Cancer Treatment Options-Discussion Post

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Mrs. Williams is a 27-year-old female diagnosed with breast cancer. She is currently in pharmacy school. She does not have children, but hopes to have them someday. She has been tested and has a genetic predisposition for this disease.

  • What treatment options does she have?
  • What are the advantages and disadvantages of those treatment options?
  • What would you tell Mrs. Williams if she decided to refuse treatment?
  • Mrs. Williams really wants to have children before she starts treatment. What would you educate her about? Why? Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials, be sure to provide proper attribution and/or citation.

Initial post requirement must be 250 words minimum. The 2 peer responses must be 150 words minimum each. 

cultural diversity discussion 1

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Select one of the discussion prompts below and respond to it with an initial post by Day #4 of the unit week. Your initial post needs to thoroughly address all parts of the selected prompt and be supported by at least one scholarly source. Then, respond to at least two threads on two additional days to drive the weekly discussions. All posts must demonstrate critical thinking and effective written communication including proper spelling, grammar, professional language, and APA formatting of references and in-text citations. All posts must also be submitted no later than the last day of the unit week.

Discussion Prompts

Prompt #1

How do you define “cultural diversity”? Do you think the way you define cultural diversity is the same or different than how others might define it? What elements contribute to a person’s “cultural identity”? What if everyone in the world had the same cultural identity? Do you think this would be a place you’d want to live? Why are discussions about cultural identity important?

(USLOs 1.1, 1.2, 1.3)

Prompt #2

Share with us some of your personal and cultural identities. Please share 6 aspects of yourself with the group. Here are some identity categories, for example:

  • Cultural Heritage(s)
  • Nationality(-ies)
  • Family
  • Race/Ethnicity
  • Religion/Religious influences
  • Sexual Identity
  • Disability Status
  • Language Community(-ies)
  • Character trait(s)

Do any of these identities relate to one another, if so, how? What would a person who read about your identity be able to reveal about you? What would a person who read about your identity not be able to tell about you? Do any of your cultural identity groups practice allyship? If they do not practice allyship, how might they engage in activities to be more inclusive and equitable?

soap for brilliant

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Week 6: Problem-Focused SOAP Note

USE the template that I gave you before. Needs the 1st blank paper for cover sheet.

Some Rubric

Some Rubric

Criteria Ratings Pts

This criterion is linked to a
Learning Outcomes (Subjective)

10 pts
Accomplished

Symptom analysis is well organized, with C/C, OLD

CART, pertinent negatives, and pertinent positives. All

data needed to support the diagnosis & differential

are present. Is complete, concise, and relevant with

no extraneous data.

10 pts

This criterion is linked to a
Learning Outcome (Objective)

10 pts
Accomplished

Complete, concise, well organized, well written, and

includes pertinent positive and pertinent negative

physical findings. Organized by body system in list

format. No extraneous data.

10 pts

This criterion is linked to a
Learning Outcome
(Assessment)

10 pts
Accomplished

Diagnosis and differential dx are correct, include ICD

code, and are supported by subjective and objective

data.

10 pts

This criterion is linked to a
Learning Outcome (Plan) 10 pts

Accomplished

Plan is organized, complete and supported with 2

evidence-based references. Addresses each diagnosis

and is individualized to the specific patient and

includes medication teaching and all 5 components:

(Dx plan, Tx plan, patient education, referral/follow-

up, health maintenance).

