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Support with 1 journals no older than 5 years. H. Pylori infection Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection. According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format. ACC/AHA Guidelines Chief complaint: “ I have recurrent H. Pylori infection”. HPI: M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms. PMH: H. Pylori infection gastritis Diabetes Mellitus, type 2 Surgeries: None Allergies: NKDA Vaccination History: She receives an annual flu shot. Last flu shot was this year Social history: High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago. Family history: Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis. ROS: Constitutional: Negative for fever. Negative for chills. Respiratory: No Shortness of breath. No Orthopnea Cardiovascular: No edema. No palpitations. Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain. Skin: No lesions. No rash. No itching. Psychiatric: No anxiety. No depression. Physical examination: Vital Signs Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored HEENT: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: Slow gait but steady. No Kyphosis. SKIN: Dry. Intact. PSYCH: Normal affect. Cooperative. Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal A: Primary Diagnosis: Recurrent H. Pylori infection gastritis Secondary Diagnoses: Dyspepsia Differential Diagnosis: Peptic Ulcer Disease Previous medication plan: two month ...
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Support with 1 journals no older than 5 years.Week 8GI Case .docx
Support with 1 journals no older than 5 years.
Week 8
GI Case Study: H. Pylori infection
Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.
ACC/AHA Guidelines
Chief complaint:
“ I have recurrent H. Pylori infection”.
HPI:
M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD.
She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries: None
Allergies
:
NKDA
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Skin: No lesions. No rash. No itching.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT
: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: Slow gait but steady. No Kyphosis.
SKIN:
Dry. Intact.
PSYCH
: Normal affect. Cooperative.
Labs day of visit
:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
A:
Primary Diagnosis: Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medic ...
Week 8GI Case Study H. Pylori infectionQuestions As an.docx
Week 8
GI Case Study: H. Pylori infection
Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.
ACC/AHA Guidelines
Chief complaint:
“ I have recurrent H. Pylori infection”.
HPI:
M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD.
She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries: None
Allergies
:
NKDA
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Skin: No lesions. No rash. No itching.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT
: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: Slow gait but steady. No Kyphosis.
SKIN:
Dry. Intact.
PSYCH
: Normal affect. Cooperative.
Labs day of visit
:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
A:
Primary Diagnosis: Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medication plan:
two months ago and failed.
Clarithromycin 500 m ...
Discussion QuestionSupport with 1 journals no older than 5 year.docx
Discussion Question:
Support with 1 journals no older than 5 years.
Week 8
GI Case Study: H. Pylori infection
Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.
ACC/AHA Guidelines
Chief complaint: “ I have recurrent H. Pylori infection”.
HPI: M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD.
She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries: None
Allergies: NKDA
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Skin: No lesions. No rash. No itching.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.
SKIN: Dry. Intact.
PSYCH: Normal affect. Cooperative.
Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
A:
Primary Diagnosis: Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medication plan:two months ago and failed.
Clar.
Week 7 Discussion Question Worth 5 pointsFor the following C.docx
Week 7 Discussion Question
Worth 5 points
For the following Case Study, as follow is Discussion Question: As an NP student, needs to determine the medications for constipation.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed for constipation? Write her complete prescriptions using the prescription writing format.
Support with 1 journal no older than 5 years.
Week 7: DISCUSSION QUESTION IN DISCUSSION BOARD
Gastroenterology-Motility Case Study
ACC/AHA Guidelines
Chief complaint: “ I have chronic constipation, incomplete defecation and abdominal bloating” for past 2 years.
HPI: M.C. a 46-year-old hispanic female presents to the GI-Motility clinic for complaint of chronic constipation, incomplete defecation and abdominal bloating. She has pmhx of DM-type 2, IBS-Constipation, Tubular Adenoma.
She also indicates that she has noticed that her symptoms are worsening for past 3 months. She has associated her symptoms with abdominal bloating, straining and incomplete defecation.
She has tried Miralax one packet po daily for at least 8 weeks and it has not relieved her symptoms.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
Diabetes Mellitus, type 2
Constipation, chronic-IBS
Surgeries: None
Allergies: Penicillin
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: + 1 pitting leg edema. + Varicose veins.
Skin: + rash crusted white in feet and inter-digit in feet.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.
SKIN: +Dryness, No open lesions. +Dry crusts in sole of feet. + moist crust in between toes.
PSYCH: Normal affect. Cooperative.
Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0 ...
For the following Case Study, as follow is Discussion Question
For the following Case Study, as follow is Discussion Question: As an NP student, needs to determine the medications for constipation.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed for constipation? Write her complete prescriptions using the prescription writing format.
Support with 1 journal no older than 5 years.
Week 7: DISCUSSION QUESTION IN DISCUSSION BOARD
Gastroenterology-Motility Case Study
ACC/AHA Guidelines
PLEASE USE THIS MEDICATION FOR THE CASE STUDY: LUBIPRISTONE 24 MCG TWO TIMES A DAY.
Case study sample:
Chief complaint:
“ I have chronic constipation, incomplete defecation and abdominal bloating” for past 2 years.
HPI:
M.C. a 46-year-old hispanic female presents to the GI-Motility clinic for complaint of chronic constipation, incomplete defecation and abdominal bloating. She has pmhx of DM-type 2, IBS-Constipation, Tubular Adenoma.
She also indicates that she has noticed that her symptoms are worsening for past 3 months. She has associated her symptoms with abdominal bloating, straining and incomplete defecation.
She has tried Miralax one packet po daily for at least 8 weeks and it has not relieved her symptoms.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
Diabetes Mellitus, type 2
Constipation, chronic-IBS
Surgeries: None
Allergies
:
Penicillin
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: + 1 pitting leg edema. + Varicose veins.
Skin: + rash crusted white in feet and inter-digit in feet.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT
: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: Slow gait but steady. No Kyphosis.
SKIN: +Dryness, No open lesions. +Dry crusts in sole of feet. + moist crust in between toes.
PSYCH
: Normal affect. ...
Surgery case presentation: A 50 year old lady with a lump in the right breast
A 50 year old lady with a lump in the right breast
Case presentation gastrology
during my internship in gastroenterology department i presented the case, chairperson was my beloved sir Prof AHM Rowshan. this is a case about a 20 year old female presented with abdominal pain, fever which was low grade, and weight loss with marked anorexia for few months. the diagnosis was a dilemma. patient was undergone laparoscopic biopsy from intrabdominal enlarged lymph nodes and ultimately the diagnosis was a case of Non-Hodgkin's lymphoma and treated by chemotherapy.
Recommended
Support with 1 journals no older than 5 years.Week 8GI Case .docx
Support with 1 journals no older than 5 years.
Week 8
GI Case Study: H. Pylori infection
Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.
ACC/AHA Guidelines
Chief complaint:
“ I have recurrent H. Pylori infection”.
HPI:
M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD.
She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries: None
Allergies
:
NKDA
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Skin: No lesions. No rash. No itching.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT
: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: Slow gait but steady. No Kyphosis.
SKIN:
Dry. Intact.
PSYCH
: Normal affect. Cooperative.
Labs day of visit
:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
A:
Primary Diagnosis: Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medic ...
Week 8GI Case Study H. Pylori infectionQuestions As an.docx
Week 8
GI Case Study: H. Pylori infection
Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.
ACC/AHA Guidelines
Chief complaint:
“ I have recurrent H. Pylori infection”.
