• Discuss the questions that would be important to include when interviewing a patient with this issue. The PQRST mnemonic guide can be used for a complete abdominal pain history is as follows: P3 – Positional, palliating, and provoking factors; Q – Quality; R3 – Region, radiation, referral; S – Severity; T3 – Temporal factors (time and mode of onset, progression, and previous episodes). This mnemonic will help to ensure a thorough history is obtained by asking question such as;
1. Where do you feel the pain?
2. What kind of pain it is?
3. When and how the pain did began?
4. How bad it is?
5. Where else do you feel it?
6. What makes it worse or better?
7. How it has changed over time?
8. Have you had this kind of pain before? (Macaluso, & McNamara, 2012).
• Describe the clinical findings that may be present in a patient with this issue? Symptoms of a patient presenting with ovarian torsion includes pelvic or abdominal pain fluctuating, radiating to loin or thigh, occasionally accompanied with
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Explain your reasoning for each. The primary diagnosis is ovarian torsion. The patient present with classical signs and symptoms of RLQ abdominal pain the worsen with any movement, nausea, tachycardia, RLQ tenderness, guarding, and rebound on examination as well as right adnexal tenderness and right adnexal mass (I-Human Patients, 2017). Differential diagnosis include; pelvic inflammatory disease (PID), appendicitis, and renal colic. Clinical features that favor the diagnosis of PID are non-migratory pain, bilateral pelvic tenderness and absence of nausea or vomiting. Appendicitis typically presents with poorly localized colicky central abdominal pain associated with anorexia and vomiting. Renal colic typically presents with sudden onset of severe unilateral colicky pain radiating from the loin to the groin, which comes in waves, very similar to torsion (Krishnan, Kaur, Bali, & Rao,
HPI: MR is a 70 y.o. male patient who presents to ER with constant, dull and RUQ abdominal pain onset yesterday that irradiate to the back of right shoulder. Client also c/o nauseas, vomiting and black stool x2 this morning. He reports that currently resides in an ALF; they called the ambulance after his second episodes of black stool. Pt reports he drank Pepto-Bismol yesterday evening without relief. Pt states that he never experienced similar symptoms in the past. Denies any CP, emesis, hematochezia or any other associated symptoms at this time. Client was found with past history gallbladder problems years ago.
They can be enumerated as difficult entry to the right hypochondrium owing to the adhesions, difficulty in exposure can also arise due to diseased gallbladder and Liver ,acutely inflamed and tense gallbladder ,gallbladder packed with stones ,thick walled gallbladder ,fibrotic gallbladder ,gallbladder mass and abnormality can also arise due to anomalous anatomy of hepatobiliary system like situs inversus, malposition of the gallbladder, arterial anomalies and short cystic duct, a huge stone impacted in the cystic duct, Hartmann’s pouch adherent to the common hepatic duct and anomalous insertion of the cystic duct.
1. The Populists advocated a calling for free coinage of silver, abolition of national banks, and a graduated income tax. Plenty of paper money were issued to ensure governmental ownership of all forms of transportation and communication leaving hard money to not be in favor for this party. They mostly appealed to the farmers and less educated, which also called for an institution progression in education. Election of Senators by direct vote of the people were strongly encouraged to form a call for progression of literacy rate to be aware of the changing world. Since most populist were nativist they discouraged foreigners to work and to own land. They called for a civil service reform so that a working complete day of hours could make citizens eligible for postal banks, pensions, revision of the law of contracts, and reform of immigration regulations.
I had a Political science professor that once said “Political survey answers depend more on how a question is asked than on what the question is asking.” I read and reread the above question. I have to admit that even after 15 weeks of topic discussions, PowerPoint, text chapters and Google; I am still confused about how tax expenditure works. The nearest I can figure out and in plain English, it is simply a tax break. That being said, this question is very methodically asked. The term “anti-poverty programs” is a gentle, non threatening term that will be met with compassion and kindness among more than 85% of (surveyed) US citizens. Second “tax expenditures” is a confusing term associated with the mean IRS that must have something to do with the government taking hard earned money and doing something with it, but what? Who knows? The final term is the big, bad anti-conservative term that only about 11% of surveyed Americans actually greet with any positivity. So the question in our subconscious mind flows something like: “What are the advantages and disadvantages of helping people who need it with your tax money instead of giving it to people who don’t want to work?” But that’s not what the question is asking. Because I know that my subconscious takes into consideration, the information it believes is true. First anti-poverty programs, such as Medicaid, are in most people’s minds still welfare. Before the New Deal many of the anti-poverty programs, as well as welfare (utility assistance, help purchasing groceries, etc.) were funded completely through private charities....
When a teacher from Tryhard high school decides to voice her/he’s distaste about the success of the students from the previous year in mathematics, a few students decide to take matters into their own hand. Using the scores of the previous years they started to analyses the documents and see if the teacher was wrong.
What? The patient is 65-year-old man Mr. John Douglas who is suffering from dysphagia and have been admitted to the surgical ward for insertion of a percutaneous endoscopic gastrostomy (PEG). Apart from that, he is a Type 1 diabetes patient and has weakness in his right leg and arm because of right-sided hemiplegia. He is thin in appearance and has stage 1 pressure sore on his right heel.
Last week at practicum was a time of renewed energy. Megan and I had a meeting with one of our supervisors and we discussed our experiences, thoughts, and concerns regarding the placement thus far. Additionally, our other supervisor completed his IPT comments, leading us to have a productive conversation about how our goals are being met and what needs to happen during term two to ensure that we achieve the remainder of our goals. Having this conversation before our mid-term evaluation was very meaningful, and at this point, I think that my practicum placement is as good as it could be. Moreover, I feel very validated by the level of support I have received from my supervisors and how they have taken our feedback of the agency seriously. Seeing my suggestions be authenticated and incorporated into the volunteer orientation makes me realize that my contributions will have a lasting impact on the community. The primary changes that I want to see are workers approaching clients from a strengths perspective instead of from a deficit one, and more mental health training for volunteers. After learning about reframing the way people think about issues during the cognitive behavioural therapy lecture in SOWK 310, I feel more prepared to give concrete strategies and examples of how workers at the agency can empower clients by using a strengths approach. In this context, reframing will aid the agency in seeing problems as opportunities
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning urination, and decreased urine output for three days. Upon admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings.
The following is a discussion of three distinct approaches in the diagnosis and treatment of major Depression. These approaches are person-centered therapy, Gestalt therapy and reality therapy. Chosen from the list in the question above, these three are the most effective in the treatment of major depression. A case
Federman DG, Chanko EH. Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis. JAMA.2007;298(17):2070-2075. doi:10.1001/jama.298.17.2072.
This week, I followed up with the girls who went to the activity the District offered last Friday. We talked about their goals and the things they are doing in order to meet them. I emailed the lady who did the speech and we are trying to set up a second meeting, so the girls can talk to her again. This week, I had to deal with a lot of drama with another group of girls. I believe since it is April and the school year is almost over, they are under a lot of stress and that is the reason they keep getting in trouble. Last week, the student got their grades report, so I went over their grade and we worked on the grades they need to improve. I like the fact that the students are not looking for me just because their emotional problems, but also
Uterine Fibroids is a common medical condition that occurs generally in women in reproductive age. Fibroids are considered as benign tumors that grow up in the muscular wall of the uterus. Fibroids are also called leiomyoma or myoma. The size of the fibroids may vary from small sizes (apricot seed) to large sizes (similar to a melon). When fibroids rise up to a large size “The uterus expands to make it look approximating to a 6 or 7 months of pregnancy”. (Gynecologists). They also can grow up as an abnormal whole unit attach to the uterus or develop similar to grapes in different areas around the uterus. (See figure 1)
“The history-taking interview should be of high quality and must be accurately recorded” (Craig & Lloyd, p.48). It is important that while obtaining a thorough health history, that the patient is treated with dignity and that their privacy is respected. A complete history involves the collection of physical and psychosocial aspects of one’s health.
Department of Health and Human Services has developed The Patient Education Materials Assessment Tool (PEMAT) to help assess whether patient education materials are understandable. Based on this guide, the Understandability Score is 86.6 percent, while the Actionability Score is 83.3 percent (Shoemaker, Wolf, & Brach, 2016). Specifically, the material provides a clear purpose and is broken down into sections, including helpful hints, applying the pouching system, tips for colostomy care, and when to call the doctor. The first section uses bullet points for each hint, the second section numbers each step, and the tips section includes subsections on applying the pouch, changing the pouch, emptying the pouch, bathing, wearing the pouch, going away from home, and reducing odor (University of Pittsburgh Medical Center, n.d.). Finally, the last section uses bullet points to highlight symptoms which would necessitate contacting the doctor.
“They were dying slowly-it was clear. They were not enemies, they were not criminals, they were nothing earthly now, nothing but black shadows of disease and starvation, lying confused in the greenish gloom”. (page 14 para. 3, line 1).