Nursing  100 work Positive reply due tomorrow morning 8am

Patient InformationFA, 42-year-old Caucasian maleSubjective.CC “Lowest back pain for the past month”HPI: FA is a 42-year-old Caucasian male who presents to the clinic due to lower back pain that c has been ongoing for the past one month. FA stated that his pain started after attempting to lift a heavy table in his home from one part of the house to another one month ago. Patient reports that resting and taking Ibuprofen to reduce the pain, while his pain increases with activity. FA rates his pain at 5 on the 0-10 pain scale, as aching/dull that radiates to her left leg intermittently.Current medications Ibuprofen 600mg as needed for pain.Allergies: Denies any allergy.PMHx: Up to date to immunization. Last influenza and pneumonia vaccine was November 2019. No past medical history noted. No previous hospitalization or blood transfusion.Soc Hx: FA owns a local car repair shop. He is married with 2 young kids 10 and 8 years old. Patient is deeply involved in the local catholic church and is a choir master. Denies use of illicit drug and tobacco. States he is a social drink and consumes 2-3 beer weekly. Exercises regularly.Fam Hx:  Father, Alive 72, HTN.Mother, Alive 68 Diabetes.Paternal Grandfather: HTN, deceased at age 78 from stroke.Paternal Grandmother: Alive, 95, Anxiety.Maternal Grandfather: Alive, 93 HTN, Hyperlipidemia.Paternal Grandmother: Alive, 88 Type 11 diabetes (controlled with diet).Daughter: No medical history, age 10.Son: No medical history, age 8.ROS:General: Pt denies fever and fatigue. Denies weight loss.Neurological: Pt headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.HEET: Eyes: T denies visual changes. Ears: denies hearing loss. Nose: Denies rhinorrhea. No hearing loss. Sneezing, runny nose or sore throat.Throat: Denies sore throat.Skin: Pt denies rash, abrasions, or bruising denies rash.Cardiovascular: Pt denies chest pain, chest pressure or chest discomfort. palpitation, and tachycardia.Respiratory: Pt denies SOB, Cough congestion or congestion. Respiratory:Musculoskeletal: Reports aching/dull lower back pain. Reports a limited range of motion with bending. Pain occasionally radiated to left leg.Objective.Diagnostic results: Vitals: T: 98.0, HR: 78, RR: 18, BP: 128/70, O2sat: 98% on RA. Pain 5/10General: Pt is AAOx4. Well-groomed male calm and cooperative Able to communicate fluently, with a good eye contact. Appears in no acute distress.Neurological: No signs of dizziness, no problems with gait or posture noted. 4/5 strength with dorsiflexion and toe extension in LLE. 5/5 strength with dorsiflexion and toe extension in RLE. No decreased sensation to BUE and BLE.HEENT:  EOMI, PERRLA, pupil round and reactive to light, moist mucus membrane noted. No head injury noted, oral mucosa dry.Skin: No edema noted on extremities No abrasions, and cyanosis. Skin taut, non-tenting, and atraumatic.Cardiovascular: S1, S2 noted with a regular rhythm. No murmur, gallops, or extra heart sounds.Respiratory: Lungs sound clear on auscultation. No adventitious breath sounds noted.Musculoskeletal: No scoliosis noted.  Negative Sciatic Nerve, Negative Mackiewicz sign in bilateral lower extremifies. Negative Lasegue’s sign in left lower extremity. Pain noted on palpation of L5. Patellar reflex 2+ bilaterally. Full range of motion in torso extension and lateral flexion. Limited range of motion with flexion and lateral rotation of torso related to pain.AssPrimary Diagnosis: Lumbosacral RadiculopathyDifferential DiagnosesLumbosacral radiculopathy (Disc herniation):  describes the types of pain caused by compression or irritation of nerve roots in the lower back, caused by lumbar disc herniation, degeneration of the spinal vertebra, and narrowing of the foramen from which the nerves exit the spinal canal. L5 is the most common injury in the lumbar