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  • [Solved] 4k25 research 2

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    – 2 years ago **files (1)** – ## 4025Researchassess2.docx **## 4025Researchassess2.docx** 4025 Research Assessment 2 Applying an EBP model Develop a 3–5 page scholarly paper in which you explain the diagnosis you researched for Assessment 1, and then apply the steps of an EBP model to your search fo…

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    – 2 years ago

    **files (1)**

    – ## 4025Researchassess2.docx

    **## 4025Researchassess2.docx**

    4025 Research

    Assessment 2

    Applying an EBP model

    Develop a 3–5 page scholarly paper in which you explain the diagnosis you researched for Assessment 1, and then apply the steps of an EBP model to your search for evidence to address your diagnosis issue.

    Expand All

    **Introduction**

    The goal of using evidence-based research findings is to enhance safety and quality of patient care and ensure optimal outcomes are achieved. It is not uncommon to hear a nurse say, "why change it as we’ve always done it this way." However, this is no longer acceptable in today's practice environment. The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided. As the profession of nursing continues to evolve and engage in healthcare transformation, baccalaureate-prepared nurses are expanding, taking on leadership roles that include incorporating EBPs. To be able to do this, the nurse needs to understand the criteria that make a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into healthcare settings. The nurse will need to incorporate the use of EBP models.

    EBP models are designed to assist the nurse in developing a plan to gather evidence to answer a practice problem or question. It is a systematic approach to direct the user to incorporate scholarly findings into current practice. These EBP models lead the nurse through the decision-making process of evaluating the literature to determine the best practice evidence for the practice issue or question.

    **Professional Context**

    As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, healthcare systems, and nursing practice outcomes are positively impacted.

    **Preparation**

    Review all resources for this assessment, as well as the scoring guide for details of how this assessment will be graded. You will use the specific diagnosis or health issue you selected for Assessment 1. You can refer to the overview of common EBP models in the
    [Evidence-Based Practice Models](https://media.capella.edu/coursemedia/nurs-fpx4025element250261/wrapper.asp) media for help in choosing the most appropriate EBP model for your issue.

    **Instructions**

    Complete the following:

    · Consider your diagnosis from Assessment 1.

    · Explain an issue associated with this diagnosis that could benefit from an EBP approach.

    · Choose the EBP model you wish to implement.

    · Describe each step of the EBP model of your choice.

    · Apply the steps of the model to your search for evidence for your diagnosis issue, and describe how you applied them.

    · Locate at least three separate resources of evidence to assist with your diagnosis issue.

    · Analyze the credibility and relevance of each resource as it relates to your diagnosis.

    This is a paper and should be 3–5 pages, not including the title page or reference page. The paper must be in APA format.

    **Competencies Measured**

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

    · Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.

    · Analyze the credibility and relevance of each resource as it relates to a diagnosis.

    · Competency 3: Apply an evidence-based practice model to address a practice issue.

    · Explain an issue associated with a chosen diagnosis that could benefit from an EBP approach.

    · Describe each step of a chosen EBP model.

    · Describe how the steps of a chosen EPB model were applied to search for evidence for a diagnosis issue.

    · Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

    · Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

    · Apply APA formatting to in-text citations and references, exhibiting adherence to most aspects of APA format.

    **## 4025Researchassess2.docx**

    4025 Research

    Assessment 2

    Applying an EBP model

    Develop a 3–5 page scholarly paper in which you explain the diagnosis you researched for Assessment 1, and then apply the steps of an EBP model to your search for evidence to address your diagnosis issue.

    Expand All

    **Introduction**

    The goal of using evidence-based research findings is to enhance safety and quality of patient care and ensure optimal outcomes are achieved. It is not uncommon to hear a nurse say, "why change it as we’ve always done it this way." However, this is no longer acceptable in today's practice environment. The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided. As the profession of nursing continues to evolve and engage in healthcare transformation, baccalaureate-prepared nurses are expanding, taking on leadership roles that include incorporating EBPs. To be able to do this, the nurse needs to understand the criteria that make a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into healthcare settings. The nurse will need to incorporate the use of EBP models.

    EBP models are designed to assist the nurse in developing a plan to gather evidence to answer a practice problem or question. It is a systematic approach to direct the user to incorporate scholarly findings into current practice. These EBP models lead the nurse through the decision-making process of evaluating the literature to determine the best practice evidence for the practice issue or question.

    **Professional Context**

    As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, healthcare systems, and nursing practice outcomes are positively impacted.

