Assignment Prompt & Instructions
– ## NUR506Dis.pdf
– ## NUR504Dis4.pdf
**## NUR506Dis.pdf**
NUR 506
Discussion 1
Nursing & Health-Care-Policy
Analyze the history, structure, and process of health-care-policy and politics in nursing and the
health care delivery systems in the United States.
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 2
Advocacy
What examples of advocacy do you see in your own nursing practice? List and discuss 2
examples.
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 3
ACA and Health-Care Outcomes & Costs
What components of the ACA do you think will have a positive effect on improving health care
outcomes and decreasing costs?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 4
Local, State & Federal Advocacy
• What are specific actions that health professionals can take regardless of their practice
area and site to promote population and community health?
• What advocacy actions might you take to improve health care through legislation at the
state or federal level?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 5
Issues in Today's Workforce Culture
Based on your reading in chapter 60, why do you think the issues presented in this chapter persist
in today’s workforce culture?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 6
Health Care Disparities in LGBTQ
Discuss how to close the health care disparities gap in the LGBTQ community?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
**## NUR504Dis4.pdf**
Gastrointestinal & Endocrine
For this Discussion, you will take on the role of a clinician who is
building a health history for one of the following cases. Your
instructor will assign you your case number. Case 2
Case 1 Case 2 Case 3
Chief
Compl
aint
(CC)
“I am here today due
to frequent and watery
bowel movements”
“I have pain in my
belly” “neck swelling”
Histor
y of
Prese
nt
Illness
(HPI)
A 37-year-old
European American
female presents to
your practice with
“loose stools” for
about three days. One
event about every
three hours
A 25-year-old female
presents to the
emergency room (ER)
with complaints of
severe abdominal pain
for 2 weeks . The pain
is sharp and crampy It
hurts if I run, sit down
hard, or if I have sex
A 42-year-old African
American female who
refers that she has
been noticing slow
and progressive
swelling on her neck
for about a year. Also
she stated she has
lost weight without
any food restriction
PMH No contributory Patient denies Patient denies
PSH Appendectomy at the
age of 14
Surgical removal of
benign left breast
Drug
Hx No meds Birth control No medication at the
time
Allergi
es Penicillin NKA NKA
Subje
ctive
Fever and chills, Lost
appetite Flatulence No
mucus or blood on
stools
Nausea and vomiting,
Last menstrual period
sexual partner about 2
months ago, No
condoms, he hates
them No pain, blood
or difficulty with
urination
Mild difficult to
shallow, Neck feels
tight, Pt states she
feels Palpitations
Objective Data
PE
B/P 188/96; Pulse 89;
RR 16; Temp 99.0; Ht
5,6; wt 110; BMI 17.8
B/P 138/90;
temperature 99°F;
(RR) 20; (HR) 110,
regular; oxygen
saturation (PO2) 96%;
pain 5/10
B/P 158/90; Pulse
102; RR 20; Temp
99.2; Ht 5,4; wt 114;
BMI 19.6
Gener
al
well-developed female
in no acute distress,
appears slightly
fatigued
acute distress and
severe pain
42-year-old female
appears thin. She is
anxious – pacing in
the room and
fidgeting, but in no
acute distress.
HEEN
T
Atraumatic,
normocephalic,
PERRLA, EOMI, arcus
senilus bilaterally,
conjunctiva and sclera
clear, nares patent,
nasopharynx clear,
edentulous.
Atraumatic,
normocephalic,
PERRLA, EOMI,
conjunctiva and sclera
clear; nares patent,
nasopharynx clear,
good dentition.
Piercing in her right
nostril and lower lip.
Bulging eyes
Neck Supple Diffuse enlargement of
the thyroid gland
Lungs CTA AP&L CTA AP&L CTA AP&L
Card S1S2 without rub or
gallop
S1S2 without rub or
gallop
S1S2 without rub,
Tachycardia
Abd
positive bowel sounds
(BS) in all four
quadrants; no masses;
no organomegaly
noted; diffuse, mild,
bilateral lower
quadrant pain noted
Mild diffuse
tenderness.
