discussion 6 div

 

Hyde Pfiefer, a retired 70-year-old German American, has lived in the United States for the last 50 years. A widower of 5 years, Mr. Pfiefer prepares his own meals following his wife’s recipes from the old country. Nine months ago, Mr. Pfiefer was told that his cholesterol is elevated, and he was instructed about a low-fat diet. His most recent test results show his values to be unchanged.

  1. Discuss the meaning of food in the German culture.
  2. Using the predominant health beliefs of people of German ancestry, how might you help Mr. Pfiefer reduce his cholesterol level?

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.  Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date. 

Health Assessment

10/17/23, 5:31 PM Topic: Week 8: Discussion

https://waldenu.instructure.com/courses/85632/discussion_topics/760465?module_item_id=2747340 1/5

This is a graded discussion: 100 points possible
due Oct 18 at 10:59pm

5 5

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(https://waldenu.instructure.com/courses/85632/modules/items/274
7339)

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The body is constantly sending signals
about its health. One of the most easily
recognized signals is pain.
Musculoskeletal conditions comprise one
of the leading causes of severe long-term
pain in patients. The musculoskeletal
system is an elaborate system of
interconnected levers that provides the
body with support and mobility. Because
of the interconnectedness of the
musculoskeletal system, identifying the
causes of pain can be challenging.
Accurately interpreting the cause of
musculoskeletal pain requires an
assessment process informed by patient
history and physical exams.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen
in a clinical setting.

ASSESSING MUSCULOSKELETAL PAIN

RESOURCES

10/17/23, 5:31 PM Topic: Week 8: Discussion

https://waldenu.instructure.com/courses/85632/discussion_topics/760465?module_item_id=2747340 2/5

To prepare:

By Day 1 of this week, you will be assigned to one of the following specific case studies for this
Discussion. Please see the “Course Announcements” section of the classroom for your
assignment from your Instructor.
Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the
traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and
the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance.
Remember that all Episodic/Focused SOAP notes have specific data included in every patient
case.
Review the following case studies:

Case 1: Back Pain

(https://waldenu.instructure.com/courses/85632/files/5407561/preview) 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?

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES (https://waldenu.instructure.com/courses/85632/modules/items/2747342)

10/17/23, 5:31 PM Topic: Week 8: Discussion

https://waldenu.instructure.com/courses/85632/discussion_topics/760465?module_item_id=2747340 3/5

Case 2: Ankle Pain

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courses/85632/files/5407623/preview)

A 46-year-old female reports pain in both of her
ankles, but she is more concerned about her
right ankle. She was playing soccer over the
weekend and heard a “pop.” She is able to
bear weight, but it is uncomfortable. In
determining the cause of the ankle pain, based
on your knowledge of anatomy, what foot
structures are likely involved? What other
symptoms need to be explored? What are your
differential diagnoses for ankle pain? What
physical examination will you perform? What
special maneuvers will you perform? Should
you apply the Ottawa ankle rules to determine
if you need additional testing?

10/17/23, 5:31 PM Topic: Week 8: Discussion

https://waldenu.instructure.com/courses/85632/discussion_topics/760465?module_item_id=2747340 4/5

Case 3: Knee Pain

(https://waldenu.instructure.com/courses/85632/files
/5407665/preview)

A 15-year-old male reports dull pain in both
knees. Sometimes one or both knees click, and
the patient describes a catching sensation
under the patella. In determining the causes of
the knee pain, what additional history do you
need? What categories can you use to
differentiate knee pain? What are your specific
differential diagnoses for knee pain? What
physical examination will you perform? What
anatomic structures are you assessing as part
of the physical examination? What special
maneuvers will you perform?

With regard to the case study you were assigned:

Review this week's Learning Resources, and consider the insights they provide about the case
study.
Consider what history would be necessary to collect from the patient in the case study you
were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more
information about the patient's condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for
the patient.

