Abdominal pain in an adult, pregnant and pediatric patient – HA W8DT1

Abdominal pain in an adult, pregnant and pediatric patient  – HA W8DT1

Type of document           Essay

1 Page Double Spaced

Subject area         Healthcare

Academic Level Undergraduate

Style      APA

References         4

Order description:

Order Instructions:

This week’s discussion focuses on complaints or symptoms related to the abdomen. I would not be surprised if you were somewhat overwhelmed by the diagnostic information in your text readings. There are numerous professional articles that address the assessment of the abdomen in an adult, pregnant and pediatric patient. As per your textbook, abdominal pain is a common complaint in the primary and emergency care settings. It is imperative that the primary care provider be competent in sorting out the subjective and objective complaints relating to the abdominal symptoms. Read the 3 articles that are in the Student Resource Area for this Unit. Your discussion should address the differences between an abdominal assessment for the adult in the ER, a pregnant female, and a pediatric patient with a complaint of abdominal pain. Be sure to address the inclusion of various laboratories and radiographic testing that may or may not be appropriate for each patient.

** Provide review and answer questions with references – all references must be in APA format and within he last 5 years of publication.

 

“Letter to Sir George Grey, 1858 [The establishment of Basutoland]”

“Letter to Sir George Grey, 1858 [The establishment of Basutoland]”

Type of document    Essay

1 Page Double Spaced

Subject area  History

Academic Level        Undergraduate

Style   APA

References   1

Order description:

Answer all three question please.. Thank you for your help..  It’s due July 25

Modern History Sourcebook: Moshweshewe: “Letter to Sir George Grey, 1858 [The establishment of Basutoland]”

  1. How does Moshweshewe compare the English and the Boers (Dutch colonists of South Africa)?
  2. What did Sir Harry Smith promise Moshweshewe and did he live up to that promise?
  3. How has Moshweshewe reacted to the Boer attacks?

 

Modern History Sourcebook:
Moshweshewe: Letter to Sir George Grey, 1858 [The establishment of Basutoland]

Your Excellency—it may scarcely appear necessary to lay before Your Excellency any lengthened details of what has taken place between the Orange Free State and myself. I know that you have followed with interest the transactions which have led to the commencement of hostilities, and you have heard with pain of the horrors occasioned by the war, at present suspended in the hopes that peace may be restored by Your Excellency’s mediation.

Allow me, however, to bring to your remembrance the following circumstances: About twenty-five years ago my knowledge of the White men and their laws was very limited. I knew merely that mighty nations existed, and among them was the English. These, the blacks who were acquainted with them, praised for their justice. Unfortunately it was not with the English Government that my first intercourse with the whites commenced. People who had come from the Colony first presented themselves to us, they called themselves Boers. I thought all white men were honest. Some of these

Boers asked permission to live upon our borders. I was led to believe they would live with me as my own people lived, that is, looking to me as to a father and a friend.

About sixteen years since, one of the Governors of the Colony, Sir George Napier, marked down my limits on a treaty he made with me. I was to be ruler within those limits. A short time after, another Governor came, it was Sir P. Maitland. The Boers then began to talk of their right to places I had then lent to them. Sir P. Maitland told me those people were subjects of the Queen, and should be kept under proper control; he did not tell me that he recognized any right they had to land within my country, but as it was difficult to take them away, it was proposed that all desiring to be under the British rule should live in that part near the meeting of the Orange and Caledon rivers.

Then came Sir Harry Smith, and he told me not to deprive any chief of their lands or their rights, he would see justice done to all, but in order to do so, he would make the Queen’s Laws extend over every white man. He said the Whites and Blacks were to live together in peace. I could not understand what he would do. I thought it would be something very just, and that he was to keep the Boers in my land under proper control, and that I should hear no more of their claiming the places they lived on as their exclusive property. But instead of this, I now heard that the Boers consider all those farms as their own, and were buying and selling them one to the other, and driving out by one means or another my own people.

