ASSESSING MUSCULOSKELETAL PAIN

  

Case: A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved?

 How would you test for each of them? 

What other symptoms need to be explored? 

What are your differential diagnoses for acute low back pain?

 Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected  

week 5 discussion

   

Week 5  Discussion Forum

   

  • What  was your motivation regarding your research study? What have you found  along your research journey that took you in a different direction,  surprised you, or confirmed your ideas? Is there anything you would do  differently if you were to implement your research?

Week 5

Soap Note 1 Acute or Chronic Conditions (10 Points)

Iron Deficiency Anemia

Must use the sample template for your soap note, keep this template for when you start clinicals.

Late Assignment Policy

Assignments turned in late will have 1 point taken off for everyday assignment is late, after 7 days assignment will get grade of 0 (zero). No exceptions 

Follow the MRU Soap Note Rubric as a guide

Use APA format and must include minimum of 2 Scholarly Citations.

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in Score must be less than 25% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25%. Copy-paste from websites or textbooks will not be accepted or tolerated.

Please see College Handbook with reference to Academic Misconduct Statement.

The use of tempates is ok with regards to Turn it in, but the Patient History, CC, HPI, The Assessment and Plan should be of your own work and individualized to your made up patient. 

MRU MSN5600L SOAP NOTE Template 2021-1.docx MRU MSN5600L SOAP NOTE Template 2021-1.docx  September 4 2023, 10:25 AMMRU Soap Note Rubric 2021-1.docx MRU Soap Note Rubric 2021-1.docx  

unit 4 551

Two-week-old Tabitha has infant respiratory distress syndrome. Eighty-year-old Anthony has emphysema, and 50-year-old Jenny has pulmonary fibrosis.

Why are the mechanics of breathing greatly compromised in all of these cases?

INSTRUCTIONS: This is a discussion post. So, a page in length or a page and a half is enough. Must have at least 3 references and has to be in Apa format. 

Nursing

Hello, this is an Advanced Health Assessment assignment. I need a PowerPoint CV-Heart Assessment, it must have 22 slides with introduction, development, conclusions, and bibliographical references. Please must have photographs and explanations of the cardiovascular evaluation. Thank you

module 3 discussion

 Mary is 27 years old and has had a history of alcohol dependence for several years. Mary has a daughter Kylie, aged 3 years, who displays signs of fetal alcohol syndrome. Social work services have been involved with Mary and Kylie since her birth, culminating in Kylie being looked after by the local authority as a result of Mary arriving to collect Kylie from the local nursery while significantly under the influence of alcohol. Mary has demonstrated ambivalence regarding her ability to control her alcohol use. Mary has referred herself to a local counseling agency as suggested by the social worker and her PCP. 

PHILOSOPHY DICCUSSION RESPONSE

1.  Introduction 

2.   Doctor of Nursing Practice Philosophy and Social Justice Advocacy

Topic: Introduce Yourself! 553

 

Your introduction should cover the following details:

  • Your name
  • Geographical area in which you live (state and/or time zone is fine)
  • Your work experiences as an RN
  • Two objectives you hope to achieve throughout this course.
  • Your thoughts on how knowledge of pharmacology enhances the function of the nurse practitioner.

Instructions: This is a discussion post. Ill provide all of the answers. The last two bullet points, you may elaborate as you wish. 

Name: Mauricio Pereyra

Geographical Area: Florida

Work experience: worked in the emergency department, went travel nursing during the covid period.

course name: MN553 Advanced pharmacology and Pharmacotherapeutics, for the APRN program. pick any to objectives related to this course.

The last bullet point elaborate as you wish.

cap3

Discuss the individual and/or community needs as it relates to the reason for your capstone research inquiry. Why do you believe your research inquiry/findings will address the identified needs that prompted your inquiry?

Expectations

Initial Post:

  • use easy to find us sources ( capstone project is nurse retention) 
  • Length: A minimum of 250 words, not including references
  • Citations: At least one high-level scholarly reference in APA from within the last 5 years

Peers responses

· respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines. 