    **Preparation**

    Review all resources for this assessment, as well as the scoring guide for details of how this assessment will be graded. You will use the specific diagnosis or health issue you selected for Assessment 1. You can refer to the overview of common EBP models in the
    [Evidence-Based Practice Models](https://media.capella.edu/coursemedia/nurs-fpx4025element250261/wrapper.asp) media for help in choosing the most appropriate EBP model for your issue.

    **Instructions**

    Complete the following:

    · Consider your diagnosis from Assessment 1.

    · Explain an issue associated with this diagnosis that could benefit from an EBP approach.

    · Choose the EBP model you wish to implement.

    · Describe each step of the EBP model of your choice.

    · Apply the steps of the model to your search for evidence for your diagnosis issue, and describe how you applied them.

    · Locate at least three separate resources of evidence to assist with your diagnosis issue.

    · Analyze the credibility and relevance of each resource as it relates to your diagnosis.

    This is a paper and should be 3–5 pages, not including the title page or reference page. The paper must be in APA format.

    **Competencies Measured**

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

    · Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.

    · Analyze the credibility and relevance of each resource as it relates to a diagnosis.

    · Competency 3: Apply an evidence-based practice model to address a practice issue.

    · Explain an issue associated with a chosen diagnosis that could benefit from an EBP approach.

    · Describe each step of a chosen EBP model.

    · Describe how the steps of a chosen EPB model were applied to search for evidence for a diagnosis issue.

    · Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

    · Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

    · Apply APA formatting to in-text citations and references, exhibiting adherence to most aspects of APA format.

  • [Solved] Asssigment

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    – 2 years ago **files (1)** – Researchassignment2InformationDirectionsGradingCriteriaRubric1.docx **Researchassignment2InformationDirectionsGradingCriteriaRubric1.docx** This file is too large to display. [View in new window](https://www.sweetstudy.com/files/researchassignment2informationdirectionsg…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – Researchassignment2InformationDirectionsGradingCriteriaRubric1.docx

    **Researchassignment2InformationDirectionsGradingCriteriaRubric1.docx**

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    **Researchassignment2InformationDirectionsGradingCriteriaRubric1.docx**

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  • [Solved] 4k15 patho 3

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    – 2 years ago **files (1)** – ## FPX4015patho.docx **## FPX4015patho.docx** FPX4015 Assessment 3 Concept Map: The 3Ps and Mental Health Care Create a concept map of a mental health diagnosis using one of the mental health scenario case studies presented in this section of the course. Expand All **In…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## FPX4015patho.docx

    **## FPX4015patho.docx**

    FPX4015

    Assessment 3

    Concept Map: The 3Ps and Mental Health Care

    Create a concept map of a mental health diagnosis using one of the mental health scenario case studies presented in this section of the course.

    Expand All

    **Introduction**

    Concept maps are useful tools to help care providers and patients visualize the big picture of a condition. By being able to present a snapshot of symptoms, impacts, treatments, as well as contributing and risk factors, concept maps can improve communication, treatment planning, and health outcomes. Understanding how to create accurate, well-organized, and easy to understand concept maps will help you improve your efficacy as a healthcare practitioner and the outcomes of the patients you work with.

    **Instructions**

    **Before beginning this assessment, make sure that you have completed the three Sentinel U case study activities included in the assessment. These will form the basis of your assessment.**

    For this assessment you will select one of the mental health Sentinel U case study activities and create a concept map that outlines the pathophysiology, pharmacology, and physical assessment of the mental health diagnosis from your chosen case study.

    The key components of a mental health diagnosis concept map include the pathophysiology, pharmacology, and physical assessment of the diagnosis. The concept map should outline the key concepts related to the diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions. The map should be organized using a nursing concept map template, such as spider maps, hierarchical maps, or flow charts, to organize the information. The concept map should be accurate, complete, well-organized, and use appropriate nursing concepts and terminology.

    To complete your concept map, you may wish to follow these steps:

    1. Select one of the mental health Sentinel U scenarios:

    · Ivy Jackson, 61 YO, Female, African American.

    · Marco Mancini, 43 YO, Male, Mediterranean.

    · Wesley Blanco, 13 YO, Non-Binary, Filipino, White.

    2. Research the pathophysiology, pharmacology, and physical assessment of the chosen mental health diagnosis within the Sentinel-U case study.

    3. Complete the case study simulation and download the simulation report showing the patient you selected and showing 100% complete.

    4. Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

    · You may wish to use the
    [Concept Map Template [DOCX]](https://courseroom.capella.edu/courses/38703/files/6876042/download), but are also free to create your own.

