Case 5 And 6(Knee Injury And Testicular Cancer )

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Knee Injury Case Studies A 15-year-old gymnast has noted knee pain that has become progressively worse during the past several months of intensive training for a statewide meet. Her physical examination indicated swelling in and around the left knee. She had some decreased range of motion and a clicking sound on flexion of the knee. The knee was otherwise stable. Studies Results Routine laboratory values Within normal limits (WNL) Long bone (femur, fibula, and tibia) X-ray No fracture Arthrocentesis with synovial fluid analysis Appearance Bloody (normal: clear and straw-colored) Mucin clot Good (normal: good) Fibrin clot Small (normal: none) White blood cells (WBCs) <200 WBC/mm3 (normal: <200 WBC/mm3 ) Neutrophils <25% (WNL) Glucose 100 mg/dL (normal: within 10 mg/dL of serum glucose level) Magnetic resonance imaging (MRI) of the knee Blood in the joint space. Tear in the posterior aspect of the medial meniscus. No cruciate or other ligament tears Arthroscopy Tear in posterior aspect of medial meniscus Diagnostic Analysis The radiographic studies of the long bones eliminated any possibility of fracture. Arthrocentesis indicated a bloody effusion, which was probably a result of trauma. The fibrin clot was further evidence of bleeding within the joint. Arthrography indicated a tear of the medial meniscus of the knee, a common injury for gymnasts. Arthroscopy corroborated that finding. Transarthroscopic medial meniscectomy was performed. Her postoperative course was uneventful. Critical Thinking Questions 1. One of the potential complications of arthroscopy is infection. What signs and symptoms of joint infection would you emphasize in your patient teaching? 2. Why is glucose evaluated in the synovial fluid analysis? 3. What are special tests used to differentiate type of Tendon tears in the knee ? Explain how they are performed (Always on boards)

Testicular Cancer Case Studies A 21-year-old male noted pain in his right testicle while studying hard for his midterm college examinations. On self-examination, he noted a “grape sized” mass in the right testicle. This finding was corroborated by his healthcare provider. This young man had a history of delayed descent of his right testicle until the age of 1 year old. Studies Results Routine laboratory studies Within normal limits (WNL) Ultrasound the testicle Solid mass, right testicle associated with calcifications HCG (human chorionic gonadotropin) 550mIU/mL (normal: <5) CT scan of the abdomen Enlarged retroperitoneal lymph nodes CT scan of the chest Multiple pulmonary nodules Diagnostic Analysis At semester break, this young man underwent right orchiectomy. Pathology was compatible with embryonal cell carcinoma. CT directed biopsy of the most prominent pulmonary nodule indicated embryonal cell carcinoma, compatible with metastatic testicular carcinoma. During a leave of absence from college, and after banking his sperm, this young man underwent aggressive chemotherapy. Repeat testing 12 weeks after chemotherapy showed complete resolution of the pulmonary nodules and enlarged retroperitoneal lymph nodes. Critical Thinking Questions 1. What impact did an undescended testicle have on this young man’s risk for developing testicular cancer? 2. What might be the side effects of cytotoxic chemotherapy? 3. What was the purpose of preserving his sperm before chemotherapy? 4. Is this young man’s age typical for the development of testicular carcinoma?

 

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Case 5 And 6(Knee Injury And Testicular Cancer ) was first posted on July 28, 2019 at 12:06 pm.
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Case 5 And 6(Knee Injury And Testicular Cancer ) was first posted on July 28, 2019 at 9:01 am.
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Chronic Condition (Graves Disease

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Soap Note 2 Chronic Conditions

Soap Note 1 Chronic Conditions (15 Points)
Pick any Chronic Disease from Weeks 6-10
Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
Follow the MRU Soap Note Rubric as a guide

Turn it in Score must be less than 20% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 20%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement

Soap Note 2 Chronic Conditions

Soap Note 2 Chronic Conditions (15 Points)

Pick any Chronic Disease from Weeks 6-10

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Late Assignment Policy

Assignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptions

Follow the MRU Soap Note Rubric as a guide:

Grading Rubric

Student______________________________________

This sheet is to help you understand what we are looking for, and what our margin remarks might be about on your write ups of patients. Since at all of the white-ups that you hand in are uniform, this represents what MUST be included in every write-up.

