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Case Study: Mr JD is a 24-year-old who presents to Urgent Care with a 2-week history of cough and congestion

Case Study: Mr JD is a 24-year-old who presents to Urgent Care with a 2-week history of cough and congestion.

For this questions, please read the following case study and then respond to the questions noted below.

Mr. JD is a 24-year-old who presents to Urgent Care with a 2-week history of cough and congestion. He says it started out as a ”normal cold” and it will not go away. He has a productive cough for green mucous and has green nasal discharge. He says he has had a low-grade temperature for the past 2 days. John reports an intermittent frontal headache with this cold. He is otherwise healthy, with no known allergies.

In his assessment it is found that his vital signs are stable, temperature is 99.9 degrees F, tympanic membranes (TMs) are clear bilaterally, pharynx is erythematous with no exudate; there is greenish postnasal drainage; turbinates are swollen and red; frontal sinus tenderness; no cervical adenopathy, and lungs are clear bilaterally.

• Is there any additional subjective or objective information you need for this client? Explain.
  Would you treat Mr. JDs cold? Why or why not?
• What would you prescribe and for how many days? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.
• Would this treatment vary if Mr. JD was a 10 year-old 78 lb child? Include the class of the medication, mechanism of action, dosing, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings
• What health maintenance or preventive education is important for this client based on your choice medication/treatment?

Case Study: Mr JD is a 24-year-old who presents to Urgent Care with a 2-week history of cough and congestion – Instructions

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized.

Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

• Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

• I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
• As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

LopesWrite Policy 

• For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
• Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
• Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
• Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

• The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
• Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
• If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
• I do not accept assignments that are two or more weeks late unless we have worked out an extension.
• As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

• Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
• Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Herzing NU621 Unit 4 Discussion Advanced Pathophysiology: Case Study: Patient with lower abdominal discomfort nausea

Digestive Function

Read the following case study and answer the posed questions

Case #1:  A 64-year-old man presents to the emergency department (Links to an external site.) with abdominal pain and distention, as well as constipation of 8 days’ duration. He denies vomiting, fever, diarrhea, or dysuria. Except for hypertension, he is otherwise healthy with no prior surgeries. Case Study: Patient with lower abdominal discomfort nausea

His vital signs are normal except for a borderline pulse of 99 bpm. His physical examination is unremarkable except for his abdomen, which is large, rotund, and tympanitic. There is diffuse tenderness everywhere in the abdomen Case Study: Patient with lower abdominal discomfort nausea.

What history would you want to obtain?

What differential diagnoses would you consider?

List and describe the specific diagnostic tests you might order to determine cause of his concern?

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Case #2:

Kyle is a 58-year-old man who is experiencing lower abdominal discomfort nausea and diarrhea lasting 2 days. He thought he had eaten something that “disturbed his stomach” but since this has lasted so long, he is afraid it’s something serious.

As you obtain a history from this patient what differential diagnoses are you considering. Give rational for your choices.

Discuss the pathophysiologic relationship between nausea and vomiting?

Three days after Kyle’s initial visit his labs confirmed a diagnosis of cirrhosis.

Discuss the pathophysiologic relationship between cirrhosis and portal hypertension.

Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position and suggestions. Case Study: Patient with lower abdominal discomfort nausea

Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Please review the rubric to ensure that your response meets the criteria.

Estimated time to complete: 2 hours

Discussion Peer/Participation Prompt [Due Sunday]

Please respond to at least 2 of your peer’s posts.  To ensure that your responses are substantive, use at least three of these prompts:

• Do you agree with your peers’ diagnosis?
• Take an alternate view and offer a potential alternate approach.
• Share your thoughts on how you support their opinion and explain why.
• Present new references that support your opinions.
• Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
• Case Study: Patient with lower abdominal discomfort nausea

Intermittent Abdominal Pain Example

Today, an 18-year-old Caucasian female appears with intermittent stomach pain. She also has a low-grade fever, cramps, and diarrhea. She has also lost her appetite. She acknowledges smoking 1/2 PPD for two years. Denies using illegal drugs or alcohol and reports a Crohn’s disease history.

Differential Diagnosis

The top differentials I would consider include Crohn’s disease, ulcerative colitis, and appendicitis. The inflammatory bowel diseases  Crohn’s disease (CD) and ulcerative colitis (UC) have an immunological basis (Ranasinghe & Hsu, 2022). The trajectory of Crohn’s disease is one of remission and relapse. Typical symptoms of Crohn’s disease flare-ups include stomach discomfort, bloating, diarrhea, fever, weight loss, and anemia. Many of the manifestations can be seen in the patient. Ulcerative colitis is an inflammation of the colon that has no known cause. 