10 pts

Total Points: 40

Patient initial: R. R

DOB: June/1991 Sex: F

Encounter Date: 08/08/2023

SUBJECTIVE:

Chief Complaint:

History Of Present Illness:

appt is requested for URI

Medical History:

#. COVID 1/2022

#. hemorrhoids

#. Postpartum Depression, Anxiety, panic attacks

#. ADD

#. Insomnia

#. Allergic rhinitis

#. Psoriasis

#. Onychymycosis

Surgical History:

none

Gynecological History:

G2 P2 A0

Family History:

M: living, arrhythmia, palpitations

F: living, healthy

S: asthma

Social History:

-Married

-Lives with husband, 2 kids, and grandparents

-Authorization coordiinator at USC Keck, also student in digital marketing

-Denies tobacco use

-etoh use: Socially

-Denies illicit drug use

Smoking Status: Never Smoked

Allergies:

No known allergies

Current Medications:

———————————-

Paxil 10 mg po qd

xanax 0.25 mg prn panic attacks

Adderall 20mg bid prn

———————————

Review of System:

Constitutional: Patient denies weight change, fever, chills, weakness, fatigue, sleep

changes, appetite changes.

Head: Patient denies headache.

Neck: Patient denies abnormal masses, neck stiffness.

Eyes: Patient denies vision loss, blurring, discharge, excessive tearing, dryness.

Ears: Patient denies hearing loss, tinnitus, vertigo, discharge, pain

Nose: #sinus congestion#

Mouth: Patient denies ulcers, bleeding gums, taste problems.

Throat: #sore throat#

Cardiovascular: Patient denies chest pain, chest pressure, palpitations, DOE,

orthopnea.

Respiratory: #dry cough#

Patient denies shortness of breath, increased sputum, hemoptysis.

Gastrointestinal: #looser stools, frequency, occ incontinence#

Patient denies nausea, vomiting, heartburn, dysphagia, constipation, melena,

abdominal pain, jaundice, hemorrhoids.

Genitourinary: #urinary urgency and frequency, occasional incontinence#

Patient denies abnormal hesitancy, hematuria, dysuria, nocturia, stones.

Musculoskeletal: Patient denies arthralgias, joint stiffness, myalgias, muscle

weakness, instability and abnormal range of motion

Integumentary (Skin and/or Breast): Patient denies rash, lesions, changes in hair,

changes in nail, pruritus

Neurological: Patient denies headache, syncope, seizures, vertigo, ataxia, diplopia,

tremor, numbness, tingling.

Psychiatric: #depression, anxiety, ADD#

Patient denies mood abnormalities, memory loss, difficulty sleeping, appetite

changes

Endocrine: Patient denies sensitivity to cold or heat, polyuria, polydipsia.

Hematologic/Lymphatic: Patient denies bleeding, bruising, lymphadenopathy.

GYN: #menorrhagia#

Patient denies changes in menstrual cycle, hot flashes.

OBJECTIVE:

Physical Exam:

Constitutional: #last exam done on 7/10/23 showed#

WD, WN, Alert, Oriented X3 in NAD. Affect appropriate. Gait normal.

Eye: PERRLA, EOMI, nl conjunctiva

Ear: No pinnea/tragal tenderness. Drums are visualized, no wax in canals

Nose: N1 mucosa. N1 Nasal septal walls and turbinates.

Mouth: N1 bucal mucosa, no lesions noted.

Throat: Clear, no erythema or exudates.

Neck: #thyroid fullness R#

supple, no masses. Trachea is midline. N1 carotid auscultation. No JVD

Cardiovascular: RRR, N1 S1 and S2, No cardiac murmurs, rubs or gallops.

Lungs: ctab, no wheezes, rhonchi or crackles

Chest/Breasts: deferred

Gastrointestinal (Abdomen): soft, nt, nd, bs(+). No palpable masses.

Genitourinary: #negative CVAT#

deferred

Lymphatic: -No LAN noted

Musculoskeletal: good ROM. Strength symmetrical and wnl. No muscle weakness or

stiffness. No joint effusion or ttp.

Skin: Normal color and texture. No lesions seen.

