NURSING

nursing - Nursing
PLACE ORDER
will explain RUNNINGHEAD: NEURO SOAP NOTE 1 Neurological Exam Soap Note Week United States University: MSN 572 August 9, 2021 Dr. Tolulope Adedayo This study source was downloaded by 100000784347808 from CourseHero.com on 10-06-2021 00:37:48 GMT -05:00 https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ Th is stu dy re so ur ce w as sh ar ed v ia C ou rs eH er o. co m https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ NEURO SOAP NOTE 2 ID: M.J. DOB 03/18/1978, 43-year-old married Black male presents to the office today accompanied by his wife. Subjective Chief complaint “My face feels like it’s numb.” History of Present Illness M.J is a43-year-old black male born and raised in California, who presents to the clinic today with complaints of his face “feels like it’s numb.” His symptoms began two days ago at work and has been constant, with the right side of his face feeling more numb than the left side. M.J has worked for the Department of Motor Vehicles for the past 15 years. His schedule is Monday thru Friday, 9am to 5pm weekly. He states that he has been feeling extremely overwhelmed at work related to an increased workload and unrealistic expectations from his managers. He states that he feels his managers are “out to fire him”, and this is the cause of his distress. Primary Medical History Allergies: No known Drug Allergies PMH: No past medical history. No history of viral infection, hypertension, diabetes, or migraines. Last doctor’s visit 1 year ago for annual physical exam. Surgical History: Drainage of rectal abscess 10 years ago. Immunizations: Childhood immunizations up-to-date to the best of his knowledge. Has never received the flu vaccine. Received Pfizer Covid vaccine 3/2021. Family history: Mother is in her early 50's and is overweight with no known medical conditions. Father is alive in his late 50’s and has hypertension and high cholesterol. He is unaware of any medical conditions to his maternal grandparents, who are alive and separated. His paternal This study source was downloaded by 100000784347808 from CourseHero.com on 10-06-2021 00:37:48 GMT -05:00 https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ Th is stu dy re so ur ce w as sh ar ed v ia C ou rs eH er o. co m https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ NEURO SOAP NOTE 3 grandfather passed away ten years ago from colon cancer and his paternal grandmother is alive in her 70’s and has a history of COPD. He has one younger brother, age 38, with no known medical history. His three school-age children are healthy with no medical history. Medications: Does not take any prescription or OTC medications. Social History Marital history: Married for 13 years Occupation: State employee for 15 years at the Department of Motor Vehicles. Diet/exercise: Drinks an adequate amount of water throughout the day and eats about two big meals with a snack. His usual meal consists of take-out food for lunch or leftover dinner with rice, vegetables, and protein. He may eat oatmeal at work for breakfast. Spiritual: Christian Safety: M.J is a registered gun owner and keeps his firearm in a locked safe, away from his family. Wears a helmet when riding his motorcycle 100% of the time. Wears a seatbelt 100% of the time. Sexual/Reproductive: In a monogamous relationship. Drug use: Occasionally uses marijuana once or twice a month, usually when he’s with friends. Last use was 3 weeks ago. First use as a teen. Alcohol use: Denies use of alcohol. Tobacco: Denies smoking cigarettes, vaping, or e-cigs. Sleep: Sleeps 6-8 hours a night. Denies waking up throughout the night. Review of Systems Constitutional: Denies pain, fever, and chills. Denies any weight changes. Integumentary: Denies any rashes, bruises, open wounds, lesions, or cuts to skin. This study source was downloaded by 100000784347808 from CourseHero.com on 10-06-2021 00:37:48 GMT -05:00 https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ Th is stu dy re so ur ce w as sh ar ed v ia C ou rs eH er o. co m https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ NEURO SOAP NOTE 4 HEENT: Patient wears prescription glasses, denies any vision changes, blurriness or diplopia. Denies sore throat, dysphagia, problems smelling. Reports dry eyes for past two days. Reports increased sensitivity to loud noise such as the vacuum and music. Reports discomfort located in the right postauricular area lasting for 30 minutes, beginning at work. Patient stated he drank more water and eventually it went away. Pain level was described as 5/10. No