Kristy Peterson is a 40-year-old female who presents to you in the primary care clinic with complaints of crying spells at work and calling in sick due to feeling overwhelmed. She reports she is just too tired to go to work. She shares she has been sad for almost every day for the past 6 months, and she has no interest in socializing. She no longer enjoys any of the activities or hobbies she used to enjoy, such as walking her dogs or her weekly bingo games with her friends. She feels distracted and tired despite sleeping 10–12 hours each night. She also reports an increase in appetite with a recent 15-pound weight gain. Her physical exam is unremarkable. Assessment Deliverable Locate and read an academic article from the University Library that relates to the condition presented in the Kristy Peterson case to improve your clinical skills. Write a 700- to 1,050-word summary regarding your patient encounter with Kristy Peterson based on the insight gained from the article you selected. Include the following in your summary: • Based on the latest evidence-based practice guidelines, what symptoms suggest that Ms. Peterson may be experiencing depression? • What are some tools primarily used to screen patients for depression and anxiety? • What labs would you order to determine differential diagnoses? Provide rationales. • How did you arrive at your differential diagnosis for Ms. Peterson? • What is the pathophysiology of depression and what are Ms. Peterson’s treatment options? • Discuss treatment (labs and diagnostic test if applicable) and management options (referral to a specialist, etc.) for this patient. • Which ICD-10 codes would you use to code this visit? Explain why. Outline a detailed collaboration and follow-up plan for Ms. Peterson, including any resources, including specialists, you would utilize to optimize her care. Cite a minimum of 2 to 3 peer-reviewed references. Format your assessment according to APA guidelines. Submit your assessment. Assessment Support • Review the grading rubric for guidance on deliverable expectations. • Review the following resources for writing guidelines and APA information: • Center for Writing Excellence

The role of the baccalaureate nurse includes identifying and explaining specific patient risk factors, incorporating evidence-based solutions to improving patient safety and coordinating care. A solid foundation of knowledge and understanding of safety organizations such as Quality and Safety Education for Nurses (QSEN), the Institute of Medicine (IOM), and The Joint Commission and its National Patient Safety Goals (NPSGs) program is vital to practicing nurses with regard to providing and promoting safe and effective patient care. You are encouraged to complete the Identifying Safety Risks and Solutions activity. This activity offers an opportunity to review a case study and practice identifying safety risks and possible solutions. We have found that learners who complete course activities and review resources are more successful with first submissions. Completing course activities is also a way to demonstrate course engagement. References Kohn, L. T., Corrigan, J., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. National Academy Press. As a baccalaureate-prepared nurse, you will be responsible for implementing quality improvement (QI) and patient safety measures in healthcare settings. Effective quality improvement measures result in systemic and organizational change, ultimately leading to the development of a patient safety culture. Consider the hospital-acquired conditions that are not reimbursed under Medicare/Medicaid, some of which are specific safety issues such as infections, falls, medication errors, and other concerns that could have been prevented or alleviated with the use of evidence-based guidelines. The purpose of this assessment is to better understand the role of the baccalaureate-prepared nurse in enhancing quality improvement (QI) measures to address patient safety risk at a healthcare setting of your choice. You will do this by exploring the professional guidelines and best practices for improving and maintaining patient safety in healthcare settings from organizations such as QSEN (Quality and Safety Education for Nurses) and the IOM (Institute of Medicine). Looking through the lens of these professional best practices to examine the current policies and procedures in place at your chosen organization and the impact on safety measures for patients, you will consider the role of the nurse in driving quality and safety improvements. You will identify stakeholders in QI improvement and safety measures as well as consider evidence-based strategies to enhance quality of care and promote safety in your chosen healthcare setting. See Nursing Competencies ( https://capella.alma.exlibrisgroup.com/leganto/public/01CAPELLA_INST/lists/3333081990006731?auth=SAML§ion=4040483460006731) for more information. Select one of the safety quality issues presented in the Assessment 01 Supplement: Enhancing Quality and Safety [PDF]Download Assessment 01 Supplement: Enhancing Quality and Safety [PDF] (https://courseroom.capella.edu/courses/64168/files/12233152?wrap=1)resource and incorporate evidence-based strategies to support communication