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NR 601 Week 6 Case Study Discussions Health Promotion, Health Protection, Disease Prevention, and Treatment Considerations in Long-Term Care (Part-1) NEW
Discussion Part One (graded)
Ms. S. is a 62-year-old black female who has returned to the clinic to discuss her concerns that her lifestyle modifications to lose weight have not worked. At the last visit 3 months ago, she was advised to change her eating habits and increase activity to promote weight loss. She reports walking at least 30 minutes a day but has lost very little weight. ……….. indicates that the walking only made her extremely thirsty and hungry and attributes her increased thirst and hunger to increased exercise and her increased urination due to drinking more water since “it’s been hot lately” and exercise makes me thirsty”…… has returned to the clinic to discuss if there is anything else that can be done to lose weight and to determine why she is so tired, thirsty and hungry all the time. She also thinks she may have an overactive bladder since she has to urinate frequently during the day, which has influenced her not to go on outings with her friends.
Discussion Questions Part One
Conduct a ROS on this patient.
Indicate which symptoms are most concerning to you.
List your differential diagnoses.
What types of screenings would be appropriate to use based on the chief complaint?
What primary diagnosis are you choosing at this point?
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NR 601 Week 1 Case Study Discussions Physical Examination (Part 1) NEW
Discussion Part One (graded)
You meet your first patient of the morning. A.K. is a 65-year-old Caucasian male who you are seeing for the first time. Both wife and daughter are present.
Background
He reports that he has had an 18-pound unintentional weight loss in the last 2 months “I am just not hungry anymore, and when I do eat, I get full so fast. In fact, it is really hard to eat, and I don’t eat nearly as much as usual, even though I eat 3 times every day”. He also reports feeling more tired than usual. “I am not sleeping very well. My wife wakes me up when I am snoring, or when she thinks I am not breathing. I used to have sleep apnea, but I don’t think I have it anymore. Besides, that mask is so horrible to wear.” He reports day time somnolence. He reports that he is at the clinic today because of his wife and daughter’s concern about his weight loss and loss of appetite.
PMH
Mr. A.K. has a history of hypertension, cataracts, and osteoarthritis. Current medications:
Ibuprofen 600 mg po TID
Lisinopril 20 mg po QD
Hydrochlorothiazide 25 mg PO QD
Simvastatin 20 mg po QD
Vitamin D3 50,000 units po weekly
Omeprazole 40 mg po QD
Sudafed 50 mg po TID prn
Surgeries
April 2010-Right cataract extraction with Intraocular Lens Placement June 2010- Left cataract extraction with Intraocular Lens Placement November 2011-Left total knee arthroplasty
Allergies: No known drug or food allergies. Allergies to latex causing difficulty breathing and to bee stings, causing widespread edema and airway obstruction.
Vaccination History
He receives annual flu shots “most of the time”. His last one was 18 months ago.
Received a Pneumovax “the day I turned 65”.
His last TD was greater than 10 years ago.
Has not had the herpes zoster vaccine.
Social history
He has an 8th grade education and is a retired concrete finisher. He lives with his wife of 45 years and his daughter lives next door. He enjoys working in his back yard garden and recently tripped over the garden hose last week where his neighbor had to come and help him up.
Family history
Both parents are deceased. Father died of a heart attack at the age of 80; mother died of breast cancer at the age of 76. He has one daughter who is 45 years old and has hypertension. Hypertension, coronary artery disease, and cancer runs in the family.
Habits
He drinks one 4 ounce glass of red wine nightly; previous smoker of 30 years; he quit for 10 years, and is now smoking ¼ pack per day for the last 6 months.
Discussion Part One:
Provide the differential diagnoses (DD) with rationale
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PSY 330 Week 5 DQ 2 Sociobiology
View the interview with E.O. Wilson (http://www.charlierose.com/view/interview/4989), a pioneer in the field of sociobiology. In the video, Dr. Wilson makes some very strong statements regarding the biological nature of human behavior. Many of these statements are in direct opposition to other models and theories that you have been exposed to throughout this course. You will be divided by last names for this discussion. Your initial post should formulate an argument either to support or refute E.O. Wilson’s claims from the interview.
Last names beginning with letters A-M: Provide a reasoned argument that supports the statements that E.O. Wilson makes regarding the biological nature of human behavior in the interview video clip. Your initial post should be a minimum of 250 words and utilize at least one peer-reviewed source that was published within the last five years, cited according to APA guidelines as outlined in the Ashford Writing Center.
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