• INSPECTION: no
masses or thrills
noted; no
discoloration and skin
is warm to; no tattoos
or piercings; abdomen
is nondistended and
round
• AUSCULTATION:
bowel sounds (BS) are
normal in all four
quadrants, no bruits
noted
• PALPATION: on
palpation, abdomen is
tender to touch in four
quadrants; tenderness
noted on light
palpation, deep
palpation reveals no
masses, spleen and
liver unremarkable
• PERCUSSION:
tympany heard in all
quadrants, no dullness
noted in abdominal
area
benign, normoactive
bowel sounds x 4
GU Non contributory
• EXTERNAL: mature
hair distribution; no
external lesions on
labia
• INTROITUS: slight
green-gray discharge,
no lesions
• VAGINAL: normal
rugae; moderate
amount of green
discharge on vaginal
walls
• CERVIX: nulliparous
os with small amount
of purulent discharge
from os with positive
cervical motion
tenderness (CMT)
• UTERUS: ante-
flexed, normal size,
shape, and position
• ADNEXA: bilateral
tenderness with
fullness; both ovaries
without masses
• RECTAL: deferred
• VAGINAL
DISCHARGE: green in
color
Non contributory
Ext no cyanosis, clubbing
or edema
no cyanosis, clubbing
or edema
no cyanosis, clubbing
or edema
Integu
ment
good skin turgor
noted, moist mucous
membranes
intact without lesions
masses or rashes
Thin skin, Increase
moisture
Neuro
No obvious
deformities, CN
grossly intact II-XII
No obvious deficits
and CN grossly intact
II-XII
No obvious deficits
and CN grossly intact
II-XII
Once you received your case number, answer the following
questions:
1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient
presenting symptoms?
5. Give rationales for your each differential diagnosis.
Submission Instructions:
• Your instructor will assign you your case number and you
will post on the case number you have been assigned.
• You will reply to the other two case studies (One of each).
• Your initial post should be at least 500 words, formatted and
cited in current APA style with support from at least 2
academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by
extending, refuting/correcting, or adding additional nuance
to their posts. Your reply posts are worth 2 points (1 point
per response.)
• All replies must be constructive and use literature where
possibl
**## NUR504Dis4.pdf**
Gastrointestinal & Endocrine
For this Discussion, you will take on the role of a clinician who is
building a health history for one of the following cases. Your
instructor will assign you your case number. Case 2
Case 1 Case 2 Case 3
Chief
Compl
aint
(CC)
“I am here today due
to frequent and watery
bowel movements”
“I have pain in my
belly” “neck swelling”
Histor
y of
Prese
nt
Illness
(HPI)
A 37-year-old
European American
female presents to
your practice with
“loose stools” for
about three days. One
event about every
three hours
A 25-year-old female
presents to the
emergency room (ER)
with complaints of
severe abdominal pain
for 2 weeks . The pain
is sharp and crampy It
hurts if I run, sit down
hard, or if I have sex
A 42-year-old African
American female who
refers that she has
been noticing slow
and progressive
swelling on her neck
for about a year. Also
she stated she has
lost weight without
any food restriction
PMH No contributory Patient denies Patient denies
PSH Appendectomy at the
age of 14
Surgical removal of
benign left breast
Drug
Hx No meds Birth control No medication at the
time
Allergi
es Penicillin NKA NKA
Subje
ctive
Fever and chills, Lost
appetite Flatulence No
mucus or blood on
stools
Nausea and vomiting,
Last menstrual period
sexual partner about 2
months ago, No
condoms, he hates
them No pain, blood
or difficulty with
urination
Mild difficult to
shallow, Neck feels
tight, Pt states she
feels Palpitations
Objective Data
PE
B/P 188/96; Pulse 89;
RR 16; Temp 99.0; Ht
5,6; wt 110; BMI 17.8
B/P 138/90;
temperature 99°F;
(RR) 20; (HR) 110,
regular; oxygen
saturation (PO2) 96%;
pain 5/10
B/P 158/90; Pulse
102; RR 20; Temp
99.2; Ht 5,4; wt 114;
BMI 19.6
Gener
al
well-developed female
in no acute distress,
appears slightly
fatigued
acute distress and
severe pain
42-year-old female
appears thin. She is
anxious – pacing in
the room and
fidgeting, but in no
acute distress.