HPI:
M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD.
She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries: None
Allergies
:
NKDA
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Skin: No lesions. No rash. No itching.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT
: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: Slow gait but steady. No Kyphosis.
SKIN:
Dry. Intact.
PSYCH
: Normal affect. Cooperative.
Labs day of visit
:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
A:
Primary Diagnosis: Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medication plan:
two months ago and failed.
Clarithromycin 500 m ...
Discussion QuestionSupport with 1 journals no older than 5 year.docx
Discussion Question:
Support with 1 journals no older than 5 years.
Week 8
GI Case Study: H. Pylori infection
Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.
ACC/AHA Guidelines
Chief complaint: “ I have recurrent H. Pylori infection”.
HPI: M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD.
She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries: None
Allergies: NKDA
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Skin: No lesions. No rash. No itching.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.
SKIN: Dry. Intact.
PSYCH: Normal affect. Cooperative.
Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
A:
Primary Diagnosis: Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medication plan:two months ago and failed.
Clar.
Week 7 Discussion Question Worth 5 pointsFor the following C.docx
Week 7 Discussion Question
Worth 5 points
For the following Case Study, as follow is Discussion Question: As an NP student, needs to determine the medications for constipation.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed for constipation? Write her complete prescriptions using the prescription writing format.
Support with 1 journal no older than 5 years.
Week 7: DISCUSSION QUESTION IN DISCUSSION BOARD
Gastroenterology-Motility Case Study
ACC/AHA Guidelines
Chief complaint: “ I have chronic constipation, incomplete defecation and abdominal bloating” for past 2 years.
HPI: M.C. a 46-year-old hispanic female presents to the GI-Motility clinic for complaint of chronic constipation, incomplete defecation and abdominal bloating. She has pmhx of DM-type 2, IBS-Constipation, Tubular Adenoma.
She also indicates that she has noticed that her symptoms are worsening for past 3 months. She has associated her symptoms with abdominal bloating, straining and incomplete defecation.
She has tried Miralax one packet po daily for at least 8 weeks and it has not relieved her symptoms.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
Diabetes Mellitus, type 2
Constipation, chronic-IBS
Surgeries: None
Allergies: Penicillin
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: + 1 pitting leg edema. + Varicose veins.
Skin: + rash crusted white in feet and inter-digit in feet.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.
SKIN: +Dryness, No open lesions. +Dry crusts in sole of feet. + moist crust in between toes.
PSYCH: Normal affect. Cooperative.
Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0 ...
For the following Case Study, as follow is Discussion Question
For the following Case Study, as follow is Discussion Question: As an NP student, needs to determine the medications for constipation.
According to the ACC/AHA Guidelines, what medication should this patient be prescribed for constipation? Write her complete prescriptions using the prescription writing format.
Support with 1 journal no older than 5 years.
Week 7: DISCUSSION QUESTION IN DISCUSSION BOARD
Gastroenterology-Motility Case Study
ACC/AHA Guidelines
PLEASE USE THIS MEDICATION FOR THE CASE STUDY: LUBIPRISTONE 24 MCG TWO TIMES A DAY.
Case study sample:
Chief complaint:
“ I have chronic constipation, incomplete defecation and abdominal bloating” for past 2 years.
HPI:
M.C. a 46-year-old hispanic female presents to the GI-Motility clinic for complaint of chronic constipation, incomplete defecation and abdominal bloating. She has pmhx of DM-type 2, IBS-Constipation, Tubular Adenoma.
She also indicates that she has noticed that her symptoms are worsening for past 3 months. She has associated her symptoms with abdominal bloating, straining and incomplete defecation.
She has tried Miralax one packet po daily for at least 8 weeks and it has not relieved her symptoms.
Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
Diabetes Mellitus, type 2
Constipation, chronic-IBS
Surgeries: None
Allergies
:
Penicillin
Vaccination History:
She receives an annual flu shot. Last flu shot was this year
Social history:
High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis.
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea
Cardiovascular: + 1 pitting leg edema. + Varicose veins.
Skin: + rash crusted white in feet and inter-digit in feet.
Psychiatric: No anxiety. No depression.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
HEENT
: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: Slow gait but steady. No Kyphosis.
SKIN: +Dryness, No open lesions. +Dry crusts in sole of feet. + moist crust in between toes.
PSYCH
: Normal affect. ...
Surgery case presentation: A 50 year old lady with a lump in the right breast
A 50 year old lady with a lump in the right breast
Case presentation gastrology
during my internship in gastroenterology department i presented the case, chairperson was my beloved sir Prof AHM Rowshan. this is a case about a 20 year old female presented with abdominal pain, fever which was low grade, and weight loss with marked anorexia for few months. the diagnosis was a dilemma. patient was undergone laparoscopic biopsy from intrabdominal enlarged lymph nodes and ultimately the diagnosis was a case of Non-Hodgkin's lymphoma and treated by chemotherapy.
Chief complaint I’m here for a medication refill because I r.docx
Chief complaint:
“I’m here for a medication refill because I ran out of my medicines”.
HPI:
Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH:
Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies
:
Penicillin
Vaccination History:
Up-to-date
Social history:
High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs:
Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT
: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: + Heberden's nodes at the DIP joints, hands. + Crepitus, bilateral .
Pharma Case Study week 8 Chief complaint I’m here for a medi.docx
Pharma Case Study week 8
Chief complaint: “I’m here for a medication refill because I ran out of my medicines”.
HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH: Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies: Penicillin
Vaccination History: Up-to-date
Social history:
High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden's nodes at the DIP joints, hands. + Crepitus, bil ...
Discussion # 13 Discuss the FDA approach for liver safety for .docx
Discussion # 13:
Discuss the FDA approach for liver safety for new drugs.
Support discussion with 1 journal no older than 5 years.
Discussion Question #14
Discuss an advantage and one disadvantage of one non-narcotic drug used for chronic pain syndrome.
Discussion week 15: (Worth 1 point)
Discuss a current issue on a pharmacological agent and your opinion.
Support with 1 peer reviewed journals no older than 5 years.
Discussion #12
CARDIOVASCULAR CASE STUDY
ACC/AHA Guidelines
Chief complaint: medication refill " I ran out of medicines"
HPI: E.D a 65-year-old AA male presents to the clinic for prescription refills. The patient also indicates that she has noticed shortness of breath which started about 4 months ago. The SOB gets worse with exertion, especially when she is walking fast and it is resolved when he is resting. He reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. His symptoms of shortness of breath resolve after sitting upright on 3 pillows. He also has lower leg edema pitting 1+ which started 2 weeks ago. He also indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight stairs, but it resolves after sitting down to rest. He has not tried any over the counter medications at home.
He never filled her prescriptions that he received at her checkup 6 months ago, she did not think it was important.
PMH:
Primary Hypertension
Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies: Penicillin
Vaccination History:
He receives an annual flu shot. Last flu shot was this year
Has not had a Td in over 10 years
Has not had the herpes zoster vaccine
Social history:
High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion.
Respiratory: Shortness of breath with exertion. + Orthopnea
Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Pt sated not taking medications for 6 months - "ran out and did not get refills"
Physical examination:
Vital Signs
Height: 5 feet 1 inches Weight: 163 pounds BMI: 31 obesity, BP 157/87 T 98.0 po P 110 R 22, non-labored
HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS: + Mild Crackles on inspiratory phase no clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without ra.