history of chronic headaches. Reports changes in taste, such as food tasting “more bland than usual”. Pulmonary: Denies shortness of breath, dyspnea, cough. Cardiovascular: Denies chest pain or abnormal swelling to his extremities. Gastrointestinal: Denies nausea, vomiting, diarrhea, or constipation. Genitourinary: Denies any pain, bleeding, burning, frequency, retention, or hesitancy with urination. Neurological: Denies any recent falls. Denies dizziness, seizures, light-headedness. Denies any trauma. Denies any numbness to bilateral hands, feet, arms, legs, and toes. Reports numbness to right side of face and lip area, does not include the orbital area. Musculoskeletal: Denies any weakness to upper and lower extremities. Psychological: Denies feelings of hopelessness, despair, intent to hurt self or others. Verbalizes feelings of frustration and being upset due to work related issues. Sleeps 6-7 hours a night, and does not awaken throughout the night. Allergy/Immunology: Denies any current or previous hematologic disorders. Denies any current or previous systemic disorders. Denies allergies to food, pets, environmental, and medications. Denies any abnormal bleeding or bruising. Objective This study source was downloaded by 100000784347808 from CourseHero.com on 10-06-2021 00:37:48 GMT -05:00 https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ Th is stu dy re so ur ce w as sh ar ed v ia C ou rs eH er o. co m https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ NEURO SOAP NOTE 5 Vital Signs: BP: 138/65. Temp: 98.9 F Pulse: 85 RR:18 O2 sat: 100% RA. Current weight and height: 6’0, 180 lbs., BMI: 24.4, normal. Integumentary: General skin color is normal for ethnicity. No skin rashes, lesions, open wounds, or scars noted. Skin turgor is normal. Lymphatic: No swelling or tenderness to the bilateral occipital, temporal, mandibular, submental, preauricular or tonsillar lymph nodes. Swelling and tenderness noted to right post auricular area. Head: Head contour and shape is normal with no visible deformities or trauma noted. No depressions, lesions, rashes or hematomas noted upon palpation. No tenderness or swelling palpated to frontal or maxillary sinuses. Ears: No drainage noted to bilateral ears. No redness or swelling noted bilaterally to auditory canal. Tympanic membrane is pearly gray. Five o’clock cone of light to right ear. Seven o’clock cone of light cone to left ear present. Whisper test is negative, patient is able to repeat whispered word to bilateral ears. Eyes: Patient wears prescription glasses. PERRLA intact. CN II, III, IV, VI intact. Confrontation is positive OD, OS. Negative for nystagmus. Sclera is white. Red reflex intact. Disc to cup ratio is 3:1, and disc is sharp to OD, OS. Conjunctiva is pink, dryness noted to OS, OD. Nose: Nasal septum midline. No postnasal drip, drainage, redness, lacerations or swelling noted to nasal canal/mucosa. Mouth: No redness, swelling, bleeding noted to oral mucosa. Oral mucosa is moist and normal color for ethnicity. CN X & IX intact. No swelling or inflammation noted to posterior pharynx, tonsils and soft palate. Tongue is midline. Throat: Trachea is symmetrical with no deviation. No swelling or tenderness of the thyroid gland. This study source was downloaded by 100000784347808 from CourseHero.com on 10-06-2021 00:37:48 GMT -05:00 https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ Th is stu dy re so ur ce w as sh ar ed v ia C ou rs eH er o. co m https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ NEURO SOAP NOTE 6 Pulmonary/Thorax: Respirations are even and unlabored. No signs of dyspnea. Posterior, lateral, and anterior lung sounds are clear with no adventitious sounds. No use of accessory muscles noted. Gastrointestinal: Abdomen is soft, flat, nontender, no visible pulsations noted. Last BM today- normal consistency and frequency for patient. Genitourinary: Bladder is soft, nontender. Musculoskeletal: ROM and motor strength to upper and lower extremities intact, 5+. Cardiovascular: S1 and S2 present. No thrills palpated. No bruits or murmurs upon auscultation. Rate and rhythm are regular at 89 beats/minute. No swelling noted to upper and lower extremities. Capillary refill to fingernails and toenails 3+. No clubbing or cyanosis noted to fingers and toes. Neurological: Speech is clear and concise. Alert and oriented x4. CN I (olfactory) intact, patient is able to smell appropriately in both nares. CN II (optic) intact, vision is 20/20 with prescription eyeglasses in place. CN III (oculomotor) intact, patient is able to , IV (trochlear), V (trigeminal), VI (abducens), VIII (acoustic), IX (glossopharyngeal), XII (hypoglossal) intact. DTR to bilateral biceps, triceps, patellar, and Achilles 2+. Weakness noted to CN VII (facial). Smile is unequal on the right side. Difficulty raising right eyebrow. No facial drooping noted. Assessment Differential Diagnosis: 1. Bell Palsy ICD G51.0- CN VII weakness noted. Impaired ability to raise ipsilateral eyebrow, impaired ability to smile, tenderness to right postauricular lymph node area, decreased tearing/dryness to eyes, changes in taste (Domino, 2022). This study source was downloaded by 100000784347808 from CourseHero.com on 10-06-2021 00:37:48 GMT -05:00 https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ Th is stu dy re so ur ce w as sh ar ed v ia C ou rs eH er o. co m https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ NEURO SOAP NOTE 7 2. Acute Stroke ICD I63.9- Complaints of numbness and tingling to right side of face. No facial drooping noted. Romberg and pronator drift negative. Speech is clear and coherent. No changes in vision. No changes in gait or balance. 3. Guillen-Barre Syndrome G61.0- Cranial nerve VII weakness to the right side of the face and complaints of paresthesia. No progressive limb weakness. CN V motor and sensory function intact. ROM and motor strength to upper and lower extremities intact, 5+. Steady gait, no c/o dizziness. DTR of biceps, triceps, patellar, Achilles 2+. No recent flu vaccinations, GI, or respiratory infections. Vital signs within normal limits. Final Diagnosis: Bell Palsy- inflammation of CN VII triggered by event related stressor. Plan Diagnostic Labs & Studies:  CBC, CRP/ESR  HIV test, rapid plasma reagin (RPR) test.  Lyme serology: ELISA or IFA, Western blot for IgM, IgG for Borrelia burgdorferi  Titers for Varicella zoster virus, rubella, cytomegalovirus, hepatitis A, B, C.  Electromyography (EMG) if paralysis lasts more than one week.  Facial/skull radiography, CT scan or MRI to rule out stroke, facial fracture, tumor, or neoplasms. (Domino, 2022) Treatment: Prednisone 60mg oral daily for the first 5 days. Then, taper dose by 10mg/day for the next five days. Valacyclovir 1,000 mg three times daily for seven days. Ibuprofen 600 mg oral every 6 hours as needed for moderate-severe pain 5-10. May alternate with acetaminophen for breakthrough pain 1,000 mg oral every 6 hours as needed (Domino, 2022) This study source was downloaded by 100000784347808 from CourseHero.com on 10-06-2021 00:37:48 GMT -05:00 https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ Th is stu dy re so ur ce w as sh ar ed v ia C ou rs eH er o. co m https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ NEURO SOAP NOTE 8 Patient teaching:  May use cold or heat packs for 10-20 minutes at a time, four times a day for pain relief. Make sure not to apply cold pack directly to skin, rather wrap it in a towel first to prevent frost bite.  Wear eye protection during the day. Taping the affected eye at night and using lubricating eyedrops or ointment will keep the eyes from drying out and remaining moist.  Take analgesics as needed. Referrals: Refer to an ENT or ophthalmology specialist if ocular complications arise. A referral to a neurologist may be warranted if symptoms worsen or do not resolve adequately after four weeks. Follow up: Follow up with PCP in four weeks, or sooner, if symptoms worsen or do not resolve. Report any new changes to vision, trouble walking, or headaches. References Cash, J. C., & Glass, C. A. (Eds.). (2017). Family Practice Guidelines. New York; Springer Publishing Company. Domino, F.J., Baldor, R.A., Berry, K., Golding, J., & Stephens, M.B. (2022). The 5-minute clinical consult 2022. Lippincott Williams & Wilkins. This study source was downloaded by 100000784347808 from CourseHero.com on 10-06-2021 00:37:48 GMT -05:00 https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ Th is stu dy re so ur ce w as sh ar ed v ia C ou rs eH er o. co m Powered by TCPDF (www.tcpdf.org) https://www.coursehero.com/file/103073583/Bernadette-Bohol-NEURO-SOAP1-Copydocx/ http://www.tcpdf.org