Bloody diarrhea, whether it contains mucus or not, is the predominant sign. Depending on how far the illness has spread and how bad it is, one may also have tenesmus, malaise, abdominal pain, weight loss, and fever (Lynch & Hsu, 2023). The condition usually worsens over time, and people with it often go through periods of remission followed by relapses. When the vermiform appendix gets inflamed, this is called appendicitis. According to research, anorexia and periumbilical pain are common symptoms of appendicitis, and they frequently precede right lower quadrant pain, nausea, vomiting, fever, and other symptoms (Echevarria et al., 2023). Crohn’s disease is, therefore, the presumptive diagnosis.

Focused Physical Examination

It would be useful for the patient with a suspected Crohn’s disease flare-up to have several targeted physical exam results. After visually inspecting the patient’s abdomen, all four quadrants should be auscultated to listen for any altered bowel sounds that might indicate obstruction. After that, the abdomen should be palpated to check for organomegaly, ascites, rebound pain, or distention (Ranasinghe & Hsu, 2022). All patients require a perineum exam. Skin tags, fistulas, scars, ulcers, and abscesses could all be seen during the examination.

Diagnostic testing to confirm the diagnosis

A thorough investigation is required for diagnosis confirmation. Infections can be ruled out by stool tests for culture, ovum and parasites, C. difficile toxins, leukocyte count, and calprotectin, which can identify active Crohn’s disease. It is possible to differentiate between Crohn’s disease and ulcerative colitis using blood tests such as the CBC, metabolic panel, ANCA, and ASCA. CRP or ESR indicates how severe the inflammation is (Kedia et al., 2019; Ranasinghe & Hsu, 2022). While plain X-rays can reveal intestinal obstruction, imaging techniques like CT scan/MRE of small bowel follow-through and VCE can see the afflicted areas.

Evidence-based treatment Approach

Crohn’s disease should be treated with a multidisciplinary approach based on the patient’s needs. Evidence-based treatment guidelines suggest that people with Crohn’s disease may need to take medicine and change their lifestyle. Anti-inflammatory drugs like aminosalicylates or corticosteroids can help reduce inflammation in the bowel (Ranasinghe & Hsu, 2022). 

Immune system suppressors like azathioprine or methotrexate stop the immune system from attacking the bowel. Anti-TNF drugs like infliximab, adalimumab, and golimumab block TNF to stop it from causing inflammation (Ranasinghe & Hsu, 2022). Nutritional support, such as a low-residue or elemental diet, is required to give the bowel time to recover. Smoking cessation and stress management are two lifestyle changes that can help to lessen flare-ups.

References

Echevarria†, S., Rauf†, F., Hussain†, N., Zaka, H., Farwa, U. -, Ahsan, N., Broomfield, A., Akbar, A., & Khawaja, U. A. (2023). Typical and atypical presentations of appendicitis and their implications for diagnosis and treatment: A literature review. Cureus. https://doi.org/10.7759/cureus.37024

Jones, M. W., Lopez, R. A., & Deppen, J. G. (2022). Appendicitis. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493193/#:~:text=Appendicitis%20is%20the%20inflammation%20of

Kedia, S., Das, P., Madhusudhan, K. S., Dattagupta, S., Sharma, R., Sahni, P., Makharia, G., & Ahuja, V. (2019). Differentiating Crohn’s disease from intestinal tuberculosis. World Journal of Gastroenterology, 25(4), 418–432. https://doi.org/10.3748/wjg.v25.i4.418

Lynch, W. D., & Hsu, R. (2023). Ulcerative colitis. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459282/#:~:text=Introduction-

Ranasinghe, I. R., & Hsu, R. (2022, May 15). Crohn disease. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK436021/

Abdominal Assessment Soap Note

The episodic SOAP note is of a 65-year-old African American male with epigastric pain.

Subjective Portion

The objective portion of the episodic SOAP note contained the chief complaint, history of presenting illness, past medical history, medication history, allergies, family history, and social history. These are essential components of the subjective portion of building a health history for any patient (Ball et al., 2022). Even though the review of the systems is also part of health history, the subjective portion of this episodic SOAP note is sufficient to construct a list of diagnoses and differential diagnoses. However, this portion would be more sufficient with extra elements to rule in or out some differential diagnoses. Important negatives are key aspects of building health history that directs the diagnostic approach and thinking of the doctor and the nurse in a patient evaluation.

The subjective portion mentioned the presence of intermittent epigastric pain. However, I would inquire more about the presence or absence of these symptoms in relation to food intake. Food intake influence is vital in evaluating dyspepsia and upper gastrointestinal symptoms because it can exacerbate or relieve some of the symptoms. Other exacerbations and relief of this pain, such as physical activity and abdominal distention, are also useful pieces of information in this patient’s history. The history of the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is also important to exclude the role of these medications in this patient’s epigastric pain.