In vain I remonstrated. Sir Harry Smith had sent Warden to govern in the Sovereignty. He listened to the Boers, and he proposed that all the land in which those Boers’ farms were should be taken from me. I was at that time in trouble, for Sikonyela and the Korannas were tormenting me and my people by stealing and killing; they said openly the Major gave them orders to do so, and I have proof he did so. One day he sent me a map and said, sign that, and I will tell those people (Mantatis and Korannas) to leave off fighting: if you do not sign the map, I cannot help you in any way. I thought the Major was doing very improperly and unjustly. I was told to appeal to the Queen to put an end to this injustice. I did not wish to grieve Her Majesty by causing a war with her people. I was told if I did not sign the map, it would be the beginning of a great war. I signed, but soon after I sent my cry to the Queen. I begged Her to investigate my case and remove “the line,” as it was called, by which my land was ruined. I thought justice would soon be done, and Warden put to rights.

I tried my utmost to satisfy them and avert war. I punished thieves, and sent my son Nehemiah and others to watch the part of the country near the Boers, and thus check stealing. In this he was successful, thieving did cease. We were at peace for a time. In the commencement of the present year my people living near farmers received orders to remove from their places. This again caused the fire to burn, still we tried to keep all quiet, but the Boers went further and further day by day in troubling

the Basutos and threatening war. The President (Boshof) spoke of Warden’s line, this was as though he had really fired upon us with his guns. Still I tried to avert war.

It was not possible, it was commenced by the Boers in massacring my people of Beersheba, and ruining that station, against the people of which there was not a shadow of a complaint ever brought forward. Poor people, they thought their honesty and love for Christianity would be a shield for them, and that the white people would attack in the first place, if they attacked at all, those who they said were thieves. I ordered my people then all to retreat towards my residence, and let the fury of the Boers be spent upon an empty land; unfortunately some skirmishes took place, some Boers were killed, some of my people also. We need not wonder at this, such is war! But I will speak of many Basutos who were taken prisoners by the Whites and then killed, most cruelly. If you require me to bring forward these cases, I will do so. I will however speak of the horrible doings of the Boers at Morija, they there burnt down the Missionary’s house, carried off much goods belonging to the Mission, and pillaged and shamefully defiled the Church Buildings.

I had given orders that no farms should be burnt, and my orders were obeyed till my people saw village after village burnt off, and the corn destroyed, they then carried destruction among the enemy’s homes. On coming to my mountain, the Boers found I was prepared to check their progress, and they consequently retired. My intention was then to have followed them up, and to have shown them that my people could also carry on offensive operations, believing that having once experienced the horrors of war in their midst, I should not soon be troubled by them again. My bands were getting ready to make a descent upon them, when the Boers thought proper to make request for a cessation of hostilities. I knew what misery I should bring upon the country by leaving the Basutos to ravage the Boer places, and therefore I have agreed to the proposal of Mr. J. P. Hoffman. I cannot say that I do so with the consent of my people, for many of those who suffered by the enemy were anxious to recover their losses. If they have remained quiet, it has been owing to my persuasions and my promises that they might have good hope of justice—Your Excellency having consented to act as arbitrator between the Boers and Basutos. With the expectation of soon meeting you, I remain, etc., etc.,

Mark X of Moshweshewe, Chief of the Basutos.

Source.

From: G. M.Theal, ed., Records of Southeastern Africa (Capetown: Government of Capetown, 1898-1903).

Scanned by Jerome S. Arkenberg, Cal. State Fullerton. The text has been modernized by Prof. Arkenberg.

This text is part of the Internet Modern History Sourcebook. The Sourcebook is a collection of public domain and copy-permitted texts for introductory level classes in modern European and World history.

Unless otherwise indicated the specific electronic form of the document is copyright. Permission is granted for electronic copying, distribution in print form for educational purposes and personal use. If you do reduplicate the document, indicate the source. No permission is granted for commercial use of the Sourcebook.

© Paul Halsall June1998

SOAP note – Reported unprotected sex – HA w11 DT1

SOAP note  – Reported unprotected sex  – HA w11 DT1

Type of document    Essay

1 Page Double Spaced

Subject area    Nursing

Academic Level        Ph. D.