Note: When you submit your initial post, please include a header as the first line
indicating your assigned case study. For example, “Review of Case Study ___.” Fill in
the blank with the number of the case study you were assigned.

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
each.

BY DAY 3 OF WEEK 8

10/17/23, 5:31 PM Topic: Week 8: Discussion

https://waldenu.instructure.com/courses/85632/discussion_topics/760465?module_item_id=2747340 5/5

Replies are only visible to those who have posted at least one reply.

Search entries or author

 Reply

Note: For this Discussion, you are required to complete your initial post before you
will be able to view and respond to your colleagues' postings. Begin by clicking on
the Reply button to complete your initial post. Remember, once you click on Post
Reply, you cannot delete or edit your own posts and you cannot post anonymously.
Please check your post carefully before clicking on Post Reply!

Read a selection of your colleagues' responses.

Respond to at least two of your colleagues on 2 different days who were assigned different
case studies than you. Analyze the possible conditions from your colleagues' differential
diagnoses. Determine which of the conditions you would reject and why. Identify the most likely
condition, and justify your reasoning.

BY DAY 6 OF WEEK 8

Unread  

safety

PNSG 1514

Quality Improvement Assignment

Course Learner Outcome Five: Collaborate with other healthcare providers to promote safe and quality patient-centered care.

· Read the policy below and decide if it reflects best practice for a skilled nursing facility.

· Research current evidence-based practice regarding the attached policy to determine if changes need to occur.

· Describe in detail what you would change in the current policy citing the evidence you gathered.

· Please include and cite at least 1 scholarly resource using APA format.

Pressure Ulcer Prevention and Managing Skin Integrity

I. PURPOSE

A. To maintain the integrity of residents’ skin and overall health.

B. To effectively identify residents who are at risk for skin breakdown.

C. To provide early interventions for residents with skin breakdown and minimize associated risks.

D. To educate staff, residents, and families on measures to prevent skin breakdown.

II. POLICY

Nursing is solely responsible for all aspects of the skin risk assessment and will assess and manage skin integrity for all residents. Risk for pressure ulcer development will be evaluated using the Braden Scale. Skin inspections will be completed on admission for all residents. Any resident with a Braden score < 8 shall have skin inspections done every month. Residents with a Braden score > 8 do not need further skin inspections done.

III.
DEFINITIONS

A. Risk assessment: identification of the potential risk that a resident will contribute to the likelihood for developing skin breakdown.

B. Skin Inspection: a head to toe assessment of residents, intended to detect skin breakdown.

C. Interventions: the steps taken by care providers to increase monitoring of the skin and reduce or alleviate pressure on body parts to minimize or eliminate the risk of skin breakdown.

IV.
PROCEDURE

A. All residents will be assessed one time, on admission to the skilled nursing facility. This will include a head to toe assessment, paying close attention to bony prominences and skin folds.

B. Screening, using the Braden Scale, will be completed by an RN, LPN, or CNA. This must be documented in the medical record.

C. Residents with a Braden score < 8 will have assessments done every month until reaching a score of 8 or higher.

D. All interventions must be documented in the medical record.

V.
INTERVENTIONS

A. Patient Repositioning and Turning; required once per shift.

B. Cleanse and dry skin at routine intervals and at the time of soiling;

recommend tub bath once per week.

C. Proper Nutrition; provide meals high in carbohydrates to promote healing.

D. Implement a specialty bed if indicated.

E. Staff Education; require annual training of nursing staff.

Minnesota State Community & Technical College

© PNSG 1514

8.2023

image1.jpg

WK 2 Discussion post reply

Please see attachment for instructions 

week 4 discussion answers

Please respond to each discussion post with 4 to 5 sentences with apa references for each 

Please Reply to the following 2 Discussion posts:

Please see the attachment for the instructions

You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.

 You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire. 

Individual Rights & Vaccination Policy

 School board trustees are requesting public comment before they vote on a vaccination policy for all children in a local school district. 

Nursing journal 2

see attached, same as last one need last 2 sections completed. see starred items that must be included.