Objective Portion

The objective portion of this episodic SOAP note contained vital signs, heart examination, respiratory, skin, abdominal examination, and diagnostic results. The documentation is focused on signs and other objective features pertinent to the patient’s chief complaint. Most of the time, the objective aspects presented are determined by the examiners’ thought process of working up the patient. However, additional information on this patient’s initial investigations, such as a urease breath test, would be important to rule out the likelihood of peptic ulcer disease. Additional information on this patient’s general condition, such as respiratory distress, body build, and mental status, is also vital in figuring out the current general state of the patient. Additional tests such as abdominal ultrasound scans and esophagogastroduodenoscopy will save some time in the evaluation of this patient.

Diagnostic Tests

Serum electrolytes, urea, and creatinine are also baseline tests that would provide additional information on the biochemical function of the patient concerning renal and metabolism status. As aforementioned, esophagogastroduodenoscopy and abdominal ultrasound scan of the abdomen would also provide vital anatomical information on the etiology of this patient’s pain (Schill et al., 2022). A complete blood count would be essential in finding out whether there are infectious and inflammatory etiologies of this patient’s pain. Serum lipase levels will help in ruling out pancreatic disease.

Assessment

The provided differential diagnoses are relevant to the documented subjective and objective information. An abdominal aortic aneurysm is supported by the long-standing presence of symptoms and lack of response to proton pump inhibitors. This condition is life-threatening and would warrant his current emergency department admission (Shaw et al., 2023). The provided test would be essential in the evaluation of abdominal aortic aneurysms (Schill et al., 2022). 

The current deterioration could also indicate a complicated peptic ulcer disease in this patient. PUD can perforate, resulting in peritonitis that would present with pain (Kuna et al., 2019). However, this pain would be generalized and cause rebound tenderness or guarding. The third assessment, pancreatitis, is also a likely diagnosis in this patient. Even though the lack of response to PPIs would suggest an etiology outside the stomach and duodenum, the role of pancreatitis in this patient’s presentation is mainly supported by the location of the pain. The radiation of the pain to the back would also suggest the presence of pancreatitis.

Verdict on the Assessment

I accept the current assessments based on the available objective and subjective information. However, additional possible diagnoses would also apply to this patient based on the provided history and physical examination. Acute cholecystitis, small intestinal obstruction, and chronic gastritis are also likely diagnoses in this patient. Small bowel obstruction in this patient is suggested by the presence of abdominal pain. However, the absence of abdominal distention or vomiting makes intestinal obstruction less likely. 

The patient is a chronic tobacco user and has a positive history of alcohol intake which makes chronic gastritis more likely in this patient (Yawar et al., 2021). However, the recent acute clinical deterioration suggests an acute complication of this illness. Acute cholecystitis is also likely in this patient because this condition sometimes presents with epigastric pain, even in the absence of right upper quadrant tenderness. Therefore, this patient would benefit from an extensive workup.

Conclusion

In sum, the provided suggest that the patient has an intraabdominal illness. Perforated PUD, chronic gastritis, acute pancreatitis, acute cholecystitis, and abdominal aortic aneurysm are likely diagnoses. Therefore, additional information on the relationship between this patient’s epigastric pain to food intake and recent meditation use is essential. Additional investigations such as esophagogastroduodenoscopy, abdominal ultrasound, serum lipase level, full blood count, serum electrolytes, and urea levels should suffice further workup before definitive management.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2022). Seidel’s physical examination handbook: An interprofessional approach (10th ed.). Elsevier – Health Sciences Division.

Kuna, L., Jakab, J., Smolic, R., Raguz-Lucic, N., Vcev, A., & Smolic, M. (2019). Peptic ulcer disease: A brief review of conventional therapy and herbal treatment options. Journal of Clinical Medicine, 8(2), 179. https://doi.org/10.3390/jcm8020179

Schill, C. N., Tessier, S., Longo, S., Ido, F., & Nanda, S. (2022). Differential diagnosis of multiple systemic aneurysms. Cureus, 14(10), e30043. https://doi.org/10.7759/cureus.30043

Shaw, P. M., Loree, J., & Gibbons, R. C. (2023). Abdominal Aortic Aneurysm. In StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/29262134/

Yawar, B., Marzouk, A. M., Ali, H., Ghorab, T. M., Asim, A., Bahli, Z., Abousamra, M., Diab, A., Abdulrahman, H., Asim, A. E., & Fleville, S. (2021). Seasonal variation of presentation of perforated peptic ulcer disease: An overview of patient demographics, management, and outcomes. Cureus, 13(11), e19618. https://doi.org/10.7759/cureus.19618

Case Study Neoplasms

Case Study Neoplasms

Case Study: Disorders of Musculoskeletal Function: Trauma, Infection, Neoplasms

Marvin is a healthy, active 36-year-old who belongs to a martial arts club. Once a week he takes lessons in Judo, and on the weekends, he participates in local competitions. At his last competition, Marvin was paired with a skilled participant from another club.

