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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.

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?

Discuss the need for institutional review boards (IRBs). How can they potentially affect or impact a study? Give 3 examples.

Discussion posts must be a minimum of 350 words, references must be cited in APA format 7th Edition, and must include a minimum of 2 scholarly resources published within the past 5 years.

Assignment attach below

 Module 3 Discussion

What makes a team?

Reflect on your experiences as a member of a clinical team. What makes a team effective or ineffective in terms of achieving expected outcomes for the patients? (Saunders, 2014)

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.

   Primary Care NP Role vs. APN Roles 

Compare the primary care NP role with other APN roles. What are the similarities among the roles, what are the differences, and how would you communicate the role to a healthcare provider and a consumer?

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. 

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.

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?