spine (Hsu, Armon, & Levin, 2019). An L5 disc herniation typically presents as back pain that radiates to the leg and foot (Hsu et al., 2019). In a disc herniation, the nerve root becomes compressed from cancer, infection, injuries from falls (Hsu et al., 2019). The straight leg test is the most helpful assessment tool when assessing for a disc herniation (Hsu et al., 2019). A magnetic resonance imaging (MRI) scan is used to diagnose a disc herniation by evaluating the intraspinal spaces for abnormalities (Hsu et al., 2019).Vertebral Osteomyelitis: is a bone infection usually caused by bacteria. In the spine, it is often found in the vertebrae, although the infection can spread into the epidural and intervertebral disc spaces. Osteomyelitis is rare and most common in young children and the elderly, but it can occur at any age (McDonald & Peel, 2019). The infection to the bone could result from surgery or other soft tissue infection (McDonald & Peel, 2019). Symptoms include pain localized to the disc that is infected and is aggravated with palpitation or physical activity (McDonald & Peel, 2019). A computerized axial tomography (CT scan) is used to diagnose Vertebral Osteomyelitis, using a guided biopsy of the vertebral disc space to culture the bacteria (McDonald & Peel, 2019). Treatments of Vertebral Osteomyelitis include antibiotic therapy for six weeks (Roblot et al., 2007).Paraspinal muscle strain: Is defined as over stretch injury or tear of paraspinal muscles and tendons in the low back. Muscle strains are common injury (Patricios, 2019). Overstretching of a muscle leads to a small tear in the tissue causing a strain (Crowley, n.d.). To assess for such muscle strain is by asking about trauma to the painful area (Patricios, 2019). Symptoms include sudden lower back pain, muscle spasms, inflammation, bruising, and soreness (Crowley, n.d.). Most times, treatment is not needed or treatments with rest, ice, pain medication and physical therapy (Cooper, 1993).Piriformis syndrome: Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (like sciatic pain). Piriformis syndrome is marked by hip and gluteal pain (Boyajian-O’Neill, McClain, Coleman, & Thomas, 2008). Clinical manifestations include acute back pain for less than four weeks (Wheeler, Wipf, Staiger, Deyo, & Jarvik, 2019). Symptoms includes worsened pain after sitting down for about 15 minutes (Boyajian-O’Neill et al., 2008). Assessments includes inspecting the back and posture, palpating the spine, performing the straight leg test, and assessing psychological distress (Waddell’s sign) (Wheeler et al., 2019). Diagnoses are made through electromyography (EMG) by differentiating between piriformis syndrome versus disc herniation (Boyajian-O’Neill et al., 2008).Lumbar Stenosis: The lumbar spine consists of five vertebrae in the lower part of the spine, between the ribs and the pelvis. Lumbar spinal stenosis is a narrowing of the spinal canal, compressing the nerves traveling through the lower back into the legs. (Ball, Dains, Flynn, Solomon, & Stewart, 2019). Symptoms include pain with activities, such as walking or standing. The pain from Lumbar Stenosis radiates down the leg, slight relief in a sitting position, and increased pain with prolonged standing/walking (Ball et al., 2019). To assess, the patient exhibits a forward gait and lower extremity weakness in progressing lumbar stenosis (Ball et al., 2019).  