His rival threw him to the mats, and as Marvin struggled, came down hard to pin him down. Marvin heard a snap, followed by instant pain in his left forearm Case Study Neoplasms. Radiographs at the local hospital confirmed he suffered a transverse fracture of the distal aspect of his left ulna.

1. What are the typical signs and symptoms of a fracture? Why shortly after the injury does the pain temporarily subside?
2. How does a hematoma form, and what function does it serve in the process of healing a fracture?
3. Marvin was told he would be seeing a physiotherapist as his healing progressed. What are the muscular and joint changes that occur during immobilization and the ways Marvin and his physiotherapist can work to address these changes?

Cancer is a neoplasm that can grow rapidly, spread, and cause damage to the body. A malignant neoplasm is cancerous, while a metastatic neoplasm is malignantcancer that has spread to nearby or distant areas of the body.

The cause of benign neoplasm is often not known, but factors such as exposure to radiation or environmental toxins; genetics; diet; stress; inflammation; infection and local trauma or injury may be linked to the formation of these growths.

The sooner a malignant neoplasm is detected, the more effectively it can be treated, so early diagnosis is important. Many types of cancer can be cured. Treatment for other types can allow people to live for many years with cancer.

Cause and effect relationship in response to disease

Cause and effect relationship in response to disease

Apply knowledge of tissue and organ structure and function to physiologic alterations in systems and analyze the cause-and-effect relationship.

Select one of the case studies below. In your discussion be sure to include evidence of your knowledge of tissue and organ structure and function to physiologic alterations in systems and analyze the cause-and-effect relationship in response to disease.

Requirements

Make sure all of the topics in the case study have been addressed.

Cite at least three sources—journal articles, textbooks, or evidenced-based websites—to support the content.

All sources must have been written within five years (2012-2017).

Do not use .com, Wikipedia, or up-to-date, etc., for your sources.

Case Study 1

Mechanisms of Infectious Disease

Thirty-two–year-old Jason is a general laborer, who fell ill shortly after working on a job digging up old water pipes for the town he lived in. The task involved working around shallow pools of stagnant water. Ten days after the contract ended, Jason developed a fever and aching muscles.

He also had nausea, vomiting, and diarrhea. Jason’s friend took him to his physician who listened carefully to Jason’s history. She told him she suspected West Nile fever and ordered serological testing. Jason went home to recover and was feeling better by the end of the week.

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Jason’s physician ordered serological tests. How would antibody titers assist the doctor in confirming his diagnosis?

When Jason was feeling at his worst, he had extreme malaise, vomiting, and diarrhea. What stage of the illness was he experiencing at that time? What are the physiological mechanisms that give rise to the signs and symptoms of infectious illness?

West Nile virus has a single-stranded RNA genome. How does this virus replicate? In general terms, what are the various effects viruses can have on host cells?

Case Study 2

Innate and Adaptive Immunity

Melissa is a 15-year-old high school student. Over the last week, she had been feeling tired and found it difficult to stay awake in class. By the time the weekend had arrived, she developed a sore throat that made it difficult to eat and even drink.

Melissa was too tired to get out of bed, and she said her head ached. On Monday morning, her mother took her to her doctor. Upon completing the physical exam, he told Melissa the lymph nodes were enlarged in her neck and she had a fever.

He ordered blood tests and told Melissa he thought she had mononucleosis, a viral infection requiring much bed rest.

Innate and adaptive immune defenses work collectively in destroying invasive microorganisms. What is the interaction between macrophages and T lymphocytes during the presentation of antigen?

Melissa’s illness is caused by a virus. Where are type I interferons produced, and why are they important in combating viral infections?

Humoral immunity involves the activation of B lymphocytes and production of antibodies. What are the general mechanisms of action that make antibodies a key component of an immune response?

Case Study 3

Disorders of the Immune Response

Ahmed has worked as a phlebotomist in the local hospital for the last 7 years. Last year, he began to complain of watery, nasal congestion and wheezing whenever he went to work. He suspected he was allergic to something at the hospital because his symptoms abated when he was at home over the weekends.

One day he arrived at work for the morning shift and put on his gloves. Within minutes, he went into severe respiratory distress requiring treatment in the emergency ward. It was determined at that time his allergic response was due to latex exposure.

Ahmed experienced a type I, IgE-mediated hypersensitivity response. How can this be determined by his signs and symptoms? How might another type of latex hypersensitivity reaction present?

How do T2H cells, mast cells, and eosinophils function to produce the signs and symptoms typical of a type I hypersensitivity disorder?

How is it that someone who does not come into direct contact with latex can still have a hypersensitivity response to the material? What do food allergies have to do with latex allergies?