SOAP NOTEName J.D.Date 03262020Time 200 pmAge 25 .docx
SOAP NOTE
Name: J.D.
Date: 03/26/2020
Time: 2:00 pm
Age: 25 y/o
Sex: F
SUBJECTIVE
CC:
” I have a lot of pain on my left side, in my lower belly”
HPI: J.D. is a 25-year-old white female that came to the office today complaining of pain in her lower abdomen. The patient has always had painful cramps with her periods but this time it is much worse being described as a 6 out of 10 and lasting up to 5 hours. The pain started 2 days ago. The pain is described as more painful cramps. It is debilitating and prevents the patient from performing most daily activities. It is localized in the lower abdominal area, and sometimes radiates down her legs, and to her lower back. The patient uses hot compresses to relieve the pain as Tylenol does not work. The patient also states that she has been feeling nauseous ever since the pain started. She also urinates more frequently and pain on urination. Denies fever, vomiting, or chills.
Medications:
2 Tylenol as needed for her pain
PMH (include-immunization status including Gardisil, GTPLA).
Current or past illnesses: No current or past illnesses
Immunizations: All vaccines updated including flu vaccine and Gardasil.
Allergies: NKDA
Medication Intolerances: None.
Chronic Illnesses/Major traumas: None.
Hospitalizations/Surgeries (include delivery of pregnancies here)
No hospitalizations.
G0P0
Family History
Mother: 49 years old, no significant health problems
Maternal Side: No significant health problems
Father: 50 years old, hypertensive
Paternal Side: no significant health problems
Social History
Patient works full-time as a research assistant at a local university. A full-time student seeking a master’s degree in biochemistry at a local university. Married. Sexually active only with husband. Always uses male condoms as contraceptive device. Does not use recreational drugs, tobacco, or electronic cigarettes. Devout follower of Christianity. Denomination: catholic.
ROS
General Patient denies fever or chills, no weight changes.
Cardiovascular Denies chest pain, or discomfort. Denies palpitations, dyspnea, or orthopnea.
Skin: Denies presences of moles, rash, or itching.
Respiratory: Denies dyspnea, cough, hemoptysis, or pleuritic pains.
Eyes Denies problems or changes in her vision; denies double or blurred vision.
Gastrointestinal Positive for nausea.Denies hemorrhoids, constipation, or diarrhea. No variation in bowel habits. Denies vomiting.
Ears Denies difficulty or changes in his hearing. Denies tinnitus, or discharges.
Genitourinary/Gynecological Menarche 11 years old. Regular menstrual periods starting around the 3rd week of every month. LMP: 03.
Case StudyChief complaint I’m here for a medication refill .docx
Case Study:
Chief complaint:
“I’m here for a medication refill because I ran out of my medicines”.
HPI:
Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH:
Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies
:
Penicillin
Vaccination History:
Up-to-date
Social history:
High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs:
Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT
: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: + Heberden's nodes at the DIP joints, hands. + Crepi.
PATIENT INFORMATIONName Mr. W.S.Age 65-year-oldSex Male.docx
PATIENT INFORMATION
Name: Mr. W.S.
Age: 65-year-old
Sex: Male
Source: Patient
Allergies: None
Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime
PMH: Hypercholesterolemia
Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago.
Surgical History: Appendectomy 47 years ago.
Family History: Father- died 81 does not report information
Mother-alive, 88 years old, Diabetes Mellitus, HTN
Daughter-alive, 34 years old, healthy
Social Hx: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone.
SUBJECTIVE:
Chief complain: “headaches” that started two weeks ago
Symptom analysis/HPI:
The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness. He states that he has been under stress in his workplace for the last month.
Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.
ROS:
CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures.
HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing.
Respiratory: Patient denies shortness of breath, cough or hemoptysis.
Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal
dyspnea.
Gastrointestinal: Denies abdominal pain or discomfort. Denies flatulence, nausea, vomiting or
diarrhea.
Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence.
MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound.
Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus.
Objective Data
CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 0/10.
General appearance: The patient is alert and oriented x 3. No acute distress noted. NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5.
HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membrane.
Case StudyChief complaint I’m here for a medication refi.docx
Case Study
Chief complaint:
“I’m here for a medication refill because I ran out of my medicines”.
HPI:
Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light-headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH:
Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies
:
Penicillin
Vaccination History:
Up-to-date
Social history:
High school graduates married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has a history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has a history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs:
Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT
: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: + Heberden's nodes at the DIP joints, hands. + Crep.
Chief complaint I have recurrent H. Pylori infection”.HP.docx
Chief complaint:
“I have recurrent H. Pylori infection”.
HPI:
M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries:
None
Allergies
:
NKDA
Vaccination History:
Up-to-date
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis. Mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea.
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
Labs day of visit
:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
Assessment:
Primary Diagnosis:
Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medication plan:
two months ago and
failed.
Clarithromycin 500 mg po BID for 2 weeks
Omeprazole 40 mg po BID for 2 weeks and then po daily.
Cipro 500 mg po BID for 2 weeks
Plan: Tests
Pt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results.
Urea breath test 8 weeks after treatment with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test.
Labs:
No new labs are needed.
Referrals
: may refer based on effect of medication therapy given for 2 weeks.
Follow up:
return to office in 8 weeks to reevaluate symptoms.
As a future nurse practitioner, it is important that you determine the medications used for recurrent H. Pylori infection.
Please discuss new therapy guidelines for H. Pylori treatment, and provide patient education.
Below is the website for the
American Academy of Gastroenterology Clinical Guidelines (ACG) for the updated H. Pylori therapy. Feel free to consult other peer-reviewed articles within 5 years of publication.
Follow APA guidelines
ht.
Case Write Up Surgical Gastric Carcinoma
Patient presented with 5 months history of progressive abdominal pain associated with per rectal bleeding and early satiety for 1 month duration.
Digital Clinical Experience Comprehensive (Head-to-Toe) Physi.docx
Digital Clinical Experience: Comprehensive (Head-to-Toe) Physical Assessment
Week 9 SOAP NOTE
Doris Ofodile
Walden University
Nurs 6512
Advanced Health Assessment & Diagnostic Reasoning
Dr Kristin Curcio
July 31st, 2022
Patient Initials: T.J Age: 28 Gender: Female
SUBJECTIVE DATA:
Chief Complaint (CC): " I came in because I'm required to have a recent physical exam for the
health insurance at my new job"
History of Present Illness (HPI): Miss Jones is currently employed by Smith, Steven, Stewart,
Silver & Company. Before she begins work, a pre-employment physical must be completed.
Despite having a history of type 2 diabetes, in which she is able to control it by taking metformin,
dieting, and doing physical activity. For the past 4-5 months, she has been compliant with
metformin. By eating yogurt, Metformin has no longer caused any side effects for her. The last
time she saw a doctor was for her gynecology appointment four months ago in which the doctor
prescribed oral birth control pills to her after she was diagnosed with the polycystic ovarian
syndrome. Although, according to her, she is in good health and does not have any acute health
issues, or stressful events, and is looking forward to starting her new job.
Medications: Metformin 850mg PO BID, the last dose taken this morning.
Fluticasone propionate (Flovent) was 110 milligrams twice daily.( taken last in
Albuterol (Proventil) 90mcg 2 puffs every four hours PRN.( taken three months )
Drospirenone/ethinyl estradiol (dosage unknown). It was taken this morning.
Tylenol 500 mg PO PRN for headache, medication was taken last week.
Ibuprofen 600mg PO TID PRN to alleviate period cramps, was taken six weeks ago.
Zantac was taken for GERD (completed)
Tetracycline was taken because of acne (completed)
Allergies: Miss Jones is allergic to penicillin which causes an allergic reaction characterized by
hives and a rash. She is also allergic to cats and dust which triggers an asthma attack causing her to
itch, wheeze and sneeze. She denies allergic reactions to latex and foods.
Past Medical History (PMH): During her second and a half years of life, Miss Jones was
diagnosed with asthma. Her medication regimen includes Proventil and Flovent.
A diagnosis of diabetes was made at the age of twenty-four. Metformin is the medication she uses
to manage her diabetes, but she had trouble complying because she had side effects like gassiness,
which was later relieved with yogurt. As a result, she is better able to monitor her blood sugar
levels daily, which last read at 90. The patient also reports losing 10 pounds in four months. Also,
she reported that she slipped and hit her right foot, resulting in a healed wound.
At the age of 28, she was diagnosed with the polycystic ovarian syndrome which she manages by
taking birth control pills. Miss Jone’s menstrual cycle flows for five days and is regular. No
Sexually transmitted diseases or pregnancies have been reported.
At 38.
Clinical meeting on Lobar Pneumonia.pptx
A clinical meeting on Lobar Pneumonia. The patient was admitted & treated in Pulmonology Department of BSMMU
Read The Death Disk and retell the story in 8 to 12 unreal conditi.docx
Read "The Death Disk" and retell the story in 8 to 12 unreal conditional sentences. Becuase the story is in the past, conditions and results will be in unreal conditional past form. 1) Tell the whole story, focusing on the most important info. Additonal Info: 1) USE past unreal conditional form (condition: had(n't) + V3/ Result: would(n't) +have+V3) 2) USE at least 5 AFFIRMATIVE VERBS and 5 NEGATIVE VERBS.
.
Read the articles Double Duty Schools as Community Centers an.docx
Read the articles
Double Duty: Schools as Community Centers
and
Community Collaboration to Improve Schools: Introducing a New Model from Ohio
. Select one of the following position statements:
Statement 1:
Schools are local institutions, central to the life of the community.
Statement 2:
Schools are government agencies, controlled and directed by political interests and power.
Evaluate and discuss the selected position statement in relation to
The issues and trends driving policy and reform
The significance of activism
Public confidence in education
Accountability within the school and community
Support your writing with information from a minimum of two credible resources. One resource should provide information from a related current event or recent legislation. (250 words)
Read the article
School Boards
. Identify and describe the role of governing or advisory board in effective implementation and operation of a federally mandated education policy (or program), including:
Resource management (including personnel)
Allocation of federally appropriated funds
Communication with the community
Support your description with information from a minimum of one credible resource. Respond to at least two of your classmates’ postings. (250 words)
.
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Chief complaint I’m here for a medication refill because I r.docx
Chief complaint:
“I’m here for a medication refill because I ran out of my medicines”.
HPI:
Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH:
Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies
:
Penicillin
Vaccination History:
Up-to-date
Social history:
High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs:
Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT
: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: + Heberden's nodes at the DIP joints, hands. + Crepitus, bilateral .
Pharma Case Study week 8 Chief complaint I’m here for a medi.docx
Pharma Case Study week 8
Chief complaint: “I’m here for a medication refill because I ran out of my medicines”.
HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH: Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies: Penicillin
Vaccination History: Up-to-date
Social history:
High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden's nodes at the DIP joints, hands. + Crepitus, bil ...
Discussion # 13 Discuss the FDA approach for liver safety for .docx
Discussion # 13:
Discuss the FDA approach for liver safety for new drugs.
Support discussion with 1 journal no older than 5 years.
Discussion Question #14
Discuss an advantage and one disadvantage of one non-narcotic drug used for chronic pain syndrome.
Discussion week 15: (Worth 1 point)
Discuss a current issue on a pharmacological agent and your opinion.
Support with 1 peer reviewed journals no older than 5 years.
Discussion #12
CARDIOVASCULAR CASE STUDY
ACC/AHA Guidelines
Chief complaint: medication refill " I ran out of medicines"
HPI: E.D a 65-year-old AA male presents to the clinic for prescription refills. The patient also indicates that she has noticed shortness of breath which started about 4 months ago. The SOB gets worse with exertion, especially when she is walking fast and it is resolved when he is resting. He reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. His symptoms of shortness of breath resolve after sitting upright on 3 pillows. He also has lower leg edema pitting 1+ which started 2 weeks ago. He also indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight stairs, but it resolves after sitting down to rest. He has not tried any over the counter medications at home.
He never filled her prescriptions that he received at her checkup 6 months ago, she did not think it was important.
PMH:
Primary Hypertension
Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies: Penicillin
Vaccination History:
He receives an annual flu shot. Last flu shot was this year
Has not had a Td in over 10 years
Has not had the herpes zoster vaccine
Social history:
High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion.
Respiratory: Shortness of breath with exertion. + Orthopnea
Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Pt sated not taking medications for 6 months - "ran out and did not get refills"
Physical examination:
Vital Signs
Height: 5 feet 1 inches Weight: 163 pounds BMI: 31 obesity, BP 157/87 T 98.0 po P 110 R 22, non-labored
HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS: + Mild Crackles on inspiratory phase no clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without ra.
SOAP NOTEName J.D.Date 03262020Time 200 pmAge 25 .docx
SOAP NOTE
Name: J.D.
Date: 03/26/2020
Time: 2:00 pm
Age: 25 y/o
Sex: F
SUBJECTIVE
CC:
” I have a lot of pain on my left side, in my lower belly”
HPI: J.D. is a 25-year-old white female that came to the office today complaining of pain in her lower abdomen. The patient has always had painful cramps with her periods but this time it is much worse being described as a 6 out of 10 and lasting up to 5 hours. The pain started 2 days ago. The pain is described as more painful cramps. It is debilitating and prevents the patient from performing most daily activities. It is localized in the lower abdominal area, and sometimes radiates down her legs, and to her lower back. The patient uses hot compresses to relieve the pain as Tylenol does not work. The patient also states that she has been feeling nauseous ever since the pain started. She also urinates more frequently and pain on urination. Denies fever, vomiting, or chills.
Medications:
2 Tylenol as needed for her pain
PMH (include-immunization status including Gardisil, GTPLA).
Current or past illnesses: No current or past illnesses
Immunizations: All vaccines updated including flu vaccine and Gardasil.
Allergies: NKDA
Medication Intolerances: None.
Chronic Illnesses/Major traumas: None.
Hospitalizations/Surgeries (include delivery of pregnancies here)
No hospitalizations.
G0P0
Family History
Mother: 49 years old, no significant health problems
Maternal Side: No significant health problems
Father: 50 years old, hypertensive
Paternal Side: no significant health problems
Social History
Patient works full-time as a research assistant at a local university. A full-time student seeking a master’s degree in biochemistry at a local university. Married. Sexually active only with husband. Always uses male condoms as contraceptive device. Does not use recreational drugs, tobacco, or electronic cigarettes. Devout follower of Christianity. Denomination: catholic.
