Category: Nursing

You are given two hours to evacuate and move to a safe area 100 miles away. Create a list of supplies and equipment you currently have available. Be honest! Assume that you and your family cannot expect any outside support for at least three days.

Be sure to address all 4 part as indicated below.

Instructions

Over the course of the semester you will choose 10 patient encounters to document an extended SOAP note for.

It is expected that you vary the primary focus of each note to ensure you are receiving quality feedback for several types of patient encounters to include acute, chronic and wellness encounters. You are not to utilize the same type of encounter, acute/chronic health condition or wellness exam, more than once unless you have received approval to do so from your clinical faculty person.

Each SOAP note carries a 15-point value.

SOAP notes will be evaluated using a standardized rubric. Please review the evaluation criterion to ensure that your SOAP notes are constructed to address the required elements and desired level of achievement.

For planned weekly clinical experiences submission of the 10 SOAP notes would be accomplished by submitting one SOAP note weekly for weeks 4 through week 13.

For planned and approved condensed, compressed or alternate clinical experiences, submission of the 10 SOAP note would be dependent on the approved clinical schedule. This may mean that more than 1 SOAP note would need to be submitted on a weekly basis. If you are not in clinical for weeks where a SOAP note is due a 0 will be input into the Grade Center as a place holder until you have submitted the required assignment.

Patient Information:

Patient: 64-year-old male

Chief Complaint: My left knee has been hurting for a few weeks.

Subjective

HPI:

64-year-old male presents with complaints of left knee pain for approximately 4 weeks. Patient reports gradual onset without known trauma or injury. Pain is described as a deep, aching sensation localized to the medial aspect of the left knee. Pain is rated 6/10 at worst and 3/10 at rest. Symptoms are worse with prolonged walking, climbing stairs, and rising from a seated position. Reports morning stiffness lasting approximately 2030 minutes. Denies locking, catching, or instability. Mild intermittent swelling noted. Denies redness, warmth, fever, recent illness, or calf pain.

Has tried OTC ibuprofen with partial relief.

Past Medical History:

• Hypertension
• Hyperlipidemia
• Type 2 Diabetes Mellitus

Medications:

• Lisinopril 20 mg daily
• Atorvastatin 20 mg nightly
• Metformin 1000 mg BID
• OTC ibuprofen PRN

Allergies: NKDA

Past Surgical History: None related to knee

Family History:

• Father: Osteoarthritis
• Mother: Type 2 DM

Social History:

• Retired
• Former smoker (quit 10 years ago)
• Occasional alcohol
• BMI: 31

Review of Systems:

• Constitutional: Denies fever, weight loss
• Musculoskeletal: Left knee pain and stiffness; denies other joint pain
• Neurological: Denies weakness or numbness
• Skin: Denies rash

Objective

Vital Signs:

BP: 132/78

HR: 72

RR: 16

Temp: 98.2F

BMI: 31

General: Alert, oriented 3, no acute distress

Musculoskeletal:

• Inspection: Mild swelling left knee, no erythema
• Palpation: Tenderness over medial joint line
• ROM: Slightly decreased flexion secondary to pain
• Crepitus noted with movement
• Negative anterior/posterior drawer
• Negative Lachman
• No varus/valgus instability
• Gait: Mild antalgic gait

Neurovascular:

• Sensation intact
• Pedal pulses 2+ bilaterally

Assessment

Primary Diagnosis:

• Likely Primary Osteoarthritis of Left Knee

Osteoarthritis

Differential Diagnoses:

• Medial meniscus tear
• Patellofemoral pain syndrome
• Inflammatory arthritis
• Gout
• Septic arthritis (low suspicion)

Plan

Diagnostics:

• X-ray left knee (AP, lateral, sunrise views)
• Consider MRI if mechanical symptoms develop

Medications:

• Continue NSAIDs PRN (educate on GI and renal precautions)
• Consider topical diclofenac gel
• Consider acetaminophen for pain control

Non-Pharmacologic:

• Weight loss counseling
• Physical therapy referral
• Quadriceps strengthening exercises
• Low-impact exercise (swimming, cycling)
• Knee brace if beneficial

Education:

• Discussed degenerative nature of osteoarthritis
• Encouraged glycemic control to reduce inflammation burden
• Reviewed red flag symptoms (increased swelling, redness, fever, inability to bear weight)

Follow-Up:

• Return in 46 weeks
• Sooner if worsening symptoms

Instructions:

Please respond to the following questions based upon these course objectives:

• Distinguish between normal and abnormal physical and psychosocial changes associated with patients in the adult population aged 50 years and older.
• Identify syndromes and disease states commonly managed by advanced practice nurses in the older adult population.
• Critique existing protocols and best practices that address differential diagnosis, pharmacotherapeutic intervention, and resources to manage and evaluate acute and chronic illness in the older adult population.
• Plan and implement therapeutic interventions to return the older adult patient to a stable state and/or optimize the patients health.
• Examine state and federal resources influencing healthcare for the older adult population.
• Effectively manage communication central to shared decision-making with other health care professionals and patients, demonstrating awareness of gender and cultural differences.