Style   APA

References   3

Order description:

Discussion Prompt:

Given the following scenario, you will note an incomplete assessment.

Based on the information you have, make an impression of what you think is the client’s problem(s). For example, you may think that the client is in heart failure.

Ask yourself what additional subjective and objective data you will need to confirm that diagnosis. Include this information in the scenario. For example, give a lab results that will be indicative of heart failure.

What are the possible differential diagnoses for this client?

Defend your diagnosis or diagnoses with documentation from required readings, pathophysiology book; nurse practitioner’s protocols found in books and journals, and professional journal articles.

Give a rationale for your contribution to the management plan.

At the end of the SOAP note, insert the references you used into a master reference list using the APA format (this will enable your classmate to use your references for further study or research).

Every student should make at least two comments in developing data for the diagnoses.

Every student should make at least one comment on two students’ comments. Indicate whether you agree or disagree; give justification and documentation for your comments.

Every student must contribute to the management plan. Focus the plan on non-medication treatments, the diagnostic plan, and your teaching plan. Each student will contribute at least two comments to the plan.

Scenario

A 56-year-old male who returns from a wild weekend in Las Vegas. He is complaining of a white milky discharge from his penis. Reported unprotected sex with a woman he met in Las Vegas. The discharged started 4 days ago and he is experiencing pain with urination. PMHx: HTN and Inguinal hernia. Meds: HCTZ. Allergies: NKDA. Social Hx: nonsmoker, nondrinker, travels extensively and has never had this problem before.

 

** ALL REFERENCES MUST BE IN APA FORMAT AND WITHIN THE LAST 5 YEARS OF PUBLICATION.

SOAP note – abdominal pain in the LRQ – HA W9 DT1

SOAP note  – abdominal pain in the LRQ – HA W9 DT1

Type of document    Essay

1 Page Double Spaced

Subject area    Nursing

Academic Level        Ph. D.

Style   APA

References   3

Order description:

Discussion Prompt:

Given the following scenario, you will note an incomplete assessment.

Based on the information you have, make an impression of what you think is the client’s problem(s). For example, you may think that the client is heart failure.

Ask yourself what additional subjective and objective data you will need to confirm that diagnosis. Include this information in the scenario. For example, give a lab results that will be indicative of heart failure.

What are the possible differential diagnoses for this client?

Defend your diagnosis or diagnoses with documentation from required readings, pathophysiology book; nurse practitioner’s protocols found in books and journals, and professional journal articles.

Give a rationale for your contribution to the management plan.

At the end of the SOAP note, insert the references you used into a master reference list using the APA format (this will enable your classmate to use your references for further study or research).

Every student should make at least two comments in developing data for the diagnoses.

Every student should make at least one comment on two students’ comments. Indicate whether you agree or disagree; give justification and documentation for your comments.

Every student must contribute to the management plan. Focus the plan on non-medication treatments, the diagnostic plan, and your teaching plan. Each student will contribute at least two comments to the plan.

Scenario:

You are the FNP making rounds at the nursing home. The client is a 70-year-old white female. She is being seen for a complaint of abdominal pain in the LRQ, she describe the pain as sharp and experiences N & V with pain. She is unrelieved with her PRN medications. She reports the pain is worse after meals. She has been a resident in the nursing home for nearly six years. She has been a widow for 10 years and has two children (a 50-year-old son and 47-year-old daughter) and five grandchildren. They live in different counties within the state. She is a retired elementary teacher with over forty-five years of practice. She has a long history of HTN, DMII, Obesity, and arthritis of the knee. Her v/s are B/P 150/88, P: 84, R: 23, T: 102, Weight: 186 Height: 5’5” She is awake, alert, and oriented X 3. She is resting quietly in her bed without any apparent distress or pain. Skin: w/d. Lungs: Clear. Heart: No abnormal sounds heard. No murmurs.

