Monthly Archives: June 2025

https://www.slideshare.net/slideshow/case-study-dev-cordoba-2021-walden-university-llc-1/253073073#1

 Review the video, Case Study: Dev Cordoba. You will use this case as the basis of this Assignment.  

Develop a Focused SOAP Note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment?  
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
• Reflection notes: What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you could follow up with this patient. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention, taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
• Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).

References:

• Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer. 
  • Chapter 2, “Neurodevelopmental Disorders and Other Childhood Disorders”
    • Section 2.8, “Trauma- and Stressor-Related Disorders in Children” (pp. 167-173)
    • Section 2.13, “Anxiety Disorders of Infancy, Childhood, and Adolescence: Separation Anxiety Disorder, Generalized Anxiety Disorder, and Social Anxiety Disorder (Social Phobia)” (pp. 194-200”)
    • Section 2.14, “Selective Mutism” (pp.  201-202)
    • Section 2.15, “Obsessive-Compulsive Disorder in Childhood and Adolescence” (pp. 203-206)
  • Chapter 8, “Anxiety Disorders”
  • Chapter 9, “Obsessive-Compulsive and Related Disorders”
  • Chapter 10, “Trauma- and Stressor-Related Disorders
• Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
  • Chapter 26, “Psychosocial Adversity”
  • Chapter 27, “Resilience: Concepts, Findings, and Clinical Implications”
  • Chapter 29, “Child Maltreatment”
  • Chapter 30, Child Sexual Abuse”
  • Chapter 58, “Disorders of Attachment and Social engagement Related to Deprivation”
  • Chapter 59, “Post Traumatic Stress Disorder”

 Using proper APA formatting, cite the peer-reviewed article you selected that pertains to your practice area and is of particular interest to you and identify the database that you used to search for the article. Explain any difficulties you experienced while searching for this article. Would this database be useful to your colleagues? Explain why or why not. Would you recommend this database? Explain why or why not. 

 Identify one vulnerable population within a selected community. Explore current literature and related data to understand better the variables that place this population at risk for health concerns and health disparities. Analyze national health directives, such as Healthy People 2030 or another national initiative, to determine the correlation to the vulnerable population’s needs/risks/disparities.

1. Create a concept map, either neatly drawn by hand or using Microsoft Word, that portrays each element and its relationships. 
2. Download the Concept Map Summary templateLinks to an external site.Open this document with ReadSpeaker docReader to answer the questions related to the concept map scenario. Use of this template is required. If the template is not used, a 10% deduction will be applied. See the rubric. Save the template and include your name in the file name. 
3. Follow APA grammar, spelling, word usage, and punctuation rules consistent with formal, scholarly writing. 
4. Use APA in-text citations and complete references to support your writing.  
5. Use no more than one short direct quote (15 words or less). 
6. Refrain from using first person within this assignment. 
7. Abide by Chamberlain University’s academic integrity policy.  
8. Submit the Concept Map and the Concept Map Summary template to the Week 2 Assignment Dropbox. 

Include the Following Sections (detailed criteria listed below and in the grading rubric)

Concept Map

1. Using a concept map format, identify the following elements:
   1. vulnerable population
   2. the variables that place the population at risk
   3. the identified health risk or disparity to which the population is susceptible
   4. the relationships between the elements

Concept Map Summary

1. Describe the elements on the Concept Map and include the following.  
   1. Provide a succinct description of the vulnerable population identified.
   2. Discuss a minimum of three variables that place the population at risk.
   3. Describe the identified health risk(s) or disparity the population is at risk of experiencing.
   4. Explain how the Concept Map portrays the relationships between each element presented.
   5. Provide an in-text citation from one scholarly source to support your writing.
2. Intervention Proposal
   1. Identify one national population health goal or objective that relates to the identified risk or disparity, such as Healthy People 2030 or another national initiative
   2. Propose one strategy for the advanced practice nurse to collaborate at the local, state, or national levels to advocate for the health of the vulnerable population and advance the identified Healthy People 2030 goal or objective
   3. Identify the stakeholders with whom the advanced practice nurse could collaborate.
   4. Provide an in-text citation from two scholarly sources to support your writing. 

Bb week 2 po

J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.

Past Medical History (PMH):
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.

Labs:
Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.

Diagnostic test:
Endoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.

Case study questions:

1. Please name the potential most common sites for metastasis on J.C and why?
2. What are tumor cell markers and why tumor cell markers are ordered for a patient with pancreatic cancer?
3. Based on the case study described, proceed to classify the tumor based on the TNM Stage classification. Why this classification important?
4. Discussed characteristic of malignant tumors regarding it cells, growth and ability to spread.
5. Describe the carcinogenesis phase when a tumor metastasizes.
6. Choose the tissue level that is affected on the patient discussed above: Epithelial, Connective, Muscle or Neural. Support your answer. 

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. You don’t need to make a presentation page.

Pulmonary Function:
D.R. is a 27-year-old man, who presents to the nurse practitioner at the Family Care Clinic complaining of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage—all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 65-70% of his regular baseline with nighttime symptoms for 3 nights on the last week and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer enough treatment for this asthmatic episode.

Case Study Questions

1. According to the case study information, how would you classify the severity of D.R. asthma attack?
2. Name the most common triggers for asthma in any given patients and specify in your answer which ones you consider applied to D.R. on the case study.
3. Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.

Fluid, Electrolyte and Acid-Base Homeostasis:
Ms. Brown is a 70-year-old woman with type 2 diabetes mellitus who has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. On admission, her laboratory values show the following:

• Serum glucose 412 mg/dL
• Serum sodium (Na+) 156 mEq/L
• Serum potassium (K+) 5.6 mEq/L
• Serum chloride (Cl–) 115 mEq/L
• Arterial blood gases (ABGs): pH 7.30; PaCO2 32 mmHg; PaO2 70 mmHg; HCO3– 20 mEq/L

Case Study Questions

1. Based on Ms. Brown admission’s laboratory values, could you determine what type of water and electrolyte imbalance does she has?
2. Describe the signs and symptoms to the different types of water imbalance and described clinical manifestation she might exhibit with the potassium level she has.
3. In the specific case presented which would be the most appropriate treatment for Ms. Brown and why?
4. What the ABGs from Ms. Brown indicate regarding her acid-base imbalance?
5. Based on your readings and your research define and describe Anion Gaps and its clinical significance.

Submission Instructions:

• You must complete both case studies
• Your initial post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources.