All posts by : chebby

My assigned disease is ANEMIA 

Review the following client scenario: 

Janessa, a 41-year-old female client, presents to the NP complaining of shortness of breath, weakness, and dizziness for “about a month.” She denies having a cough or recent illness. She has a history of endometriosis, and her physical assessment reveals her lungs are clear to auscultation bilaterally, and her mucous membranes are pale.  

 Review your assigned disease process and answer the discussion prompts below with explanation and detail, providing complete references for all citations.   

1. Discuss the underlying pathophysiological mechanisms of your assigned disease process. Which clinical manifestations observed in Janessa’s case could be explained by the pathophysiological mechanisms? 
2. Analyze Janessa’s clinical manifestations in the context of your assigned disease process. Do these findings support a diagnosis of your assigned disease process? Why or why not?  
3. Identify and justify the diagnostic tests (including labs, imaging, or other diagnostic tests) that would be most appropriate for investigating a diagnosis of your assigned disease process in Janessa. What could the results of these tests look like in your assigned disease process? 
4. Compare and contrast your response with a peer who was assigned a different condition. Does their condition fit Janessa’s case? Why or why not? 

Directions: Read over the SOAP note and formulate a primary diagnosis.  Based on the diagnosis complete the SOAP note with the details that would be expected for the diagnosis. Use UptoDate and/or Dyna MedPlus to find out what is expected from the history and physical, diagnostic workup and management for the diagnosis. Include other peer review resources and and journal articles to support the development of your SOAP note. Complete and attach the evaluation & management score sheet to show how you coded the note for billing in each section.

• Upload a copy of your completed SOAP note.
• Upload a copy of the evaluation & management score sheet.

Case Study: A 45-year-old white man presents to your office complaining of left knee pain that started last night. He says that the pain started suddenly after dinner and was severe within a span of 3 hours. He denies any trauma, fever, systemic symptoms, or prior similar episodes. He has a history of hypertension for which he takes hydrochlorothiazide (HCTZ). He admits to consuming a great amount of wine last night with dinner .On examination, his temperature is 98°F, his pulse is 90 beats/min, his respirations are 22 breaths/min, and his blood pressure is 129/88 mm Hg. Heart and lung examinations are unremarkable. The patient is reluctant to flex the left knee, wincing in pain at touch, and has passive range of motion. The knee is edematous, hot to touch, and has erythema of the overlying skin. No crepitation or deformity is apparent. No other joints are involved. Inguinal lymph nodes are not enlarged. Complete blood count (CBC) reveals a white blood cell count of 10,900 cells/mm3 and is otherwise normal.

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course. 

Access the County Health Rankings & Roadmaps websiteLinks to an external site. and search for health outcomes data for your state. Use the Rankings feature on the Data by County page to determine the county with the best and worst health outcomes rankings. Identify the ranking of your home county or the county where you practice.  

Next, use the Search by County feature to find your home county. Review the available data.   

Finally, use the Compare Counties feature to compare your home county to those identified with the best and worst health outcomes ranking in your state. Reflect on findings. 

Include the following sections:

1. Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
   • Provide an overview of the health outcomes and factors in your country. Which health factors are strengths in your county? Which are areas for improvement?  
   • Consider the communities within your county. What influencing factors might be at the root of health factors needing improvement?  
   • How does your home county or county of practice compare to the counties with the highest and lowest health outcomes rankings?   
   • How will the information you found impact your role as an advanced practice nurse? 
2. Integration of Evidence: Integrate relevant scholarly sources as defined by program expectationsLinks to an external site.:
   • Cite a scholarly source in the initial post.
   • Cite a scholarly source in one faculty response post.
   • Cite a scholarly source in one peer post.
   • Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.
   • Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations.
3. Engagement in Meaningful Dialogue: Engage peers and faculty by asking questions and offering new insights, applications, perspectives, information, or implications for practice.
   • Peer Response: Respond to at least one peer.
   • Faculty Response: Respond to at least one faculty post.
   • Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.

Mrs. Nasser arrived at the urgent-care center with her 16-year-old daughter, who had been experiencing burning upon urination, itching around her genital area, and a high fever. Mrs. Nasser appeared very anxious, explaining to the nurse that her daughter had never had these symptoms before. The nurse tried to calm Mrs. Nasser and asked that her daughter, Samia, get undressed in preparation for a physical examination. Mrs. Nasser appeared concerned and requested that the nurse inform the doctor that she will not allow the doctor to perform a vaginal examination on her daughter.