Please answer the following questions with supporting examples and full explanations.

1. For each of the learning objectives, provide an analysis of how the course supported each objective.
2. Explain how the material learned in this course, based upon the objectives, will be applicable to certification success and professional application.

Provide evidence (citations and references) to support your statements and opinions.

Initial Response

Instructions:

The American Geriatrics Society (2003) defines transitional care as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location (Cited in Boltz, et. al., 2012). It also encompasses both the sending and the receiving aspects of the transfer and is based on a comprehensive plan of care and includes logistical arrangements, education of the patient and family, and coordination among the health professionals involved in the transition (Coleman & Boult, 2003 cited in Boltz, et. al., 2012). Finally, it involves a broad range of services and environments designed to promote the safe and timely passage of patients between levels of health care and across care settings (Naylor & Keating, 2008 cited in Boltz, et. al., 2012). Therefore, transitional care is an essential component of managing very ill geriatric clients. You will be expected to provide this care.

• Select five research articles that address transitional care of the geriatric client and briefly describe at least three strategies you will use in your practice to minimize the negative effects associated with transitional care.

Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the students position.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Initial Response

Instructions:

Caring for an elderly family member can be overwhelming for families. If the stress of caregiving is left unchecked, it can take a toll on the caregivers health, relationships, and state of mindeventually leading to burnout. Families may often be faced with a serious decision concerning the care of their loved ones.

• Discuss strategies that are proven to help families deal with caregiver stress and burnout.
• How can you assist them in making decisions about the care of their loved ones?
• Include a discussion on handling advance directives with families.
• Document your discussion with at least five evidence-based references on the topics.

Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the students position.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Introduction

Hello class, beginning with week 3, your initial discussion response will be a little different from the previous weeks. There are a few headings you need to be sure to include. You will identify the pertinent positives and negatives. These will be the specific findings from the history and your exam that help you rule in or rule out a diagnosis. For example, if a patient has a complaint of chest pain, but has no N/V, pain radiating in the arm or jaw, diaphoresis, etc. – these would all be pertinent negatives. If the patient reported these symptoms, they would be pertinent positives. For the Missing Information section, you would want to include any other information you need from the case to help make your diagnosis, but was not included. This might be things like smoking history, any OTC meds, any recent falls, etc. that are relative to the case. To ensure you are covering each part of the requirement, I am listing the different sections you will need to include in your initial response. You do not need to include all information as you would a soap note, just the headings below. I hope you find this informational helpful. Reach out with any questions.

Instructions:

It has been projected that the older population will grow from 40.3 million in 2010 to 72.1 million in 2030. This population is unique because they grew up in a time (1960-1970s) where the stance on alcohol and drugs were different. We are left with learning how to identify and manage this unique situation (Kuerbis, Sacco, Blazer & Moore, 2014).

Reference: Kuerbis, A., Sacco, P., Blazer, D.G., & Moore, A.A. (2014).

Links to an external site.

Clinics in Geriatric Medicine, 30(2): 629-654. doi: 10.1016/j.cger.2014.04.008

Initial Post Requirements:

Please critically evaluate the subjective and objective information provided to you in the attached file below, and use the SOAP template as a reference.

1? The first part of the discussion board is to identify all pertinent positive and, negative information and list missing information. Then create a differential diagnosis list with at least 3 possibly actual diagnosis based on your findings. Here are the headings you should use:

• Pertinent positives
• Pertinent negatives
• Missing information
• Differential diagnoses

2? The second part is to create a plan utilizing clinical practice guidelines for the priority diagnosis. Here are the headings you should use:

• Diagnostics
• Therapeutics
• Educational
• Consultation/Referrals

Be sure to utilize the template, in-text citations and provide full reference citation at the end of the discussion.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Introduction

Hello class, beginning with week 3, your initial discussion response will be a little different from the previous weeks. There are a few headings you need to be sure to include. You will identify the pertinent positives and negatives. These will be the specific findings from the history and your exam that help you rule in or rule out a diagnosis. For example, if a patient has a complaint of chest pain, but has no N/V, pain radiating in the arm or jaw, diaphoresis, etc. – these would all be pertinent negatives. If the patient reported these symptoms, they would be pertinent positives. For the Missing Information section, you would want to include any other information you need from the case to help make your diagnosis, but was not included. This might be things like smoking history, any OTC meds, any recent falls, etc. that are relative to the case. To ensure you are covering each part of the requirement, I am listing the different sections you will need to include in your initial response. You do not need to include all information as you would a soap note, just the headings below. I hope you find this informational helpful. Reach out with any questions.

Instructions:

The geriatric population has a higher prevalence for endocrine/metabolic disorders like osteoporosis, diabetes and hypothyroidism. As this population grows in numbers and their physiologic reserve diminished, how might be care for this vulnerable population.

Initial Post Requirements:

Please critically evaluate the subjective and objective information provided to you in the attached file below, and use the SOAP template as a reference.