ROS
General Patient denies fever or chills, no weight changes.
Cardiovascular Denies chest pain, or discomfort. Denies palpitations, dyspnea, or orthopnea.
Skin: Denies presences of moles, rash, or itching.
Respiratory: Denies dyspnea, cough, hemoptysis, or pleuritic pains.
Eyes Denies problems or changes in her vision; denies double or blurred vision.
Gastrointestinal Positive for nausea.Denies hemorrhoids, constipation, or diarrhea. No variation in bowel habits. Denies vomiting.
Ears Denies difficulty or changes in his hearing. Denies tinnitus, or discharges.
Genitourinary/Gynecological Menarche 11 years old. Regular menstrual periods starting around the 3rd week of every month. LMP: 03.
Case StudyChief complaint I’m here for a medication refill .docx
Case Study:
Chief complaint:
“I’m here for a medication refill because I ran out of my medicines”.
HPI:
Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH:
Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies
:
Penicillin
Vaccination History:
Up-to-date
Social history:
High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs:
Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT
: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: + Heberden's nodes at the DIP joints, hands. + Crepi.
PATIENT INFORMATIONName Mr. W.S.Age 65-year-oldSex Male.docx
PATIENT INFORMATION
Name: Mr. W.S.
Age: 65-year-old
Sex: Male
Source: Patient
Allergies: None
Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime
PMH: Hypercholesterolemia
Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago.
Surgical History: Appendectomy 47 years ago.
Family History: Father- died 81 does not report information
Mother-alive, 88 years old, Diabetes Mellitus, HTN
Daughter-alive, 34 years old, healthy
Social Hx: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone.
SUBJECTIVE:
Chief complain: “headaches” that started two weeks ago
Symptom analysis/HPI:
The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness. He states that he has been under stress in his workplace for the last month.
Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.
ROS:
CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures.
HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing.
Respiratory: Patient denies shortness of breath, cough or hemoptysis.
Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal
dyspnea.
Gastrointestinal: Denies abdominal pain or discomfort. Denies flatulence, nausea, vomiting or
diarrhea.
Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence.
MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound.
Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus.
Objective Data
CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 0/10.
General appearance: The patient is alert and oriented x 3. No acute distress noted. NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5.
HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membrane.
Case StudyChief complaint I’m here for a medication refi.docx
Case Study
Chief complaint:
“I’m here for a medication refill because I ran out of my medicines”.
HPI:
Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light-headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.
She started taking her medications but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.
PMH:
Primary Hypertension, Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies
:
Penicillin
Vaccination History:
Up-to-date
Social history:
High school graduates married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.
Family history:
Both parents are alive. Father has a history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has a history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Non-contributory.
Physical examination:
Vital Signs:
Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored
HEENT
: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease.
NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS
: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART
: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally.
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL
: + Heberden's nodes at the DIP joints, hands. + Crep.
Chief complaint I have recurrent H. Pylori infection”.HP.docx
Chief complaint:
“I have recurrent H. Pylori infection”.
HPI:
M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries:
None
Allergies
:
NKDA
Vaccination History:
Up-to-date
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis. Mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea.
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
Labs day of visit
:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
Assessment:
Primary Diagnosis:
Recurrent H. Pylori infection gastritis
Secondary Diagnoses:
Dyspepsia
Differential Diagnosis:
Peptic Ulcer Disease
Previous medication plan:
two months ago and
failed.
Clarithromycin 500 mg po BID for 2 weeks
Omeprazole 40 mg po BID for 2 weeks and then po daily.
Cipro 500 mg po BID for 2 weeks
Plan: Tests
Pt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results.
Urea breath test 8 weeks after treatment with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test.
Labs:
No new labs are needed.
Referrals
: may refer based on effect of medication therapy given for 2 weeks.
Follow up:
return to office in 8 weeks to reevaluate symptoms.
As a future nurse practitioner, it is important that you determine the medications used for recurrent H. Pylori infection.
Please discuss new therapy guidelines for H. Pylori treatment, and provide patient education.
Below is the website for the
American Academy of Gastroenterology Clinical Guidelines (ACG) for the updated H. Pylori therapy. Feel free to consult other peer-reviewed articles within 5 years of publication.
Follow APA guidelines
ht.
Case Write Up Surgical Gastric Carcinoma
Patient presented with 5 months history of progressive abdominal pain associated with per rectal bleeding and early satiety for 1 month duration.
Digital Clinical Experience Comprehensive (Head-to-Toe) Physi.docx
Digital Clinical Experience: Comprehensive (Head-to-Toe) Physical Assessment
Week 9 SOAP NOTE
Doris Ofodile
Walden University
Nurs 6512
Advanced Health Assessment & Diagnostic Reasoning
Dr Kristin Curcio
July 31st, 2022
Patient Initials: T.J Age: 28 Gender: Female
SUBJECTIVE DATA:
Chief Complaint (CC): " I came in because I'm required to have a recent physical exam for the
health insurance at my new job"
History of Present Illness (HPI): Miss Jones is currently employed by Smith, Steven, Stewart,
Silver & Company. Before she begins work, a pre-employment physical must be completed.
Despite having a history of type 2 diabetes, in which she is able to control it by taking metformin,
dieting, and doing physical activity. For the past 4-5 months, she has been compliant with
metformin. By eating yogurt, Metformin has no longer caused any side effects for her. The last
time she saw a doctor was for her gynecology appointment four months ago in which the doctor
prescribed oral birth control pills to her after she was diagnosed with the polycystic ovarian
syndrome. Although, according to her, she is in good health and does not have any acute health
issues, or stressful events, and is looking forward to starting her new job.
Medications: Metformin 850mg PO BID, the last dose taken this morning.
Fluticasone propionate (Flovent) was 110 milligrams twice daily.( taken last in
Albuterol (Proventil) 90mcg 2 puffs every four hours PRN.( taken three months )
Drospirenone/ethinyl estradiol (dosage unknown). It was taken this morning.
Tylenol 500 mg PO PRN for headache, medication was taken last week.
Ibuprofen 600mg PO TID PRN to alleviate period cramps, was taken six weeks ago.
Zantac was taken for GERD (completed)
Tetracycline was taken because of acne (completed)
Allergies: Miss Jones is allergic to penicillin which causes an allergic reaction characterized by
hives and a rash. She is also allergic to cats and dust which triggers an asthma attack causing her to
itch, wheeze and sneeze. She denies allergic reactions to latex and foods.
Past Medical History (PMH): During her second and a half years of life, Miss Jones was
diagnosed with asthma. Her medication regimen includes Proventil and Flovent.
A diagnosis of diabetes was made at the age of twenty-four. Metformin is the medication she uses
to manage her diabetes, but she had trouble complying because she had side effects like gassiness,
which was later relieved with yogurt. As a result, she is better able to monitor her blood sugar
levels daily, which last read at 90. The patient also reports losing 10 pounds in four months. Also,
she reported that she slipped and hit her right foot, resulting in a healed wound.
At the age of 28, she was diagnosed with the polycystic ovarian syndrome which she manages by
taking birth control pills. Miss Jone’s menstrual cycle flows for five days and is regular. No
Sexually transmitted diseases or pregnancies have been reported.
At 38.