1)      Identifying Data (___5pts): The opening list of the note. It contains age, sex, race, marital status, etc. The patient complaint should be given in quotes. If the patient has more than one complaint, each complaint should be listed separately (1, 2, etc.) and each addressed in the subjective and under the appropriate number.

2)      Subjective Data (___30pts.): This is the historical part of the note. It contains the following:

a) Symptom analysis/HPI(Location, quality , quantity or severity, timing, setting, factors that make it better or worse, and associate manifestations.(10pts).

b) Review of systems of associated systems, reporting all pertinent positives and negatives (10pts).

c) Any PMH, family hx, social hx, allergies, medications related to the complaint/problem (10pts). If more than one chief complaint, each should be written u in this manner.

3)      Objective Data(__25pt.): Vital signs need to be present. Height and Weight should be included where appropriate.

a)      Appropriate systems are examined, listed in the note and consistent with those identified in 2b.(10pts).

b)      Pertinent positives and negatives must be documented for each relevant system.

c)        Any abnormalities must be fully described. Measure and record sizes of things (likes moles, scars). Avoid using “ok”, “clear”, “within normal limits”, positive/ negative, and normal/abnormal to describe things. (5pts).

4)      Assessment (___10pts.): Diagnoses should be clearly listed and worded appropriately.

5)      Plan (___15pts.): Be sure to include any teaching, health maintenance and counseling along with the pharmacological and non-pharmacological measures. If you have more than one diagnosis, it is helpful to have this section divided into separate numbered sections.

6)      Subjective/ Objective, Assessment and Management and Consistent (___10pts.): Does the note support the appropriate differential diagnosis process? Is there evidence that you know what systems and what symptoms go with which complaints? The assessment/diagnoses should be consistent with the subjective section and then the assessment and plan. The management should be consistent with the assessment/ diagnoses identified.

7)      Clarity of the Write-up(___5pts.): Is it literate, organized and complete?

Comments:

Total Score: ____________                                                          Instruc

 

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Chronic Condition (Graves Disease was first posted on July 28, 2019 at 12:04 pm.
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Chronic Condition (Graves Disease was first posted on July 28, 2019 at 9:03 am.
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What would you have done in this situation in both the roles of the police officer and of the football player?

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What would you have done in this situation in both the roles of the police officer and of the football player? he following is a true story – and it made national headlines several years ago. A Houston Texans football player and his wife got the call from a hospital in Dallas that his wife’s […]

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Regulation For Nursing Practice Staff Development Meeting

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  • Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.
  • Review the NCSBN and ANA websites to prepare for your presentation.

The Assignment: (9- to 10-slide PowerPoint presentation)

Develop a 9- to 10-slide PowerPoint Presentation that addresses the following:

  • Describe the differences between a board of nursing and a professional nurse association.
  • Describe the geographic distribution, academic credentials, practice positions, and licensure status of members of the board for your specific region/area.
    • Who is on the board?
    • How does one become a member of the board?
  • Describe at least one federal regulation for healthcare.
    • How does this regulation influence delivery, cost, and access to healthcare (e.g., CMS, OSHA, and EPA)?
    • Has there been any change to the regulation within the past 5 years? Explain.
  • Describe at least one state regulation related to general nurse scope of practice.
    • How does this regulation influence the nurse’s role?
    • How does this regulation influence delivery, cost, and access to healthcare?
  • Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).
    • How does this regulation influence the nurse’s role?
    • How does this regulation influence delivery, cost, and access to healthcare?

 

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