Case Study 4

Inflammation, Tissue Repair, and Wound Healing

Carlton, a six-year-old boy, was playing on a sandy beach with his mother. He began to run along the shoreline when he stepped on the sharp edge of a shell, giving himself a deep cut on his foot. His mother washed his foot in the lake and put on his running shoe to take him home.

One day later, Carlton’s foot looked worse. The gash was red and painful. The foot was warm to touch and appeared swollen. Carlton’s mom put some gauze over the wound and prepared to take him to the local community health clinic.

What is the physiologic mechanism causing the wound to become red, hot, swollen, and painful? How is this different than the inflammatory response that might occur in an internal organ?

What are the immunologic events that are happening at the local level during Carlton’s acute inflammatory response?

Nutrition plays an important factor in wound healing. What stages of wound healing would be affected by a deficiency in vitamins A and C?

Case Study 5

Acquired Immunodeficiency Syndrome

Patience is 29 years old and has been HIV positive for nine years. She has remained asymptomatic and is not taking antiretroviral medication. Recently she was at the drop-in clinic to talk to a public health nurse about having a baby through artificial insemination.

She said she had met a man who wanted to marry her and have children with her, but she was concerned about the baby contracting HIV.

Her latest blood tests indicated her CD4+ count was 380/µL. The PCR test indicated her viral load was 850. The nurse referred her to the physician to discuss antiretroviral therapy during her pregnancy.

What are the factors that increase the chance of HIV transmission from mother to infant, and how the transmission occurs?

Patience was told that after she became pregnant, she would begin HAART therapy. Describe what this therapy is and what particular antiretroviral medication would be particularly useful to her during her pregnancy. What concern is there about administering certain antiretrovirals early in the pregnancy?

Individuals with HIV are prone to contracting opportunistic infections. What are opportunistic infections and the risk factors that leave an individual with HIV particularly prone to contracting this type of illness?

Case Study 6

Blood Cells and the Hematopoietic System

Charlie is a 53-year-old man with non-Hodgkin lymphoma. His treatment has been only modestly successful in delaying the progression of the disease, and he has recently relapsed. His medical team decided to administer aggressive chemotherapy.

Knowing that the intensive treatment would have a destructive effect on Charlie’s bone marrow, they removed stem cells from his blood before the chemotherapy began. Afterward, the stem cells were returned by IV to reestablish his bone marrow function.

What are the therapeutic advantages of an autologous stem cell transplant on Charlie’s bone marrow and immune system?

Before harvesting stem cells, a cytokine growth factor is administered to the patient. What is the benefit of this procedure?

Non-Hodgkin lymphoma is a disease involving B and T lymphocytes. What aspects of the immune response are these cells responsible for?

When considering erythrocytes, how is the body able to meet hematopoietic demand in conditions such as hemolytic anemia or blood loss?

Case Study: The Case of Goodwill Impairment at Jackson Enterprises

Case Study: The Case of Goodwill Impairment at Jackson Enterprises

Case Study: The Case of Goodwill Impairment at Jackson Enterprises

WRITING ASSESSMENT

By: Casey McNellis, Ronald Premuroso, & Robert Houmes

This writing assessment is designed to enhance your research skills using the FASB Codification and improve your graduate level writing skills. Login credentials to the FASB Codification are provided in the syllabus under Class Guidelines. Case Study: The Case of Goodwill Impairment at Jackson Enterprises

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Academic writing is different from general writing. You are strongly advised to start this project early in the semester and engage the help of UMUC Writing Tutors. Every graduate accounting course offers free UMUC writing tutors Case Study: The Case of Goodwill Impairment at Jackson Enterprises.

Register for a writing tutor at the beginning of the semester and submit drafts of this assignment for guidance Case Study: The Case of Goodwill Impairment at Jackson Enterprises.

Upon receiving guidance from a UMUC writing tutor, improve your next draft, and resubmit your paper for additional guidance. Writing is an iterative process whereby you plan, research, write, edit, research more if needed, rewrite, edit, and rewrite until you have created a clear, concise, and correct paper Case Study: The Case of Goodwill Impairment at Jackson Enterprises.

Instructions:

• Read the case study and prepare answers to the questions at the end of the case.
• APA style formatting is required..
• Approximate length of paper using APA style is 10 pages.

Case Study: The Case of Goodwill Impairment at Jackson Enterprises Resources

Writing a Research Paper: https://owl.english.purdue.edu/owl/resource/658/01/

APA: https://owl.english.purdue.edu/owl/section/2/10/

Developing your graduate level writing skills: https://owl.english.purdue.edu/owl/section/1/2/

Proposed Accounting Standards Update: Simplifying the Accounting for Goodwill Impairment, by FASB; May 12, 2016: http://www.fasb.org/jsp/FASB/Document_C/DocumentPage?cid=1176168146260&acceptedDisclaimer=true

What Constitutes Graduate Level Writing; source unknown. In LEO, Content, Week 9.

