Lesacote - Lesa Cote

NR 601 Week 5 Case Study Discussions Physical Examination  (Part-1) NEW

Discussion Part One (graded)

 C.W. is a tall, thin 78-year-old African American male brought into the office by his son who states that the patient is restless, angry, and has been unable to sleep for the last week. The son indicates that he is very concerned about his father because he lives alone. Also, he is concerned about the “strange” symptoms that his father has presented with recently.

 Background: 

C.W. presents as restless, hyperverbal, obnoxious and angry. He expresses himself by periodic yelling. He is unkempt and smells strongly of urine, alcohol and body odor. ………… has an unsteady gait and sways while standing. As you converse with the son, you determine that C.W. was medically separated from military service due to mental health issues after 2 years of active duty that ended in 1947. He has been married and divorced three times over the years. He typically seeks no acute or preventative medical care. ___ was treated by a psychiatrist previously, but he did not like taking the prescribed medications so he stopped taking them and did not keep any further psychiatric appointments.  

 PMH:

Patient denies any previous diagnoses. However, when asked why he saw a psychiatrist in the past, he tells you that the psychiatrist diagnosed paranoid schizophrenia, but that he does not have any psychiatric diagnoses or problems. He states: “It was just a way for him to make money off me coming in and seeing him and paying the drug companies for me to take all those meds!” 

Current medications: 

Denies prescription medications, over the counter medication, herbal therapies or vitamins.  

Surgeries:

Denies surgeries 

Allergies: NKA

Vaccination History:

Flu vaccine: never given

Pneumovax: never given

Tetanus: never given

Herpes zoster: never given 

Screening History:

 Last Colonoscopy was 2012-normal

Last dilated retinal and glaucoma exam was 2013 

 Social history and Risk Factors:

 Patient admits to smoking cigarettes and cigars. …… estimates that he smokes about 1 pack of cigarettes daily for the last 40 years, and 2 cigars each week for the last 30 years.

He states that he drinks a 24 ounce bottle of beer 4-6 times a week. … denies drinking wine or hard liquor. …….. does admit to smoking marijuana on occasion but does not use other recreational drugs. Patient denies falling. You notice some scrapes on his forearms, and when asked, he tells you that he fell yesterday: “I got pretty drunk out fishin’ with friends and fell off my bike trying to ride home”. He does not use any assistive devices for ambulation or balance.

Significant ROS:

Productive cough with white sputum. Denies hemoptysis.

He answers “No” to the PHQ-2 screening questions. 

Family history:

Reports no significant family history

  Discussion Part One:

Provide differential diagnoses (DD) with rationale. Further ROS questions needed to develop DD. Based on the patient data provided, choose geriatric assessment tools that would be appropriate to use in conducting a thorough geriatric assessment. Provide a rationale on why you are choosing these particular tools.

for assignment help and quiz, ‘visit 

http://www.dreamassignment.com/

NR 601 Week 3 Case Study Discussions Physical Examination  (Part-1) NEW

Discussion Part One (graded)

Katie Smith, a 65 year-old female of Irish descent, is being seen in your office for an annual physical exam. You are concerned since she has rescheduled her appointment three times after forgetting about it. She and her husband John are currently living with their daughter Mary, son-in-law Patrick, and their four children. She confesses that while she loves her family and appreciates her daughter’s hospitality, she misses having her own home.  As she is telling you this, you notice that she develops tears in her eyes and does not make eye contact with you. 

Background:

Although Mrs. Smith is scheduled for an annual physical exam and reports no particular chief complaint, you will need to complete a detailed geriatric assessment. Katie reports a lack of appetite. She tells you that she nibbles most of the time rather than eating full meals. She also reports having insomnia on a regular basis.

PMH:

Katie reports a recent bout of pneumonia approximately 3 months ago, but did not require hospitalization.  She also has a history of HTN and high cholesterol.

Current medications: 

HCTZ 25mg daily

Evista 60mg daily

Multivitamin daily

Surgeries:      

Appendectomy as a child in Ireland (date unknown)

1968- Cesarean section

Allergies: Denies food, drug, or environmental allergies Vaccination History:

Cannot remember when she had her last influenza vaccine

Does not recall having received a Pneumovax

Her last TD was greater than 10 years ago

Has not had the herpes zoster vaccine

 Screening History:

Last Colonoscopy was 12 years ago

Last mammogram was 4 years ago

Has never had a DEXA/Bone Density Test

 Social history:

Emigrated with her husband from Ireland in her 20s and has always lived in the same house until recently. She retired a year and a half ago from 30 years of teaching elementary school; has never smoked but drinks alcohol socially. She states that she does not have an advanced directive, but her daughter Mary keeps asking her about setting one up.   Family history:

Both parents are deceased but lived disease-free up into their late 90s.  She has one daughter who is 44 years old with no chronic illness and two sons, ages 42 and 40, both in good health.  

Discussion Day 1:

Differential Diagnoses with rationale

Further ROS questions needed to develop DD

Based on the patient data provided, choose geriatric assessment tools  that would be appropriate to use in conducting a thorough geriatric assessment. Provide a rationale on why you are choosing these particular tools.

for assignment help and quiz

visit 

http://www.dreamassignment.com/

PSY 490 Week 5 DQ 2

How can psychology be integrated into your career and educational decisions?

 Would you recommend a Bachelor of Science in Psychology to people in other fields of study? Explain your response.

PSY 490 Week 5 Learning Team Jeopardy Game Presentation 

Develop a 20-minute Jeopardy game presentation that integrates the breadth and depth of core psychology knowledge.

Search the Internet for a Microsoft® PowerPoint® jeopardy game template.

You will be developing Questions & Answers related to your topics. Remember that your questions should increase in level of difficulty related to your point value.

Include the following topics in your game:

 ·      Holistic approach to prior learning

·      Integrating psychology into your personal life

·      Psychology across all disciplines

·      Integrating psychology into career and educational decisions

      ·      Your personal learning theory (you and your team will agree on a learning theory to use for this category.)

 for assignment help and quiz

http://www.dreamassignment.com/

Get Dissertation and Term Paper from Business Law Assignment Help!

Visit:  https://bit.ly/2GG5puC

NR 601 Week 1 Case Study Discussions Physical Examination (Part 1) NEW

Discussion Part One (graded)

 You meet your first patient of the morning. A.K. is a 65-year-old Caucasian male who you are seeing for the first time. Both wife and daughter are present.

Background

He reports that he has had an 18-pound unintentional weight loss in the last 2 months “I am just not hungry anymore, and when I do eat, I get full so fast. In fact, it is really hard to eat, and I don’t eat nearly as much as usual, even though I eat 3 times every day”. He also reports feeling more tired than usual. “I am not sleeping very well. My wife wakes me up when I am snoring, or when she thinks I am not breathing. I used to have sleep apnea, but I don’t think I have it anymore. Besides, that mask is so horrible to wear.” He reports day time somnolence. He reports that he is at the clinic today because of his wife and daughter’s concern about his weight loss and loss of appetite.

PMH

Mr. A.K. has a history of hypertension, cataracts, and osteoarthritis. Current medications:

Ibuprofen 600 mg po TID

Lisinopril 20 mg po QD

Hydrochlorothiazide 25 mg PO QD

Simvastatin 20 mg po QD

Vitamin D3 50,000 units po weekly

Omeprazole 40 mg po QD

Sudafed 50 mg po TID prn

Surgeries      

 April 2010-Right cataract extraction with Intraocular Lens Placement  June 2010- Left cataract extraction with Intraocular Lens Placement  November 2011-Left total knee arthroplasty

Allergies: No known drug or food allergies. Allergies to latex causing difficulty breathing and to bee stings, causing widespread edema and airway obstruction.

Vaccination History

He receives annual flu shots “most of the time”. His last one was 18 months ago.

Received a Pneumovax “the day I turned 65”.

His last TD was greater than 10 years ago.

Has not had the herpes zoster vaccine.

Social history

He has an 8th grade education and is a retired concrete finisher. He lives with his wife of 45 years and his daughter lives next door. He enjoys working in his back yard garden and recently tripped over the garden hose last week where his neighbor had to come and help him up.

Family history

Both parents are deceased. Father died of a heart attack at the age of 80; mother died of breast cancer at the age of 76. He has one daughter who is 45 years old and has hypertension. Hypertension, coronary artery disease, and cancer runs in the family.

Habits

He drinks one 4 ounce glass of red wine nightly; previous smoker of 30 years; he quit for 10 years, and is now smoking ¼ pack per day for the last 6 months.

  Discussion Part One:

Provide the differential diagnoses (DD) with rationale

for assignment help and quiz, 

visit 

http://www.dreamassignment.com/

Dream assignment provides effective html assignment help,homework help and coding help for your projects. We are ready to help college and university students to submit their html assignments questions with proper solution.