• Soap Note 1 Acute Conditions (15 Points) Due 06/15/2019

  Pick any Acute Disease from Weeks 1-5 (see syllabus)
  Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

  Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.
  Late Assignment Policy
  Assignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptions 
  Follow the MRU Soap Note Rubric as a guide:
  Grading Rubric

  Student______________________________________
  This sheet is to help you understand what we are looking for, and what our margin remarks might be about on your write ups of patients. Since at all of the white-ups that you hand in are uniform, this represents what MUST be included in every write-up.

  1)      Identifying Data (___5pts): The opening list of the note. It contains age, sex, race, marital status, etc. The patient complaint should be given in quotes. If the patient has more than one complaint, each complaint should be listed separately (1, 2, etc.) and each addressed in the subjective and under the appropriate number.

  2)      Subjective Data (___30pts.): This is the historical part of the note. It contains the following:

  a) Symptom analysis/HPI(Location, quality , quantity or severity, timing, setting, factors that make it better or worse, and associate manifestations.(10pts).
  b) Review of systems of associated systems, reporting all pertinent positives and negatives (10pts).
  c) Any PMH, family hx, social hx, allergies, medications related to the complaint/problem (10pts). If more than one chief complaint, each should be written u in this manner.

  3)      Objective Data(__25pt.): Vital signs need to be present. Height and Weight should be included where appropriate.

  a)      Appropriate systems are examined, listed in the note and consistent with those identified in 2b.(10pts).
  b)      Pertinent positives and negatives must be documented for each relevant system.
  c)        Any abnormalities must be fully described. Measure and record sizes of things (likes moles, scars). Avoid using “ok”, “clear”, “within normal limits”, positive/ negative, and normal/abnormal to describe things. (5pts).

  4)      Assessment (___10pts.): Diagnoses should be clearly listed and worded appropriately.

  5)      Plan (___15pts.): Be sure to include any teaching, health maintenance and counseling along with the pharmacological and non-pharmacological measures. If you have more than one diagnosis, it is helpful to have this section divided into separate numbered sections.

  6)      Subjective/ Objective, Assessment and Management and Consistent (___10pts.): Does the note support the appropriate differential diagnosis process? Is there evidence that you know what systems and what symptoms go with which complaints? The assessment/diagnoses should be consistent with the subjective section and then the assessment and plan. The management should be consistent with the assessment/ diagnoses identified.

  7)      Clarity of the Write-up(___5pts.): Is it literate, organized and complete?

  Comments:

  Total Score: ____________                                                          Instructor: __________________________________

  • Soap Note 1 Acute ConditionsAssignment
• Case Study 3 & 4

  Case Study 3 & 4 (10 Points) Due 06/29/2019
  Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

   Case Study 3 & 4 S Inflammatory Bowel Disease and Urinary Obstruction 
  Case Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
  Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

  Late Assignment Policy
  Assignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptions

  • Case Study 3 & 4Assignment
• Soap Note 2 Chronic Conditions

  Soap Note 2 Chronic Conditions (15 Points) Due 7/13/2019

  Pick any Chronic Disease from Weeks 6-10

  Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

  Late Assignment Policy
  Assignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptions

   Follow the MRU Soap Note Rubric as a guide:
  Grading Rubric

  Student______________________________________
  This sheet is to help you understand what we are looking for, and what our margin remarks might be about on your write ups of patients. Since at all of the white-ups that you hand in are uniform, this represents what MUST be included in every write-up.

  1)      Identifying Data (___5pts): The opening list of the note. It contains age, sex, race, marital status, etc. The patient complaint should be given in quotes. If the patient has more than one complaint, each complaint should be listed separately (1, 2, etc.) and each addressed in the subjective and under the appropriate number.

  2)      Subjective Data (___30pts.): This is the historical part of the note. It contains the following:

  a) Symptom analysis/HPI(Location, quality , quantity or severity, timing, setting, factors that make it better or worse, and associate manifestations.(10pts).
  b) Review of systems of associated systems, reporting all pertinent positives and negatives (10pts).
  c) Any PMH, family hx, social hx, allergies, medications related to the complaint/problem (10pts). If more than one chief complaint, each should be written u in this manner.

  3)      Objective Data(__25pt.): Vital signs need to be present. Height and Weight should be included where appropriate.

  a)      Appropriate systems are examined, listed in the note and consistent with those identified in 2b.(10pts).
  b)      Pertinent positives and negatives must be documented for each relevant system.
  c)        Any abnormalities must be fully described. Measure and record sizes of things (likes moles, scars). Avoid using “ok”, “clear”, “within normal limits”, positive/ negative, and normal/abnormal to describe things. (5pts).

