 3 letters; AVPU measures a patient's level of consciousness on a 4-point scale; and SAMPLE is used to obtain a patient's health history by assessing Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading to illness or injury. Mnemonics help nurses accurately and quickly assess patients in different conditions and situations by systematizing important clinical steps and processes.
SOAP Note TemplateSubjective – The history” sectionHPI inc.docx
SOAP Note Template
Subjective – The “history” section
HPI: include symptom dimensions, chronological narrative of patient’s complains, information obtained from other sources (always identify source if not the patient).
Pertinent past medical history.
Pertinent review of systems, for example, “Patient has not had any stiffness or loss of motion of other joints.”
Current medications (list with daily dosages).
Objective – The physical exam and laboratory data section
Vital signs including oxygen saturation when indicated.
Focuses physical exam.
All pertinent labs, x-rays, etc. completed at the visit.
Assessment/Problem List – Your assessment of the patient’s problems
Assessment: A one sentence description of the patient and major problem
Problem list: A numerical list of problems identified
All listed problems need to be supported by findings in subjective and objective areas above. Try to take the assessment of the major problem to the highest level of diagnosis that you can, for example, “low back sprain caused by radiculitis involving left 5th LS nerve root.”
Provide at least 2 differential diagnoses for the major new problem identified in your note.
Plan – Your plan for the patient based on the problems you’ve identified
Develop a diagnostic and treatment plan for each differential diagnosis.
Your diagnostic plan may include tests, procedures, other laboratory studies, consultations, etc.
Your treatment plan should include: patient education, pharmacotherapy if any, other therapeutic procedures. You must also address plans for follow-up (next scheduled visit, etc.).
Also see your Bates Guide to Physical Examination for excellent examples of complete H & P and SOAP note formats.
Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved. Page 1
BATES’ VISUAL GUIDE TO PHYSICAL EXAMINATION
OSCE 1: Chest Pain
This video format is designed to help you prepare for objective structured clinical examinations, or
OSCEs.
You are going to observe and participate in a clinical encounter of a patient who comes to the office
with a complaint of chest pain.
As you observe the encounter, you will be asked to answer questions while the image on the screen
freezes. Such questions will allow you to practice history taking and physical examination skills as well as
your clinical reasoning skills in developing an assessment or differential diagnosis and a plan—that is, an
appropriate next diagnostic workup.
You will have time to record your findings and receive feedback.
Health History
Tell me your special concerns today.
I’m a little worried because I have been having sharp pains in my chest for the last two weeks.
What findings might be important to look for as you observe this patient?
Level of distress.
Labored breathing.
Skin color: central and peripheral cyanosis.
Respiratory rate.
Two weeks ago I was reading a story in the paper about a car crash, when I noticed sharp pains in my
l.
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Dr. Anil Kumar discusses issues faced by the elderly population in rural India and how communities can help address them. He outlines common medical issues like diabetes, hypertension, and injuries. Psychological problems like depression are also discussed. The document then provides strategies for primary prevention, including lifestyle modifications, injury prevention, exercise, and social support. It emphasizes training community health workers to monitor vital signs and provide basic emergency care for issues like hypoglycemia, hypertension, and pneumothorax. The summary concludes by stressing the importance of a community-based approach and national policies to support healthcare for the aging population.
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Dr. Shodhan Patel presented on myths and realities related to prevention of coronary heart disease. Some myths discussed included that CAD only affects wealthy countries, elderly males, and that cholesterol-lowering drugs allow an unhealthy diet. Realities included CAD being common in poor populations, younger adults and females, the harms of trans fats and benefits of exercise. Stress and an unhealthy lifestyle from a young age can increase risk factors for heart disease. Public press can help spread scientific information to help more people make beneficial lifestyle changes for prevention.
Caring for Coronary Artery Disease
Coronary artery disease (CAD), the most common type of heart disease, is a condition where plaque progressively builds up in arteries and restricts adequate blood flow to the heart muscles. Coronary Artery Disease symptoms can include increased chest tightness, pressure, and pain, in addition to pain in the neck, jaw, throat, upper abdomen, and back, and palpitations and fatigue.
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Coronary artery disease (CAD), the most common type of heart disease, is a condition where plaque progressively builds up in arteries and restricts adequate blood flow to the heart muscles. Coronary Artery Disease symptoms can include increased chest tightness, pressure and pain, in addition to pain in the neck, jaw, throat, upper abdomen and back, and palpitations and fatigue.
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The Edge
Hip hop is a musical art form that has a sociopolitical message. The hip hop movement originated in New York in the mid 70s and it early pioneers were African Americans who were members of the lower socioeconomic class. Grandmaster Flash can arguably be recognized as the father of the hip hop. His song
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