Directions are in files. Agency that Im doing is: Gallagher Services (SE, DH, MD) Residential Kristen Crowther kcrowther@cc-md.org 667-600-2520 Linda Lippa llippa@cc-md.org Alyscia Smith asmith2@cc-md.org 667-600-2520 2520 Pot Spring Road, Timonium, MD 21093 website: answer sheet I already did which is also linked in files. only use the website.

The purpose of this assignment is to enhance your ability to assess and understand the cultural context of individuals and families by utilizing the Culturagram as a tool. This assignment supports the development of cultural humility, empathy, and communication skills, all of which are essential competencies for social work and trauma-informed care practice. Complete a Culturagram by interviewing a classmate, friend, roommate, etc. (keeping their personal information anonymous). Review the assigned reading “Using the Culturagram to Assess and Empower Culturally Diverse Families” to help you develop the questions you will ask in advance. Turn in the completed Culturagram and complete an essay of 500-750 words that analyzes the culturagram by explaining the results of the interview. Address the following in your essay: Explain what insights you have about your interviewee based on the information collected. Discuss the understanding of their experience gained from completing the culturagram. Reference the “6 Guiding Principles of Trauma-Informed Care,” found in the resources for Topic 5. Explain which of the principles would be demonstrated by completing a culturagram with a client and why. Cite two to four scholarly sources in addition to the 6 Guiding Principles of Trauma-Informed Care to support your claims. Here is the website for “6 Guiding Principles of Trauma-Informed Care” Provide 5 more references and in-text citations that you may have used to complete this assignment.

INCLUDE CITATIONS, AND REFERENCES AND A NEW IDEA

Sara

The PHQ-9 is a validated and widely used screening tool that assesses both the presence and severity of depressive symptoms. Item #9 evaluates passive or active thoughts of death or self-harm, making it a critical safety question rather than simply another symptom indicator (Zakhari, 2021). A positive response to item #9 warrants immediate and focused follow-up because endorsement of suicidal ideation, whether passive or active, requires further risk evaluation. In the context of this patient with a spinal cord injury, following up with the Columbia-Suicide Severity Rating Scale (C-SSRS) would be clinically appropriate due to his answer of several days in the last two weeks when asked about the 9th question. The C-SSRS provides a more detailed and structured assessment of suicidal ideation severity, intent, plan, and past behaviors, allowing the clinician to determine the level of risk and necessary interventions (Neal, 2024). While the PHQ-9 functions well as a screening instrument, it is not sufficient alone to determine suicide risk level or disposition. Using the C-SSRS after a positive #9 response enhances patient safety and aligns with best practices in psychiatric assessment (2024).

In the video, I thought the clinician did a nice job administering the PHQ-9 in a calm and structured manner, maintaining a neutral tone and appropriate pacing. When the patient endorsed question #9, the clinician avoided minimizing his response or reacting with alarm. Instead, she followed up to clarify the nature and extent of the patients thoughts. This response reflects therapeutic communication principles. She remained composed, direct, and nonjudgmental, which helps reduce shame and encourages honest disclosure (Zakhari, 2021). I appreciated how she explained why this question is asked in this assessment, stating, “these feelings are not unusual to go through people’s minds”. She also tells the patient not hesitate to reach out to his support team should the feelings he is describing intensify, which is reassuring to the patient. As Neal (2024) explains, sest practice includes explicitly assessing for intent, plan, means, and prior attempts using a structured framework such as the C-SSRS to ensure comprehensive risk assessment.

Protective factors are essential to assess alongside risk factors because they buffer against suicidal behavior and inform clinical decision-making (CDC, 2024). Protective factors include strong social support, family connectedness, religious or spiritual beliefs that discourage suicide, a sense of responsibility to dependents, engagement in treatment, effective coping skills, problem-solving ability, and future orientation (Neal, 2024). Additional protective elements include cultural beliefs that value resilience, positive therapeutic alliance, and restricted access to lethal means (Zakhari, 2021). The CDC notes that availability to consistent and high quality community physical and behvioral healthcare is also an important community protective factor (2024). Identifying protective factors guides safety planning, strengthens resilience-focused interventions, and supports collaborative treatment planning.

References:

Centers for Disease Control and Prevention. (2024, April 25). Risk and protective factors for suicide. Centers for Disease Control and Prevention.