To diagnose, a radiology imaging (X-ray), CT scan, and an MRI are used (American Association of Neurological Surgeons [AANS], n.d.).ConclusionAccording to the scenario presented, the probable nerve that are involved are L4-S1. The cause could also be from lumbar two, three, and four (L2,3,4) (Ball, Dains, Flynn, Solomon, & Stewart, 2019). The straight leg test is used to test for L4-S1 abnormalities (Standford Medicine 25, n.d.). The femoral stretch test is used to test for L2,3,4 abnormalities (Mackiewicz sign). Also, using the patient’s history, such as pain onset, location, duration, character, aggravating and relieving factors could help in diagnoses (Ball et al., 2019). I chose these 5-differential diagnosis, disc herniation, vertebral osteomyelitis, lumbar stenosis, paraspinal muscle strain, and piriformis syndrome. The assessment and diagnosis of the lower back pain should involve examination of gait, posture, range of motion, inspection, and palpation of the painful location (Bratton, 1999). Assessment should include asking the patient to bend forward in flexion, extension, lateral flexion, and lateral rotation to evaluate the range of motion and limitation (Bratton, 1999).ReferencesAmerican Association of Neurological Surgeons. (n.d.). Lumbar spinal stenosis. Retrieved January 13, 2020, fromhttps://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Lumbar-Spinal-StenosisBall, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Boyajian-O’Neill, L. A., McClain, R. L., Coleman, M. K., & Thomas, P. P. (2008). Diagnosis and management of Piriformis Syndrome: An osteopathic approach. The Journal of the American Osteopathic Association, 108, 657-664. Retrieved fromhttps://jaoa.org/article.aspx?articleid=2093614Bratton, R. L. (1999). Assessment and management of acute low back pain. American Family Physician, 60(8), 2299-2306. Retrieved fromhttps://www.aafp.org/afp/1999/1115/p2299.htmlCooper, R. G. (1993). Understanding paraspinal muscle dysfunction in low back pain: A way forward? Annals of the Rheumatic Diseases, 52(6), 413. https://doi.org/10.1136/ard.52.6.413Crowley, K. (n.d.). Patient education: Muscle strain (The Basics). Retrieved January 12, 2020, fromhttps://www.uptodate.com/contents/muscle-strain-the-basics?search=back%20muscle%20strain&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H276646807Engle, A. M., Chen, Y., Marascalchi, B., Wilkinson, I., Abrams, W. B., He, C., Yao, A. L., Adekoya, P., Cohen, Z. O., & Cohen, S. P. (2019). Lumbosacral Radiculopathy: Inciting Events and Their Association with Epidural Steroid Injection Outcomes. Pain Medicine, 20(12), 2360–2370. https://doi-org.ezp.waldenulibrary.org/10.1093/pm/pnz097Hsu, P. S., Armon, C., & Levin, K. (2019). Acute lumbosacral radiculopathy: Pathophysiology, clinical features, and diagnosis. Retrieved January 12, 2020, fromhttps://www.uptodate.com/contents/acute-lumbosacral-radiculopathy-pathophysiology-clinical-features-and-diagnosis?search=disc%20herniation&source=search_result&selectedTitle=1~101&usage_type=default&display_rank=1#H17McDonald, M., & Peel, T. (2019). Vertebral osteomyelitis and discitis in adults. Retrieved January 12, 2020, fromhttps://www.uptodate.com/contents/vertebral-osteomyelitis-and-discitis-in-adults?search=disc%20herniation&topicRef=5262&source=see_link#H1Patricios, J. (2019). Adductor muscle and tendon injury. Retrieved January 12, 2020, fromhttps://www.uptodate.com/contents/adductor-muscle-and-tendon-injury?search=paraspinal%20muscle%20strain&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H6959568Roblot, F., Besnier, J. M., Juhel, L., Vidal, C., Ragot, S., Bastidies, F., … Godet, C. (2007). Optimal duration of antibiotic therapy in vertebral osteomyelitis. Seminars in Arthritis and Rheumatism, 36(5), 269-277. https://doi.org/10.1016/j.semarthrit.2006.09.004Standford Medicine 25. (n.d.). Approach to the low back exam. Retrieved January 12, 2020, fromhttps://stanfordmedicine25.stanford.edu/the25/BackExam.htmlWheeler, S. G., Wipf, J. E., Staiger, T. O., Deyo, R. A., & Jarvik, J. G. (2019). Evaluation of low back pain in adults. Retrieved January 13, 2020, fromhttps://www.uptodate.com/contents/evaluation-of-low-back-pain-in-adults?search=piriformis%20syndrome&source=search_result&selectedTitle=4~29&usage_type=default&display_rank=4#H7