1? The first part of the discussion board is to identify all pertinent positive and, negative information and list missing information. Then create a differential diagnosis list with at least 3 possibly actual diagnosis based on your findings. Here are the headings you should use:

• Pertinent positives
• Pertinent negatives
• Missing information
• Differential diagnoses

2? The second part is to create a plan utilizing clinical practice guidelines for the priority diagnosis. Here are the headings you should use:

• Diagnostics
• Therapeutics
• Educational
• Consultation/Referrals

Be sure to utilize the template, in-text citations and provide full reference citation at the end of the discussion.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Initial Response

Introduction

Hello class, beginning with week 3, your initial discussion response will be a little different from the previous weeks. There are a few headings you need to be sure to include. You will identify the pertinent positives and negatives. These will be the specific findings from the history and your exam that help you rule in or rule out a diagnosis. For example, if a patient has a complaint of chest pain, but has no N/V, pain radiating in the arm or jaw, diaphoresis, etc. – these would all be pertinent negatives. If the patient reported these symptoms, they would be pertinent positives. For the Missing Information section, you would want to include any other information you need from the case to help make your diagnosis, but was not included. This might be things like smoking history, any OTC meds, any recent falls, etc. that are relative to the case. To ensure you are covering each part of the requirement, I am listing the different sections you will need to include in your initial response. You do not need to include all information as you would a soap note, just the headings below. I hope you find this informational helpful. Reach out with any questions.

Instructions:

This week you are learning quite a bit regarding the older adults’ experience with cardiovascular, pulmonary and neurological problems. According to the CDC, 60% of older adults are living with two or more chronic conditions. This starts to become a challenge as you manage and educate multiple conditions and let’s not forget the polypharmacy involved (NIA, n.d.).

Reference: National Institute on Aging. (n.d.).

U.S. Department of Health and Human Services. Retrieved from https://www.nia.nih.gov/health/supporting older-patients-chronic-conditions

Initial Post Requirements:

Please critically evaluate the subjective and objective information provided to you in the attached file below, and use the SOAP template as a reference.

1? The first part of the discussion board is to identify all pertinent positive and, negative information and list missing information. Then create a differential diagnosis list with at least 3 possibly actual diagnosis based on your findings. Here are the headings you should use:

• Pertinent positives
• Pertinent negatives
• Missing information
• Differential diagnoses

2? The second part is to create a plan utilizing clinical practice guidelines for the priority diagnosis. Here are the headings you should use:

• Diagnostics
• Therapeutics
• Educational
• Consultation/Referrals

Be sure to utilize the template, in-text citations and provide full reference citation at the end of the discussion.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Initial Response

Introduction

Hello class, beginning with week 3, your initial discussion response will be a little different from the previous weeks. There are a few headings you need to be sure to include. You will identify the pertinent positives and negatives. These will be the specific findings from the history and your exam that help you rule in or rule out a diagnosis. For example, if a patient has a complaint of chest pain, but has no N/V, pain radiating in the arm or jaw, diaphoresis, etc. – these would all be pertinent negatives. If the patient reported these symptoms, they would be pertinent positives. For the Missing Information section, you would want to include any other information you need from the case to help make your diagnosis, but was not included. This might be things like smoking history, any OTC meds, any recent falls, etc. that are relative to the case. To ensure you are covering each part of the requirement, I am listing the different sections you will need to include in your initial response. You do not need to include all information as you would a soap note, just the headings below. I hope you find this informational helpful. Reach out with any questions.

Instructions:

This week you will be focusing on anemia and infectious diseases in this vulnerable population. Remember that serum ferritin levels can be affected by acute or chronic inflammation. Therefore, your chronic kidney disease patient may have a normal ferritin level but actually be iron deficit due to the serum being elevated in response to the CKD.

Initial Post Requirements:

Please critically evaluate the subjective and objective information provided to you in the attached file below, and use the SOAP template as a reference.

1? The first part of the discussion board is to identify all pertinent positive and, negative information and list missing information. Then create a differential diagnosis list with at least 3 possibly actual diagnosis based on your findings. Here are the headings you should use:

• Pertinent positives
• Pertinent negatives
• Missing information
• Differential diagnoses

2? The second part is to create a plan utilizing clinical practice guidelines for the priority diagnosis. Here are the headings you should use:

• Diagnostics
• Therapeutics
• Educational
• Consultation/Referrals

Be sure to utilize the template, in-text citations and provide full reference citation at the end of the discussion.

Please be sure to validate your opinions and ideas with citations and references in APA format.

1. Select the assigned medications provided by your instructor.
2. Complete a Medication Concept Map for each drug using the attached template.
3. Each concept map must include:

• Generic name, brand name, and drug class
• Route/dosage
• Therapeutic uses
• Mechanism of action
• Adverse effects
• Contraindications
• Notes and considerations
• Nursing assessment
• Indicate if the drug is a High-Alert Medication (Yes/No)

1. Work must be handwritten or neatly typed into the template. Handwriting must be legible.
2. All sections of the template must be completed for credit. Incomplete maps will lose points.
3. Submit all completed concept maps as one clear PDF or scanned file.

All required sections fully addressed.

Accuracy of Content: Correct drug information, appropriate terminology.

Organization & Neatness : Legible, easy to follow, professional presentation.

Compliance with Instructions : Proper file type, correct format, all maps included.