Neal, A. M. (2024). Psychiatric-mental health nurse practitioner review and resource manual (5th ed.).

YouTube. (2021, June 17). Patient Health Questionnaire-9 (PHQ-9)

[Video]. YouTube.

Zakhari, R. (2021). Psychiatric-mental health nurse practitioner certification review. Springer Publishing.

Course Project Lab 1 of 6: Project Scope and High-Level Requirements Scenario/Summary This week, we will begin the process of engineering a solution to a business problem scenario. Once we have defined the problem, our next task will be to get an idea of the project’s scope, so we will begin by eliciting functional requirements and documenting them. As we do so, we will attempt to identify potential use cases to help us understand the types of things that the users will expect to do with the new system. Deliverables Step 1: Detailed description of a business problem scenario CEIS400-BusinessProblemScenario-TEMPLATE-v2.docxOpen this document with ReadSpeaker docReader Download CEIS400-BusinessProblemScenario-TEMPLATE-v2.docxOpen this document with ReadSpeaker docReader Step 2: Elicit high-level requirements (not graded) Step 3: Initial draft of a software requirements specification (SRS) CEIS400-IEEE-830-SRS-Outline-TEMPLATE-v2.docxOpen this document with ReadSpeaker docReader Download CEIS400-IEEE-830-SRS-Outline-TEMPLATE-v2.docxOpen this document with ReadSpeaker docReader Step 4: Initial list of use cases Step 5: Project plan (All lab assignments are activities and tasks within the traditional SDLC phases as the Work Breakdown Structure (WBS)) Required Software Microsoft Word Steps 1, 3, and 4 Microsoft Project Step 5 To access the software, click the DeVry Desktop to launch a session from the course navigation (left side). Lab Steps Step 1: Define the Business Problem Scenario Think of a new software product, service, or system that you would like to engineer. Any type of program on any type of computing device may be used, as long as it is substantial enough to justify a semiformal software engineering process. For instance, you may want to design a new point-of-sale system for convenience stores, a shopping cart for online retailers, a video game for mobile devices, a social network specializing in your favorite hobby or career, or so forth. Perhaps you can get ideas from friends or relatives by asking them what kind of technology would help them in their lives or jobs. Keep in mind that you will be designing, developing, and testing a functional prototype of this system later in the course. Once you have a clear vision of the software system you would like to develop, document it as thoroughly as possible using the Business Problem Scenario template. The template will help you figure out what information you need to provide and how to organize it. Step 2: Elicit High-Level Requirements This step is essentially a brainstorm in which we are just trying to gather as much information as we possibly can about the system we will be designing. Read your Business Problem Scenario carefully. As you do, pay attention to anything that implies features, functions, or capabilities that the system will be expected to have, and write them down on scratch paper, a whiteboard, a text file, or whatever is easy and convenient for you. Regardless of how you choose to record your findings, this will become the input to Step 3 below. Some helpful tips follow. Object-oriented analysis (OOA) techniques can be most effective at generating an initial list of requirements. Look for nouns (people, places, things) and verbs (actions) to get an idea of what elements may exist and the behaviors that they may perform. User-centered design (UCD) is another area from which we can borrow ideas. Pay special attention to things that require the user to perform an action or provide input or things that show output or give feedback to the user. A TOR chart can be an incredibly handy artifact for capturing this information quickly and in a somewhat organized manner. TOR stands for tasks-objects-remarks. It’s a simple table with three columns that are used as follows. The first column is tasks. Every time you see an action verb phrase, write it in this column. The second column is objects. For each task in the first column, list every noun that is associated with it in any way. This includes objects that perform the task, objects that are affected by the task, and objects that may somehow influence the task. The third column is remarks. For our purposes here, you don’t necessarily need to use this column, but you may if you find it helpful. Step 3: Create the SRS Now you should have an idea of what the system will contain and what features it will have. The next step is to organize and formalize this information in a document that will serve as the basis for much of the work to follow. Fortunately, we have a document template that was designed for just that purpose: IEEE Standard 830 is a professional, industry-standard template for a software requirements specification (SRS). We are not going to complete the entire document right now. We’re just going to fill in what we know so far and then come back for the rest later. Download the SRS template. On the cover page: Name the project or the product. Include the phrase Software Requirements Specification. Include a version number that you can update later as changes are made to the document. On the Revisions page, create a table with four columns. Label the first column Date. This column will contain the dates that revisions were made. Label the second column Revision. This column will list the version numbers