    5. Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).

    Your assessment submission will be assessed on the following criteria.

    ·
    **Diagnosis:** Describe a mental health diagnosis. The diagnosis should be accurate and supported by relevant and evidence-based sources.

    · Make sure that the diagnosis is accurate and includes specific symptoms or criteria that support the diagnosis.

    · Ensure you have downloaded the completed Sentinel-U simulation report showing the patient you selected.

    ·
    **Concept Map:** Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

    · Make sure that your use of evidence to support the concept map is explicit and relevant, and that the relationships between the concepts are clearly defined.

    ·
    **Organization:** The concept map should be well-organized and easy to follow. The content should be presented in a logical and clear manner, with a clear purpose and goals.

    · Also, you should make sure that your map is visually appealing and easy to read, incorporating appropriate use of colors, shapes, and symbols.

    ·
    **Professional Communication:** The concept map should demonstrate professionalism and effective communication. The map should be free of errors and typos and should use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis to a professional audience.

    ·
    **APA format and style:** The reference list should be formatted in APA style. All sources used should be relevant to the topic and evidence-based, published within the last 5 years.

    **Additional Requirements**

    ·
    **Concept Map:** 1-page concept map that clearly organizes the 3Ps related to a mental health diagnosis, risk factors, diagnostics, complications, nursing diagnosis, and nursing interventions.

    ·
    **SIM Report:** Ensure you download the completed SIM report showing the patient selected.

    ·
    **Reference List:** Create an APA style reference list for all sources that you used to help build and support the information in your concept map. Include this in the same document as your concept map, but on its own page.

    ·
    **APA Style:** Use current APA style for all in-text citations and any current APA-approved font.

    **Competencies Measured**

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

    · Competency 2: Create evidence based interventions to address the health needs, risks, and resources of individuals from diverse backgrounds and cultures.

    · Describe a mental health diagnosis that is supported by relevant and evidence-based sources.

    · Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

    · The concept map is well-organized and easy to follow, with a clear purpose and goals.

    · Competency 4: Perform comprehensive and focused physical assessments using appropriate techniques and tools.

    · Upload the Sentinel-U case study showing the Simulation name OR showing 100% complete.

    · Competency 5: Apply scholarly writing standards to communicate evidence based strategies that support safe and effective patient care.

    · The concept map should demonstrate professionalism and effective communication, use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis.

    · The reference list is formatted in APA style. All sources used should be relevant to the topic, evidence-based, and published within the last 5 years.

    **Assessment 3**

    **Concept Map: The 3Ps and Mental Health Care**

    **## FPX4015patho.docx**

    FPX4015

    Assessment 3

    Concept Map: The 3Ps and Mental Health Care

    Create a concept map of a mental health diagnosis using one of the mental health scenario case studies presented in this section of the course.

    Expand All

    **Introduction**

    Concept maps are useful tools to help care providers and patients visualize the big picture of a condition. By being able to present a snapshot of symptoms, impacts, treatments, as well as contributing and risk factors, concept maps can improve communication, treatment planning, and health outcomes. Understanding how to create accurate, well-organized, and easy to understand concept maps will help you improve your efficacy as a healthcare practitioner and the outcomes of the patients you work with.

    **Instructions**

    **Before beginning this assessment, make sure that you have completed the three Sentinel U case study activities included in the assessment. These will form the basis of your assessment.**

    For this assessment you will select one of the mental health Sentinel U case study activities and create a concept map that outlines the pathophysiology, pharmacology, and physical assessment of the mental health diagnosis from your chosen case study.

    The key components of a mental health diagnosis concept map include the pathophysiology, pharmacology, and physical assessment of the diagnosis. The concept map should outline the key concepts related to the diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions. The map should be organized using a nursing concept map template, such as spider maps, hierarchical maps, or flow charts, to organize the information. The concept map should be accurate, complete, well-organized, and use appropriate nursing concepts and terminology.

    To complete your concept map, you may wish to follow these steps:

    1. Select one of the mental health Sentinel U scenarios:

    · Ivy Jackson, 61 YO, Female, African American.

    · Marco Mancini, 43 YO, Male, Mediterranean.

    · Wesley Blanco, 13 YO, Non-Binary, Filipino, White.

    2. Research the pathophysiology, pharmacology, and physical assessment of the chosen mental health diagnosis within the Sentinel-U case study.

    3. Complete the case study simulation and download the simulation report showing the patient you selected and showing 100% complete.