 

** ALL REFERENCES MUST BE APA FORMAT AND WITHIN THE LAST 5 YEARS OF PUBLICATION.

bacterial vaginosis. BV = HA W10 R1

bacterial vaginosis. BV  = HA W10 R1

Type of document    Essay

1 Page Double Spaced

Subject area    Nursing

Academic Level        Master

Style   APA

References   3

Order description:

Charli Souza Main Post

COLLAPSE

A 28 year old female with an offensive and fishy-smelling, abnormal vaginal discharge is characteristic for bacterial vaginosis. BV is not always associated with sexual intercourse as it can be from a a change in the pH or normal bacteria in the vagina (Fenstermacher & Hudson, 2016). Douching, tampon use, or new/multiple sex partners can all be causes of BV. In order to evaluate this patient, I would first assess the vaginal discharge during a pelvic examination. There are a few diagnostic tests that can be done to diagnose this. According to Fenstermacher and Hudson (2016) there are 4 diagnostic tests that can be done in which 3 out of the 4 must be present to diagnose BV. First the pH can be tested. A pH that is greater than 4.5 may indicate BV. Another diagnostic test is to simply assess the vaginal discharge. Discharge that is copious, thin, grey-white that coats the vagina indicated BV (Fenstermacher & Husdon, 2016). A third diagnostic test is the positive whiff test. This test uses 10% KOH to the sample and produces a fishy odor that can be smelled. A fourth test is clue cells on wet prep that shows 20% more clue cells than epithelial cells when looks at under a microscope (Fenstermacher & Hudson, 2016). There are no NPO or fasting that must take place before examination. It would be best for the patient to be free from sexual intercourse prior to the exam.

Education that should be given to the patient is to avoid any type of douching and the use of tampons. This patient is married and has one sex partner so there is not a concern with multiple sex partners. There is also no need to treat the partner for this. Sex should be avoided during antibiotic treatment. The patient may benefit from using cotton, lose fitting underwear (Fenstermacher & Hudson, 2016).

Reference

Fenstermacher, K., and Hudson, B. (2016). Practice guidelines for family nurse practitioners, 4th Edition. St. Louis, Missouri: Elsevier.

**PROVIDE RESPONSE WRITING WITH REFERENCES. ALL REFERENCES MUST BE APA FORAMT AND WITHIN THE LAST 5 YEARS OF PUBLICATION.

Hepatic Disease PowerPoint

Hepatic Disease PowerPoint

Type of document    PowerPoint Presentation

6 Pages Double Spaced

Subject area    Nursing

Academic Level        Master

Style   APA

References   6

Order description:

Develop a 5- to 10-slide PowerPoint presentation that addresses the following:

Describe your selected disorder I chose Hepatic Disease Liver Disease, as well as associated alterations. Explain the pathophysiology of the alterations, including changes that occur in at least two body systems.

Explain how genetics, gender, ethnicity, age, and behavior might impact the pathophysiology of the alterations you identified, as well as diagnosis and treatment of your selected disorder.

Construct a mind map for the disorder you selected. Include the epidemiology, pathophysiology of alterations, risk factors, and clinical presentation, as well as the diagnosis and treatment of the disorder.

Please use some of the readings resources as references

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

 

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Chapter 35, “Structure and Function of the Digestive System”

This chapter provides information relating to the structure and function of the digestive system. It covers the gastrointestinal tract and accessory organs of digestion.

Chapter 36, “Alterations of Digestive Function”

This chapter presents information relating to disorders of the gastrointestinal tract and accessory organs of digestion. It also covers the pathogenesis, clinical manifestations, evaluation, and treatment of gastroesophageal reflux disease, gastritis, peptic ulcer disease, inflammatory bowel disease, and irritable bowel syndrome.

Chapter 37, “Alterations of Digestive Function in Children”

This chapter presents information relating to disorders of the gastrointestinal tract and liver that affect children. It focuses on congenital impairment, inflammatory disorders, metabolic disorders, as well as the impairment of digestion, absorption, and nutrition.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Chapter 13, “Gastrointestinal Disease”

This chapter provides a foundation for exploring gastrointestinal disorders by reviewing the structure and function of the GI tract. It also describes mechanisms of regulation of GI tract disorders such as acid-peptic disease, inflammatory bowel disease, and irritable bowel syndrome.