that the document goes through as revisions are made. Label the third column Description. This column will contain a brief description of the revision, such as what was changed or the reason for the change. Label the fourth column Author. This column will contain the name of the author who made the revision. Enter this information as the first entry in the table of revisions. Date: Revision: 1.0 (or whatever version number you put on the title page) Description: Initial draft Author: On the Table of Contents page, use the table of contents feature in Word to insert a table of contents. It won’t show much yet, but later you can tell Word to update it after we fill in the other sections. In Section 2.1 (Product Perspective), summarize the software that you intend to create. You may be able to copy this paragraph from the Business Problem Scenario. In Section 3.1 (External Interface Requirements), describe how you expect the system to communicate with the outside world. The sections might be used as follows, though not all sections will apply to all software systems. User interfaces: How will the software communicate with users? What screens, devices, or views will provide the required input and output? Hardware interfaces: What additional devices will the system need to communicate with, if any? Software interfaces: If the system will need to interact with other programs, what technology will enable this to happen? Communications protocols: If the software needs to communicate over a network, what protocols will it use to do so? Section 2.2 (Software Product Features) is where the most essential content of the document will be. In this section, you will list all of the requirements you have identified so far. For each requirement statement, do the following. Assign a unique number to the requirement. This will allow us to trace the requirement through the various phases of the software development life cycle. State the requirement in a clear, unambiguous way. A best practice for writing requirements statements is to begin with a phrase such as “The system shall…” and then state in a clear and simple way what the system will do. You may also be more specific in some cases and say things such as “The user interface shall…” or “The security subsystem shall…” and so forth. Section 2.3 (Software System Attributes) can be left empty for now. This section is for nonfunctional requirements (NFR), which we will discuss later in the course. We will return to complete this section in a later lab. For now, just put in the section title as a placeholder. If your system will require a database or other persistent data store, briefly describe in Section 2.4 (Database Requirements) what the data store will need to do for the software. Step 4: Identify Use Cases A use case describes a way that a user will interact with a feature of the system. Later in the course, we will elaborate on use cases to gain an understanding of how the system is expected to behave in response to user interaction. For now, we just want to make a list of the things that the user will be doing. A best practice for naming use cases is to follow a format such as below. Some examples are as follows. User creates profile. Customer enters payment information. Player launches game. Manager generates report. In a new document, provide at least five use cases. This should be easily attainable for even the simplest software applications. Step 5: Create the Project Plan Create an MS Project plan, assigning weekly lab assignment activities (deliverables) for the entire session. The Work Breakdown Structure (WBSphases, activities, and tasks) is based on the four traditional SDLC phases outlined in the Week 1 Lesson. For example, the first SDLC phase will be planning. The creation of the Week 1 Lab assignment deliverables will be the activities within the planning phase. You can go to the task level, if necessary. Also, be sure to add any additional activities or tasks you think are necessary in each phase, such as research, reviews, and so forth. See the six lab assignment sections for details on the deliverables (potential activities). MS Project Key Creation Steps Create the four SDLC phases first (Planning, Analysis, Design, and Implementation) to start off the WBS. Create activities from all six lab assignments within the appropriate SDLC phase. You should be able to map each lab assignment to the correct SDLC phase by reading the lab assignment description. Again, see the Week 1 Lesson for the SDLC overview. If you prefer to use the week as the activities and lab assignment deliverables as the task, that can work. Create estimate durations for each activity, from 1 to 8 days (standard weekly grading period due dates for the lab assignment). Indicate a few dependencies (predecessors) among activities (or tasks) within each SDLC phase. The MS project plan can be updated every week, but the final version must be submitted for grading in Week 8. Step 6: Submit Deliverables Create a zipped archive containing the following files. Business Problem Scenario (see template provided) Software requirements specification List of use cases MS Project plan (.mpp file). Note: Use the four traditional SDLC phases and all lab assignments as activities within the appropriate phase. Submit the zip file for grading.

For this presentation, you will identify a contemporary social issue from within the past eight years and analyze it using sociological frameworks. Your goal is to apply sociological theory to better understand the issue, its causes, its impact, and potential solutions.