    4. Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

    · You may wish to use the
    [Concept Map Template [DOCX]](https://courseroom.capella.edu/courses/38703/files/6876042/download), but are also free to create your own.

    5. Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).

    Your assessment submission will be assessed on the following criteria.

    ·
    **Diagnosis:** Describe a mental health diagnosis. The diagnosis should be accurate and supported by relevant and evidence-based sources.

    · Make sure that the diagnosis is accurate and includes specific symptoms or criteria that support the diagnosis.

    · Ensure you have downloaded the completed Sentinel-U simulation report showing the patient you selected.

    ·
    **Concept Map:** Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

    · Make sure that your use of evidence to support the concept map is explicit and relevant, and that the relationships between the concepts are clearly defined.

    ·
    **Organization:** The concept map should be well-organized and easy to follow. The content should be presented in a logical and clear manner, with a clear purpose and goals.

    · Also, you should make sure that your map is visually appealing and easy to read, incorporating appropriate use of colors, shapes, and symbols.

    ·
    **Professional Communication:** The concept map should demonstrate professionalism and effective communication. The map should be free of errors and typos and should use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis to a professional audience.

    ·
    **APA format and style:** The reference list should be formatted in APA style. All sources used should be relevant to the topic and evidence-based, published within the last 5 years.

    **Additional Requirements**

    ·
    **Concept Map:** 1-page concept map that clearly organizes the 3Ps related to a mental health diagnosis, risk factors, diagnostics, complications, nursing diagnosis, and nursing interventions.

    ·
    **SIM Report:** Ensure you download the completed SIM report showing the patient selected.

    ·
    **Reference List:** Create an APA style reference list for all sources that you used to help build and support the information in your concept map. Include this in the same document as your concept map, but on its own page.

    ·
    **APA Style:** Use current APA style for all in-text citations and any current APA-approved font.

    **Competencies Measured**

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

    · Competency 2: Create evidence based interventions to address the health needs, risks, and resources of individuals from diverse backgrounds and cultures.

    · Describe a mental health diagnosis that is supported by relevant and evidence-based sources.

    · Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

    · The concept map is well-organized and easy to follow, with a clear purpose and goals.

    · Competency 4: Perform comprehensive and focused physical assessments using appropriate techniques and tools.

    · Upload the Sentinel-U case study showing the Simulation name OR showing 100% complete.

    · Competency 5: Apply scholarly writing standards to communicate evidence based strategies that support safe and effective patient care.

    · The concept map should demonstrate professionalism and effective communication, use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis.

    · The reference list is formatted in APA style. All sources used should be relevant to the topic, evidence-based, and published within the last 5 years.

    **Assessment 3**

    **Concept Map: The 3Ps and Mental Health Care**

  • [Solved] Book review

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    No AI/chatgpt please, message me for details – 2 years ago

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    No AI/chatgpt please, message me for details

    – 2 years ago

  • [Solved] PLAGIARISM FREE “A” WORK IN 12 HOURS

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    PLEASE UPLOAD EACH DISCUSSION RESPONSE SEPARATELY – 2 years ago

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    PLEASE UPLOAD EACH DISCUSSION RESPONSE SEPARATELY

    – 2 years ago

  • [Solved] Health

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    – 2 years ago **files (1)** – ## Casestudy4.docx **## Casestudy4.docx** Identify the steps in the system selection process with graphic examples demonstrating the use of project management tools; e.g. Gantt and PERT charts. (no references needed) Please see the below for more insight. Word count 200…

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    – 2 years ago

    **files (1)**

    – ## Casestudy4.docx

    **## Casestudy4.docx**

    Identify the steps in the system selection process with graphic examples demonstrating the use of project management tools; e.g. Gantt and PERT charts. (no references needed) Please see the below for more insight. Word count 200 (please remain as a word doc)

    ![A book with text and blue circles AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/health-20884019)

    ## image1.jpg

    **## Casestudy4.docx**

    Identify the steps in the system selection process with graphic examples demonstrating the use of project management tools; e.g. Gantt and PERT charts. (no references needed) Please see the below for more insight. Word count 200 (please remain as a word doc)

    ![A book with text and blue circles AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/health-20884019)

    ## image1.jpg

  • [Solved] case study

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    please see attachment – 2 years ago **files (1)** – ## Week6casestudy.docx **## Week6casestudy.docx** Review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references within 5 years. Answer the case studies on the same document. The answers must b…

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    please see attachment

    – 2 years ago

    **files (1)**

    – ## Week6casestudy.docx

    **## Week6casestudy.docx**

    Review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references within 5 years. Answer the  case studies on the same document.

