Map a nursing care plan/clinical pathway for a patient with a specific genetic disorder (e.g., sickle cell disease, hemophilia, cystic fibrosis, Huntington disease).

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Map a nursing care plan/clinical pathway for a patient with a specific genetic disorder (e.g., sickle cell disease, hemophilia, cystic fibrosis, Huntington disease). Prepare to discuss your care plan and rationales following a minimum of three nursing diagnosis for the disease specified.

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Reflect on the tenets of the Theory of Human becoming and its core concepts and assumptions.

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Reflect on the tenets of the Theory of Human becoming and its core concepts and assumptions. Then compare and contrast how the core concepts currently apply to your nursing practice versus how you anticipate they will relate to your future practice as a family nurse practitioner. Please identify at least 2 specific assumptions of the theory in your discussion as outlined in your textbook.

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Episodic/Focused SOAP Note: Ankle Injury

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1 day ago

Christina Alvarez 

Alvarez: Ankle Injury

COLLAPSE

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Episodic/Focused SOAP Note: Ankle Injury

Patient Information: F.P, 46 y/o, Hispanic, Woman

S.

CC: Right ankle pain. “I was playing soccer over the weekend and heard a pop.”

HPI: Patient, F.P., is a 46-year-old Hispanic woman who presents in the clinic today complaining of bilateral ankle pain, with right ankle of primary concern.  She states she was playing soccer 2 days ago and heard a “pop”.  She further states she heard the “pop” after running approximately 50 yards. She denies recent trauma or fall.  She describes the pain as sharp when bearing weight, and dull/throbbing when she is at rest.  She is able to bear weight but is uncomfortable.  The pain is constant but worse when she bears weight.  She rates the pain at its worst as a 7/10 and at its best 2/10.  Pain is reproducible with palpation.  The pain does not radiate. Patient states she did not apply ice to the injured ankle, and has only taken 200 mg of Ibuprofen, which she took 2 days ago and provided no relief.  Patient states she doesn’t like to take medicine for pain one only took one tablet.  She reports no associated signs and symptoms.

Current Medications: no prescription medications; centrum complete multi-vitamin daily, ibuprofen, 200 mg; denies homeopathic products.

Allergies: No known medication allergies.  Denies environmental, food, and latex allergies.

PMH: Reports history of insomnia, never treated.  Denies having major illnesses, surgical procedures and hospitalizations.  Reports being up-to-date on vaccinations.  Last tetanus shot was 09/2019 – as preventative measure.  Flu vaccination given 10/2019.  SH: F.P. is a single woman with no children.  She lives in a home she owns and is independent.  She works as an online life coach and operates from her home.  She lives alone with four dogs and a lizard.  She denies drinking alcohol, smoking/vaping, using nicotine products, and recreational drugs.  She endorses drinking 1-2 cups of coffee daily.  She drives routinely, does not text-and-drive, and wears seatbelts.  Her home is equipped with NEST home security and fire/carbon dioxide detectors.  She has been celibate for the last three years and has practiced safe-sex. She is not currently on birth control, and her last menstrual cycle started 2-days ago.  She denies having any sexually transmitted diseases.  She participates in a local soccer league, and has for the last 10 years.  She plays soccer every weekend and participates in hot yoga 3 times a week.  She reports that her living environment is safe and her dogs are well-behaved and provide “all the emotional support I need.”

FH: Mother, died at 69 of lung cancer; father, 75, living, high blood pressure, high cholesterol, osteoarthritis; Paternal grandmother, died at 70, complications from osteoporosis/diabetes; Paternal grandfather, died at 78, heart attack; Maternal grandmother, died at 98, ruptured aortic aneurysm; Maternal grandfather, died at 78, complications from Alzheimer’s.  Patient has no siblings or children.

ROS:

· GENERAL:  No weight loss, fever, chills, weakness or fatigue.

· CARDIOVASCULAR:  No chest pain, chest pressure, chest discomfort, palpitations, or edema.

· RESPIRATORY:  No shortness of breath, cough or sputum.

· NEUROLOGICAL:  No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control

· MUSCULOSKELETAL:  No muscle, back pain, or stiffness. Pain and swelling on lateral aspect of right ankle

· SKIN: No rash or itching

O.

· VS: BP 110/70, HR 65, Resp 16, Temp 98.4, O2 100%, Ht: 5’5”, Wt: 170 lbs.

· GENERAL: Alert and oriented x 3, appropriate, calm, cooperative

· CARDIOVASCULAR: s1s2, no murmur, no edema, pulses equal +2

· RESPIRATORY: Lungs clear to auscultation bilaterally, no rhonchi or wheezes, expansion equal and symmetric

· NEUROLOGICAL:  Equal strength (+5), equal sensation, no numbness, no decrease in sensation in upper and lower extremities.  No ataxia.