Your analysis should remain objective and research-focused.

Presentation Content Requirements

Your presentation must include the following components:

1. Identification of the Social Issue

Clearly identify a contemporary social issue that has emerged or gained significant attention within the past eight years.

2. Explanation of the Issue as a Social Problem

Explain why this issue qualifies as a social problem. Consider factors such as:

• Widespread impact
• Social consequences
• Public concern
• Institutional or structural involvement

Support your explanation with research.

3. Root Causes and Sociological Theory

Identify the root causes of the issue using relevant sociological theory.

You should:

• Clearly explain the theory you are applying
• Demonstrate how the theory helps interpret the issue

4. Populations Affected

Discuss which populations are most affected by this issue. Consider variables such as:

• Social class
• Race/ethnicity
• Gender
• Age
• Geographic location
• Other relevant social categories

Use research to support your discussion.

5. Research-Based Evidence

Incorporate credible, scholarly sources throughout your presentation to support your claims and analysis.

6. Evidence-Based Solutions

Propose potential solutions grounded in research. These solutions should be realistic and supported by sociological evidence.

Expectations

• Maintain an objective, analytical tone.
• Avoid opinion-based arguments.
• Clearly apply sociological frameworks.
• Organize your presentation logically and coherently.
• Properly cite all sources used.
• Review the .

This assignment is designed to assess your ability to apply sociological theory to real-world issues and to support your analysis with credible academic research.

750 words max. APA must be 100% accurate.

Objectives

• Demonstrate documentation of the abdominal assessment findings
• Explain how to conduct a physical assessment of the abdomen
• Develop a plan of care for the abdomen

Assignment Overview

In this writing assignment, you will review a case scenario and submit an assignment, providing information on how you would conduct a focused physical assessment of the client based on the presenting complaints. You will document your findings from the focused history and physical assessment data elicited and develop a nursing plan of care for this client.

The rubric used to grade this assignment is attached below the assignment description.

Deliverables

Write a 3-page (750 word) paper using APA 7.0 format style.

Step 1

Review the case scenario.

Gil Martin is a 55-year-old Hispanic male who presents to the clinic today with weakness, fatigue, and loss of appetite. He has a history of excessive alcohol use, chronic back pain, and hyperlipidemia.

• Onset: You ask Mr. Martin when he noticed his symptoms first began. He tells you he is not sure, but it seems like over the past year they have been getting worse. At first he thought it was just due to stress, but now he is not sure.
• Location: He tells you his weakness is “all over his body.”
• Duration: You ask Mr. Martin to describe how long his fatigue lasts. He tells you it is “pretty much all day.” He wakes up tired and never feels like he has any energy. You ask Mr. Martin to tell you about his appetite, when it changed, and has anything else occurred with the change. He tells you that in the last several months he has not really felt like eating much, and he often experiences nausea that just lingers throughout the day.
• Characteristics: You ask Mr. Martin to describe his weakness, and he tells you he isn’t sure if he is weak because he is tired, but he doesn’t seem to be able to do as much physical work as before. His back is always hurting though, so he thought maybe it was because of that. You ask Mr. Martin to describe his nausea; does it occur before eating or after eating? He tells you it occurs all the time. You ask him if his has any bloating or gas, and he tells you he doesn’t think so.
• Aggravating factors: You ask Mr. Martin if anything makes his nausea and loss of appetite worse. He tells you that when he drinks (alcohol), he never feels like eating anything. You ask Mr. Martin to describe anything that improves his fatigue, and he tells you that nothing does, even sleep doesn’t really help.
• Alleviating factors: You ask Mr. Martin if anything helps the nausea, and he tells you “not really.” You also ask him if anything improves his appetite, like eating his favorite foods. He tells you that he just never feels like eating. He only eats because his wife “nags” at him to eat. You ask him if anything helps his fatigue and weakness. He tells you “No, I am just tired all the time.”
• Other background information: Gil Martin is married with three children. He has two children with his current wife Helen (Anthony 21, Kristina 19). His 29-year-old son Mark (from a previous relationship) has been living at home since his spinal cord injury (MVA, DUI) two years ago. His mother also lives with them. His son Anthony has schizophrenia, has been non-compliant with his treatment, and creates frequent disturbances at home. Gil has had chronic back pain for years, which he often self-medicates with alcohol and prescription pain killers, when he can obtain them. He does not admit to being an alcoholic and has never sought treatment for his drinking, which he believes is normal considering his stressful home situation.

