Nursing and Community (Due 24 hours)

1) Minimum 10 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

 Parts 4 and 5 must be different. Different writing and perspective, but always answering questions objectively 

              Part 1: Minimum 1 page

              Part 2: minimum 1 page

              Part 3: minimum 5 pages

              Part 4: minimum 1 page 

              Part 5: Minimum 1 page

              Part 6: Minimum 1 page

Submit 1 document per part

2)¨******APA norms, please use headers

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question.

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1:

A predominant theme in research and practice today is obesity, which is increasing at an alarming rate worldwide in all ages. As a future nurse practitioner:

1. How would you approach or discuss the topic of obesity and diet with your adult or geriatric patients?

2. What are the possible health consequences of obesity and what factors need to be taken into consideration when treating the obese patient who also has multiple comorbidities (e.g., hypertension, diabetes, high cholesterol)?

Part 2:

DERMATOLOGY CASE STUDY

Chief complaint:  “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”.

HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief. She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin  AF cream and it did not help relief her symptoms. She has not tried other remedies.

Denies associated symptoms of fever and chills. 

PMH: Diabetes Mellitus, type 2.

Surgeries: None

Allergies: Augmentin

Medication: Metformin 500mg PO BID.

Vaccination History:  Immunization is up to date and she received her flu shot this year.

Social history: College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago.

Family history:Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, HTN.

ROS:

Constitutional: Negative for fever. Negative for chills.

Respiratory: No Shortness of breath. No Orthopnea

Cardiovascular: Regular rhythm.

Skin: Right great toe swollen, itchy, painful and discolored.

Psychiatric: No anxiety. No depression.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130/70 T 98.0, P 88 R 22, non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.

NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.

LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.

HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle bilaterally.

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.

MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.

SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit.

PSYCH: Normal affect. Cooperative.

Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

Assessment:

Primary Diagnosis: Proximal subungual onychomycosis

Differential Diagnosis:  Irritant Contact Dermatitis, Lichen Planus, Nail Psoriasis

Special Lab:

Fungal culture confirms fungal infection.

As an NP student, you need to determine the medications for onychomycosis.

Questions:

1. According to the AAFP/CDC Guidelines, what antifungal medication(s) should this patient be prescribed, and for how long? Write her complete prescriptions using the prescription writing format in your textbook.

2.  What labs for baseline and follow up of therapy would you order for this patient? Give rationale.

Part 3:

1. Create a case with the following information, include vital sign and explain in detail the case.

Name: YM

Gender: Female

Diagnosis: asthma

 2. Make a diagnosis about the case

3. Explain the pathophysiology  about asthma and the case

4. Indicate sign and symptoms about asthma and the case 

5. Indicate diagnostic test about asthma and the case 

6. Assessment technique used for making diagnosis about asthma and the case

7. Make 3 differential diagnosis about the case

Part 4:

following website and answer the following question.

Visit thehttps://nurse.org/resources/family-nurse-practitioner/

 After reviewing the different setting in which Family Nurse Practitioners work. 

1. What setting will be your career choice and why?

Part 5:

following website and answer the following question.

Visit thehttps://nurse.org/resources/family-nurse-practitioner/

 After reviewing the different setting in which Family Nurse Practitioners work. 

1. What setting will be your career choice and why?

Part 6:

Discuss at least 3 regulations impose in APRN in the state of Florida and would you like to change the process.

Review the following websites: https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf

American Association of Nurse Practitioners “Standards of Practice”

https://storage.aanp.org/www/documents/advocacy/position-papers/StandardsOfPractice.pdf