HEEN
T
Atraumatic,
normocephalic,
PERRLA, EOMI, arcus
senilus bilaterally,
conjunctiva and sclera
clear, nares patent,
nasopharynx clear,
edentulous.
Atraumatic,
normocephalic,
PERRLA, EOMI,
conjunctiva and sclera
clear; nares patent,
nasopharynx clear,
good dentition.
Piercing in her right
nostril and lower lip.
Bulging eyes
Neck Supple Diffuse enlargement of
the thyroid gland
Lungs CTA AP&L CTA AP&L CTA AP&L
Card S1S2 without rub or
gallop
S1S2 without rub or
gallop
S1S2 without rub,
Tachycardia
Abd
positive bowel sounds
(BS) in all four
quadrants; no masses;
no organomegaly
noted; diffuse, mild,
bilateral lower
quadrant pain noted
Mild diffuse
tenderness.
• INSPECTION: no
masses or thrills
noted; no
discoloration and skin
is warm to; no tattoos
or piercings; abdomen
is nondistended and
round
• AUSCULTATION:
bowel sounds (BS) are
normal in all four
quadrants, no bruits
noted
• PALPATION: on
palpation, abdomen is
tender to touch in four
quadrants; tenderness
noted on light
palpation, deep
palpation reveals no
masses, spleen and
liver unremarkable
• PERCUSSION:
tympany heard in all
quadrants, no dullness
noted in abdominal
area
benign, normoactive
bowel sounds x 4
GU Non contributory
• EXTERNAL: mature
hair distribution; no
external lesions on
labia
• INTROITUS: slight
green-gray discharge,
no lesions
• VAGINAL: normal
rugae; moderate
amount of green
discharge on vaginal
walls
• CERVIX: nulliparous
os with small amount
of purulent discharge
from os with positive
cervical motion
tenderness (CMT)
• UTERUS: ante-
flexed, normal size,
shape, and position
• ADNEXA: bilateral
tenderness with
fullness; both ovaries
without masses
• RECTAL: deferred
• VAGINAL
DISCHARGE: green in
color
Non contributory
Ext no cyanosis, clubbing
or edema
no cyanosis, clubbing
or edema
no cyanosis, clubbing
or edema
Integu
ment
good skin turgor
noted, moist mucous
membranes
intact without lesions
masses or rashes
Thin skin, Increase
moisture
Neuro
No obvious
deformities, CN
grossly intact II-XII
No obvious deficits
and CN grossly intact
II-XII
No obvious deficits
and CN grossly intact
II-XII
Once you received your case number, answer the following
questions:
1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient
presenting symptoms?
5. Give rationales for your each differential diagnosis.
Submission Instructions:
• Your instructor will assign you your case number and you
will post on the case number you have been assigned.
• You will reply to the other two case studies (One of each).
• Your initial post should be at least 500 words, formatted and
cited in current APA style with support from at least 2
academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by
extending, refuting/correcting, or adding additional nuance
to their posts. Your reply posts are worth 2 points (1 point
per response.)
• All replies must be constructive and use literature where
possibl
**## NUR506Dis.pdf**
NUR 506
Discussion 1
Nursing & Health-Care-Policy
Analyze the history, structure, and process of health-care-policy and politics in nursing and the
health care delivery systems in the United States.
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 2
Advocacy
What examples of advocacy do you see in your own nursing practice? List and discuss 2
examples.
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 3
ACA and Health-Care Outcomes & Costs
What components of the ACA do you think will have a positive effect on improving health care
outcomes and decreasing costs?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 4
Local, State & Federal Advocacy
• What are specific actions that health professionals can take regardless of their practice
area and site to promote population and community health?