You perform the following assessment:

• Abdominal: Abdomen is protuberant, bowel sounds are active in all four quadrants, dullness during percussion of the liver suggests liver enlargement. Dullness is noted also during percussion of the abdomen suggesting ascites. Palpation of the liver also suggests enlargement but no nodules felt. No rebound tenderness noted. Percussion of the spleen is normal.

Diagnosis and treatment: Mr. Martin is sent for an abdominal CT scan and blood work is done to measure his liver function. He is diagnosed with cirrhosis of the liver and is told he needs to stop drinking.

Step 2

Write a 3-page (750 word) paper using APA 7.0 format style and address the information below. As a minimum, the resources for this assignment should by the required course textbook and any article you are asked to read. The next level of evidence you may use would be peer reviewed articles after that well known web sites for example CDC or the AHA. Avoid blogs or obscure web sites. Never cite/reference Wikipedia.

You are precepting a student nurse today who is taking her assessment class. She is learning about focused history and assessment skills. In your paper, discuss the following items:

• Write a detailed explanation describing what you would say to the student when explaining the assessment conducted and the findings. Discuss any additional assessments you would also perform. What are other potential factors related to the probable diagnosis you would be concerned about with this client?
• Explain how you would document your findings in the medical record.
• Develop your plan of care. Identify two nursing diagnoses and two nursing interventions related to those diagnoses. The interventions should be evidence based. Cite the references used in your plan in APA7.0 formatting.
• Identify specific client education should be done for Mr. Martin, given his background and presenting concerns. Describe your teaching strategy and how you will evaluate the effectiveness of the educational intervention.
• Be sure to cite all the sources you used in the completion of this assignment and include a reference list.

*Link to course textbook below:

Cover

Lapum, J. L. & Hughes, M. (2024). Introduction to health assessment for the nursing professional (2024)- Canadian edition. Creative Commons Attribution-NonCommercial 4.0 International License.

750 words max. APA must be 100% accurate.

Objectives

• Develop a plan of care for the neurologic system
• Explain how to conduct a physical assessment of the neurologic system
• Demonstrate documentation of the neurologic system assessment findings

Assignment Overview

In this writing assignment, you will review a case scenario and submit an assignment providing information on how you would conduct a focused physical assessment of the client based on the presenting complaints. You will document your findings from the focused history and physical assessment data elicited and develop a nursing plan of care for this client.

The rubric used to grade this assignment is attached below the assignment description.

Deliverables

Write a 3-page (750 word) paper using APA 7.0 format style.

Step 1

Review the case scenario.

Lydia Ocampo is a 69-year-old female who is brought in to the clinic today by her husband, Dr. Danillo Ocampo. She has had a mild decline in her mental status over the past several years, but recently things have progressed. Her husband is concerned that she might have Alzheimer’s disease. She was hospitalized two weeks ago with pneumonia and a urinary tract infection and was on intravenous antibiotics.

• Onset: You ask Mrs. Ocampo to explain what brings her here today. She tells you she is not really sure. She tells you her husband wanted her to come because she has been forgetting things. She tells you that she does forget things sometimes, but that is because she is “getting old.” You ask Dr. Ocampo to tell you when he noticed things were getting worse with her cognitive status. He tells you that since she was discharged from the hospital, he has noticed that Lydia doesn’t want to go out with their friends or go for walks, and she seems confused more often.
• Duration: You ask Dr. Ocampo how long her periods of confusion are. He tells you that she used to start talking about their son (who died at age 22) like he was still living. He would remind her that Emillo was killed in a car accident, and she would remember he had died. Now she continues to talk about Emillo as if he were alive and gets angry when he tries to tell her that Emilio died. She also gets frustrated more easily when she can’t remember how to turn the TV on or start the dishwasher.
• Characteristics: You ask Dr. Ocampo to describe Lydia’s current day and her ability to carry out her daily activities. He tells you that Lydia used to be able to take a shower and get dressed in the morning. She would go for walks with him during the day and out to dinner with friends. She would read, watch TV, and work in her garden in the backyard. She had periods of forgetfulness and confusion but could be redirected. Now, he cannot trust her to be outside by herself; she wandered out of the backyard and into a neighbor’s house last week. She wakes up at night, gets confused, and doesn’t remember where she is. When he tries to reorient her, she becomes angry. She has also stopped reading and working in the garden and has more difficulty getting dressed in the morning by herself.
• Aggravating or alleviating factors: Redirecting or reorienting Lydia used to help, but now that seems to frustrate her more. Distractions in the environment and strange places also make her dementia worse.
• Other background information: Lydia Ocampo was born and raised in the Philippines and came to this country when she was 18. She has no living relatives in the United States and has a niece and nephew in the Philippines. Dr. Ocampo is a retired pathologist and has class II heart failure and hypertension. He is Lydia’s primary care giver and was very distressed when she was recently hospitalized.

