2023 Journal Title Reflect on the role of the NP in primary care Purpose It is important to summarize the

2023 Nursing Journal Title: Reflect on the role of the NP in primary care

Journal Title Reflect on the role of the NP in primary care Purpose It is important to summarize the 2023

Journal Title: Reflect on the role of the NP in primary care
Purpose

It is important to summarize the role of the NP in primary care. This reflection Assignment helps to internalize the role of the NP.

Directions

This Journal Assignment is reflective in nature. Describe in your own words and using your perspective, describe the role of the NP in primary care.

Where to Post Response

You will post this response to the online Journal. However, please write your response in Word® or another text tool and save your work. When you are ready to post, copy your response text and paste it into the online Journal. This approach will ensure that you have a backup of your work.

To access the Journal, click the Journal tab located in the upper right area of the screen.

Assignment Requirements

As this assignment is a Journal entry and not a formal paper, it may at times be difficult to follow the organization, style, and formatting of the APA 6th Edition Manual. Despite this, your Journal assignment should:

  • clearly establish and maintain the viewpoint and purpose of the assignment;
  • follow the conventions of Standard American English (correct grammar, punctuation, etc.);
  • be well ordered, logical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th edition format as outlined in the APA Progression Ladder.

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2023 The Affordable Care Act was signed into law by President Barack Obama in March 2010 Many of

2023 Nursing Please Follow Instructions. Answer Every Question. Al Least 260 Worlds In APA Format. Academic References Need.SUBTANTIVE POST Please. Thanks

The Affordable Care Act was signed into law by President Barack Obama in March 2010 Many of 2023

The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials:

  1. Key Features of the Affordable Care Act
  2. Health Care Transformation: the Affordable Care Act and More

What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

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2023 Week 6 Assignment Critique of Research Studies Part 2 Follow the instructions

2023 Nursing NUR-504 Week 6 Assignment Critique of Research Studies – Part 2

Week 6 Assignment Critique of Research Studies Part 2 Follow the instructions 2023

Week 6 Assignment Critique of Research Studies – Part 2

 

Follow the instructions provided in “Critique of Research Studies Instructions.”

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center.

 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

 

You are not required to submit this assignment to Turnitin, unless otherwise directed by your instructor. If so directed, refer to the Student Success Center for directions. Only Word documents can be submitted to Turnitin.

 

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2023 Please read the following case study and answer accordingly with a minimum of two paragraphs cited

2023 Nursing Week_12

Please read the following case study and answer accordingly with a minimum of two paragraphs cited 2023

Please read the following case study and answer accordingly with a minimum of two paragraphs, cited with two references not older than 5yrs old and no plagiarism. APA Style. 

__________________________________________________________________________________________

HPI: E.D a 65-year-old AA male presents to the clinic for prescription refills. The patient also indicates that she has noticed shortness of breath which started about 4 months ago. The SOB gets worse with exertion, especially when she is walking fast and it is resolved when he is resting. He reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. His symptoms of shortness of breath resolve after sitting upright on 3 pillows. He also has lower leg edema pitting 1+ which started 2 weeks ago. He also indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight stairs, but it resolves after sitting down to rest. He has not tried any over the counter medications at home.

He never filled her prescriptions that he received at her checkup 6 months ago, she did not think it was important.

PMH:

Primary Hypertension

Previous history of MI 1 year ago

Surgeries:

1 year ago-Left Anterior Descending (LAD) cardiac stent placement

Allergies: Penicillin

Vaccination History:

He receives an annual flu shot. Last flu shot was this year

Has not had a Td in over 10 years

Has not had the herpes zoster vaccine

Social history:

High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.

Family history:

Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.

ROS:

Constitutional: Lightheaded and faint with exertion.

Respiratory: Shortness of breath with exertion. + Orthopnea

Cardiovascular: + 2 pitting leg edema for 3 weeks.

Psychiatric: Pt sated not taking medications for 6 months – “ran out and did not get refills”

Physical examination:

Vital Signs

Height: 5 feet 1 inches Weight: 163 pounds BMI: 31 obesity, BP 157/87 T 98.0 po P 110 R 22, non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.

NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.

LUNGS: + Mild Crackles on inspiratory phase no clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.

HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.

MUSCULOSKELETAL: + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis.

PSYCH: Normal affect. Cooperative.

SKIN: No rashes. + Dry skin. Skin intact.

Labs:: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98

A:

Primary Diagnosis:

Congestive Heart Failure (CHF) (150.9)

Secondary Diagnoses:

Primary Hypertension (I10)

Obesity (E66):

Osteoarthritis (OA) (715.90)

Differential Diagnosis:

Peripheral Vascular Disease (PVD) (173.9)

P:

Medications:

Tylenol 650 mg PO Q4 hours as needed for arthritis pain

Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH.

12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index

Referrals: may refer based on lab results

Follow up: return to office in 2 weeks

Additional lab results:

Echo results 1 week ago: Left ventricular EJ Fraction decreased to 30 %

BNP – no available

Questions: As an NP student, need to determine the medications for CHF/ASCVD

According to the ACC/AHA Guidelines, what medications should this patient be prescribed? Does he need medication given his history of MI? Write her complete prescriptions using the prescription writing format.

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