and ensure safe and effective care. For this assessment, be sure to focus on an organizational setting. This could be a primary care office, urgent care, mobile clinic, hospital ED, rural clinic, etc. Then use the literature to support the problem and solution in the organization. Reflect on costs to that organization/setting and what nurses can do to coordinate the care within the setting. Reflect on stakeholders who may be involved. Be sure that your plan addresses the following, which corresponds to the grading criteria in the rubric. Please study the rubric carefully so you understand what is needed for a distinguished score. Explain factors leading to a specific patient safety risk. Explain evidence-based and best-practice solutions to improve patient safety related to a specific patient-safety risk and reduce costs. Explain how nurses can help coordinate care to increase patient safety and reduce costs. Identify stakeholders with whom nurses would need to coordinate to drive safety enhancements. Communicate using writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style. Length of submission: 3–5 pages of content plus title and reference pages. Number of references: Cite a minimum of 4 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old. Use the Capella University Library (https://lat.strategiced.com/redirect?linkid=1651) and (https://capellauniversity.libguides.com/BSN) as needed. APA formatting: References and citations are formatted according to current APA style. See the APA Module(https://lat.strategiced.com/redirect?linkid=2586)

Kate Parker is a 64-year-old, Jamaican American female patient who comes to the clinic reporting “dizziness and near-fainting that has been happening off and on for the last 48 hours.” She reports a 10-year history of hypertension, which she describes as usually controlled. She considers herself as healthy, other than being recently ill with a bad case of influenza. Med list current (see below)—she took all medications as scheduled this morning. She denies any pain, palpitations, angina, or signs of stroke (facial droop, arm weakness, or trouble with speech). Physical assessment reveals an irregular heart rate; weak peripheral pulses; cool, pale skin; and decreased capillary refill. The ECG shows atrial fibrillation. Ms. Parker reveals that she is in the United States illegally and is undocumented. The patient expresses concern about her status as you prepare her for treatment. PMH · Other active problems: hyperlipidemia and hypertension · Medical, surgical, obstetric, hospitalizations: Appendectomy at age 20; no other hospitalizations or surgical procedures Prescriptions and allergies · Prescriptions (current) o Nebivolol (Bystolic) 5 mg daily o Lisinopril and hydrochlorothiazide 20/25 mg daily o ASA 81 mg daily o Atorvastatin (Lipitor) 40 mg daily · Allergies: No known allergies to food or medicine Preventive health · Seen 6 months ago for a well-woman visit o Pap smear and mammogram both normal o Lipid profile: § Total cholesterol 220 mg/dL § HDL cholesterol 36 mg/dL § Triglycerides 152 mg/dL § LDL cholesterol 134 mg/dL o Sees dentist yearly o Last colonoscopy 5 years ago and within normal limits · Immunizations o Flu shot o Pneumovax and Zostavax 6 months ago o Last Tdap 2 years ago FHx/SHx · FHX (family history) o Father died at age 78: stroke o Mother died at age 85: heart disease · SHS (social history) o Occupation: cashier; emigrated from Jamaica; fluent in English o Living situation: lives with husband of 30+ years in an apartment o Alcohol use: 4 glasses of wine/week o Tobacco use: none/never o Illicit drugs: none/never o Sexual history: monogamous o Diet: high rice consumption; little red meat; lots of chicken, fish, beans for protein o Exercise: walks 20 minutes three times a week ROS (from patient interview) · General/constitutional: Reports 6 hours of sleep normally at night; fatigued and weak · Skin/breast: Normal · HEENT and neck: Normal · Cardiovascular: Felt dizzy on and off for the past 2 days; no chest pain · Respiratory: Bad case of influenza 2 months ago; no recent cough, wheeze, or sputum production · Abdomen/gastrointestinal: No history of peptic acid disease or gastroesophageal reflux. Last BM this morning (once daily is normal) · Genitourinary: No use of estrogen; LMP at age 48 · Musculoskeletal: Normal · Neurological: Intermittent dizziness and feeling near fainting over the last 2 days · Allergic/immunologic: Normal · Lymphatic/endocrine: No history of diabetes mellitus or thyroid disease · Hematologic: No history of anemia · Psychological: No history of anxiety, panic disorder, or depression VS · BP: 128/84 · HR:180 · RR: 30 · T: 99.1 · HT: 70’’ · WT: 197 · BMI: 28.27 Physical exam · General: Appears in moderate distress · Skin/breast: Cool, pale, no rash or lesions · HEENT and neck: PERRLA. Thyroid WNL to palpation · Cardiovascular: No jugular venous distension; point of maximal impulse (PMI) 5th intercostal space (ICS); tachycardic (180 bpm); irregular rhythm, no murmur; weak peripheral pulses; decreased capillary refill; no peripheral edema. EKG shows an absence of P waves, fibrillatory waves, irregular · Respiratory: Breath sounds clear to auscultation and percussion; tachypneic · Abdomen/gastrointestinal: Soft, nontender to palpation in all quadrants · Genitourinary: Not examined · Musculoskeletal: Normal, no edema · Neurological: CN II – XII intact; DTRs +2; no facial droop, arm weakness, or tMusculoskeletal: Normal, no edema · Neurological: CN II – XII intact; DTRs +2; no facial droop, arm weakness, or trouble with speech · Psychological: Not examined · Allergic/immunologic: NKDA, no food or seasonal allergies · Lymphatic/endocrine: No lymphadenopathy · Hematologic: Not examined