Neurological exam: You decide to perform the Mini Cog Test. She scores 0 on the word recall, and her clock drawing is incomplete. Her mood during the exam is irritable, and she argues with her husband as he responds to questions. Her reflexes and motor strength are normal and her gait is normal. Her swallowing reflex is normal.

Diagnosis and treatment: You suspect her dementia is worsening and that she is in the early stages of Alzheimer’s disease. She undergoes brain imaging studies and neuropsychological testing, and a diagnosis of Alzheimer’s is made.

Step 2

Write a 3-page (750 word) paper using APA 7.0 format style and address the information below. The minimum resources for this assignment must include the required course textbook and any article you are asked to read should be used as evidence. The next level of evidence you might use would be peer reviewed articles after that well known web sites for example CDC or the AHA. Avoid blogs or obscure web sites. Never cite/reference Wikipedia.

You are precepting a student nurse today who is taking her assessment class. She is learning about focused history and assessment skills. In your paper, discuss the following items:

• Write a detailed explanation describing what you would say to the student when explaining the assessment conducted and the findings. Discuss any additional assessments you would also perform, such as the mini-mental exam. What are other potential factors related to the probable diagnosis you would be concerned about with this client?
• Explain how you would document your findings in the medical record.
• Develop your plan of care. Identify two nursing diagnoses and two nursing interventions related to those diagnoses. These interventions should include evidence-based practices from the Hartford Institute for Geriatric Nursing. Cite the references used in your plan in correct format.
• Identify specific client education should be done for Lydia and her husband, given her background and presenting concerns. Describe your teaching strategy and how you will evaluate the effectiveness of the educational intervention.
• Explain how you would determine care giver strain on Dr. Ocampo.
• Be sure to cite all the sources you used in the completion of this assignment and include a reference list, all in APA 7.0 format style.

*Link to course textbook below:

Cover

Lapum, J. L. & Hughes, M. (2024). Introduction to health assessment for the nursing professional (2024)- Canadian edition. Creative Commons Attribution-NonCommercial 4.0 International License.

750 words max. APA must be 100% accurate.

Objectives

• Demonstrate documentation of the musculoskeletal assessment findings
• Develop a plan of care for the musculoskeletal system
• Explain how to conduct a physical assessment of the musculoskeletal system

Assignment Overview

In this assignment, you will review a case scenario and submit an assignment providing information on how you would conduct a focused physical assessment of the client based on the presenting complaints. You will document your findings from the focused history and physical assessment data elicited and develop a nursing plan of care for this client.

The rubric used to grade this assignment is attached below the assignment description.

Deliverables

Write a 3-page (750 word) paper using APA 7.0 format style.

Step 1

Review the case scenario.

Cecelia Bley is a 75-year-old Native American female who presents to the urgent care today with complaints of wrist pain and swelling. She has a history of osteoarthritis and has joint pain that primarily affects her hands and knees.