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Your assignment may be more than 5 paragraphs but not less. INSTRUCTIONS:  To access the FNU Online Library for journals and articles you can go the FNU library link here:  https://www.fnu.edu/library/ In order to n that draws upon the theoretical reading to explain and contextualize the design choices. Be sure to directly quote or paraphrase the reading ce to the vaccine. Your campaign must educate and inform the audience on the benefits but also create for safe and open dialogue. A key metric of your campaign will be the direct increase in numbers.  Key outcomes: The approach that you take must be clear Mechanical Engineering Organic chemistry Geometry nment Topic You will need to pick one topic for your project (5 pts) Literature search You will need to perform a literature search for your topic Geophysics you been involved with a company doing a redesign of business processes Communication on Customer Relations. Discuss how two-way communication on social media channels impacts businesses both positively and negatively. Provide any personal examples from your experience od pressure and hypertension via a community-wide intervention that targets the problem across the lifespan (i.e. includes all ages). Develop a community-wide intervention to reduce elevated blood pressure and hypertension in the State of Alabama that in in body of the report Conclusions References (8 References Minimum) *** Words count = 2000 words. *** In-Text Citations and References using Harvard style. *** In Task section I’ve chose (Economic issues in overseas contracting)" Electromagnetism w or quality improvement; it was just all part of good nursing care.  The goal for quality improvement is to monitor patient outcomes using statistics for comparison to standards of care for different diseases e a 1 to 2 slide Microsoft PowerPoint presentation on the different models of case management.  Include speaker notes... .....Describe three different models of case management. visual representations of information. They can include numbers SSAY ame workbook for all 3 milestones. You do not need to download a new copy for Milestones 2 or 3. When you submit Milestone 3 pages): Provide a description of an existing intervention in Canada making the appropriate buying decisions in an ethical and professional manner. Topic: Purchasing and Technology You read about blockchain ledger technology. Now do some additional research out on the Internet and share your URL with the rest of the class be aware of which features their competitors are opting to include so the product development teams can design similar or enhanced features to attract more of the market. The more unique low (The Top Health Industry Trends to Watch in 2015) to assist you with this discussion.         https://youtu.be/fRym_jyuBc0 Next year the $2.8 trillion U.S. healthcare industry will   finally begin to look and feel more like the rest of the business wo evidence-based primary care curriculum. Throughout your nurse practitioner program Vignette Understanding Gender Fluidity Providing Inclusive Quality Care Affirming Clinical Encounters Conclusion References Nurse Practitioner Knowledge Mechanics and word limit is unit as a guide only. The assessment may be re-attempted on two further occasions (maximum three attempts in total). All assessments must be resubmitted 3 days within receiving your unsatisfactory grade. You must clearly indicate “Re-su Trigonometry Article writing Other 5. June 29 After the components sending to the manufacturing house 1. In 1972 the Furman v. Georgia case resulted in a decision that would put action into motion. Furman was originally sentenced to death because of a murder he committed in Georgia but the court debated whether or not this was a violation of his 8th amend One of the first conflicts that would need to be investigated would be whether the human service professional followed the responsibility to client ethical standard.  While developing a relationship with client it is important to clarify that if danger or Ethical behavior is a critical topic in the workplace because the impact of it can make or break a business No matter which type of health care organization With a direct sale During the pandemic Computers are being used to monitor the spread of outbreaks in different areas of the world and with this record 3. Furman v. Georgia is a U.S Supreme Court case that resolves around the Eighth Amendments ban on cruel and unsual punishment in death penalty cases. The Furman v. Georgia case was based on Furman being convicted of murder in Georgia. Furman was caught i One major ethical conflict that may arise in my investigation is the Responsibility to Client in both Standard 3 and Standard 4 of the Ethical Standards for Human Service Professionals (2015).  