• What advocacy actions might you take to improve health care through legislation at the
state or federal level?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 5
Issues in Today's Workforce Culture
Based on your reading in chapter 60, why do you think the issues presented in this chapter persist
in today’s workforce culture?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 6
Health Care Disparities in LGBTQ
Discuss how to close the health care disparities gap in the LGBTQ community?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
**## NUR504Dis4.pdf**
Gastrointestinal & Endocrine
For this Discussion, you will take on the role of a clinician who is
building a health history for one of the following cases. Your
instructor will assign you your case number. Case 2
Case 1 Case 2 Case 3
Chief
Compl
aint
(CC)
“I am here today due
to frequent and watery
bowel movements”
“I have pain in my
belly” “neck swelling”
Histor
y of
Prese
nt
Illness
(HPI)
A 37-year-old
European American
female presents to
your practice with
“loose stools” for
about three days. One
event about every
three hours
A 25-year-old female
presents to the
emergency room (ER)
with complaints of
severe abdominal pain
for 2 weeks . The pain
is sharp and crampy It
hurts if I run, sit down
hard, or if I have sex
A 42-year-old African
American female who
refers that she has
been noticing slow
and progressive
swelling on her neck
for about a year. Also
she stated she has
lost weight without
any food restriction
PMH No contributory Patient denies Patient denies
PSH Appendectomy at the
age of 14
Surgical removal of
benign left breast
Drug
Hx No meds Birth control No medication at the
time
Allergi
es Penicillin NKA NKA
Subje
ctive
Fever and chills, Lost
appetite Flatulence No
mucus or blood on
stools
Nausea and vomiting,
Last menstrual period
sexual partner about 2
months ago, No
condoms, he hates
them No pain, blood
or difficulty with
urination
Mild difficult to
shallow, Neck feels
tight, Pt states she
feels Palpitations
Objective Data
PE
B/P 188/96; Pulse 89;
RR 16; Temp 99.0; Ht
5,6; wt 110; BMI 17.8
B/P 138/90;
temperature 99°F;
(RR) 20; (HR) 110,
regular; oxygen
saturation (PO2) 96%;
pain 5/10
B/P 158/90; Pulse
102; RR 20; Temp
99.2; Ht 5,4; wt 114;
BMI 19.6
Gener
al
well-developed female
in no acute distress,
appears slightly
fatigued
acute distress and
severe pain
42-year-old female
appears thin. She is
anxious – pacing in
the room and
fidgeting, but in no
acute distress.
HEEN
T
Atraumatic,
normocephalic,
PERRLA, EOMI, arcus
senilus bilaterally,
conjunctiva and sclera
clear, nares patent,
nasopharynx clear,
edentulous.
Atraumatic,
normocephalic,
PERRLA, EOMI,
conjunctiva and sclera
clear; nares patent,
nasopharynx clear,
good dentition.
Piercing in her right
nostril and lower lip.
Bulging eyes
Neck Supple Diffuse enlargement of
the thyroid gland
Lungs CTA AP&L CTA AP&L CTA AP&L
Card S1S2 without rub or
gallop
S1S2 without rub or
gallop
S1S2 without rub,
Tachycardia
Abd
positive bowel sounds
(BS) in all four
quadrants; no masses;
no organomegaly
noted; diffuse, mild,
bilateral lower
quadrant pain noted
Mild diffuse
tenderness.