1st peer post:

Kiersten Echols

 There are many things that can influence your predisposition to specific disease processes. For example, culture can affect your predisposition to disease based on genetic factors and diet. Certain cultures have diets that contain higher sodium or higher use of trans fat. For example, if we take the Collins-Kim's Korean culture diet, their traditional dishes tend to contain more sodium which can lead to a pre-disposition and a higher likelihood of high blood pressure later in life. Financials can influence your predisposition to disease because they may influence the environment you live in and the food you eat. If you are on a lower income, you are more likely to live in an area that may be higher in air pollutants and unhygienic living spaces directly causing diseases such as COPD or Asthma. You also may only be able to afford lower quality food containing higher sodium, saturated fats, and processed foods containing chemicals leading to obesity or high cholesterol. Your genetics play just as big of a role as all of the factors listed above in your risk of disease development. Things such as Sickle Cell disease are passed down through the generations, most common in African-American ancestry, and are unavoidable if it is part of your genetic makeup when you are born. 

 The two family members I would like to focus on are Noah Collins and Grandpa Kim (Akio). The lifespan considerations I would look at for Noah would be her higher risk for things like heart disease and diabetes. These things are more common in African Americans and should be monitored as they age. Given that we do not know anything about her birth parent's health history, she should be screened for any genetic diseases that are prominent in this population such as Sickle Cell. For Grandpa Kim, considering he already has a diagnosis of hypertension, I would make sure he sees his PCP and Cardiologist regularly to watch his heart health closely. This diagnosis may be related to the high sodium diet from Korean dishes leading to increased inflammation in the body. He needs to adhere to the lifestyle changes that must be made when given this diagnosis such as watching sodium intake, monitoring his blood pressure daily, and taking his medications regularly throughout his life. 

References

Basdeki, E. D., Kollias, A., Mitrou, P., Tsirimiagkou, C., Georgakis, M. K., Chatzigeorgiou, A., Argyris, A., Karatzi, K., Manios, Y., Sfikakis, P. P., & Protogerou, A. D. (2021, July 30). 
Does sodium intake induce systemic inflammatory response? A systematic review and meta-analysis of randomized studies in humans. Nutrients. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399701/

Centers for Disease Control and Prevention. (2019, January 3). 
Introduction to environmental public health tracking. Centers for Disease Control and Prevention. 

https://www.cdc.gov/nceh/tracking/tracking-intro.html#:~:text=Environmental%20hazards%E2%80%94like%20water%20and,acute%20illnesses%20like%20heat%20exhaustion
.

Centers for Disease Control and Prevention. (2018, January 19). 
Behavior, environment, and genetic factors all have a role in causing people to be overweight and obese. Centers for Disease Control and Prevention. 

https://www.cdc.gov/genomics/resources/diseases/obesity/index.htm

Kim, S. H., Kim, M. S., Lee, M. S., Park, Y. S., Lee, H. J., Kang, S., Lee, H. S., Lee, K.-E., Yang, H. J., Kim, M. J., Lee, Y.-E., & Kwon, D. Y. (2016, March 15). 
Korean diet: Characteristics and historical background. Journal of Ethnic Foods. 

https://www.sciencedirect.com/science/article/pii/S2352618116300099#:~:text=The%20principal%20aspects%20of%20the,and%20sesame%20or%20perilla%20oil
.

U.S. National Library of Medicine. (n.d.). 
Why are some genetic conditions more common in particular ethnic groups?: Medlineplus Genetics. MedlinePlus. 

https://medlineplus.gov/genetics/understanding/inheritance/ethnicgroup/#:~:text=People%20in%20an%20ethnic%20group,frequently%20seen%20in%20the%20group
.