SOCW 6060 SOCIAL WORK CLINICAL THEORY AND PRACTICE Application of Role Theory to a Case Study, Part 1 WHAT TO KNOW This week, you will use role theory to apply to your chosen case study. In other words, your theoretical orientation—or lens—is role theory as you analyze the case study. Use the same case study you chose in Week 2. (Remember: You will be using this same case study throughout the entire course.) Use the Analysis of a Theory Worksheet to help you dissect the theory. You do not need to submit this handout. It is a tool for you to use to dissect the theory, and then you can employ the information in the table to complete your Assignment. PLEASE REFER TO THE WEEK 2 CASE STUDY. TO PREPARE • Review and focus on the same case study that you used in Week 2. • Use the Analysis of a Theory Worksheet to help you dissect the theory. Use this tool to dissect the theory, employ the information in the table to complete your Assignment, and then keep it to add to your Theories Study Guide in Week 11. • Review the websites and guides for developing PowerPoint skills found in the Learning Resources. • Be sure to review the Kaltura Guide item in the Learning Resources. • Use Personal Capture to record the PowerPoint slides on your screen and your audio as you present the information. You will then use Kaltura Media to upload this recording to the Assignment link. • . ASSIGNMENT Submit a PowerPoint presentation using the Personal Capture feature of the Kaltura media feature in the online classroom. Record yourself giving the audio-visual presentation much like you would in a case presentation or other public setting. The presentation should include 11–12 slides. • Use bullet points when writing on each slide, meaning no long paragraphs of written text should be in the slides. • Keep in mind that the recording takes the place of fully written paragraphs, while the bullet points provide context and cues for the audience to follow along. • Be sure to review the Kaltura Guide item in the Learning Resources. Your presentation should address the following: • Identify the presenting problem for the case study you selected. (Remember: The presenting problem has to be framed from the perspective of role theory. For example, the presenting problem can be framed within the context of role functioning.) • Identify all the relevant roles assumed by the client. • Analyze the social expectations and social and cultural norms revolving around the role, social position, and role scripts of one of the roles assumed by the client. • Explain the role and social position of the social worker in working with the client in the case study. • Describe how the role(s) and social position(s) assumed by the social worker will influence the relationship between the social worker and the client. • Identify three assessment questions that are guided by role theory that you will ask the client to better understand the problem. • Identify and describe two interventions that are aligned with the presenting problem and role theory. • Identify one advantage and one limitation in using role theory in understanding the case. Submit also, as a separate document, your Week 4 Analysis of a Theory Worksheet. Be sure to: • Identify and correctly reference the case study you have chosen. • Use literature to support your claims. • Use APA formatting and style. • Include a Reference List on the last slide. Part two of the home work.. Analysis of Theory Worksheet Use this worksheet to help you apply a theory as a lens to the case study for your assignments. Fill in the column on the right with all applicable information, and then consider it a reference for how to apply the theory. You must submit this worksheet, where indicated, in applicable assignments. Then you will compile the worksheet for your Theories Study Guide (that you can use for the licensure exam) at the end of the course. Name of theory Author or founder Historical origin of theory Basic assumptions Underlying assumptions Key concepts Foci/unit of analysis Philosophical or conceptual framework Strengths of theory Limitations of theory Common criticisms When and with whom it would be appropriate to use the theory/model Consistency of theory/model with social work principles Identification of goodness of fit with ethical principles Ways in which theory/model informs research methods Implications for social work practice Support your post with examples from the course text to demonstrate that you have completed the required readings, understand the material, and are able to apply the concepts. As the course progresses, you will be expected to cite using APA. To develop APA skills, utilize resources from the Writing PLEASE WRITE THE HEADINGS COURSE BOOK/MATERIAL Social Work Treatment 7TH 25 Author: Franklin, Cynthia ISBN-13: 978-0-19-767725-4 ISBN-10: 0-19-767725-8 Edition/Copyright: 7TH 25 Publisher: Oxford University Press WEEKLY RESOURCES REQUIRED READING • Franklin, C., & Jordan, C. (Ed.). (2024). Turner’s social work treatment: Interlocking theoretical approaches (7th ed.). Oxford University Press o Chapter 3, “Relational Social Work: Psychosocial Perspective” (pp. H19–H29) o Chapter 6, “Social Learning Theory” (pp. H49–H59) • Blakely, T. J., & Dziadosz, G. M. (2008). Case management and social role theory as partners in service deliveryLinks to an external site.. Care Management Journals, 9 (3), 106–112. https://doi.org/10.1891/1521-0987.9.3.106 • Dulin, A. M. (2007). A lesson on social role theory: An example of human behavior in the social environment theoryLinks to an external site.. Advances in Social Work, 8 (1), 104–112. https://doi.org/10.18060/134 • Document: Psychological and Social Factors RefresherDownload Psychological and Social Factors Refresher (Word document) • Document: Analysis of a Theory WorksheetDownload Analysis of a Theory Worksheet (Word document) • Document: Theory Into Practice: Four Social Work Case StudiesDownload Theory Into Practice: Four Social Work Case Studies (PDF) REQUIRED MEDIA • Walden University, LLC. (2017). Theories knowledge check, part 1 Links to an external site. [Interactive media]. Walden University Canvas. https://waldenu.instructure.com • Document: Theories

Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs. More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions. To Prepare: Review the Resources. Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare. Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery. To Complete: Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim. Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of: Patient experience Population health Costs

Nurses at the baccalaureate level in all practice areas are involved in nursing informatics through interaction with information management and patient care technologies. Nurses must not only demonstrate knowledge of and skills in health information and patient care technologies, but also how to use these tools at the bedside and organizational levels. Moreover, nurses need to recognize how information gathered from various health information sources can impact decision making at the national and state regulatory levels. As you begin to prepare this assessment, you are encouraged to complete the Team Perspectives of the Nurse Informaticist activity. Completion of this will help you succeed with the assessment as you explore the nurse informaticist’s role from the different perspectives of the health care team. Completing activities is also a way to demonstrate engagement. To successfully prepare for this assessment, you will need to complete these preparatory activities: Review assessment resources and activities. Review the focus of the new nurse informaticist position you will propose by examining the Assessment 01 – Nursing Informatics in Health Care [PDF]Download Assessment 01 – Nursing Informatics in Health Care [PDF] (https://courseroom.capella.edu/courses/64002/files/12232533?wrap=1) resource. Conduct independent research on the nursing knowledge and skills necessary to interact with health information and patient care technology. Focus your research on current resources available through peer-reviewed articles, professional websites, government websites, professional blogs, wikis, job boards, and so on. Consult the BSN Program Library Research Guide(https://capellauniversity.libguides.com/BSN)for help in identifying scholarly and authoritative sources. Interview peers in your network who are considered information technology experts. Ask them about how information technology advances are impacting patient care at the bedside, at the organizational level, and beyond. For this assessment, assume you are a nurse attending a meeting of your state’s nurses association. A nurse informaticist conducted a presentation on their role and its impact on positive patient and organizational outcomes in their workplace. You realize that your organization is undergoing many technological changes. You believe this type of role could provide many benefits to your organization. Review the focus of the new nurse informaticist position you will propose by examining the Assessment 01 – Nursing Informatics in Health Care [PDF]Download Assessment 01 – Nursing Informatics in Health Care [PDF] resource. You decide to pursue proposing a nurse informaticist role in your organization. You speak to your chief nursing officer (CNO) and human resources (HR) manager, who ask you to prepare a 4–5 page evidence-based proposal to support the new role. In this way, they can make an informed decision as to whether the addition of such a role could justify the return on investment (ROI). They need your proposal before an upcoming fiscal meeting.