· MUSCULOSKELETAL:  smooth and rounded malleolar prominences, prominent heels, and prominent metatarsophalangeal joints. No calluses or corns. Feet are aligned with tibias. Weight bearing in on the midline of feet.  Longitudinal arch.  Toes are straight forward, flat, and in alignment with each other.  No pain upon palpation of bilat metatarsophalangeal joints.  No heat or redness on bilat ankles/feet.  (+) Swelling and tenderness on anterior-inferior tibiofibular ligament with dorsiflexion-external rotation and weight-bearing. Bilat dorsiflexion of 20 degrees; inversion of 30 degrees, eversion of 20 degrees, abduction of 10 degrees and adduction of 20 degrees, flexion and extension of all toes bilaterally. No signs of instability in bilat hips or knees.   (-) OTTAWA ANKLE RULES: No bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus, medial malleolus.  Patient is able to bear weight for 4 steps.

· SKIN: Skin intact, no rash

Diagnostic results:

· X-rays of the ankle and lower leg: Ottawa Ankle Rules should be assessed before ordering radiographs (O’Neill, 2019).  In the case of patient F.P. the Ottawa Ankle Rules do not apply. X-rays are used to rule-out fracture.  Reliability and validity of x-ray’s being used to diagnose ankle syndesmosis have been found to be questionable (Chun et al., 2019). Plain radiographs can be used to confirm a diagnosis of ankle impingement (Talusan, Toy, Perez, Milewski, & Reach, J., 2014). X-rays are also used to diagnose osteochondritis dissecans (OCD) (American Academy of Orthopaedic Surgeons (AAOS), n.d.)

· Magnetic Resonance Imaging (MRI): MRI has the highest specificity and sensitivity in diagnosing ankle syndesmosis (Chun et al., 2019).  MRI can be used to diagnose ligament injury, and subtle bone injuries (Dearde, Reeve, & Sharpe, 2018), and evaluate the extent of OCD (AAOS, n.d.)

· Computed Tomography (CT): When compared to x-rays, CTs can reveal more detail about the bone and soft tissue.  They are more sensitive in detecting ankle syndesmosis, but consideration should be made to radiation exposure (Chun et al., 2019)..

A.

Differential Diagnoses

· Soft-tissue injury (sprained ankle): A sprained ankle is characterized by an over-stretching of the ligaments that support the ankle.  Symptoms can include tenderness on palpation, swelling, and bruising.  Ankle sprains are common among all age groups and are one of the most common injuries in United Kingdom emergency rooms (Dearden, Reeve, & Sharpe, 2019). Syndesmosis injuries comprise approximately 20% of ankle sprains and misdiagnosis can cause chronic ankle instability and pain (Chun et al., 2019).

· Tendinitis: Ankle tendonitis is characterized by inflammation of the tendons surrounding the ankle joint.  The most common symptoms include pain and swelling.  The pain typically increases with activity and can be exacerbated by applying pressure to the affected area (Smith, 2019).

· Fracture:  Fractures vary in severity.  Symptoms associated can include immediate throbbing pain, pain that worsens with weight bearing and is alleviated by rest, swelling, tenderness, and difficulty in walking (Mayo Clinic, n.d.)

· Impingement: Anterior ankle impingement is clinical condition characterized by chronic anterior ankle pain that worsens with dorsiflexion and is associated with ankle instability and limited motion (Talusan et al., 2014).

· Osteochondritis Dissecans: OCD is characterized by small segments of bone separating from surrounding regions due to lack of blood supply.  Although the exact cause is unknown, it is speculated to be associated with repetitive trauma/stresses to the bone. Symptoms include pain and swelling and are exacerbated by physical activity (AAOS, n.d.).

 

References

AAOS. (n.d.) Osteochondritis dissecans. Retrieved from https://orthoinfo.aaos.org/en/diseases–conditions/osteochondritis-dissecans/

Ball, J., Dains, J., Flynn, J., Solomon, B., & Stewart, R. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Chun, D., Cho, J., Min, T., Yi, Y., Park, S., Kim, K. …Won, Sung. (2019) Diagnostic accuracy of radiologic methods for ankle syndesmosis injury: A systematic review and meta-analysis. Journal of Clinical Medicine, 8(7), 968. https://doi.org/10.3390/jcm8070968

Dearde, P., Reeve, W., Sharpe, I. (2018). Management of acute ankle ligament injuries. Orthopaedics and Trauma, 32(6), 394-400. https://doi.org/10.1016/j.mporth.2018.09.003

Mayo Clinic. (n.d.) Broken ankle. Retrieved from https://www.mayoclinic.org/diseases-conditions/broken-ankle/symptoms-causes/syc-20450025