• INSPECTION: no
masses or thrills
noted; no
discoloration and skin
is warm to; no tattoos
or piercings; abdomen
is nondistended and
round
• AUSCULTATION:
bowel sounds (BS) are
normal in all four
quadrants, no bruits
noted
• PALPATION: on
palpation, abdomen is
tender to touch in four
quadrants; tenderness
noted on light
palpation, deep
palpation reveals no
masses, spleen and
liver unremarkable
• PERCUSSION:
tympany heard in all
quadrants, no dullness
noted in abdominal
area
benign, normoactive
bowel sounds x 4
GU Non contributory
• EXTERNAL: mature
hair distribution; no
external lesions on
labia
• INTROITUS: slight
green-gray discharge,
no lesions
• VAGINAL: normal
rugae; moderate
amount of green
discharge on vaginal
walls
• CERVIX: nulliparous
os with small amount
of purulent discharge
from os with positive
cervical motion
tenderness (CMT)
• UTERUS: ante-
flexed, normal size,
shape, and position
• ADNEXA: bilateral
tenderness with
fullness; both ovaries
without masses
• RECTAL: deferred
• VAGINAL
DISCHARGE: green in
color
Non contributory
Ext no cyanosis, clubbing
or edema
no cyanosis, clubbing
or edema
no cyanosis, clubbing
or edema
Integu
ment
good skin turgor
noted, moist mucous
membranes
intact without lesions
masses or rashes
Thin skin, Increase
moisture
Neuro
No obvious
deformities, CN
grossly intact II-XII
No obvious deficits
and CN grossly intact
II-XII
No obvious deficits
and CN grossly intact
II-XII
Once you received your case number, answer the following
questions:
1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient
presenting symptoms?
5. Give rationales for your each differential diagnosis.
Submission Instructions:
• Your instructor will assign you your case number and you
will post on the case number you have been assigned.
• You will reply to the other two case studies (One of each).
• Your initial post should be at least 500 words, formatted and
cited in current APA style with support from at least 2
academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by
extending, refuting/correcting, or adding additional nuance
to their posts. Your reply posts are worth 2 points (1 point
per response.)
• All replies must be constructive and use literature where
possibl
**## NUR506Dis.pdf**
NUR 506
Discussion 1
Nursing & Health-Care-Policy
Analyze the history, structure, and process of health-care-policy and politics in nursing and the
health care delivery systems in the United States.
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 2
Advocacy
What examples of advocacy do you see in your own nursing practice? List and discuss 2
examples.
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 3
ACA and Health-Care Outcomes & Costs
What components of the ACA do you think will have a positive effect on improving health care
outcomes and decreasing costs?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 4
Local, State & Federal Advocacy
• What are specific actions that health professionals can take regardless of their practice
area and site to promote population and community health?
• What advocacy actions might you take to improve health care through legislation at the
state or federal level?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 5
Issues in Today's Workforce Culture
Based on your reading in chapter 60, why do you think the issues presented in this chapter persist
in today’s workforce culture?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
Discussion 6
Health Care Disparities in LGBTQ
Discuss how to close the health care disparities gap in the LGBTQ community?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA style
with support from at least 2 academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or
adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per
response.)
• All replies must be constructive and use literature where possible.
**## NUR504Dis4.pdf**
Gastrointestinal & Endocrine
For this Discussion, you will take on the role of a clinician who is
building a health history for one of the following cases. Your
instructor will assign you your case number. Case 2
Case 1 Case 2 Case 3
Chief
Compl
aint
(CC)
“I am here today due
to frequent and watery
bowel movements”
“I have pain in my
belly” “neck swelling”
Histor
y of
Prese
nt
Illness
(HPI)
A 37-year-old
European American
female presents to
your practice with
“loose stools” for
about three days. One
event about every
three hours
A 25-year-old female
presents to the
emergency room (ER)
with complaints of
severe abdominal pain
for 2 weeks . The pain
is sharp and crampy It
hurts if I run, sit down
hard, or if I have sex
A 42-year-old African
American female who
refers that she has
been noticing slow
and progressive
swelling on her neck
for about a year. Also
she stated she has
lost weight without
any food restriction
PMH No contributory Patient denies Patient denies
PSH Appendectomy at the
age of 14
Surgical removal of
benign left breast
Drug
Hx No meds Birth control No medication at the
time
Allergi
es Penicillin NKA NKA
Subje
ctive
Fever and chills, Lost
appetite Flatulence No
mucus or blood on
stools
Nausea and vomiting,
Last menstrual period
sexual partner about 2
months ago, No
condoms, he hates
them No pain, blood
or difficulty with
urination
Mild difficult to
shallow, Neck feels
tight, Pt states she
feels Palpitations
Objective Data
PE
B/P 188/96; Pulse 89;
RR 16; Temp 99.0; Ht
5,6; wt 110; BMI 17.8
B/P 138/90;
temperature 99°F;
(RR) 20; (HR) 110,
regular; oxygen
saturation (PO2) 96%;
pain 5/10
B/P 158/90; Pulse
102; RR 20; Temp
99.2; Ht 5,4; wt 114;
BMI 19.6
Gener
al
well-developed female
in no acute distress,
appears slightly
fatigued
acute distress and
severe pain
42-year-old female
appears thin. She is
anxious – pacing in
the room and
fidgeting, but in no
acute distress.