​ This is not an essay, but instead, it is a proposal to create a new Nurse Informaticist position. One important part of this assessment is the justification of the need for a nurse informaticist in a health care organization and references from relevant and timely scholarly or professional resources to support the justification for creating this nurse informaticist position. The term justify means to show or prove that the nurse informaticist position brings value to the organization. This justification must include evidence from the literature to support that this position will provide a return on investment for the organization. The chief nursing officer (CNO) and human resources (HR) manager have asked you to include the headings below in your proposal and to be sure to address the bullets following each heading. Remember that you will emphasize the focus of the new nurse informaticist position as described in the Assessment 01 – Nursing Informatics in Health Care [PDF]Download Assessment 01 – Nursing Informatics in Health Care [PDF] resource. Nursing Informatics and the Nurse Informaticist What is nursing informatics? What is the role of the nurse informaticist? Highlight one influential nurse informaticist and their contributions to nursing. Nurse Informaticists and Other Health Care Organizations What is the experience of other health care organizations with nurse informaticists? How do these nurse informaticists collaborate with the rest of the nursing staff and the interdisciplinary team? Impact of Full Nurse Engagement in Health Care Technology How does fully engaging nurses in health care technology impact: Patient care? Protected health information (security, privacy, and confidentiality)? In this section, you will explain evidence-based strategies that the nurse informaticist and interdisciplinary team can use to effectively manage patients’ protected health information, particularly privacy, security, and confidentiality. Evidence-based means that they are supported by evidence from scholarly sources. Workflow? Costs and return on investment? Opportunities and Challenges What are the opportunities and challenges for nurses and the interdisciplinary team with the addition of a nurse informaticist role? How can the interdisciplinary team collaborate to improve quality care outcomes through technology? Summary of Recommendations What are 3–4 key takeaways from your proposal about the recommended nurse informaticist role that you want the CNO and the HR manager to remember? This is the section where the justification for the implementation of the nursing informaticist role is addressed. Remember to include evidence from the literature to support your recommendation.

Health care providers today must develop their skills in mitigating risks to their patients and themselves related to patient information. At the same time, they need to be able distinguish between effective and ineffective uses of social media in health care. This assessment will require you to develop a staff update for an interprofessional team to encourage team members to protect the privacy, confidentiality, and security of patient information. Health professionals today are increasingly accountable for the use of protected health information (PHI). Various government and regulatory agencies promote and support privacy and security through a variety of activities. Examples include: Meaningful use of electronic health records (EHR). Provision of EHR incentive programs through Medicare and Medicaid. Enforcement of the Health Insurance Portability and Accountability Act (HIPAA) rules. Release of educational resources and tools to help providers and hospitals address privacy, security, and confidentiality risks in their practices. Technological advances, such as the use of social media platforms and applications for patient progress tracking and communication, have provided more access to health information and improved communication between care providers and patients. At the same time, advances such as these have resulted in more risk for protecting PHI. Nurses typically receive annual training on protecting patient information in their everyday practice. This training usually emphasizes privacy, security, and confidentiality best practices such as: Keeping passwords secure. Logging out of public computers. Sharing patient information only with those directly providing care or who have been granted permission to receive this information. Today, one of the major risks associated with privacy and confidentiality of patient identity and data relates to social media. Many nurses and other health care providers place themselves at risk when they use social media or other electronic communication systems inappropriately. For example, a Texas nurse was recently terminated for posting patient vaccination information on Facebook. In another case, a New York nurse was terminated for posting an insensitive emergency department photo on her Instagram account. Health care providers today must develop their skills in mitigating risks to their patients and themselves related to patient information. At the same time, they need to be able distinguish between effective and ineffective uses of social media in health care. This assessment requires you to develop a staff update for an inter-professional team to encourage team members to protect the privacy, confidentiality, and security of patient information. Technology has become so commonplace in our lives that organizations are now using it to reach their workforce. Gone are the days of paper flyers on the breakroom