NSG6340 Week 2 Discussion latest 2018

This week you learned about common conditions in the adolescent client. Please review the following case study and answer the following questions.

A fifteen-year-old female presents to your clinic complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately, she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms.

Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema, and her father has high blood pressure. She is the only child. She denies smoking and illegal drug use. On examination, she is in no acute distress and her vital signs are: T 98.6, BP 120/80, pulse 80, and respirations 20.

Her head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is decreased air movement and high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.

What is the chief complaint?
Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?
What treatment plan would you consider utilizing current evidence based practice guidelines?

Submission Details:

Post your response to the Discussion Area by the due date assigned. Respond to at least two posts by the end of the week. NSG6340 Week 2 Discussion latest 2018

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Week 3 Discussion

In Week 3 you learned about other common adolescent health conditions. Review the following case study and answer the following questions:

An 18 year old white female presents to your clinic today with a 2 week history of intermittent abdominal pain. She also is positive for periodic cramping and diarrhea as well as low grade fever. She also notes reduced appetite. She notes that She admits smoking ½ PPD for the last 2 years. Denies any illegal drug or alcohol use. Does note a positive history of Crohn’s Disease. Based on the information provided answer the following questions:

What are the top 3 differentials you would consider with the presumptive final diagnosis listed first?
What focused physical exam findings would be beneficial to know?
What diagnostic testing needs completed if any to confirm diagnosis?
Using evidence based treatment guidelines note a treatment plan.

Submission Details:

Post your response to the Discussion Area by the due date assigned. Respond to at least two posts by the end of the week.

NSG6340 Week 4 Discussion

This week’s content addressed common chronic diseases. Please review the case study below and answer the following questions:

A sixty-year-old baker presents to your clinic, complaining of increasing shortness of breath and nonproductive cough over the last month. She feels like she can’t do as much activity as she used to do without becoming tired. She even has to sleep upright in her recliner at night to be able to breathe comfortably.

She denies any chest pain, nausea, or sweating. Her past medical history is significant for high blood pressure and coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is married and is retiring from the local bakery soon. She denies any tobacco, alcohol, or drug use. Her mother died of a stroke, and her father died from prostate cancer.

She denies any recent upper respiratory illness, and she has had no other symptoms. On examination, she is in no acute distress. Her blood pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory rate is 16. With auscultation, she has distant air sounds and she has late inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2 are distant and an S3 is heard over the apex.

What is the chief complaint?
Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?
What treatment plan would you consider utilizing current evidence based practice guidelines?

Submission Details:

Post your response to the Discussion Area by the due date assigned. Respond to at least two posts by the end of the week.

Week 5 Discussion latest 2018

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.
For this assignment, go to the Discussion Area and post a response to one question in the Discussion Area by the due date assigned. You may respond to your classmates’ posts for either question.
To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

As an adult gerontology nurse practitioner you are working in a rural health clinic. You are evaluating a 16-year-old adolescent patient who comes in complaining of having a difficulty concentrating in school. On exam you also note that the patient is very thin and frail in appearance and is asking you for diet pills.

What are some initial areas for concern? What screening tools can help lead you closer to your diagnosis?
Describe 1 health promotion strategy you can discuss with the patient.

Be sure to address the following in your plan of care: pharmacological and non-pharmacological (OTC) interventions, labs, follow-up, teaching, and referral/s.

Your work should integrate course resources (text/s) as well as a minimum of two (2) other evidence-based guidelines and/or articles published within 3-5 years.

Centers for Disease Control and Prevention. (2013). Youth risk behavior surveillance system (YRBSS). Retrieved from http://www.cdc.gov/healthyyouth/data/yrbs/ index.htm

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Week 6 Discussion latest 2018

This week’s content discussed common psychiatric disorders in the Adult and Older Adult client. Often times a secondary diagnosis is masked due to their psychiatric disorder. Review the following case study and answer the following questions.

Mr. White is a 72-year-old man, with a history of hypertension, COPD and moderate dementia, who presents with 4 days of increased confusion, nighttime restlessness, visual hallucinations, and urinary incontinence. His physical exam is unremarkable except for tachypnea, a mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score from a baseline of 18 to 12 today.

Mr. White’s presentation is most consistent with an acute delirium (acute change in cognition, perceptual derangement, waxing and waning consciousness, and inattention).

What is the most likely diagnosis to frequently cause acute delirium in patients with dementia?
What additional testing should you consider if any?
What are treatment options to consider with this patient?

Submission Details:

Post your response to the Discussion Area by the due date assigned. Respond to at least two posts by the end of the week.

NSG6340 Week 2 Discussion latest 2018