Weida, E. B., Phojanakong, P., Patel, F., & Chilton, M. (2020, May 18). 
Financial Health as a measurable social determinant of health. PloS one. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233592/

 

2nd peer post:

Jasmin Seay

Culture affects an individual's beliefs regarding healthcare, including whom they seek as providers, how they respond to recommendations, and their willingness to adhere to lifestyle changes and treatment modalities (Hernandez & Blazer, 2006; Nielsen-Bohlman et al., 2004). The Collins-Kim family consists of individuals descending from Greek/Scottish/Irish and East Asian cultures. East Asian culture primarily seeks herbal and holistic treatments as opposed to Western medicine. Finances determine the quality of accessible healthcare resources (Hernandez & Blazer, 2006; Purdue University, 2020). Financial stress/strain directly impacts health because it can influence the adoption of unhealthy coping mechanisms (Purdue University, 2020). A potential example is the history of smoking and obesity within the Collins family. The environment presents similar, if not more detrimental damage than genetics because environmental conditions can mutate genes and trigger disease(National Institute of Environmental Health Sciences, 2018). Environmental factors include air pollutants, chemical and noise exposures, and climate change (Regis College, 2020). Regarding genetic influence, family history directly influences the genetic prevalence of a disease occurrence in subsequent generations (Hernandez & Blazer, 2016). There were various incidences of this in the case study, for example, Elliot Collins has asthma which likely was influenced by his mother who has a history of asthma. Additionally, heart disease was prominent in both of Leslie Collins parent's health history. I chose to follow Leslie Collins and Kali Collins-Kim throughout the case study. With analysis of Leslie Collins personal history and family history, he is a great risk of:

· Obesity (he is currently overweight for his height and family history – both parents) (Earhart, 2010)

· Heart Disease (hypertension, hyperlipidemia, and ex-smoker) 

· COPD (ex-smoker and family history – paternal) (Hersh et al., 2011)

Upon review of Kali Collins-Kim, she is at risk of:

· Antibiotic Resistance (PCN allergy = increased use of broad-spectrum antibiotics) (Blumenthal et al., 2019)

· Dementia and Alzheimer's (family history – maternal) (Alzheimer's Association, 2023)

REFERENCES

Alzheimer's Association. (2023). 
Causes and Risk Factors for Alzheimer’s Disease. Alzheimer’s Disease and Dementia. https://www.alz.org/alzheimers-dementia/what-is-alzheimers/causes-and-risk-factors#:~:text=Another%20strong%20risk%20factor%20is

Blumenthal, K. G., Peter, J. G., Trubiano, J. A., & Phillips, E. J. (2019). Antibiotic allergy. 
The Lancet
393(10167), 183–198. https://doi.org/10.1016/s0140-6736(18)32218-9

Earhart, S. (2010). 
Obesity – The Link between Your Weight and Your Family. Obesity Action Coalition. https://www.obesityaction.org/resources/obesity-the-link-between-your-weight-and-your-family/#:~:text=Research%20on%20families%20and%20obesity

Hernandez, L. M., & Blazer, D. G. (2006). 
The Impact of Social and Cultural Environment on Health. Nih.gov; National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK19924/

Hernandez, L. M., & Blazer, D. G. (2016). 
Genetics and Health. Nih.gov; National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK19932/

Hersh, C. P., Hokanson, J. E., Lynch, D. A., Washko, G. R., Make, B. J., Crapo, J. D., & Silverman, E. K. (2011). Family History Is a Risk Factor for COPD. 
Chest
140(2), 343–350. https://doi.org/10.1378/chest.10-2761

National Institute of Environmental Health Sciences. (2018). 
Gene and Environment Interaction. National Institute of Environmental Health Sciences. https://www.niehs.nih.gov/health/topics/science/gene-env/index.cfm

Nielsen-Bohlman, L., Panzer, A. M., & Kindig, D. A. (2004). Culture and Society. In 
www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK216037/#:~:text=Cultural%20health%20beliefs%20affect%20how

Purdue University. (2020, January). 
A surprising connection: Financial wellness and your overall health – Healthy Boiler – Purdue University. Www.purdue.edu. https://www.purdue.edu/hr/CHL/healthyboiler/news/newsletter/2020-01/finances-health.php#:~:text=%E2%80%9CFinancial%20stress%20can%20and%20does

Regis College. (2020, November 16). 
Environmental Factors that Affect Health. Regis College Online. https://online.regiscollege.edu/blog/environmental-factors-that-affect-health/