Select two broad subject areas (for example: the economy, health, or literature). Select two sub-topics for both of your broad subject areas (for example The Great Depression and unemployment for the economy OR pancreatic cancer and smoking for health).

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To develop these four sub-topics:

Consult a general encyclopedia and a specialized encyclopedia for your research (this week’s Learning Materials covers the difference between the two). Do not look for books or articles at this point. Just use encyclopedias. 
You must have at least two encyclopedias for each of your four sub-topics, and only one can be a general encyclopedia. You can use the same general encyclopedia for all four sub-topics.

Write the following as a document for each sub-topic:
Your broad subject area
Your sub-topic
A description of the sub-topic (no more than a paragraph)
Which encyclopedias you used
Create a search vocabulary of that sub-topic.  A search vocabulary is a list of terms and phrases appropriate to your sub-topic that would be useful for searching databases and catalogs.
Pay attention to the terminology used in the encyclopedias to develop your search vocabulary.
You must have at least five but no more than ten terms or phrases for your sub- topic.

Medication refill

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Case Study

Chief complaint: Im here for a medication refill because I ran out of my medicines.

HPI:  Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.

She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.

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:  Up-to-date

Social history:

High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 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: Non-contributory.

Physical examination:

Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111,  R 22 and non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not 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. Positive for dry skin.

Labs: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

A:

Primary Diagnosis: Congestive Heart Failure (CHF)

Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA)

Differential Diagnosis: Peripheral Vascular Disease (PVD)

Plan:

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.

Additional lab results: Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 %

BNP not available.

As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease).

Questions:

1.    According to the ACC/AHA guidelines, what medications should this patient be prescribed?

2.    Does he need medication(s) given his history of MI?

3.    Considering that you have a case study, you only need 2 posts for this discussion board, 1 initial and 1 reply. As usual, all posts must be supported by at least 2 peer reviewed references and all paragraphs must be cited.

Thanks!

Faith and Learning

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Integration THEMATIC INTEGRATION OF FAITH AND LEARNING PAPER INSTRUCTIONS
Write a thematic integration of faith and learning concept paper using a well-rounded approach to the concepts found in Northouse textbook and current scholarly literature. This paper must be submitted in compliance with the instructions found in the Thematic of Faith and Learning Paper Grading Rubric.

The paper must contain the following components:

1.    A 23-page overview that defines the course (Leadership Theory) as an academic field of study (significance of the course to business).
2.    A 34-page discussion of the top 58 concepts you believe are critical in order to demonstrate that a student who completes this course can synthesize the key concepts in leadership theory and make real-world applications. 
3.    A 23-page discussion that integrates the concepts from the Northouse and Merida texts along with the Bible and other sources to present a cohesive biblical understanding of leadership theory.
4.    A minimum of 10 scholarly journal references; each reference must be less than 10 years old.

Coding Compliance Policy

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The most important part of a coding compliance program are the standards supporting it. The organizations standards of conduct provide the ethical culture expected of all employees. Coding professionals should also understand and abide by AHIMAs Standards of Ethical Coding (See AHIMA Standards of Ethical Coding.
Coding policies and procedures serve as guidelines for coding and billing functions and provide documentation of the organizations intent to correctly report services provided. The policies should include requirements for accurate, complete, and timely documentation and coding practices as well as incorporate the laws and regulations governing coding. Complying with these policies is key in preventing coding errors or reimbursement problems.