NR 508 Week 3 Discussions Recent
NR 508 Week 3 Discussions Recent
discussion part one
elliot is a 74 year-old male who presents to your clinic with complaints of frequent nosebleeds (4 in the past week) and several severe bruises scattered variously throughout his anatomy. the patient is also complaining of a runny nose, cough, and head/chest congestion. he has a history of chronic atrial fibrillation and is currently prescribed and taking warfarin. approximately 3 weeks previously, he started taking over-the-counter cimetidine for heartburn he was experiencing. below is a list of the patient’s medications, his physical examination, and his laboratory findings: NR 508 Week 3 Discussions Recent
medications
digoxin 0.25 mg qd cimetidine otc bid
pseudoephedrine sr 120 bid warfarin 7 mg qd
allergies: nkda
vs: bp: 180/95, hr 75, irregularly irregular, rr 17
weight: 95 kg
heent: wnl
abd: + bowel sounds ext: bruising on arms and legs
neuro: alert & oriented x 3 gen: well developed, well-nourished male
ecg: atrial fibrillation
laboratory
na 143 meq/l k 4.5 meq/l
cl 99 mmol/l co2 25 meq/l
bun 18 mg/dl scr 0.9 mg/dl
inr 4.8 hct 42%
hbg 15 mg/dl digoxin 3.8 ng/ml
what problems should be identified in this patient?
what are the precise mechanisms of action of each drug? NR 508 Week 3 Discussions Recent
what do you think is contributing to the patient’s hypertension?
are there any drug interactions that you can identify as associated with this current drug regimen, and if so how, mechanistically, are they occurring?
what is the clinical significance of these interactions?
NR 508 Week 3 Discussions 1 (Part Two) Recent
discussion part two
you have decided to have him stop the pseudoephedrine related to his hypertension, as well as the cimetidine related to its interaction with warfarin. the patient returns for his monthly follow-up appointment, and it is noticed that his blood pressure (195/80) has not come under control. you decide to start him on hydrochlorothiazide. NR 508 Week 3 Discussions Recent
is there a better medication than a thiazide, and if so what dose should you initiate this medication?
how would you proceed, and how you would monitor for efficacy and toxicity?
Description
SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The episodic SOAP note is to be written using the attached template below. NR 508 Week 3 Discussions Recent
Graduate SOAP NOTE TEMPLATE.docx
For all the SOAP note assignments, you will write a SOAP note about one of your patients and use the following acronym:
| S = | Subjective data: Patient’s Chief Complaint (CC). |
| O = | Objective data: Including client behavior, physical assessment, vital signs, and meds. |
| A = | Assessment: Diagnosis of the patient’s condition. Include differential diagnosis. |
| P = | Plan: Treatment, diagnostic testing, and follow up |
Submission Instructions:
- Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
PLEASE DO THIS ON A 25 YEAR OLD PATIENT WHO CAME WITH A YEAST INFECTION. WHO CAME INTO THE GYNO OFFICE.
I have attached the rubric, and example and the template please follow it
Description
SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The episodic SOAP note is to be written using the attached template below. NR 508 Week 3 Discussions Recent
For all the SOAP note assignments, you will write a SOAP note about one of your patients and use the following acronym:
| S = | Subjective data: Patient’s Chief Complaint (CC). |
| O = | Objective data: Including client behavior, physical assessment, vital signs, and meds. |
| A = | Assessment: Diagnosis of the patient’s condition. Include differential diagnosis. |
| P = | Plan: Treatment, diagnostic testing, and follow up |
ATTACHED IS THE TEMPLATE, RUBRIC, AND EXMAPLE. PLEASE FOLLOW THE EXAMPLE ATTACHED!!!! ALSO PLEASE DO THIS ON A 26 YEAR OLD PATIENT WHO IS SUFFERING FROM polycystic ovary syndrome