wall. Organizations are using intranets, workplace social media, or communications systems like Workplace, Slack, or Teams. As you begin to consider the assessment, it would be an excellent choice to complete the Breach of Protected Health Information (PHI) activity. The activity will support your success with the assessment by creating the opportunity for you to test your knowledge of potential privacy, security, and confidentiality violations of protected health information. The activity is not graded and counts towards course engagement. To successfully prepare to complete this assessment, complete the following: Review the settings presented in the Assessment 02 – Protected Health Information [PDF]Download Assessment 02 – Protected Health Information [PDF] (https://courseroom.capella.edu/courses/64002/files/12232516?wrap=1)resource and select one to use as the focus for this assessment. Search the Internet for infographics about protecting PHI. These infographics should serve as examples of how to succinctly summarize evidence-based information about protecting the security, privacy, and confidentiality of patient data. Some examples of infographics are provided for you in the reading list Infographics(https://capella.alma.exlibrisgroup.com/leganto/public/01CAPELLA_INST/lists/3711613860006731?auth=SAML§ion=3763622410006731) Analyze these infographics and distill them into five or six principles of what makes them effective. As you design your interprofessional staff update, apply these principles. Note: In a staff update, you will not have all the images and graphics that an infographic might contain. Instead, focus your analysis on what makes the messaging effective. Select from any of the following options, or a combination of options, as the focus of your interprofessional staff update: Social media best practices. What not to do: social media. Social media risks to patient information. Steps to take if a breach occurs. Conduct independent research on the topic you have selected in addition to reviewing the suggested resources for this assessment. This information will serve as the source(s) of the information contained in your interprofessional staff update. Consult the BSN Program Library Research Guide(http://capellauniversity.libguides.com/BSN) for help in identifying scholarly and/or authoritative sources. In this assessment, imagine you are a nurse in one of the health care settings described in the following resource: Assessment 02 – Protected Health Information [PDF]Download Assessment 02 – Protected Health Information [PDF] Before your shift begins, you scroll through Facebook and notice that a coworker has posted a photo of herself and a patient on Facebook and described how happy she is that her patient is making great progress. You have recently completed your annual continuing education requirements at work and realize this is a breach of your organization’s social media policy. Your organization requires employees to immediately report such breaches to the privacy officer to ensure the post is removed immediately and that the nurse responsible receives appropriate corrective action. You follow appropriate organizational protocols and report the breach to the privacy officer. The privacy officer takes swift action to remove the post. Due to the severity of the breach, the organization terminates the nurse. Based on this incident’s severity, your organization has established a task force with two main goals: Educate staff on HIPAA and appropriate social media use in health care. Prevent confidentiality, security, and privacy breaches. The task force has been charged with creating a series of interprofessional staff updates on the following topics: Social media best practices. What not to do: Social media. Social media risks to patient information. Steps to take if a breach occurs. Technology has become so commonplace in our lives that organizations are now using it to reach their workforce. Gone are the days of paper flyers on the breakroom wall. Organizations are

INSTRUCTION: Using the blank SOAP Note Template (found in the Learning Materials module), complete a comprehensive SOAP Note for a patient in your target patient population. S: Subjective 39-year-old G3P2 female at 33 weeks and 5 days gestation presents for routine high-risk prenatal visit. Pregnancy is complicated by diabetes mellitus and chronic hypertension. Patient reports good fetal movement. Denies vaginal bleeding, leakage of fluid, contractions, headache, visual disturbances, right upper quadrant pain, chest pain, shortness of breath, or decreased fetal movement. Reports compliance with prescribed medications, prenatal vitamins, blood glucose monitoring, and blood pressure monitoring. O: Objective BP: 132/81, HR: 87, RR: 18, SaO2: 97%, Temp: 98.1°F General: Alert and oriented, no acute distress. Vital Signs: Reviewed and stable. Blood Pressure: Monitored due to history of hypertension. Abdomen: Gravid, soft, non-tender. Fundal Height: Consistent with gestational age. Fetal Heart Rate: 140 bpm, reassuring. Fetal Movement: Present. Extremities: No significant edema. Urine dipstick: Negative for protein Blood glucose log reviewed. A: Assessment High-risk pregnancy, third trimester. ICD-10: O09.93 