Extremities: Warm, no clubbing, cyanosis or edema. N1 DP/PT pulses bilaterally

Neurological/Psychiatric: CN I-XII intact, neurosensory wnl, strength (5/5), (2+) DTR

UE/LE bilaterally -Judgment and insight intact

ASSESSMENT:

Diagnosis:

ICD-10 Codes:

1)J069; Upper respiratory infection, unspecified

PLAN:

Procedures (CPT code):

1) 99213; Detailed

2) 99401; 15 min

Medications:

Promethazine-DM 6.25-15 MG/5ML Oral Syrup; Take 5 ml orally every 4 hours Take

as needed for dry cough; Qty: 120; Refills: 0

Care Plan:

.***URI- x4 days, sore throat, sinus congestion, dry cough, headache. took

tylenol/cough syrup, claritin with not much relief. sent home today from work, COVID

test today from work pending results. sisters also similar sxs, but has tested

negative for COVID.

-off work this week

-Rx promethazine/DM 5mL prn cough, r/b d/w pt

-sudafed and tylenol prn

-f/u 1 week, if no improvement and covid neg, come back in office for exam

***urinary incontinence- h/o occasional stress incontinence, however over last 1 mo,

c/o increasing urengency, frequency and 2 episodes of incontinence, which occured

with only minimal alcohol use. denies hematuria, dysuria. c/o menorrhagia

worsening after delivering her 2 yo. denies LBP/trauma/saddle paresthesia

-pelvic floor PT ordered

-UA/UCx ordered

-referred to uro gyn

-ordered transvaginal u/s r/o uterine fibroids

-counseled on wt loss. keep voiding journal

-avoid irritants such as caffeine/ETOH

***diarrhea- c/o looser stools, 4-5xd and few episodes of incontinence. c/o abd

cramping after bm, othewise no abd pain, fever, melena, wt loss. has had h/o abd

pain and cramping which we ordered stool studies, CRP, ESR but pt never did.

denies LBP/trauma/saddle paresthesia. abd exam normal today

-ordered stool studies, ESR, CRP

-referred to GI

-ER precautions

***Hyperlipidemia, lipoprotein deficiency- On 1/16/23, FLP showed 237/47/182/156.

Has lost 6 lbs intentionally since last visit.

-Rec low fat, low carb diet

-FLP with next annual

***obesity- BMI 31.37, wt 221 lbs, Has lost 6 lbs intentionally since last visit.

-counseled

***thyroid fullness- noted on exam. 1/16/23, TSH wnl.

-ordered thyroid u/s 11/8/22, pt has not done yet

Plan Notes Continued: .

***trigger finger- unsure of duration, ono/off. R ring finger locks. Pt has seen hand

specialist in the past for another issue

-Rx ibuprofen as noted above, r/b d/w pt

-pt rec to f/u with hand specialist

***Vitamin D deficiency- On 1/16/23, Vitamin D level was 24. not supplementing.

-Rec Vitamin D 4000 IU qd

-Vitamin D level with next annual

***Onychymycosis- b/l feet on PEX on 2/1/23. pt is interested in tx.

-given the interactions between terbinafine and her psychiatric meds, I rec she

checked with them first before we start

***Depression, Anxiety- F/b psychiatrist, Dr. Askins and psychologist, Dr. Tricia

Duncan Hassle. Takes Paxil 10 mg po qd and xanax 0.25 mg prn panic attacks.

Denies SI/HI.

-mgmt per psych

***ADD- F/b psychiatrist, Dr. Askins. Takes Adderall 20mg bid prn.

-mgmt per psych

Patient Instructions: .

.

-Pt has been instructed to take medications as prescribed

-Pt received education on compliance with medications and recommendations

-Pt received counseling regarding Medication Side Effects

-Pt received counseling on following a well-balanced healthy diet with veg, fruit and

fiber.

-Pt was instructed to do CV exercise at least 3-4 times every week for 30 minutes.

PHCM: .

.