Making sure we do not disclose information without consent ev 4. Identify two examples of real world problems that you have observed in your personal Summary & Evaluation: Reference & 188. Academic Search Ultimate Ethics We can mention at least one example of how the violation of ethical standards can be prevented. Many organizations promote ethical self-regulation by creating moral codes to help direct their business activities *DDB is used for the first three years For example The inbound logistics for William Instrument refer to purchase components from various electronic firms. During the purchase process William need to consider the quality and price of the components. In this case 4. A U.S. Supreme Court case known as Furman v. Georgia (1972) is a landmark case that involved Eighth Amendment’s ban of unusual and cruel punishment in death penalty cases (Furman v. Georgia (1972) With covid coming into place In my opinion with Not necessarily all home buyers are the same! When you choose to work with we buy ugly houses Baltimore & nationwide USA The ability to view ourselves from an unbiased perspective allows us to critically assess our personal strengths and weaknesses. This is an important step in the process of finding the right resources for our personal learning style. Ego and pride can be · By Day 1 of this week While you must form your answers to the questions below from our assigned reading material CliftonLarsonAllen LLP (2013) 5 The family dynamic is awkward at first since the most outgoing and straight forward person in the family in Linda Urien The most important benefit of my statistical analysis would be the accuracy with which I interpret the data. The greatest obstacle From a similar but larger point of view 4 In order to get the entire family to come back for another session I would suggest coming in on a day the restaurant is not open When seeking to identify a patient’s health condition After viewing the you tube videos on prayer Your paper must be at least two pages in length (not counting the title and reference pages) The word assimilate is negative to me. I believe everyone should learn about a country that they are going to live in. It doesnt mean that they have to believe that everything in America is better than where they came from. It means that they care enough Data collection Single Subject Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an I would start off with Linda on repeating her options for the child and going over what she is feeling with each option.  I would want to find out what she is afraid of.  I would avoid asking her any “why” questions because I want her to be in the here an Summarize the advantages and disadvantages of using an Internet site as means of collecting data for psychological research (Comp 2.1) 25.0\% Summarization of the advantages and disadvantages of using an Internet site as means of collecting data for psych Identify the type of research used in a chosen study Compose a 1 Optics effect relationship becomes more difficult—as the researcher cannot enact total control of another person even in an experimental environment. Social workers serve clients in highly complex real-world environments. Clients often implement recommended inte I think knowing more about you will allow you to be able to choose the right resources Be 4 pages in length soft MB-920 dumps review and documentation and high-quality listing pdf MB-920 braindumps also recommended and approved by Microsoft experts. The practical test g One thing you will need to do in college is learn how to find and use references. References support your ideas. College-level work must be supported by research. You are expected to do that for this paper. You will research Elaborate on any potential confounds or ethical concerns while participating in the psychological study 20.0\% Elaboration on any potential confounds or ethical concerns while participating in the psychological study is missing. Elaboration on any potenti 3 The first thing I would do in the family’s first session is develop a genogram of the family to get an idea of all the individuals who play a major role in Linda’s life. After establishing where each member is in relation to the family A Health in All Policies approach Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum Chen Read Connecting Communities and Complexity: A Case Study in Creating the Conditions for Transformational Change Read Reflections on Cultural Humility Read A Basic Guide to ABCD Community Organizing Use the bolded black section and sub-section titles below to organize your paper. For each section Losinski forwarded the article on a priority basis to Mary Scott Losinksi wanted details on use of the ED at CGH. He asked the administrative resident