Chapter 14, “Liver Disease”

This chapter reviews the structure and function of the liver. It then explores the clinical presentation, etiology, pathogenesis, pathology, and clinical manifestations of three liver disorders: acute hepatitis, chronic hepatitis, and cirrhosis.

Chapter 15, “Disorders of the Exocrine Pancreas”

This chapter begins by reviewing the anatomy, histology, and physiology of the exocrine pancreas. It then examines the clinical presentation, etiology, pathology, pathogenesis, and clinical manifestations of acute and chronic pancreatitis, pancreatic insufficiency, and pancreatic cancer.

de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., & Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787

Required Media

Laureate Education, Inc. (Executive Producer). (2012c). The gastrointestinal system. Baltimore, MD: Author.

This media presentation outlines the pathophysiology of the gastrointestinal system and associated alterations.

Optional Resources

American Liver Foundation (2016). Retrieved from http://www.liverfoundation.org/

National Digestive Diseases Information Clearinghouse. (2016). Retrieved from http://digestive.niddk.nih.gov/index.aspx

 

Analysis and the Design phases and sub-steps of the ADDIE model – HRM402 CASE#1

Analysis and the Design phases and sub-steps of the ADDIE model  – HRM402 CASE#1

Type of document           Essay

4 Pages Double Spaced

Subject area       Management

Academic Level Undergraduate

Style      APA

References         3

Order description:

For THE Case 1 follow the Analysis and the Design phases and sub-steps of the ADDIE model, step by step. Cover everything in detail. Be as specific as possible. If there is unknown information, make logical assumptions for information needed and include a section in your paper showing the assumptions you made. Bring in at least one source found outside of your course materials to help build your paper (be sure to cite sources).

Phase: Analysis

  1. Instructional Goals: Clearly define what the training topic and parameters need to be.
  2. Instructional Analysis: Provide all the steps learners need to follow to complete the task.
  3. Learner Analysis: What do you know about the learners? Also, what do you still need to know about them? How will you find out?
  4. Learning Objectives: What do you want the learner to be able to do, explain, or demonstrate at the end of the training period?

 

What was the purpose of Romanesque tympanum sculpture? – Week 7 Discussion: Chapters 10 & 11

What was the purpose of Romanesque tympanum sculpture? – Week 7 Discussion: Chapters 10 & 11

Type of document           Essay

1 Page Double Spaced

Subject area       Art

Academic Level Undergraduate

Style      APA

References         1

Order description:

It’s not an essay it’s a discussion board … Thank you for your help!!! Due 7/18

Read chapters 10 & 11 and choose at least one of the topics below to discuss (you may discuss more than one if you choose):

  1. What was the purpose of Romanesque tympanum sculpture?

 Response Guidelines:

After you post your response and reply to at least two other students.

Post your response by Wednesday, 7/18 

Abdominal pain – HA W8 R1

Abdominal pain  – HA W8 R1

Type of document   Essay

1 Page Double Spaced

Subject area      Nursing

Academic Level       Master

Style        APA

References      2

Order description:

Ismael Parets. Main Post U8 D1

COLLAPSE

Abdominal pain, both acute and chronic, can be the symptom of the wide range of conditions. A nursing professional will need to work hard to interrogate a patient with this symptom, assess the received information, perform the physical examination, and order the lab tests based on the preliminary results (Buttaro, Trybulski, Bailey, & Sandberg, 2016).Clinicians must contemplate multiple diagnoses, especially those life-threatening situations that require timely intervention to limit morbidity and mortality. It is important to complete a history as possible as this is the cornerstone of an accurate diagnosis. The history should include a complete description of the patient’s pain and associated symptoms. Medical, surgical, and social history should also be sought as this may provide important information.