O’Neill, J. (2019) The diagnostic challenge of ankle injuries in the emergency department. The Journal for Nurse Practitioners, 15(8), e170-e172. https://doi.org/10.1016/nurprs.2019.03.003

Smith, M. (2019). Ankle tendinitis symptoms and treatment. Retrieved from https://www.livestrong.com/article/82098-ankle-tendonitis-symptoms-treatment/

Talusan, P., Toy, J., Perez, J., Melewski, M., Reach, J. (2014). Anterior ankle impingement: Diagnosis and treatment. Journal of the American Academy of Orthopaedic Surgeons, 22(5), 333. https://doi.org/10/5435/JAAOS-22-05-333

 

 

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Sociologists use theory to study society. In science, theory is used to develop a deeper understanding of the universe

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Introduction

Sociologists use theory to study society. In science, theory is used to develop a deeper understanding of the universe. Although abstract, sociologists use theory to expand on original ideas and develop practical solutions to problems. In sociology, there are three main sociological theories or perspectives: functionalist, conflict, and symbolic interactionist. Each of these perspectives has a distinct worldview, or interpretation, of the social world and human interaction:

  • The functionalist perspective presents the world as a system of inter-related parts, where all parts must work together for society to function.
    • For example, if we looked at sports teams, the functionalist perspective would argue that sports teams serve a purpose for society. They have a particular utility that helps society function properly. What purpose do sports teams have? Do they provide us with entertainment? Some people with jobs? Do they help to form a bond between people who otherwise would not be connected? The functionalist perspective would see all of these reasons as important functions of sports teams.
  • The conflict perspective disagrees, seeing society as an arena made up of groups competing over scarce resources in which there are issues of power and structural inequality.
    • The conflict perspective would see sports teams as groups competing over scarce resources. Those resources may be a title, fans, finances, or athletes. With this struggle between teams, some come out on top and others at the bottom. Thus, there is inherently inequality in sports teams.
  • Symbolic interactionism examines the symbols and social meanings we attach to individuals, behavior, objects, or interaction in face-to-face exchanges on a daily basis. The focus is more microcosmic than that of both functionalism and conflict perspective.
    • Since the symbolic interactionist perspective is a micro-level perspective it will look at the interactions that go on between individuals and small groups in sports teams. Are there symbols that exist between players on teams? Think of the gestures that are used by baseball players as an example. This perspective also looks at how communication differs for people on sports teams than it does for those in other groups. In football, for example, tackling is an acceptable form of interaction. That is not the case in an office setting.

As you can see, each of these three perspectives proposes a framework for interpreting encountered social phenomenon.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Examine how theory and sociological concepts apply to everyday life.
    • Describe a current issue or event related to the learner’s field.
    • Examine an issue or event from the functionalist perspective.
    • Examine an issue or event from the conflict perspective.
    • Examine an issue or event from the symbolic interactionist perspective.
  • Competency 6: Compose text that articulates meaning relevant to its purpose and audience.
    • Develop text using organization, structure, and transitions that demonstrate understanding of cohesion between main and subtopics.

For this assessment, search the Internet or print resources for a popular (as opposed to scholarly) article concerning a larger issue or event that has occurred in the last six months to a year related to your field or the field you are considering working in (business, healthcare, technology, criminal justice, et cetera). For example, if your field of study is healthcare management, you could choose a recent article concerning the cost of prescription medicine.

Deliverable

Search for a popular article (magazine or newspaper) about an issue or event related to your field of interest.

Write an essay in which you complete all of the following:

  • Part 1 – Describe a current event or issue related to your field (1–2 paragraphs).
    • Describe the current event or issue objectively. What is the main issue?
  • Part 2 – Examine this event or issue from the three sociological perspectives: functionalist, conflict, and symbolic interactionist.
  • Address all three theories in your essay.
    • Use at least two scholarly sources when explaining your theories.
  • Examine how each perspective might explain or understand this event or issue.
  • Use the article you’ve chosen to support your use of the perspectives and to provide examples to highlight theoretical ideas.
  • It is expected that you use the vocabulary and concepts for each theory (for example, manifest and latent functions when discussing the functionalist perspective).

Additional Requirements

  • Written communication: Develop text using organization, structure, and transitions that demonstrate understanding of cohesion between main and subtopics. Write in a professional style using references and correct grammar, usage, and mechanics. Written communication is free of errors that detract from the overall message.
  • Sources: Cite at least two scholarly sources.
  • Length: 2–3 pages, not including title and reference pages
  • Format: Include a title page and reference page. Use in-text citations to cite your sources. [Example: Writing becomes better as the child matures (Britton, Thomas, & Miller, 1996).]
  • Font and size: Times New Roman, 12-point.

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