1. Identify and cite the relevant topics/subtopics from the FASB Accounting Standards Codification for this case.

Average cost is $1,495; times 1.5385 equals a selling price of $2,300. The $2,300 unit selling price less $1,495 unit cost equals a gross margin of $805, which is 35 percent of selling price.

2. Identify the specific accounting issue that you believe needs to be initially addressed for JE’s consideration of goodwill with regards to both Dynamic and ZD.

3. What does the qualitative evidence from the case indicate about whether JE should perform the two-step impairment test? In your response, identify specific factors discussed in the Codification and relate them to the information provided to you in the case Case Study: The Case of Goodwill Impairment at Jackson Enterprises.

4. Beyond the assessment of qualitative factors, what other evidence should be considered for the purposes of the analysis? What does this information suggest? With respect to Dynamic, what do you think is the most appropriate fair value amount to use in assessing the fair value of this reporting unit? Explain. Why is this important?

5. Based upon the information provided above, should Dynamic and ZD be combined or separated for the purposes of the goodwill analysis? Explain. Why is this important?

6. Based upon your initial analysis, do you think the $200 million goodwill balance (i.e., the $150 million for Dynamic and the $50 million for ZD) is the appropriate valuation for goodwill on the December 31, 2014 balance sheet of JE?

7. Prepare a memo detailing the issues involved, the judgments you made in connection with the authoritative literature, and your recommendation for the direction of the goodwill valuation as it relates to Dynamic and ZD (i.e., does the evidence suggest further action is required in determining the appropriate valuation of goodwill? If so, what steps need to be taken?). Case Study: The Case of Goodwill Impairment at Jackson Enterprises

Chamberlain NR451 Capstone Project Paper

NR451 Capstone Project

Directions: Please choose ONE topic and its corresponding systematic review that is of most interest to you, or most relevant to your practice Chamberlain NR451 Capstone Project Paper. This systematic review will be the basis for your capstone project. Please refer to the guidelines for each milestone for more details.

Promoting breastfeeding

Sinha, B., Chowdhury, R., Sankar, M. J., Martines, J., Taneja, S., Mazumder, S., … Bhandari, N. (2015). Interventions to improve breastfeeding outcomes: A systematic review and meta-analysis. Acta Paediatrica, 104, 114-134.

Preventing central venous catheter-related infections

Lai, N. M., Lai, N. A., O’Riordan, E., Chaiyakunapruk, N., Taylor, J. E., & Tan, K. (2016). Skin antisepsis for reducing central venous catheter-related infections. Cochrane Database of Systematic Reviews, (7), CD010140.

Increasing health insurance coverage for vulnerable populations

Jia, L., Yuan, B., Huang, F., Lu, Y., Garner, P., & Meng, Q. (2014). Strategies for expanding health insurance coverage in vulnerable populations. Cochrane Database of Systematic Reviews, (11), 1-41. CD008194. doi:10.1002/14651858.CD008194.pub3.

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Preventing teen pregnancy and sexually-transmitted disease

Mason-Jones, A. J., Sinclair, D., Mathews, C., Kagee, A., Hillman, A., & Lombard, C. (2016). School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents. Cochrane Database of Systematic Reviews, (11), CD006417. doi:10.1002/14651858.CD006417.pub3.

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Reducing hospital readmissions

Mistiaen, P., & Poot, E. (2006). Telephone follow-up, initiated by a hospital-based health professional, for post discharge problems in patients discharged from hospital to home. Cochrane Consumers and Communication Group. (4), CD004510. doi:10.1002/14651858.CD004510.pub3.

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Capstone Project Milestone 1: Practice Issue and Evidence Summary Worksheets

Student Name:                                                          Date:

Directions

1. Refer to the guidelines for specific details on how to complete this assignment.
2. Type your answers directly into the worksheets below.
3. Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT.
4. Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response.
5. Chamberlain NR451 Capstone Project Paper

Practice Issue Worksheet

___ Education

___ Other (list)_________________________________

___ Unsatisfactory patient outcomes

___ Wide variations in practice

___ Significant financial concerns

___ Clinical practice issue is a concern

___ Procedure or process is a time waster

___ Clinical practice issue has no scientific base

__ Other:

___ Expert Opinion

___ Patient Preferences

___ Standards (Regulatory, professional, community)

___ Other

Chamberlain NR451 Capstone Project Paper

Evidence Summary Worksheet

Directions: Please type your answers directly into the worksheet.

Define the search terms for your systematic review:

Provide a statement of the questions being addressed in the work and how they relate to your practice issue:

Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome.  Consider the relevance to your project proposal for the Milestone 2 project paper.

