Discussion Part Two (graded)
Physical examination:
Vital Signs:
Height: 5’8” Weight: 188 pounds BMI: 28.58 BP: 130/70 T: 99.0 oral P: 72 regular R: 24, pursed-lip breathing; Pain level-7-right shoulder HEENT: Normocephalic, symmetric. PERRLA, EOMI, cerumen impaction bilateral ears.
NECK: Neck supple; non-palpable lymph nodes; no carotid bruits. LUNGS: Labored respirations; posterior RLL, LLL, RML, LML diminished breath sounds. Rhonchi right and left anterior chest.
HEART: RRR with regular without S3, S4, murmurs or rubs. ABDOMEN: Normal contour; active bowel sounds, LLQ tenderness.
PV: Diminished pedal pulses; hair loss noted over extremities.
NEUROLOGIC: Negative
GENITOURINARY: Urinary dribbling, urgency, gets up 4 times during the night, distended bladder.
MUSCULOSKELETAL: Limited ROM in right shoulder. Crepitus in knees bilaterally.
PSYCH: Negative
SKIN: Negative
Discussion Part Two:
Summarize the history and results of the physical exam. Discuss the differential diagnosis and rationale for choosing the primary diagnosis. Include one evidence-based journal article that supports your rationale and include a complete treatment plan that includes medications, possible referrals, patient education, ICD 10 Codes, and plan for follow up.
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Discussion Part Two (graded)
Physical examination:
Vital Signs:
Height: 5’8” Weight: 154 pounds BMI: 23.4 BP: 132/76 P: 76 regular R: 16
HEENT: Normocephalic, symmetric. PERRLA, EOMI, no cataracts noted; poor dentition.
NECK: Neck supple; non-palpable lymph nodes; no carotid bruits. LUNGS: Respirations are unlabored, decreased breath sounds and crackles at the bases bilaterally. Prolonged expiratory phase throughout lung fields, inspiratory wheezes and a productive cough of cloudy white sputum.
HEART: RRR with regular without S3, S4, murmurs or rubs.
ABDOMEN: Round, firm abdomen; active bowel sounds; non-tender. NEUROLOGIC: Unsteady gait, swaying while standing during periods of agitation. Achilles reflexes are present bilaterally. Strength is equal but decreased in the upper and lower extremities bilaterally.
GENITOURINARY: Urinary incontinence with strong odor of urine. NO CVA tenderness.
MUSCULOSKELETAL: Mild kyphosis. Heberden’s nodes at the distal interphalangeal joints (DIP) of all fingers, and marked crepitus of the bilateral knees on flexion and extension. Pedal pulses palpable. No edema noted in lower extremities.
PSYCH: Manic, restless, angry and hyperverbal
SKIN: Right forearm with 3 cm x 5 cm x 0 cm dry, scabbed abrasion. Left forearm with 4 cm x 5 cm x 0 cm dry, scabbed abrasion.
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Assignment 1: Parental Responsiveness
Due Week 5 and worth 160 points Story Before my first child was born, I studied child development. I learned the importance of responsive caregiving. I learned that I would soon be able to read my baby’s cries. I would know what was wrong and what I could do by the sound of the cry. After my baby was born, I responded quickly when he cried. To my surprise, I had difficulty calming him. I realized I did not always know what was wrong by the sound of his cry. I became very frustrated and decided that if my baby was dry, fed, and not tired. I would just let him cry it out. I didn’t know what else to do. Write a two to three (2-3) page paper in which you: Explain how Behaviorism, Psychoanalytic Theory, and Attachment Theory suggest handling this situation and predict what would be each likely outcome. Identify the characteristics that a baby could have that may disrupt the attachment process. Suggest a solution that is supported by research and theory. Explain what the research says regarding how parents should react to the cries of a child. Assess the behavior of the mother in supporting secure attachment. Use at least four (4) quality resources in this assignment. Note: Wikipedia and similar Websites do not qualify as quality resources. Your assignment must follow these formatting requirements: Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions. Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. The specific course learning outcomes associated with this assignment are: Assess the biological, cognitive, cultural, environmental, and social factors that influence development throughout the lifespan. Use technology and information resources to research issues in lifespan development. Write clearly and concisely about lifespan development using proper writing mechanics
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