Assignment: Practicum

In addition to Journal Entries, SOAP Note submissions are a way to reflect on your Practicum experiences and connect these experiences to your classroom experience. SOAP Notes, such as the ones required in this course, are often used in clinical settings to document patient care. Please refer to this week’s Learning Resources for guidance on writing SOAP Notes.

Select a patient who you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

• Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent, as well as possible reasons for these discrepancies.
• Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.
• Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?
• Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
• Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?

Assignment: Adaptive Response

Assignment: Adaptive Response

As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

· Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

· Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

· Construct a mind map for the disorder described on the Scenario 1: Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

To Complete

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

· For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.

· Construct one mind map on the disorder described on Scenario 1. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

The Financial

Using your NAB Company Portfolio and the first year of your business plan for the company, complete the Income Statement, Cash Flow Projections, and Balance Sheet sections from the “Business Plan Financials” spreadsheet. (These files are found in the Student Center). Attach the completed Excel worksheet to the discussion thread.
Remember to include your marketing costs from the Marketing Plan you completed in Week 6.
Use the figures you arrived at in the operations and technology sections of your plan to help fill out your financial forms.
Go through the worksheets in order. The Excel worksheets will automatically enter the numbers into your Income Statement as you enter them.
Develop the following financial sections of your NAB company’s Business Plan. Attach the completed Word document to the discussion thread.
Sources and use of funds
Plan assumptions
Break-even analysis
Provide constructive feedback to at least one (1) other classmate’s post.

Crimes in Paris

You need to apply the main theories in the readings cited below (Scott and Foucault) to my chosen city, Paris France and issue, crimes. You don’t need to use every single idea from all of those theoretical readings; decide which ones work the best for explaining what is going on in the case of crimes in Paris. The class is called Power and place in the city, it is a political science class where we talked mainly about political thoughts and the organization and problems occurring in cities. 
Main sources: 
Foucault: Discipline and Punish, pp. 73-103
Foucault: Discipline and Punish, pp. 170-228
Foucault: Security, Territory, Population, pp. 87-110
Foucault: The Birth of Biopolitics, pp. 27-70
Scott: Seeing Like a State, pp. 87-146
Scott: Seeing Like a State, pp. 193-222
James C. Scott, et al.: “The Production of Legal Identities Proper to the State:
The Case of the Permanent Family Surname"
 

Parallel Assignment

1) Identify one significant strength of the districts educational program, and describe a strategy for building on this strength to improve the district's educational program.
2) Identify two significant weaknesses of the districts education program.
3) For each of the weaknesses you have identified,describe one strategy to address that weakness; and 
4) explain why each of these strategies is likely to be effective in improving the districts program. 

Mental and Emotional Stress amongst Children and Younger Adults

Review and report on approximately 50-60 scholarly articles of importance in your area of interest. You may find as you are writing that you still need to support some parts of your argument better with more research, or that some research does not really fit with your overall organization and plan. 

Write a coherent, well-organized paper. Be sure that paper has an introduction, a main body, which is subdivided by topic and subtopic, and a summary. Your summary should draw a conclusion, based on your review of the research, as to what type of program would be best to either prevent or intervene in the problem you focused on, in the population that you chose. You may find that there is insufficient evidence to draw such a conclusion, or that a new program needs to be devised to meet the needs of that particular population.

In your own words distinguish between a eukaryotic species, a bacterial species, and a strain.

In your own words distinguish between a eukaryotic species, a bacterial species, and a strain.

Disclosing Officer Untruthfulness to the Defense

Disclosing Officer Untruthfulness to the Defense: Is a Liar’s Squad Coming to Your Town?

Environmental Assessment

In this assignment, you will prepare a research paper that describes, illustrates, and critiques an Environmental Assessment in a Canadian jurisdiction. To do this, you will use the EA report (DOC99145E) as your main source of information. Your paper must include a critical/analytical component as well as descriptive elements.You must demonstrate that you are familiar with the current state of EA in your case study jurisdiction. You may include figures, maps, tables and comparative lists/charts to help explain key point

Entomology- honeybee waggle Dance related

You are a honeybee forager who has just found a rich source of nectar. Your find was made in the afternoon at a time when the sun was exactly halfway between the zenith (top of the daily arc) and the horizon. If you were to plot the position of the sun to compass bearings on a flat surface, it would be exactly southwest or a bearing of 225 degrees. Your source of nectar is directly southeast of the hive at a bearing of 135 degrees. The distance of the nectar is 315 meters from the hive. You must tell your nest-mates how to find the source.

Explain in essay form, the events that occur from your landing at the hive’s front entrance. 

1. What do you do upon landing

2. who greets you

3. what do you do with the nectar

4. how do you explain where the nectar is located. 

You must have a diagram of the hive, sun and the food source as well as a diagram of the dance. (total of two diagrams). Make sure you label all the directions. The dance should be described in detail. Remember, you are dancing on a vertical surface.