HEEN
T
Atraumatic,
normocephalic,
PERRLA, EOMI, arcus
senilus bilaterally,
conjunctiva and sclera
clear, nares patent,
nasopharynx clear,
edentulous.
Atraumatic,
normocephalic,
PERRLA, EOMI,
conjunctiva and sclera
clear; nares patent,
nasopharynx clear,
good dentition.
Piercing in her right
nostril and lower lip.
Bulging eyes
Neck Supple Diffuse enlargement of
the thyroid gland
Lungs CTA AP&L CTA AP&L CTA AP&L
Card S1S2 without rub or
gallop
S1S2 without rub or
gallop
S1S2 without rub,
Tachycardia
Abd
positive bowel sounds
(BS) in all four
quadrants; no masses;
no organomegaly
noted; diffuse, mild,
bilateral lower
quadrant pain noted
Mild diffuse
tenderness.
• INSPECTION: no
masses or thrills
noted; no
discoloration and skin
is warm to; no tattoos
or piercings; abdomen
is nondistended and
round
• AUSCULTATION:
bowel sounds (BS) are
normal in all four
quadrants, no bruits
noted
• PALPATION: on
palpation, abdomen is
tender to touch in four
quadrants; tenderness
noted on light
palpation, deep
palpation reveals no
masses, spleen and
liver unremarkable
• PERCUSSION:
tympany heard in all
quadrants, no dullness
noted in abdominal
area
benign, normoactive
bowel sounds x 4
GU Non contributory
• EXTERNAL: mature
hair distribution; no
external lesions on
labia
• INTROITUS: slight
green-gray discharge,
no lesions
• VAGINAL: normal
rugae; moderate
amount of green
discharge on vaginal
walls
• CERVIX: nulliparous
os with small amount
of purulent discharge
from os with positive
cervical motion
tenderness (CMT)
• UTERUS: ante-
flexed, normal size,
shape, and position
• ADNEXA: bilateral
tenderness with
fullness; both ovaries
without masses
• RECTAL: deferred
• VAGINAL
DISCHARGE: green in
color
Non contributory
Ext no cyanosis, clubbing
or edema
no cyanosis, clubbing
or edema
no cyanosis, clubbing
or edema
Integu
ment
good skin turgor
noted, moist mucous
membranes
intact without lesions
masses or rashes
Thin skin, Increase
moisture
Neuro
No obvious
deformities, CN
grossly intact II-XII
No obvious deficits
and CN grossly intact
II-XII
No obvious deficits
and CN grossly intact
II-XII
Once you received your case number, answer the following
questions:
1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient
presenting symptoms?
5. Give rationales for your each differential diagnosis.
Submission Instructions:
• Your instructor will assign you your case number and you
will post on the case number you have been assigned.
• You will reply to the other two case studies (One of each).
• Your initial post should be at least 500 words, formatted and
cited in current APA style with support from at least 2
academic sources. Your initial post is worth 8 points.
• You should respond to at least two of your peers by
extending, refuting/correcting, or adding additional nuance
to their posts. Your reply posts are worth 2 points (1 point
per response.)
• All replies must be constructive and use literature where
possibl
– 1
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