The nurse explained to Mrs. Nasser that it will be necessary for the doctor to examine Samia so that she can determine the cause of Samia’s discomfort. Mrs. Nasser became extremely agitated and explained to the nurse that in her culture, young girls are not allowed to have a vaginal examination for fear that their virginity will be compromised. Mrs. Nasser insisted that she would not allow her daughter to be examined by the female doctor on duty. Mrs. Nasser requested that the nurse ask the doctor to write a prescription for her daughter’s infection, or else she would leave the clinic immediately.

1. How should the nurse respond to Mrs. Nasser’s request? Explain your rationale.
2. Identify culturally congruent strategies that may be most effective in addressing the needs of Mrs. Nasser.
3. How might the nurse ensure that Mrs. Nasser’s concerns are addressed appropriately and that Samia has received the appropriate care?

 Reply for the following discussion. at least 150 words, 2 references, APA style, Turnitin less than 10 % and 0% AI.

Mounjaro (tirzepatide) and Ozempic (semaglutide) are two groundbreaking therapies for type 2 diabetes and obesity, each offering distinct benefits based on their unique mechanisms of action. While both drugs improve glycemic control and facilitate weight loss, understanding their differences is key to tailoring treatment to individual patient needs.

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist that works by stimulating glucose-dependent insulin secretion, suppressing glucagon release, and delaying gastric emptying. These effects stabilize blood glucose levels, particularly after meals, and increase satiety, leading to significant weight loss. The efficacy of Ozempic in lowering hemoglobin A1c (HbA1c) levels and reducing body weight has been well documented over several years, making it a trusted option with a well-established safety profile (Wilding et al., 2021).

In contrast, Mounjaro employs a dual mechanism of action by targeting both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. This dual receptor engagement not only enhances insulin secretion and lowers glucagon levels but also appears to drive greater weight reduction. The simultaneous activation of both incretin pathways leads to more robust metabolic effects, which may translate into more pronounced improvements in glycemic control and weight loss for certain patient populations. Clinical evidence suggests that tirzepatide might offer superior reductions in HbA1c and body weight compared to therapies solely based on GLP-1 agonism (Buse et al., 2021).

The benefits of these medications extend beyond glucose regulation. Both drugs contribute to lowering cardiovascular risk factors through weight reduction and improved metabolic profiles. However, the choice between them often depends on individual patient characteristics and treatment history. For instance, patients who have experienced positive outcomes with traditional GLP-1 receptor agonists may continue to see benefits with Ozempic. On the other hand, individuals with severe obesity or those who have not achieved optimal glycemic control might find Mounjaro’s dual-action approach more effective.

Another important consideration is the safety and tolerability of these agents. Both Ozempic and Mounjaro are associated with gastrointestinal side effects, such as nausea, vomiting, and diarrhea, particularly during the initial phase of treatment or dose escalation. Despite these similarities, the extensive clinical use of Ozempic has provided a more established long-term safety profile, whereas Mounjaro, being newer, continues to be evaluated in broader patient populations.

In conclusion, while both Mounjaro and Ozempic offer significant benefits in managing type 2 diabetes and obesity, their differences in receptor activity and resultant metabolic effects provide clinicians with a diverse toolkit for personalized treatment. The dual mechanism of Mounjaro may offer enhanced benefits for some patients, whereas Ozempic’s established efficacy and safety make it a reliable choice for many. Individualized patient assessment remains essential in selecting the most appropriate therapy.

Examine workflow processes in your place of employment for areas that may need improvement. 

• Explore the literature for a technology that could be utilized to improve that workflow process.

When introducing workflow redesign or a new technology there are many steps to consider.

• Who does this impact?
• What are the costs?
• How do we know it is successful?

For this assignment create a PowerPoint presentation using the waterfall or agile method for a workflow redesign in your project.

Requirements

• 10-12 slide presentation not including title or reference slides.
• Discuss design from start to finish (for instance…)
• What is your workflow redesign or technology being implemented? Why is it needed?
• What are the costs, risks, benefits?
• How will the optimal redesign be chosen and created?
• How will it be implemented and by who?
• How will you know if your redesign is successful? How long until you know?
• What maintenance is needed (guidelines updated, new software etc)?
• Include at least 3 recent peer-reviewed journal articles to support your proposed workflow redesign.

1. Click and choose (1) Case Study below and post answers.

2. Answers must:

-minimum 100 words or more

-Use the standard English grammar and spelling

– Recited references

3. Respond to at least two (2) of your classmates.

4. Responses must:

Use the standard English grammar and spelling

Be substantial.

Do NOT just say, ″I agree″ or ″Good point″.