Week 4 Assignment 1: Baker Case Study

Week 4 Assignment 1: Baker Case Study

Week 4 Assignment 1: Baker Case Study

Two Assignments:

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.

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

 

Week 5

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.

Using the following table—search the 5 databases based on your PICOT Question—under findings note the number of relevant articles found—you may not find something in every database. Under features discuss what you liked about that database. ON the discussion board summarize your search—attach your chart . You may not find what you are looking for in every search—and that is OK—but you must search every database to see what may be out there.

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Exploring the Literature

Picot Question: 

Research Tool	Search Tips	Search Terms &  Limits	Findings	Features
CINAHL CINAHL is an SU subscription-only resource that offers full text access to 336 scholarly journals and indexes over 3,000 journals from the fields of nursing and allied health. Indexed journals do not provide access to full-text. Just because it is indexed in does not mean the library has full-text access to the journal. SU can always request articles for students via Interlibrary Loan, but the service is not instantaneous	Look at the Major Subject Heading in the Full Record Use the Limits Feature: Example: Publication Type=Systematic Review Try the CINAHL Heading search:	Keyword search: Limits: CINAHL Heading search: Limits:
PubMed PubMed is a free health science citation & abstracts index from the National Center for Biotechnology Information at the U.S. National Library of Medicine.	Look at MeSH Terms in Full Record Use the Limits Feature: Examples: Article Type=Meta-Analysis; Age=All Adult Look for the open access Free articles!	Keyword search: Limits:   MESH search: Limits:
Cochrane Library Cochrane Library provides access to the Cochrane Library of Systematic Reviews. Full text of reviews are subscription only. Index summaries are a public resource. Indexed journals do not provide access to full-text. Just because it is indexed in does not mean the library has full-textaccess to the journal. SU can always request articles for students via Interlibrary Loan, but the service is not instantaneous	Use the Simple Search and the Advance Search Features Allows you to search with MeSH Terms Check out the New Reviews  Browse reviews by topic	Keyword search:   Limits: MESH search: Limits:
Dynamed	Use the Simple Search and the Advance Search Features Allows you to search with MeSH Terms Check out the New Reviews Browse reviews by topic	Keyword search:   Also browse by:
TRIP Database TRIP is a clinical search engine to locate publicly available clinical evidence.	Limit to: Systematic Reviews Guidelines-US	Keyword search: Limits:
SU Library Search	Library Search is setup just like an EBSCO The Library even has a specialized PICOT search setup in Library Search—must go to Advance search to get to PICOT option
Other Databases: