TOPIC: OTITIS MEDIA- IN A 2 YEARS OLD PATIENT

INSTRUCTIONS AND GUIDELINES ATTACHED

NO PLAGIARRISM ALLOWED

ALL FORMAT MUST BE IN APA 7TH EDITION STYLEN

SPEAKER NOTES IN ALL SLIDES

DUE DATE MARCH 26, 2025

10 SLIDES

psych soap note, template and rubric attached. 

template attached

Patient name, GR- will fill in remaining name and vitals at end, other stuff will need to develop

HPI: Patient is a 14 year old male patient who presents with mother for follow-up on depression and ADHD- predominately inattentive type. GR is a 14 year old male who presents with his mother for a follow up visit for the management of depression, social anxiety, and binge eating disorder. He takes Vraylar  and Venlafaxine ER 150mg. During last visit, we started Vyvanse 20mg due to
poor focus, inattentiveness, and to assist in the binge eating disorder (BED). He reports feeling some improvement. He feels more energy and is not sleeping all day like he used to. He also relates to decreased appetite and denies episodes of binge eating.Gavin still reports sleeping 12 hours at night. He does not take as many naps as he used to. Patient does online school from home. He relates to improved motivation. Gavin reports moderate depressive and anxiety symptoms. PHQ-9 score is 12. GAD-7 score is 14. His mother reports noticing improved mood. He has been going out more and willing to dine at restaurants. We’ll continue Venlafaxine ER 150mg daily. Increase to Vyvanse 30mg daily in the morning. Follow up in three weeks.

Chief Complaint, patient “I am feeling more motivated and interested in leaving the house.” Mother, states “I see some improvement and he is socializing more with the family at home.” 

Medications are: Lisdexamfetamine (Vyvanse) 30 mg capsule, take one tablet every morning, Venlafaxine ER 150 mg capsule ER, take one capsule in the morning, every day

Primary Diagnosis, Depression, moderate, recurrent. ADHD-predominately inattentive type, and Binge Eating disorder (BED). Plus in ICD 10 codes

Differentials: Anxiety, Social anxiety, thyroid abnormality, anemia- iron versus folate/ b12 (micro versus macrocytic anemia)

Follow-up in 3 weeks

Continue current prescriptions x 30 days

Will need at least three references, APA- in past five years- in text citations for differentials and main diagnosis 

 Module 4 Discussion 

 

Discussion 4

Urinary Function:
Mr. J.R. is a 73-year-old man, who was admitted to the hospital with clinical manifestations of gastroenteritis and possible renal injury. The patient’s chief complaints are fever, nausea with vomiting and diarrhea for 48 hours, weakness, dizziness, and a bothersome metallic taste in the mouth. The patient is pale and sweaty. He had been well until two days ago, when he began to experience severe nausea several hours after eating two burritos for supper. The burritos had been ordered from a local fast-food restaurant. The nausea persisted and he vomited twice with some relief. As the evening progressed, he continued to feel “very bad” and took some Pepto-Bismol to help settle his stomach. Soon thereafter, he began to feel achy and warm. His temperature at the time was 100. 5°F. He has continued to experience nausea, vomiting, and a fever. He has not been able to tolerate any solid foods or liquids. Since yesterday, he has had 5–6 watery bowel movements. He has not noticed any blood in the stools. His wife brought him to the ER because he was becoming weak and dizzy when he tried to stand up. His wife denies any recent travel, use of antibiotics, laxatives, or excessive caffeine, or that her husband has an eating disorder.

Case Study Questions

1. The attending physician is thinking that Mr. J.R. has developed an Acute Kidney Injury (AKI). Analyzing the case presented name the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney injury.
2. Create a list of risk factors the patient might have and explain why.
3. Unfortunately, the damage on J.R. kidney became irreversible and he is now diagnosed with Chronic kidney disease. Please describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.

Reproductive Function:
Ms. P.C. is a 19-year-old white female who reports a 2-day history of lower abdominal pain, nausea, emesis and a heavy, malodorous vaginal discharge. She states that she is single, heterosexual, and that she has been sexually active with only one partner for the past eight months. She has no previous history of genitourinary infections or sexually transmitted diseases. She denies IV drug use. Her LMP ended three days ago. Her last intercourse (vaginal) was eight days ago and she states that they did not use a condom. She admits to unprotected sex “every once in a while.” She noted an abnormal vaginal discharge yesterday and she describes it as “thick, greenish-yellow in color, and very smelly.” She denies both oral and rectal intercourse. She does not know if her partner has had a recent genitourinary tract infection, “because he has been away on business for five days.
Microscopic Examination of Vaginal Discharge
(-) yeast or hyphae
(-) flagellated microbes
(+) white blood cells
(+) gram-negative intracellular diplococci

Case Study Questions

1. According to the case presented, including the clinical manifestations and microscopic examination of the vaginal discharge, what is the most probably diagnosis for Ms. P.C.? Support your answer and explain why you get to that diagnosis.
2. Based on the vaginal discharged described and the microscopic examination of the sample could you suggest which would be the microorganism involved?
3. Name the criteria you would use to recommend hospitalization for this patient

Submission Instructions:

• You must complete both case studies.
• Your initial post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources. 

 Module 4 Discussion 

 

Practices in other states

Choose a state and review the scope of practice for the advanced practice nurse. How does it compare to Florida?

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.