  4)      Assessment (___10pts.): Diagnoses should be clearly listed and worded appropriately.

  5)      Plan (___15pts.): Be sure to include any teaching, health maintenance and counseling along with the pharmacological and non-pharmacological measures. If you have more than one diagnosis, it is helpful to have this section divided into separate numbered sections.

  6)      Subjective/ Objective, Assessment and Management and Consistent (___10pts.): Does the note support the appropriate differential diagnosis process? Is there evidence that you know what systems and what symptoms go with which complaints? The assessment/diagnoses should be consistent with the subjective section and then the assessment and plan. The management should be consistent with the assessment/ diagnoses identified.

  7)      Clarity of the Write-up(___5pts.): Is it literate, organized and complete?

  Comments:

  Total Score: ____________                                                          Instructor: __________________________________

  • Soap Note 2 Chronic ConditionsAssignment
• Case Study 5 & 6

  Case Study 5 & 6 (10 Points) DUE 07/27/2019

  Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

  Case Study 5 & 6 Knee Injury and Testicular Cancer
  Case Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
  Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

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4-5 page paper concept map

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  Urinary Obstruction Case Studies The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft. Studies Results Routine laboratory studies Within normal limits (WNL) Intravenous pyelogram (IVP) Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate Uroflowmetry with total voided flow of 225 mL 8 mL/sec (normal: >12 mL/sec) Cystometry Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O) Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O) Electromyography of the pelvic sphincter muscle Normal resting bladder with a positive tonus limb Cystoscopy Benign prostatic hypertrophy (BPH) Prostatic acid phosphatase (PAP) 0.5 units/L (normal: 0.11-0.60 units/L) Prostate specific antigen (PSA) 1.0 ng/mL (normal: <4 ng/mL) Prostate ultrasound Diffusely enlarged prostate; no localized tumor Diagnostic Analysis Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems. Critical Thinking Questions 1. Does BPH predispose this patient to cancer? 2. Why are patients with BPH at increased risk for urinary tract infections? 3. What would you expect the patient’s PSA level to be after surgery? 4. What is the recommended screening guidelines and treatment for BPH? 5. What are some alternative treatments / natural homeopathic options for treatment?   Case Studies The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft. Studies Results Routine laboratory studies Within normal limits (WNL) Intravenous pyelogram (IVP) Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate Uroflowmetry with total voided flow of 225 mL 8 mL/sec (normal: >12 mL/sec) Cystometry Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O) Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O) Electromyography of the pelvic sphincter muscle Normal resting bladder with a positive tonus limb Cystoscopy Benign prostatic hypertrophy (BPH) Prostatic acid phosphatase (PAP) 0.5 units/L (normal: 0.11-0.60 units/L) Prostate specific antigen (PSA) 1.0 ng/mL (normal: <4 ng/mL) Prostate ultrasound Diffusely enlarged prostate; no localized tumor Diagnostic Analysis Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems. Critical Thinking Questions 1. Does BPH predispose this patient to cancer? 2. Why are patients with BPH at increased risk for urinary tract infections? 3. What would you expect the patient’s PSA level to be after surgery? 4. What is the recommended screening guidelines and treatment for BPH? 5. What are some alternative treatments / natural homeopathic options for treatment?  

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 Considering the various virtues or dimensions of character for a servant leader (e.g., virtue, credibility, trust), how might the application of servant leadership be appraised in a health care setting? Is servant leadership, versus transformational leadership, plausible in the health care setting that often depends on a hierarchy of command for the safety of patients? 1 page, 2 sources, APA. 

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Discussions are not just opinion to obtain full points, postings must be based on supported fact, not simply opinion. Posting should be a minimum of one short paragraph and a maximum of two paragraphs.  Word totals for each post should be in the 100-200 words range.  Whether you agree or disagree explain why with supporting evidence and concepts from the readings or a related experience.  Include a reference, link, or citation when appropriate. APA 6th edition format for references as well as in-text citations is expected.

Application of Health Literacy & Motivational Interviewing Concepts to Promote Wellness

Health literacy is not simply the ability to read health information. The National Institutes of Health defines health literacy as the ability to read, comprehend, and analyze information; decode instructions, symbols, charts, and diagrams; weigh risks and benefits; and ultimately make decisions and take action.

After the reading the following HRSA guideline https://www.hrsa.gov/advisorycommittees/bhpradvisory/actpcmd/Reports/twelfthreport.pdf

Discuss how shared decision making , motivational interviewing, and best practices of models of care can improve the health literacy of a especial popualtion ( children ,elderly, veterans)

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