Pre-existing hypertension complicating pregnancy, third trimester. ICD-10: O10.913 Diabetes mellitus complicating pregnancy, third trimester. ICD-10: O24.913 Advanced maternal age multigravida, third trimester. ICD-10: O09.523 33 weeks gestation of pregnancy. ICD-10: Z3A.33 P: Plan Continue routine high-risk prenatal care. Continue prenatal vitamins daily. Continue antihypertensive and diabetic medications as prescribed. Encourage adherence to diabetic diet and regular blood glucose monitoring. Continue home blood pressure monitoring and maintain log. Review fetal kick counts and instruct patient to report decreased fetal movement. Educate regarding signs and symptoms of preeclampsia, including severe headache, visual changes, right upper quadrant pain, and sudden swelling. Educate regarding signs of preterm labor, including regular contractions, vaginal bleeding, leakage of fluid, and pelvic pressure. Follow up in 1 week or sooner for any concerns. INSTRUCTIONS: Patient Information and Chief Complaint Includes required identifying information and clearly states the chief complaint in concise, appropriate language. Subjective Data Subjective section is complete, relevant, and well organized, including HPI, pertinent past medical/surgical/family/social history, allergies, immunizations, medications, and ROS as appropriate to the visit. Objective Data Objective section is complete, accurate, and focused, including vital signs, physical exam findings, and relevant labs/diagnostics interpreted during the visit as appropriate. : (FOR PHYSICAL ASSESSMENT (EXAMPLE): please review proper PE documentation (health assessment course). What does the rash look like? Provide specific location of the rash, upper arm, medial arm? See exams below: Chest: normal AP diameter, symmetrical expansion, normal tactile fremitus bilaterally, clear on percussion and auscultation. No wheezes, rales or rhonchi heard. Cardiovascular: S1 and S2 normal, physiologic splitting, a loud S4 is present at the cardiac apex, no murmurs or rubs Respiratory: Lung sounds are even and unlabored. No crackles, rhonci or wheezing to auscultation. Able to converse w/o SOB or tachypnea. No sign of respiratory distress or accessory muscle usages. O2 saturation at 98%). Assessment and Clinical Reasoning Identifies 2-3 appropriate differential diagnoses, includes ICD-10 codes, and supports the primary diagnosis with sound clinical reasoning based on subjective and objective findings supported with one to two references in APA format. (There must have a clinical reasoning based on subjective and objective findings supported with references). Plan of Care Reflection demonstrates meaningful clinical insight, and the SOAP note is organized, concise, professional, and written at the graduate level with appropriate clinical terminology. Includes at least one to two references beyond the course learning materials.

INSTRUCTIONS: Using the blank SOAP Note Template (found in the Learning Materials module), complete a comprehensive SOAP Note for a patient in your target patient population. (THIS IS A COMPREHENSIVE SOAP NOTE). S- 62-year-old female presents with left arm pain localized under the left armpit, ongoing for approximately 1 year and progressively worsening. The pain is rated as 10/10 in severity and is most pronounced at night, making it difficult to move the arm or sleep on the affected side. The area is tender to palpation. The most comfortable position is with the arm resting down. The pain radiates from the left axilla down the arm and is tender to palpation in the axillary area. Lifting the arm overhead exacerbates the pain, while holding it at the side provides relief. The patient also reports intermittent shortness of breath. Vitals are stable at this time. The patient expresses feelings of depression and anxiety related to work stress. (PHQ-9 score:17), reporting a lack of support from management and negative interactions with coworkers. The patient has been employed at Costco for 34 years and plans to retire next year, but is currently experiencing significant emotional distress and a desire to take time off work. Past history is notable for a motor vehicle accident 4–5 years ago, resulting in a right shoulder fracture, for which physical therapy provided minimal improvement. The patient also has a history of sciatic nerve pain and reports that an X-ray taken at an urgent care visit about one year ago revealed an “extra vein” in the left axillary region. However, no further evaluation or treatment was completed.Pt denies SOB, chest, palpitations, N/V/D, fever/chills, or any acute changes to health status. MEDICATIONS: Medications ibuprofen 600 mg tablet, 1 tab by mouth every 6 hours prn pain CeleXA 40 mg tablet, TAKE 1 TAB PO QD guaiFENesin 100 mg/5 mL oral liquid, Take 10ml PO every 4-6 hours as needed for cough Lopid 600 mg tablet, Take 1 tablet PO twice daily citalopram 40 mg tablet, TAKE 1 TAB PO QD Vitamin D2 1,250 mcg (50,000 unit) capsule, Take 1 capsule PO weekly for 8 weeks Mental/Functional: PHQ-9 total score: 17 The patient’s speech was normal, sharing conversation with normal laryngeal efforts. Appropriate mood and affect were seen on exam. Thought processes were logical, relevant, and thoughts were completed normally. Thought