Clinical meeting on Lobar Pneumonia.pptx
A clinical meeting on Lobar Pneumonia. The patient was admitted & treated in Pulmonology Department of BSMMU
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Read The Death Disk and retell the story in 8 to 12 unreal conditi.docx
Read "The Death Disk" and retell the story in 8 to 12 unreal conditional sentences. Becuase the story is in the past, conditions and results will be in unreal conditional past form. 1) Tell the whole story, focusing on the most important info. Additonal Info: 1) USE past unreal conditional form (condition: had(n't) + V3/ Result: would(n't) +have+V3) 2) USE at least 5 AFFIRMATIVE VERBS and 5 NEGATIVE VERBS.
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Read the articles Double Duty Schools as Community Centers an.docx
Read the articles
Double Duty: Schools as Community Centers
and
Community Collaboration to Improve Schools: Introducing a New Model from Ohio
. Select one of the following position statements:
Statement 1:
Schools are local institutions, central to the life of the community.
Statement 2:
Schools are government agencies, controlled and directed by political interests and power.
Evaluate and discuss the selected position statement in relation to
The issues and trends driving policy and reform
The significance of activism
Public confidence in education
Accountability within the school and community
Support your writing with information from a minimum of two credible resources. One resource should provide information from a related current event or recent legislation. (250 words)
Read the article
School Boards
. Identify and describe the role of governing or advisory board in effective implementation and operation of a federally mandated education policy (or program), including:
Resource management (including personnel)
Allocation of federally appropriated funds
Communication with the community
Support your description with information from a minimum of one credible resource. Respond to at least two of your classmates’ postings. (250 words)
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Read the article,complete three two-page
response papers.
And follow the question write the paper.
Peter Singer,
One World: The Ethics of Globalization
(New Haven: Yale University Press, 2002), Chapter 2:
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Read the article, Organizational life cycles and shifting criteria .docx
Read the article, “Organizational life cycles and shifting criteria of effectiveness: Some preliminary evidence”. Describe the chronicle of life cycle change and the early stages of development, performance and resource acquisition, events leading to later stages of development, and the development of the formalization and control stage. Why do you think the author wrote about this topic? Why is it important?
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Read the 4 readings:
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Oedipus
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Macbeth
by William Shakespeare, and
Tracks
by Louise Erdrich.
Annotate the plays
Create 16 Journal Entries for each play with TEXT I LIKE=QUOTATION and WHY I LIKE IT=UNPACKING
The journal can be configured any way you choose. To get all the points, the journal has 16 more quotations per reading with page or line numbers. All Readings are clearly identified with the play's title and the author's name.
Medea
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read talking trash by andy rooneyDiscussion Topic 1. Talking .docx
read "talking trash" by andy rooney
Discussion Topic 1. “Talking Trash” and/or “The Singer
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Pick one of the two essays we’re reading this week to focus on. Tell us the following:
(1) What is the writer’s thesis?
(2) How does he support it (logic, evidence, etc.)?
(3) In a
TSIS
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National Counterterrorism Center Web site
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After reading this piece, complete the following:
Define (that is, "operationalize") the concepts of
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Do differences in these terms matter?
How might either be easier—or more difficult—to share with other agencies?
Also consider if some levels of government or sectors of society might be more or less amenable to sharing information. (For example, private sector entities that own and operate critical infrastructure upon which the nation or communities rely might hesitate to share proprietary information that makes them less competitive, economically. Is their reluctance reasonable?)
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For each of these challenges, use or dispute at least 2 of Travers’ main arguments that he makes in his paper to explain or justify these challenges.
Make certain to connect Travers’ arguments to the report’s challenges that you select.
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Read the article listed and write a paper (minimum 750 words) using .docx
Read the article listed and write a paper (minimum 750 words) using APA standards, that answers the questions below.
McKinlay, John B., Lin, Ting, Freund, Karen, & Moskowitz, Mark. (2002).
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Journal of Health and Social Behavior, 43
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What is the social problem the researchers are investigating?
What is the research method (i.e.: survey, participant observation, experiment, secondary sources) used by the researchers?
What were the results or findings of the research?
What do you think would be a good solution to the social problem?
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Read the article and do all the following please.Include the fol.docx
Read the article and do all the following please.
Include the following 3 components in your Journal Article Review:
Reference
Reference article in proper APA format
Summary
Define the general subject/problem/research areas, the scope (what the author intends to discuss and why), and the central idea.
Summarize the author’s major findings and conclusions.
Strengths & Weaknesses
Analyze the various parts of the article thoughtfully and carefully so that you can establish its strengths and weaknesses. Considering both strengths and weaknesses allows you to explore the article more thoroughly and evaluate it more persuasively by presenting a balanced view.
Conclusion
Provide your thoughts regarding the journal article and the study findings.
Passing Criteria:
must successfully complete
ALL
of the following criteria to “Pass”:
Journal Article Review contains
each
of the following headings:
Reference
Reference citation must be in proper APA format
Summary
Strengths & Weaknesses
Conclusion
Article reviewed comes from a peer reviewed journal
Journal Article Review submitted on time
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Read Developmental Assets.(below) Count the number of Assets.docx
Read
Developmental Assets
.(below) Count the number of "Assets" you have experienced as a child (note that some assets are related to the child's internal attitudes and behaviors and others assets are related to external elements of the child's world). After you count your experienced assets, post your number of assets and your reaction to your selected assets
Attachment********************
40 Developmental Assets
How Many Have You Experienced?
Asset Name & Definition
Support
Family support
Family life provides high levels of love and support.
Positive family communication
Young person and her or his parent(s) communicate positively, and young person is willing to seek advice and counsel from parent(s).
Other adult relationships
Young person receives support from three or more nonparent adults.
Caring neighborhood
Young person experiences caring neighbors.
Caring school climate
School provides a caring, encouraging environment.
Parent involvement in schooling
Parent(s) are actively involved in helping young person succeed in school.
Empowerment
Community values youth
Young person perceives that adults in the community value youth.
Youth as resources
Young people are given useful roles in the community.
Service to others
Young person serves in the community one hour or more per week.
Safety
Young person feels safe at home, at school, and in the neighborhood.
Boundaries and Expectations
Family boundaries
Family has clear rules and consequences, and monitors the young person's whereabouts.
School boundaries
School provides clear rules and consequences.
Neighborhood boundaries
Neighbors take responsibility for monitoring young people's behavior.
Adult role models
Parent(s) and other adults model positive, responsible behavior.
Positive peer influence
Young person's best friends model responsible behavior.
High expectations
Both parent(s) and teachers encourage the young person to do well.
Constructive Use of Time
Creative activities
Young person spends three or more hours per week in lessons or practice in music, theater, or other arts.
Youth programs
Young person spends three or more hours per week in sports, clubs, or organizations at school and/or in community organizations.
Religious community
Young person spends one hour or more per week in activities in a religious institution.
Time at home
Young person is out with friends "with nothing special to do" two or fewer nights per week.
Commitment to Learning
Achievement motivation
Young person is motivated to do well in school.
School engagement
Young person is actively engaged in learning.
Homework
Young person reports doing at least one hour of homework every school day.
Bonding to school
Young person cares about her or his school.
Reading for pleasure
Young person reads for pleasure three or more hours per week.
Positive Values
Caring
Young person places hig.
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the assignment is basically you Telling the students the main importance of each time period. Read the directions in the attached document
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Read it carefully!!!1. 3-5 typed pages double-spaced. 2. ci.docx
Read it carefully!!!