Discuss any limitations to the studies performed that you believe impacts your ability to utilize the research in your project.

iCARE Paper

Assignment

Purpose

The purpose of the iCARE Paper assignment is to explore the concept of interprofessional teams and patient outcomes Chamberlain NR451 Capstone Project Paper. Nursing supportive actions of compassion, advocacy, resilience, and evidence-based practice will serve as a way to apply care concepts.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

• CO 1: Applies principles of nursing, theories, and the care philosophies to self, colleagues, individuals, families, aggregates and communities throughout the healthcare system. (PO 1)
• CO 6: Plans clinical practice activities that integrate professional nursing standards in accordance with the Nursing Code of Ethics and the American Nurses’ Association (ANA) standards of practice. (PO 6)

Due Date

Submit your completed assignment by Sunday end of Week 5 by 11:59 p.m. MT.

Total Points Possible

The assignment is worth 200 points.

Preparing the Assignment

1. 1. Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity.
   2. View a short tutorial with tips for completing this assignment: iCARE Paper Tutorial

1. 1. Getting Started: Interprofessional teams are part of practice trends we see developing in all aspects of care delivery. Consider you own work environment (or recent clinical setting).
      • For this assignment, consider the concept of interprofessional teamwork and patient outcomes.
      • Look to your current workplace as an example. (If you are not currently employed, look to a past workplace or clinical practice area.)
      • Apply the components of the iCARE concept to interprofessional teams in a short paper. (Body of the paper to be 3 pages, excluding the title page and references page)
      • iCARE components are:
        1. C ompassion
        2. A dvocacy
        3. R esilience
        4. E vidence-Based Practice (EBP)
      • How could you contribute to the interprofessional team, the culture of your practice setting, and positive patient outcomes through nursing actions demonstrating compassion, advocacy, resilience, and evidence-based practice?
   2. Select one scholarly nursing article from CINAHL as a resource for your paper.
      1. Additional scholarly sources can be used but are optional.
      2. When searching in the CINAHL database, please limit your search word to one component of the paper you wish to emphasize, such as ‘Resilience’.  Searching for the term iCARE will not produce the results you need.
   3. Elements of iCARE paper
      • Title page
      • Below are the headings to be used for this assignment.
        • Title of your paper as the heading for the introduction (Do not use the word Introduction, just the paper title from your title page. See page 61 of the APA Manual, 7th edition for an example). Explain the type of work setting you are discussing and whether interprofessional teams are currently present. If interprofessional teams are present, indicate a team function that could be improved. If interprofessional teams are NOT present, indicate what type of team you think might be possible in the setting.
        • Describe a nursing action item for each component below that could contribute to: interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.
          • Compassion
          • Advocacy
          • Resilience
          • Evidence-Based Practice
        • Summary: Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes. Address how you may be able to influence this process of support for interprofessional teams overall in your unit or organization.
        • References: List any references used in APA format.

Templates

The prepared paper template is RECOMMENDED for this assignment.

iCare Assignment Template. – APA 7th edition

Only the APA 7th edition is to be used in this assignment.

Best Practices

• Please use your browser’s File setting to save or print this page.
• The template provided is recommended.
• Spell check for spelling and grammar errors prior to final submission.
• Use the rubric as a final check prior to submission to ensure all content is clearly addressed.
• Chamberlain NR451 Capstone Project Paper

Scholarly Sources and Citations

• Use APA format for citations and references.
• Please paraphrase throughout. One short quote is permitted.
• Chamberlain NR451 Capstone Project Paper

**Academic Integrity**

As detailed in the Simple Syllabus, all required Chamberlain papers, discussions or other written learning activities are subject to submission for detection of plagiarism to Turnitin ® or other anti-plagiarism software. Remember, Chamberlain’s philosophy is Integrity Matters so please use all resources within your course and your instructor if you have any questions or need assistance with this assignment.

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

iCARE Paper Example

The care management specialty pays attention to the coordination of care and effective and efficient utilization of resources to offer patients with chronic illnesses the highest quality of care during their stay in the hospital. Educating the patients, advocating for their wellness, and communicating clearly are vital to ensure their health outcomes are enhanced in the long run. It necessitates employing an interdisciplinary team with workers from other fields to ensure patients receive holistic care that suits their needs.

To ensure that this existing interdisciplinary team offers better healthcare, it is essential to employ open communication and availing of information to the team members on time. The application of resilience and compassion skills when dealing with these patients is essential to implementing practice based on scientific evidence. Despite these valuable interventions in place to ensure that patients receive the highest quality of care, the healthcare sector still faces challenges that hinder progress, requiring novel solutions.