content was normal. Thought content was normal with no psychotic or suicidal thoughts. The patient’s judgement was realistic with normal insight into their present condition. Mental status included: correct time, place, person orientation, normal recent and remote memory, normal attention span and concentration ability. Language skills included the ability to correctly name objects. Fund of knowledge included normal awareness of current and past events. Allergies No known allergies O- Vital Signs: BP 133/63, HR 59, RR 15, T 98.3 °F, Ht 5’2″, Wt 180.6 lbs, BMI 32.99, SPO2 92%. Alert and oriented. Objective GEN: NAD NECK: supple, NT, FROM RESP: lungs clear to auscultation bilaterally, no rales, wheezes or rhonchi, nonlabored breathing, no use of accessory of muscles of respiration CV: RRR, no m/r/g GI: +BS, nontender to palpation, no masses, no HSM DERM: skin warm and dry EXT: no cyanosis/clubbing/edema NEURO: AO x 3 PSYCH: judgment/insight intact, NL mood/affect IMMUNIZATIONS: Influenza (LAIV, TIV) Pneumococcal (PCV, PPSV) Tetanus; Diphtheria; Pertussis (Tdap, Td) Zoster (Shingles) Medical History (PMHx) Other skin condition(s): NO MEDICAL HISTORY Past Surgical History (PSHx) REMOVAL OF A MASS IN ARMPIT Family History (FHx) father: Deceased mother: Deceased, +cancer (unsure of type) Social History (SHx) Alcohol: Do not drink Tobacco: Never smoker Social Determinants of Health (SDOH) No social determinants of health data have been documented for this patient OB & Pregnancy History: A- Body mass index (BMI) 32.0-32.9, adult (Z68.32) Body mass index (BMI) 32.0-32.9, adult Mild depression (F32.A) Depression, unspecified Mass of left axillary region (L02.412) Cutaneous abscess of left axilla Prediabetes (R73.03) Prediabetes Obesity (E66.9) Obesity, unspecified Anxiety (F41.9) Anxiety disorder, unspecified Plan Plan Rx: -ibuprofen 600mg q6 Diagnostics: -mammogram -US Left axillary -annual labs -CTscan with contrast (after annual labs) Referral(s): -psych -therapy Follow-up: in 1-2 weeks for LAB and US review INSTRUCTIONS: Patient Information and Chief Complaint Includes required identifying information and clearly states the chief complaint in concise, appropriate language. Subjective Data Subjective section is complete, relevant, and well organized, including HPI, pertinent past medical/surgical/family/social history, allergies, immunizations, medications, and ROS as appropriate to the visit. Objective Data Objective section is complete, accurate, and focused, including vital signs, physical exam findings, and relevant labs/diagnostics interpreted during the visit as appropriate. : (FOR PHYSICAL ASSESSMENT (EXAMPLE): please review proper PE documentation (health assessment course). What does the rash look like? Provide specific location of the rash, upper arm, medial arm? See exams below: Chest: normal AP diameter, symmetrical expansion, normal tactile fremitus bilaterally, clear on percussion and auscultation. No wheezes, rales or rhonchi heard. Cardiovascular: S1 and S2 normal, physiologic splitting, a loud S4 is present at the cardiac apex, no murmurs or rubs Respiratory: Lung sounds are even and unlabored. No crackles, rhonci or wheezing to auscultation. Able to converse w/o SOB or tachypnea. No sign of respiratory distress or accessory muscle usages. O2 saturation at 98%). Assessment and Clinical Reasoning Identifies 2-3 appropriate differential diagnoses, includes ICD-10 codes, and supports the primary diagnosis with sound clinical reasoning based on subjective and objective findings supported with one to two references in APA format. (There must have a clinical reasoning based on subjective and objective findings supported with references). Plan of Care Reflection demonstrates meaningful clinical insight, and the SOAP note is organized, concise, professional, and written at the graduate level with appropriate clinical terminology. Includes at least one to two references beyond the course learning materials.

As a nurse practitioner, a commonly occurring issue among male patients will be erectile dysfunction (ED). Patients with ED have an increased risk of developing heart disease. Write a 700- to 1,050-word paper in which you: • Briefly summarize the pathophysiology of ED and the connection between ED and cardiovascular risk factors. • Identify and describe the impact of a minimum of 3 risk factors associated with ED. • Explain the importance of considering the evaluation of cardiovascular disease with a chief complaint of ED. • Describe a plan for evaluation using current practice guidelines. • Explain how you would educate the patient about ED and its relationship to cardiovascular disease. • Discuss certain situations when you would refer patients to specialists and provide rationale. • Identify which ICD-10 codes you would use to code this visit and explain why. Cite a minimum of 2 to 3 peer-reviewed references. Format your assignment according to APA guidelines. Submit your assignment. Assignment Support • Review the following resources for writing guidelines and APA information: • Center for Writing Excellence • Reference and Citation Generator • Grammar Assistance • Use the following resources to research evidence-based care for any disease, disorder, or condition: • Medscape