NR 512 Week 4 Discussion Informatics Skills
NR 512 Week 4 Discussion Informatics Skills
Informatics Skills
How do the informatics skills you are now developing/expanding upon and validating help you meet current informatics skills levels? Did the TANIC self-assessment change your impression of your current informatics skill levels?
Discussion Part One (graded)
You meet your first patient of the morning. A.K. is a 65-year-old Caucasian male who you are seeing for the first time. Both wife and daughter are present.
Background
He reports that he has had an 18-pound unintentional weight loss in the last 2 months “I am just not hungry anymore, and when I do eat, I get full so fast. In fact, it is really hard to eat, and I don’t eat nearly as much as usual, even though I eat 3 times every day”. He also reports feeling more tired than usual. NR 512 Week 4 Discussion Informatics Skills
“I am not sleeping very well. My wife wakes me up when I am snoring, or when she thinks I am not breathing. I used to have sleep apnea, but I don’t think I have it anymore. Besides, that mask is so horrible to wear.” He reports day time somnolence. He reports that he is at the clinic today because of his wife and daughter’s concern about his weight loss and loss of appetite. NR 512 Week 4 Discussion Informatics Skills
PMH
Mr. A.K. has a history of hypertension, cataracts, and osteoarthritis.
Current medications:
Ibuprofen 600 mg po TID
Lisinopril 20 mg po QD
Hydrochlorothiazide 25 mg PO QD
Simvastatin 20 mg po QD
Vitamin D3 50,000 units po weekly
Omeprazole 40 mg po QD
Sudafed 50 mg po TID prn
Surgeries
April 2010-Right cataract extraction with Intraocular Lens Placement
June 2010- Left cataract extraction with Intraocular Lens Placement
November 2011-Left total knee arthroplasty
Allergies: No known drug or food allergies. Allergies to latex causing difficulty breathing and to bee stings, causing widespread edema and airway obstruction. NR 512 Week 4 Discussion Informatics Skills
Vaccination History
He receives annual flu shots “most of the time”. His last one was 18 months ago.
Received a Pneumovax “the day I turned 65”.
His last TD was greater than 10 years ago.
Has not had the herpes zoster vaccine.
Social history
He has an 8th grade education and is a retired concrete finisher. He lives with his wife of 45 years and his daughter lives next door. He enjoys working in his back yard garden and recently tripped over the garden hose last week where his neighbor had to come and help him up. NR 512 Week 4 Discussion Informatics Skills
Family history
Both parents are deceased. Father died of a heart attack at the age of 80; mother died of breast cancer at the age of 76. He has one daughter who is 45 years old and has hypertension. Hypertension, coronary artery disease, and cancer runs in the family.
Habits
He drinks one 4 ounce glass of red wine nightly; previous smoker of 30 years; he quit for 10 years, and is now smoking ¼ pack per day for the last 6 months.
Discussion Part One:
Provide the differential diagnoses (DD) with rationale
Description
option1: The borders of time in The Break by Katherena Vermette. In part four of the book the character Rain says, “A storyteller once told me our languages never had a sense of time, that past and present and future happened all at once” (244). Discuss how this idea of time is explored in The Break by Katherena Vermette, and specifically how it relates to the cycles of violence and trauma portrayed in the book.In short: this topic asks you to consider how the portrayal of time and trauma are connected in The Break. Relevant research areas might include Indigenous storytelling and ideas of time, trauma studies, and articles directly on Vermette and the novel
option2: In her seminal text, Borderlands: La Frontera border theorist Gloria Anzaldúa describes the Borderlands as both a psychological state and a physical place: “A Borderland is a vague and indeterminate place created by the emotional residue of an unnatural boundary. It is in a constant state of transition. The prohibited and forbidden are its inhabitants” . Discuss how this characterization of the Borderlands relates to Francisco Cantú’s portrayal of the Mexican American border in The Line Becomes a River. NR 512 Week 4 Discussion Informatics Skills
In short: This topic asks you to consider what the connection is between the physical setting of Cantú’s Borderlands and the psychological state of those who inhabit them. Relevant research areas might include Gloria Anzaldúa’s work, border theory in general, and articles directly on Cantú’s memoir. NR 512 Week 4 Discussion Informatics Skills