1. 3-5 typed pages double-spaced.
2. citing this textbook (no online research)
3. Make sure to have a thesis statement and use examples from images that i attached.
4. Make sure you include examples from the majority of chapters covered.
5. no plagiarism.
6. Here are the topics
Describe the development of depicting the human form from Paleolithic art through the arts of Ancient near-East, Ancient Egypt, the Aegean and Greek cultures.
Think about how humans are represented and what functions representation of humans have served. Is there in fact a clear “development”?
7.
Here is examples for citation. (use only this contents what i wrote on this question and should see and use the picture what i uploaded)
1. PALEOLITHIC and NEOLITHIC
-PALEOLISTHIC (OLD STONE AGE) ART, ca. 30,000–9000 BCE
VENUS OF WILLENDORF The composite feline-human from Germany is exceptional for the Stone Age. The vast majority of prehistoric sculptures depict either animals or humans. In the earliest art, humankind consists almost exclusively of women as opposed to men, and the painters and sculptors almost invariably showed them nude, although scholars generally assume that during the Ice Age both women and men wore garments covering parts of their bodies. When archaeologists first discovered Paleolithic statuettes of women, they dubbed them “Venuses,” after the Greco-Roman goddess of beauty and love, whom artists usually depicted nude (FIG. 5-62). The nickname is inappropriate and misleading. It is doubtful that the Old Stone Age figurines represented deities of any kind. One of the oldest and the most famous of the prehistoric female figures is the tiny limestone figurine of a woman that long has been known as the Venus of Willendorf (FIG. 1-5) after its findspot in Austria. Its cluster of almost ball-like shapes is unusual, the result in part of the sculptor’s response to the natural shape of the stone selected for carving. The anatomical exaggeration has suggested to many that this and similar statuettes served as fertility images. But other Paleolithic stone women of far more slender proportions exist, and the meaning of these images is as elusive as everything else about Paleolithic Paleolithic Art 3 1-4 Human with feline head, from Hohlenstein-Stadel, Germany, ca. 30,000–28,000 BCE. Mammoth ivory, 11 5 – 8 high. Ulmer Museum, Ulm. One of the oldest known sculptures is this large ivory figure of a human with a feline head. It is uncertain whether the work depicts a composite creature or a human wearing an animal mask. 1-5 Nude woman (Venus of Willendorf ), from Willendorf, Austria, ca. 28,000–25,000 BCE. Limestone, 4 1 – 4 high. Naturhistorisches Museum,Vienna. The anatomical exaggerations in this tiny figurine from Willendorf are typical of Paleolithic representations of women, whose child-bearing capabilities ensured the survival of the species. 1 in. 1 in. 73558_02_Ch01_p001-015.qxd 10/20/08 8:10 AM Page 3 art. Yet the prepondera.
Read Lilienfeld, S. O., Waldman, I. D., Landfield, K., Watts, A. L..docx
Read: Lilienfeld, S. O., Waldman, I. D., Landfield, K., Watts, A. L., Rubenzer, S., & Faschingbauer, T. R. (2012). Fearless dominance and the U.S. presidency: Implications of psychopathic personality traits for successful and unsuccessful political leadership.
Journal of Personality and Social Psychology
,
103
(3), 489-505.
http://library.gcu.edu:2048/login?url=http://search.ebscohost.com.library.gcu.edu:2048/login.aspx?direct=true&db=pdh&AN=2012-19403-001&site=ehost-live&scope=site
Read: van Eeden, R., Cilliers, F., & van Deventer, V. (2008). Leadership styles and associated personality traits: Support for the conceptualisation of transactional and transformational leadership. S
outh African Journal of Psychology
,
38
(2), 253-267.
http://library.gcu.edu:2048/login?url=http://search.ebscohost.com.library.gcu.edu:2048/login.aspx?direct=true&db=a9h&AN=33720593&site=ehost-live&scope=site
Read: Odom, S. F., Boyd, B. L., & Williams, J. (2012). Impact of Personal Growth Projects on Leadership Identity Development.
Journal of Leadership Education
,
11
(1), 49-63.
http://library.gcu.edu:2048/login?url=http://search.ebscohost.com.library.gcu.edu:2048/login.aspx?direct=true&db=eric&AN=EJ980968&site=ehost-live&scope=site
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
Refer to the resource, "Preparing Annotated Bibliographies," located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center.
Directions:
Provide an annotated bibliography (750-1,000 words total) of the articles listed above. Including the following for each article:
1.
The article citation and persistent link. These are provided above for you to paste into the assignment and are not included in the total word count.
2.
A written summary of the key concept(s) of the article. Why was the study done? What was the population studied? What did the researcher(s) conclude? What other information about this study do you believe is unique or important to recall? Are there specific statements made by the author that you wish to retain?
Construct an outline for a paper that will explain and synthesize the articles you read for this assignment. The paper will require identification of themes common to the articles as well as a statement of the conclusions that can be drawn when the articles are taken together as a single entity You will be writing the paper in the next assignment.
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Read doubt the entire play be sure to read the preface first.Pr.docx
Read doubt: the entire play be sure to read the preface first.
Prompt for response: the play is called doubt A Parable. Explain why you think shanley titled the play doubt. use textual evidence to discuss how numerous characters deal with the concept of doubt throughout the play.
at the end of the play it is not clear wheather father flynn is guilty or not. take a side, either father flynns or sister Aloysius and use textual evidence to support wheather or not father flynn is guilty.
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Read Chapter 3 Analysis of Financial StatementsW2 Assignment Chap.docx
Read Chapter 3 Analysis of Financial Statements
W2 Assignment "Chapter 3 Questions"
Principles of Finance I
Chapter 3 Questions
·
QUESTIONS: 3-2, 3-4
·
PROBLEMS: 3-13
Learning Objective
Measure a company’s free cash flows and perform a financial analysis of a firm based upon financial statements.
Reading and Assignments
Reading "Chapter 3 Analysis of Financial Statements"
Lecture "Financial Ratios"
Discussion "Investors and Creditors or Financial Statement Ratios"
Assignment "Chapter 3 Questions"
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Read Chapter 2 and review the below NBC Learn video, then answer the.docx
Read Chapter 2 and review the below NBC Learn video, then answer the following questions:
Title: The Death Penalty Is Dying Out
Date: Dec 17, 2011
Duration: 00:02:29
Do you agree with Beccaria's assessment of the death penalty? Explain.
What portions of his reasoning do you most agree or disagree with?
Make sure to:
Write a short essay or paragraph of at least
300 words.
Use concrete examples/details and avoid generalities.
Address all questions.
Use proper grammar and punctuation.
If you researched your topic and are using information from what you learned, remember to cite your sources.
Do not plagiarize.
.
Race, Ethnicity, and Gender in the 19th CenturyBackground Many Am.docx
Race, Ethnicity, and Gender in the 19th Century
Background: Many Americans like to imagine the history of their nation as one of continual progress. While acknowledging that not all persons and groups enjoyed equal rights at all times, Americans often take it for granted that American history moves in only one direction: toward greater rights, greater freedom, and greater equality. However, from roughly 1867 to 1875, African Americans enjoyed far more political influence and equal rights than they ever had before, or ever would again, until the end of the modern Civil Rights Movement almost a century later. In addition to the disturbance in the social hierarchy created by the end of slavery, the nation experienced the influx of huge numbers of immigrants during the last half of the 1800s, many of whom were viewed by the American population as different and inferior to earlier waves of immigrants. Adding to concerns about social order was the push for women’s suffrage that arose after Civil War. These factors came together to create a threat to White male supremacy and combined to create a period characterized by conflict over race, ethnicity, and gender.