 
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Nursing  4-5 page Bio-Ethical Paper

Can i get help with a 4-5 page bio-ethical paper?

 
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Nursing  Opinion 1 Assignment

some clarification on assignment and personal video

 
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Nursing  4413 Discussion Board 7.1: Professional Identity in Nursing

Step 1: Listen to the following:Priddy, K. D., Lindeman Read, J., & Weybrew, K. (2020, September 15). Professional Identity in Nursing: Background and introduction.https://sigma.nursingrepository.org/handle/10755/21082 (Links to an external site.) (Link will open in new tab.)Step 2:List and define the domains of Professional Identity in Nursing.What are the benefits of fostering Professional Identity in Nursing?(1 paragraph for each question)

 
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Nursing  Community/ public health nursing

Compare vulnerable populations. Describe an example of one of these groups in the United States or from another country. Explain why the population is designated as “vulnerable.” Include the number of individuals belonging to this group and the specific challenges or issues involved. Discuss why these populations are unable to advocate for themselves, the ethical issues that must be considered when working with these groups, and how nursing advocacy would be beneficial.

 
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Nursing  NURSING – Evidence Based Practice Poster and Presentation (APA FORMAT and ZERO PLAGIARISM)

Nurs 363 : Evidence Based Practice Posterand Presentation.Objective:  To help nursing students become accustomed to searching the literature for evidence that supports nursing practice, and to polish poster creation and presentation skills.Task:  You are an experienced nurse who just signed a contract for a staff position at Passaway General Hospital.  On your first month at work, you notice a few questionable nursing practices that you learned to do differently at your previous place of employment.  As a BSN-prepared nurse, your unit manager has asked you to review the best evidence on the topic and create an A/V poster presentation for your colleagues on the unit.   He has asked you record your presentation so both night and day shifts can view it at their convenience.Issues:  The following is a list of your priority areas.  You must choose one to focus on right now.IV InsertionUse of Bariatric bedsNursing uniforms for proper identificationBed pansBed baths vs Bath wipesProper use of RestraintsIntramuscular injection techniqueWet to dry dressing changesFundal massageUmbilical cord careNasogastric tube insertionUse of Bed AlarmsTransfusion proceduresPrevention of CLABSITracheostomy CarePlan:1. Choose a topic area from the list above.2.  Review nursing, medical, and evidence-based practice literature related to your topic, following guidelines from the rubric to ensure you obtain information that addresses each section of the rubric.3.  Critically appraise the evidence you have located using the CASP Tool (refer to textbook) to determine the strength of the studies you base your recommendations upon.4.  Synthesize information using the grading rubric as a guide.4.  Create a Professional Poster:  Create a professional scientific poster in MS Power point, to be saved as a computer file (you do not need to have it printed) using a scientific poster template.  Poster templates can be downloaded from many sources.  Here are a few suggestions.www.makesigns.comwww.posterpresentations.comwww.postersession.comRead the Article:  How to Create a Professional Poster in PLE resources, as your guide for spacing, text size, headings, and content in your poster.  Poster examples are also located in the resources tab. See article attached.Please Note:  A good presentation should address each of the areas of the rubric below.  However, your poster should not contain, word for word, everything in the rubric.  There should not be full paragraphs on your poster. Please use bullet points. The purpose of the poster is to highlight and summarize the information.Other useful resources/materials :  https://www.youtube.com/watch?v=9Ds2WEVLoVEhttps://www.youtube.com/watch?v=ojUN4ZFarAAEBP Project Grading RubricRequirementPossiblePointsFaculty CommentsPointsAwardedIntroduction· Clearly introduce/identify the   topic· Identify the types of   organizations or nursing units that would be interested in topic and able to   apply EBP recommendations related to this topic5· Identify the relevant patient   population for this topic· Identify the usual patient   outcomes related to this topic.5Synthesize at least 3   current research articles related to the topic. Discuss individual articles   separately, identifying the following:Purpose/Research        Question/HypothesisIdentify        variables in the study.  If appropriate, label them as independent        or dependent.  State how each variable is measured.Sample        sizeDesign:         Identify the type of design the researchers used.Findings:         Briefly state in your own words the findings of the study.  If        multiple research questions are present in the study, state the findings        for each.Implications:         Briefly state in your own words what the researchers indicated future        studies should focus on, what new areas should be researched, or how the        findings impact clinical practice.Synthesizethe findings of all three (or more) articles into a summary of research on   your topic.15Identify and summarize systematic   review articles related to the topic.· Include a summary of any   meta-analysis articles that are related to the topic.Identify and summarize any   practice guidelines related to the topic area.10Identify current recommended   nursing interventions discussed in the evidenced based literature, systematic   review or practice guidelines.· Identify the level of evidence for   each recommendation.10For each of the major   recommendations identified, discuss whether there is sufficient evidence to   warrant a change to policies and procedures according to what is current in   the research literature. Identify which nursing guidelines are inconsistent   with the recommendations in the research literature10Conclusion: should be brief but   thoughtful.· As part of the conclusion,   summarize the overall progression of evidence for this topic· Identify the areas most in need of   additional systematic research.5Correct grammar, spelling, punctuation   use of citations on poster10Properly uploaded per instructions   (Audio and Video with visible poster)10Professional poster appearance using   powerpoint10Presentation Skills10Total Points100

 
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Nursing  HEALTHCARE DELIVERY

What are your thoughts about the emerging accountable care organizations? In what ways do you think they will affect the current health care delivery system? How do you think the practice patterns of primary care physicians will change under the new models of health care? What are the biggest problems that this could bring to primary care practices? BE SURE TO ADD IN-TEXT CITATION AND REFERENCE

 
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Nursing  Healthcare Management

1. You are the system vice president of a 12-hospital system in the Northwest United States. Because your 12 hospitals are separated by many miles, most of your system-wide meetings are virtual. These meetings are very important to the success of your organization. How will you make certain that these virtual meetings are effective and that they accomplish their purpose? Discuss some SBAR and TeamSTEPPS for health care recommendations and solutions.Your journal entry must be at least 200 words in length. No references or citations are necessary.2. What distinguishes the role of the governing body from the role of management in health care?Your response should be at least 200 words in length.3.Discuss the challenges of forming groups, such as a board of directors, in health care. Address the phases that the board will likely go through as they learn to work effectively together.Your response should be at least 300 words in length.Management of Healthcare Organizations: An IntroductionPeter Olden, PhDRead the Unit III Study Guide and Chapter 5 – Organizations and Chapter 6 – Groups and Teams.

 
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Nursing  Discussion 8

Research potential IT tech teaching tools that you would like to see utilized on the LMS to deliver course content.What are the benefits of using the tool?How accessible is it for students?If possible, provide link to website.Students should respond to at least one other student. Minimum 100 words.

 
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Nursing  Nursing

Which healthcare provider at a rehabilitation facility addresses the cognitive, behavioral, and psychological problems that result following a patient’s traumatic brain injury?

 
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