Compassion

Compassion helps healthcare workers show kindness and understanding of patients and their loved ones, which is essential in achieving high-quality health outcomes. Forging supportive relationships based on trust has helped increase satisfaction and boost the best customer experience and entails a good show of compassion from the healthcare workers (Straughair & Machin, 2020). Compassion ensures clients receive social, psychological, physical, and emotional needs, thus promoting holistic care. To encourage compassion, an interprofessional team should ensure that the patient and family are involved in the client’s care.

The team can provide essential information about the client’s health status and involve them in decision-making about any procedures the patient will likely undergo. The team must seek informed consent from the patient or their family members if they cannot make sound decisions independently. The patient and the family will ultimately increase their trust in the interdisciplinary team and heed the interventions formulated by the team. A safety culture is forged when patients and families are involved in their care, which can increase the organization’s reputation (Son?ur et al., 2018).

Advocacy

Healthcare workers can enhance advocacy by understanding patients’ unique needs, values, and beliefs. Advocacy involves the healthcare workers standing by what the patients believe is right for them in their absence and ensuring their voice is heard during decision-making. Through advocacy, the patient’s autonomy is respected through a third party, the nurse overseeing the care of the patients. The nurse can communicate openly with the client and present them with facts so that they can apply them in making decisions, which the nurse ensures are considered by other interdisciplinary teams when tailoring interventions (Abbasinia et al., 2019).

Nurses can aid in fostering a culture of patient-centered care by making the advocacy of patients a top priority and promoting teamwork among healthcare professionals. Better patient experience and clinical outcomes may result from this shift in attitude on the healthcare team. Evidence suggests that a patient-centered culture helps to decrease the number of hospitalizations and a general improvement in the quality of care of all patients.

Resilience

Promoting effective collaboration and open communication channels among the different interdisciplinary teams in the hospital can promote resilience. Resilient healthcare personnel can deal with the stresses of their jobs without letting them affect their health or performance. Resilience is the capacity to deal with hardship while providing excellent patient care. Heavy workloads, extended shift hours, psychological demands, and experiencing traumatic events entail pressures that healthcare employees experience (Odom-Forren, 2020). Because of their resilience, they can overcome these challenges and continue providing excellent patient treatment.

Resilient healthcare providers are better equipped to deal with difficult situations, keep a positive attitude, and communicate effectively with patients and their families (Odom-Forren, 2020). They are not likely to suffer from burnout, which is associated with dissatisfaction with one’s work and an increased likelihood of making mistakes in patient care. Resilience can help keep workers motivated to provide high-quality healthcare to their patients, devoid of errors, which can help achieve the organization’s mission and vision.

Evidence-Based Practice

Carrying out regular interdepartmental sessions to enlighten the healthcare workers about relevant changes in guidelines in managing healthcare conditions and new evidence that supports those changes can help foster evidence-based practice. Along with other medical experts, nurses can learn from one another at these conferences and improve their ability to give patients evidence-based care. Encouraging an approach based on scientific evidence, applied by interprofessional teams, the organization’s culture can value the inception of interventions based on the current evidence and research in informing patient care (Son?ur et al., 2018).

The healthcare outcomes are likely to improve since interventions backed up with credible scientific findings can help enhance the overall quality of care and complications experienced by patients and promote increased patient satisfaction. The organization’s reputation improves, and reimbursements are likely to increase. When workers apply evidence-based interventions and see improved patient outcomes, they can become highly motivated and will likely work for longer in the organization, decreasing employee turnover.

Summary

Employment of the iCARE components can help increase patient satisfaction, enhance patient outcomes, and promote collaboration through interdisciplinary teams. These components can help promote a patient-centered culture that ensures patients are involved in their care and that they make their own decisions. They are also empowered to partake in self-care, which has been shown to increase the overall quality of care and satisfaction. Ensuring that the patient’s beliefs, values, and attitudes are considered in decision-making ensures that they accept the interventions employed by the healthcare teams. Nurses can influence the adoption of interdisciplinary teams in the organization by advocating for the adoption of iCARE and providing evidence on how they can be essential in improving the achievement of organizational goals.

References

Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2019). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 27(1), 141–151. https://doi.org/10.1177/0969733019832950

Odom-Forren, J. (2020). Nursing resilience in the world of COVID-19. Journal of PeriAnesthesia Nursing, 35(6), 555–556. https://doi.org/10.1016/j.jopan.2020.10.005

Son?ur, C., Özer, Gün, Ç., & Top, M. (2018). Patient safety culture, evidence-based practice and performance in nursing. Systemic Practice & Action Research, 31(4), 359–374. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1007/s11213-017-9430-y

Straughair, C., & Machin, A. (2021). Compassion in nursing: exploring the perceptions of students and academics. Nursing standard (Royal College of Nursing (Great Britain): 1987), 36(7), 45–50. https://doi.org/10.7748/ns.2021.e11720

Chamberlain NR451 Capstone Project Paper Rubric