Review the following sources about the differences between primary and secondary sources:
Primary, Secondary, Tertiary Sources
Transcript
How to Research Primary Sources
How to Research Secondary Sources
Required sources:
What is Freedom?—Freedom: A History of US
in the Films on Demand database in the Ashford University Library
Alien Menace
Recommended sources:
Entertaining Citizenship: Masculinity and Minstrelsy in Post-Emancipation San Francisco
Identity, Marriage, and Schools: Life along the Color Line/s in the Era of Plessy v. Ferguson
Whiteness, Freedom, and Technology: The Racial Struggle Over Philadelphia’s Streetcars, 1859-1867
Instructions: Explore the
Alien Menace
exhibit thoroughly, viewing all of the links. You are not required to answer the questions on the website, but consider them. Watch
What is Freedom?—Freedom: A History of US
from the Films on Demand database. Based on Chapter 1 in your textbook, the required exhibit, and the film, explain
Why the last half of the 1800s was a time of conflict over the meanings of citizenship, race, and gender.
How African Americans, White Americans, and immigrants worked to secure their places in the social and political hierarchy.
Your initial post should be at least 250 words in length. Provide specific examples to support your points. Your references and citations must be formatted according to APA style as outlined by the Ashford Writing Center. Respond to at least two of your classmates’ posts by Day 7.
.
QuizQuestion 1(1 point)The actual change in th.docx
Quiz
Question 1
(1 point)
The actual change in the money supply equals
Save
Question 2
(1 point)
The required reserve ratio equals 10 percent and all banks initially have zero excess reserves. The Fed buys $1 million in U.S. government securities. The most the money supply can increase is
Save
Question 3
(1 point)
The more people decide to hold currency, the
Save
Question 4
(1 point)
The discount rate is the
Save
Question 5
(1 point)
The most precise way the Fed has to control the money is
Save
Question 6
(1 point)
According to the above figure, a shortage is shown between which two points?
Save
Question 7
(1 point)
A decrease in demand and a decrease in supply will lead to a
Save
Question 8
(1 point)
If the current price of a market basket of goods is $850 and the base year price for the same market basket is $500, what is the value of the price index?
Save
Question 9
(1 point)
The only way that a society can produce outside the production possibilities curve is
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Question 10
(1 point)
Suppose the tax rate on the first $10,000 income is 0; 10 percent on the next $20,000; 20 percent on the next $20,000; 30 percent on the next $30,000; and 40 percent on any income over $80,000. Family A has income of $40,000 and Family B has income of $100,000. What is the marginal and average tax rate for each family?
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Question 11
(1 point)
The marginal tax rate is equal to
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Question 12
(1 point)
One solution to the Social Security problem cited in the text is to
Save
Question 13
(1 point)
Social Security taxes are regressive because
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Question 14
(4 points)
Assume an open, mixed economy (C + I + G + X = real GDP) and an MPS of .2 What is the multiplier?
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Question 15
(1 point)
The U.S. fiduciary monetary system
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Question 16
(1 point)
Refer to the above table. The value of M1 is
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Question 17
(1 point)
Possession of information by one party in a financial transaction but not by the other party is
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Question 18
(1 point)
The Federal Reserve bank is managed by
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Question 19
(1 point)
As a "lender of last resort" the Fed
Save
Question 20
(1 point)
Required reserves are
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Question 21
(1 point)
A bank with deposits of $500 million has $75 million in cash on hand, $50 million in deposits with the Fed, and $80 million in government securities. If the reserve requirement is 15 percent, the bank has excess reserves of
Save
Question 22
(1 point)
A bank with $100 million in deposits has $6 million in vault cash, $6 million on deposit with the Fed, and $6 million in government securities. The reserve requirement is 20 percent. A person deposits a check for $10 million drawn on another bank. The maximum loan this bank can make once the check clears is
Save
Question 23
(1 point)
Assuming a reserve ratio of 10 percent, if a bank sells $100,000 in securities how much can the bank loan.
Rachel Quick and Maria DeCasa , two friends in Caras 4-yr-old clas.docx
"Rachel Quick and Maria DeCasa , two friends in Cara's 4-yr-old class, bring lunch to school every day. Maria brings meals prepared at home: rice and beans, a piece of fruit, and a thermos with a cold tropical juice drink. Rachel usually brings a store-bought brightly colored, pre-packaged children's meal with processed meat and crackers, a sugary dessert and a soda.
Maria wants to eat lunches like her friend at school and has become disinterested in her own food. Mrs. DeCasa expresses to Cara her concern with her daughter's interest in pre-packaged foods and does not want her daughter to eat those kinds of "American" meals. As an aside, Rachel's mother and father are busy executives and do not have time to prepare lunches for their child to bring to school."
As an ECP, how can you reach out to the families about this situation?
How can you help Maria's mother understand Rachel's family situation?
What can Maria's mom do to make Maria's meal more appealing?
What can be done to encourage Rachel's family to send her to school with healthier foods?
Share two activities will help children and their families understand different cultures.
submit a 200–300 word essay answering the Seminar questions listed. Your assignment should be composed in complete sentences and paragraphs. Be sure to answer all questions
.
QuizQuestion 1(1 point)SaveQuestion 2(.docx
Quiz
Question 1
(1 point)
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Question 2
(1 point)
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Question 3
(1 point)
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Question 4
(1 point)
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Question 5
(1 point)
Unit 7 in the Online Review discusses one of the most important developments over the past two decades in the field of alcohol and drug studies: the “brain disease” model of addiction. Researchers and top administrators at the National Institute on Drug Abuse (NIDA) have taken the lead in defining virtually all forms of addictive behavior—including alcohol dependence—as
chronic, relapsing diseases of the brain
. These advocates have used dramatic, high-tech images of the “addicted brain” and massive media campaigns, such as the HBO documentary,
Addiction
, to promote this individualistic viewpoint and to stress the need for research on pharmacological and biomedical interventions. At the same time, a number of critics have argued that the brain disease model ignores social and psychological factors involved in the etiology and treatment of addiction. They contend that drinking and drug use are unlike most diseases and involve choices and voluntary behavior. Finally, critics claim that the most effective treatments of addiction rely upon group relationships and personal decisions to change behavior.
Take a look at the material in Unit 7 of the Online Review. Use the “Resources” link to view two or three episodes of the HBO documentary,
Addiction
, and become familiar with the work and ideas of Dr. Nora Volkow, one of the foremost advocates of the brain disease model. Next, follow the links near the bottom of the “Lectures” page and read two brief essays by Sally Satel, a psychiatrist and critic of this biomedical approach to addiction. Then, post your 200-word (minimum) response to this controversial issue. What do you think of the “brain disease” model of alcohol and drug dependence? Is it a valid way of describing addiction? Is it helpful or harmful to the treatment process?
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AC505 MANAGERIAL ACCOUNTING – PRACTICE FINAL
Applied Sciences
Architecture and Design
Biology
Business & Finance
Chemistry
Computer Science
Geography
Geology
Education
Engineering
English
Environmental science
Spanish
Government
History
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