Discuss three ways of creating an environment that provides psychological comfort for both patient and practitioner when conducting an examination and assessment of the Genitourinary system. Discuss medications that can affect the sexual performance of an aging adult male, possibly resulting in withdrawal from sexual activity. Discuss circumcision and the arguments for and against it. Discuss its associated religious connections. week 6 DQ 1 Georgina Graves is a 42-year-old female who presents to the provider’s office with fatigue. Subjective Data PMH: none, (except gynecological issues) Significant family history of heart disease Fatigue started about 2 months ago, getting worse Relieved with rest, exacerbated with activity Denies chest pain C/O shortness of breath on exertion Smoker 1 PPD Objective Data Vital signs: T 37 P 100 R 18 BP 110/54 Lungs: clear O2 Sat = 94% Skin = cool to touch CV = heart rate regular, positive peripheral pulses, ECG = intermittent complete left bundle branch block (New Finding) Edema Medications: Premarin 0.3 mg po/day What other questions should the nurse ask about the fatigue? What other assessments would be necessary for this patient? What are some causes of fatigue? What should be included in the plan of care? Based on the readings, what is the most likely cause of fatigue for this patient? DQ 2 Nelson Carson is a 62-year-old man who presents to his private practitioner’s office with a hacking, raspy cough. Subjective Data PMH: HTN, CAD Cough is productive, bringing up green, thick phlegm Runny nose, sore throat No history of smoking or seasonal allergies Complains of fatigue Objective Data Vital signs: T 37 P 72 R 14 BP 134/64 Lungs: + Rhonchi bilateral upper lobes, wheezes O2 Sat = 98% Medications: Metoprolol 25 mg per day, ASA 325 mg/daily What other questions should the nurse ask about the cough? What nursing diagnoses can be derived from the data? What should be included in the plan of care? What risk factors are associated with this age group? Based on the readings, what is the most likely cause of cough for this patient? week 7 DQ 1 Jonah Kotter is a 5-year-old male preschooler who presents to the pediatrician’s office for complaints that his leg “hurts”. Subjective Data PMH negative Immunizations: Up to date No medications No allergies Pain: 3/5 on pain scale Attends Kindergarten Does not remember injuring leg Objective Data Vital signs: T 37 degrees Centigrade, P 94, R 18, BP 100/70 Lungs: clear Heart rate and rhythm regular Moving all extremities + Range of motion legs and arms Strength 5/5 in all extremities What other questions should the nurse ask? What techniques are helpful to incorporate in assessing a patient in this age group? What are a few of the major differences in the musculoskeletal assessment of a child? What should be included in the plan of care? Based on the readings, what is the most likely cause of leg pain for this patient? DQ 2 Read the case study below and respond to two of the questions below. Make sure you respond to a classmate as well, before the week ends. Katherine Trembly is a 67-year-old woman who presents to the neurologist’s office after referral from her PCP (primary care provider) for a seizure. Subjective Data PMH: Seizure, hypertension, anxiety Retired book keeper C/o being “tired” Periods of unresponsiveness to verbal stimuli Objective Data Vital signs: T 37 degrees Centigrade, P 80, R 18, BP 174/84 Lungs: clear O2 Sat = 98% Heart rate regular, + peripheral pulses What other questions should the nurse ask? What techniques are helpful to incorporate in assessing a patient in this age group? What are some of the more common conditions that may cause seizure activity in this age group? What diagnostic tools will the physician use to diagnose this condition? What should be included in the plan of care? week 8 ek 8 Discussion 1 Give an example of a rapid assessment of a client and provide a SBAR report to a classmate. Remember to include all concepts of patient safety, standard precautions, and professional standards. OR Finish the story on our subject, Mr. Red Yoder, who is a patient you met in Week 2 and wrote a teaching plan on. What do you think his status might be today? Remember to include all concepts of patient safety, standard precautions, and professional standards
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