 

Acute Abdominal Pain in Adults

 

Assessment of an adult patient in the ER includes respiratory rate and pattern, look for evidence of anemia and jaundice, look for visible peristalsis of abdominal distention, or dehydration. In all four quadrants, it is necessary to auscultate the bowel sounds and look for bruits (Buttaro et al., 2016). Common diagnostic tools for abdomen include abdominal radiography, US, CT, and MRI.

 

Acute Abdominal Pain in Children

 

Most abdominal pain in children is functional. When assessing the pediatric patient, the provider should focus on any clues such as weight loss, recurrent vomiting, skin rash, mouth sores, night pain, family history, and dysphagia. Initial laboratory studies may include a CBC and urinalysis (Buttaro et al., 2016). Plain film abdominal radiographs are most useful when intestinal obstruction or perforation is a concern. US and CT are useful in diagnostic of abdomen pathologies.

 

Acute Abdominal Pain in Pregnant

 

Similar to working with other categories of patients with abdominal pain, a detailed history regarding the time of onset, duration, intensity, and character of the pain, as well as any associated symptoms should be obtained from a pregnant woman (Buttaro et al., 2016). With pregnant patients, determining the source of abdominal and pelvic pain is necessary. With diagnostics for women who are pregnant, MRI is considered since it does not use radiation which creates a large advantage in the safety of the patient and fetus (Norman, Murray, Shetty, Bendall, & Dalton, 2017).

 

References

 

Buttaro, T. M., Trybulski, J. A., Bailey, P. B., & Sandberg, J. (2016). Primary Care. New York, N. Y.: Elsevier.

 

Norman, S. D., Murray, I. A., Shetty, D., Bendall, R. P., & Dalton, H. R. (2017). Jaundice, abdominal pain, and fever in a young woman. The Lancet, 390(10103), 1713-1714.

 

** PROVIDE RESPONSE WRITING WITH REFERENCES. ALL REFERENCES MUST BE IN APA FORMAT AND WITHIN THE LAST 5 YEARS OF PUBLICATION.

 

 

 

bacterial vaginosis – saline wet mount and testing the pH – HA W10 R2

bacterial vaginosis – saline wet mount and testing the pH – HA W10 R2

Type of document   Essay

1 Page Double Spaced

Subject area      Nursing

Academic Level       Master

Style        APA

References      2

Order description:

Jessica Martin’s Main Post

COLLAPSE

The diagnostic tools that should be used to evaluate the condition of this patient include a saline wet mount and testing the pH of the vaginal secretions. Given the description of symptoms the patient is experiencing, it is likely that she has bacterial vaginosis. With bacterial vaginosis, there is an unpleasant fishy or musty genital odor due to an overgrowth of bacteria in the vagina. This is diagnosed by scanning a saline wet mount for clue cells, doing the whiff test, and testing the vaginal secretions for pH greater than 4.5 (Bickley, 2017). There are three different diagnostic criteria systems used in diagnosing bacterial vaginosis. They are Amsel criteria, Nugent criteria, and Spiegel criteria. The most widely accepted guideline used is Amsel criteria. Using these criteria, three out of the four following must be present: thin/milky discharge, elevated pH 4.5, clue cells on microscopy, and a fishy odor. One study suggests that the use of pH testing and wet mount was the least expensive and most effective at diagnosing bacterial vaginosis (Armstrong & Weisz, 2016). The scenario mentioned that the patient has one sexual partner and she treated herself for a yeast infection a year ago. This may have caused a disruption in her normal vaginal flora, leading to bacterial vaginosis.

 

References

 

Armstrong, E.., & Weisz, D. (2016). Diagnostic and treatment strategies for vaginitis: A literature review. Journal of Doctoral Nursing Practice, 9(1), 139-144. doi:http://dx.doi.org.prx-herzing.lirn.net/10.1891/2380-9418.9.1.139

 

Bickley, L. S. (2017). Bates’ Guide to Physical Examination and History Taking, 12th Edition. [Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781496354709/

 

**PROVIDE RESPONSE WRITING WITH REFERENCES. ALL REFERENCES MUST BE IN APA FORAMT AND WITHIN THE LAST 5 YEARS OF PUBLICATION.