• Onset: You ask Mrs. Bley to tell you when her wrist pain started. She tells you that she was taking a walk yesterday and fell. She put her hands out in front of her as she fell and landed on her knees and wrists. Her right wrist has been more swollen since the fall.
• Location: You ask Mrs. Bley about the location of her pain, and she tells you it is in her right wrist.
• Duration: The pain has occurred since the fall.
• Characteristics: You ask Mrs. Bley to describe her pain. She tells you her wrist feels tender and hurts more than usual when she moves it.
• Aggravating factors: You ask Mrs. Bley to describe what makes the pain worse. She tells you that her wrists are always sore in the morning and moving them throughout the day usually makes them feel better, but today her right wrist hurts all the time, especially when she tries to use it.
• Alleviating factors: You ask Mrs. Bley if anything has helped the pain. She tells you that she took some of her arthritis pain medication, and it helped “a little.” She also put some ice on it, and that decreased the pain.
• Other background information: Mrs. Bley has had osteoarthritis for many years and has found that over the past several years her activities have been significantly limited. She is able to care for herself and her husband, but she has been unable to make jewelry, which has always been her passion. This is very upsetting for her, and she is having a difficult time finding activities that she can comfortably do and that she enjoys.

Mrs. Bley was just seen in the clinic last week for her yearly checkup. At that time, she had a complete history and physical. Her musculoskeletal findings were as follows:

• Joints: Mrs. Bley has limited range of motion in many of her joints, including her hands, wrists, hips, and knees. Her hands were tender to palpation, and her finger joints were swollen and tender.
• Strength: Her muscle strength was 4/5 in all her extremities, and pain was noted in the joints.
• Spine: No abnormal curvatures noted.

Diagnosis and treatment: You suspect her wrist is sprained or broken, and an x-ray take shows a Colles’ fracture. She is placed in a cast. You also note that at her appointment last week, she had an x-ray done to measure bone density. The results are positive for osteoporosis, and you share that information with her. Mrs. Bley is discharged from urgent care with her cast and a prescription for a narcotic pain medication (Vicoden), which she has taken for her arthritis pain. After consultation with her primary care physician, she is also started on Fosamax.

Step 2

Write a 3-page (750 word) paper using APA 7.0 format style and address the information below. As a minimum, the resources used should be the required course textbook and any article you are asked to read should be used as evidence, next level of evidence you might use would be peer reviewed articles, and after that well known web sites for example CDC or the AHA. Avoid blogs or obscure web sites. Never cite/reference Wikipedia.

You are precepting a student nurse today who is taking her assessment class. She is learning about focused history and assessment skills.

• Write a detailed explanation describing what you would say to the student, explaining the assessment conducted and the findings. Discuss the musculoskeletal assessments you would perform and any additional assessments you would perform. What are other factors related to the probable diagnosis you would be concerned about with this client?
• Explain how you would document your findings in the medical record.
• Develop your plan of care. Identify one to two nursing diagnoses and one to two nursing interventions related to those diagnoses. The interventions should be evidence based. Cite the references used in your plan in correct format.
• Identify what client education should be done for Mrs. Bley, given her background and presenting concerns, including her new diagnosis of osteoporosis. Describe your teaching strategy and how you will evaluate the effectiveness of the educational intervention.
• Be sure to cite all the sources you used in the completion of this assignment and include a reference list.

*Link to course textbook below:

Cover

Lapum, J. L. & Hughes, M. (2024). Introduction to health assessment for the nursing professional (2024)- Canadian edition. Creative Commons Attribution-NonCommercial 4.0 International License.

how did Peter describe the church using different bible sources

I want to write an spe paper about Importance of Water Chemistry in Geothermal Operations , include the following parts : Introduction 1. Introduces geothermal systems and explains why water chemistry is important. 2. Methodology Explains how the research was conducted (literature review of geothermal studies). 3. Nature and Composition of Geothermal Fluids Describes the chemical components found in geothermal fluids. 4. Role of Water Chemistry in Geothermal Operations Explains how fluid chemistry affects geothermal production systems. 5. Scaling and Mineral Precipitation Discusses mineral scaling problems caused by chemical changes in fluids. 6. Corrosion of Wells and Surface Equipment Explains corrosion mechanisms caused by geothermal fluid chemistry. 7. Reservoir Interaction and Reinjection Effects Describes how reinjection fluids interact with reservoir rocks. 8. Monitoring and Control of Geothermal Water Chemistry Discusses monitoring techniques and chemical mitigation strategies. 9. Results and Discussion Interprets findings from the reviewed studies and links them to operational impacts. 10. Future Research and Recommendations Suggests areas where further research is needed. 11. Conclusion Summarizes the key findings of the paper Include prper citations, in text citations, figures, tables, and proper illustrations , also ensure that u use spe papers and journles as resources and use one petro and ensure that everything is clear, avoid plagarisim and ai