31 y/o F:

-Annual physical: done 2/1/23- next due 2/1/24

-Annual labs: done 1/16/23- next due 1/16/24

-Cervical CA screening: managed by GYN

-Skin CA screening; Referred to derm on 3/30/22

Immunizations:

Tetanus: doen 2021- next due 2031

Influenza: Fall 2022

COVID19: Pfizer in 7/1/21, bivalent booster Pfizer 1/14/23

HPV: will check records

  • Week 6: Problem-Focused SOAP Note

Health Assessment 11

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Reflection

Top of Form

Bottom of Form

Module 11 Content

1.

Top of Form

In a Word® document answer the following questions.

1. What two areas of knowledge have you gained?

2. What specific health assessment skills are you now able to integrate into your nursing care?

3. Are there any areas that still remain unclear? What will you do to increase your clarity?

informatics

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Read pages 460-461 of your textbook to learn more about the challenges of long-term care. Based on what you have learned so far (1) Why is important and challenging to offer insurance for long-term care? (2) What kind of solution you can think of to increase value and/or reduce costs in long-term care? (3) Are there any type of organizations (think ACOs, etc) be able to offer these services at a low cost that would allow insurers to participate in this market?

Healthcare Infotmatic discussion

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NSG 3150 – Healthcare Informatics

Week 8 Discussion

In this course wrap-up discussion, please reflect on your experience in the course
NSG 3150 – Healthcare Informatics and address the following items:

· Identify one of your major takeaways from this course.

· What aspect of the course helped you achieve this?

· How will you apply this knowledge to your practice and career?


Please be sure to provide appropriate APA-formatted in-text citations and references to support your response.

dicussion post sociology

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Respond to two (2) of the following prompts:

  1. How is masculinity described by the authors of our text? Using specific examples, discuss why patriarchal masculinity is not the only form of masculinity. (USLO 5.1, 5.3)
  2. How is sexism explained by the authors of our text? Using specific examples, discuss how society propagates misogyny and objectification of women. (USLO 5.3)
  3. Using one of the three theoretical primary sociological perspectives featured in our text (i.e., functionalism, conflict, and symbolic interactionism) discuss the social construction of gender. Present two tangible examples of how this theory best explains how gender is socially constructed. (USLO 5.4)
  4. Where and how do you get your news? Do you watch network television? Read the newspaper? Go online? How about your parents or grandparents? Do you think it matters where you seek out information? Why, or why not? (USLO 5.5)
  5. How have digital media changed social interactions? Do you believe it has deepened or weakened human connections? Defend your answer. (USLO 5.6)
  6. Do you think technology has truly leveled the world in terms of opportunity? What is your community’s situation in terms of digital inclusion – do you feel there are communities in your region that are struggling to achieve digital inclusion and equity? What are some techniques that we may use to achieve digital equity and inclusion in the U.S.? (USLO 5.7)
  7. In what ways has the Internet and digital apps changed your perception of reality? Explain using a symbolic interactionist, functionalist, and conflict theory perspective. (USLO 5.8)

informatics

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follow all instruction in word document 

In the reflection for Module 1, please focus on the following question:

What are the most interesting traits of US health policy and its development process that you learned? How do you link these traits to what you know about the Affordable Care Act? Why do business professionals need to understand health policy and the process required to make them?

Nursing

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Title: “The Benefits and Challenges of Breastfeeding: Exploring Breastfeeding Resources for Empowered Mothers and Healthy Infants” 

Guidelines: 

APA Format 

MUST utilize credible data sources such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Library resources can be accessed from the Library page at the FNU.edu website. FNU Librarians are available to assist each student with retrieving the required scholarly content.

Research paper must be 650-1000 words. 

3 or more scholarly sources must be utilized

Sources must be within the last 5 years 

Must have a minimum of 3 Sources 

All article sources must be cited by including them in reference sheet (separate).


Reimbursement & Financing Issues

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After studying Module 4: Lecture Materials & Resources, discuss the following:

  • As decisions are made to address changes in reimbursement in your work place, how are these changes shared with the nursing staff?
  • What suggestions do you have that could increase nurses’ awareness of health care financing issues?