    The answers must be in your own words with reference to the journal or book where you found the evidence to your answer.

    Copy-paste from websites or textbooks will not be accepted or tolerated.  Copy-paste from websites (chat gtp) or textbooks will not be accepted or tolerated. 0% plagiarism No artificial intelligence

    All answers to case studies must-have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites)  per case Study

    case study

    Bertha, a 58 – year – old Hispanic female, presents to the primary care clinic to establish care. She states that in 1985 she received a blood transfusion after sustained an MVA. She had tested positive for hepatitis C virus ( HCV ) in the past, but ignored any advice regarding treatment options. She brings a previous lab result with her today that shows :(ALT) level of 85 IU/mL (range 8 – 35 IU/mL). The lab form also states, “ HCV antibody is positive by enzyme immunoassay — confirmation is suggested. The patient also arrived with diagnosis with exacerbation of A-Fib (pulse 110 beats per mint. and COPD exacerbation as well (O2 sat: 87%)

    Past medical h story: Hypertension, dyslipidemia, hepatitis C.

    Family history: Unremarkable

    Social history: She works as a case manager of an HMO and is married with 2 children. Denies use of illegal drugs, denies alcohol abuse, and has no tattoos.

    Medications: HCTZ, 12,5 mg daily; Atorvastatin 20 mg daily, Metoprolol Succinate 25 mg and Pro-Air HFA 90mcg one puff q 4- 6 hrs as needed x pain.

    Allergies: No known drug or food allergies.

    OBJECTIVE General a ppearance: 58 – year – old female; pleasant, in no acute distress; good eye contact. Vital signs: T: 96.8; P: 110; RR: 23; SaO 2 : 87; BP: 150/100. Her weight is 214 lb, and her height is 6.3 inches.

    HEENT : Negative. Neck: Thyroid nonpalpable. No lymphadenopathy.

    Cardiovascular: A-fib rhythm. irregular and rapid heartbeat.

    Respiratory: Crackles and Wheezing.

    Abdomen: Mild tenderness in right upper quadrant. BS x 4 no bruits. Nondistended, soft. No organomegaly. No ascites.

    Neurological: A & O × 4, CN II – XII grossly intact.

    Depression scale: negative. Musculoskeletal: Full ROM. No deformities. Muscle strength is 5/5.

    **CRITICAL THINKING**

    **Which diagnostic or imaging studies should be considered confirm the**

    **diagnosis?**

    **What is the most likely differential diagnosis?**

    **What is your plan of treatment?**

    **Are there any emergency referrals needed?**

    **What is first line treatment for AFib in patients with the mentioned comorbidities?**

    **What is the first line of treatment for COPD exacerbation?**

    **## Week6casestudy.docx**

    Review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references within 5 years. Answer the  case studies on the same document.

    The answers must be in your own words with reference to the journal or book where you found the evidence to your answer.

    Copy-paste from websites or textbooks will not be accepted or tolerated.  Copy-paste from websites (chat gtp) or textbooks will not be accepted or tolerated. 0% plagiarism No artificial intelligence

    All answers to case studies must-have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites)  per case Study

    case study

    Bertha, a 58 – year – old Hispanic female, presents to the primary care clinic to establish care. She states that in 1985 she received a blood transfusion after sustained an MVA. She had tested positive for hepatitis C virus ( HCV ) in the past, but ignored any advice regarding treatment options. She brings a previous lab result with her today that shows :(ALT) level of 85 IU/mL (range 8 – 35 IU/mL). The lab form also states, “ HCV antibody is positive by enzyme immunoassay — confirmation is suggested. The patient also arrived with diagnosis with exacerbation of A-Fib (pulse 110 beats per mint. and COPD exacerbation as well (O2 sat: 87%)

    Past medical h story: Hypertension, dyslipidemia, hepatitis C.

    Family history: Unremarkable

    Social history: She works as a case manager of an HMO and is married with 2 children. Denies use of illegal drugs, denies alcohol abuse, and has no tattoos.

    Medications: HCTZ, 12,5 mg daily; Atorvastatin 20 mg daily, Metoprolol Succinate 25 mg and Pro-Air HFA 90mcg one puff q 4- 6 hrs as needed x pain.

    Allergies: No known drug or food allergies.

    OBJECTIVE General a ppearance: 58 – year – old female; pleasant, in no acute distress; good eye contact. Vital signs: T: 96.8; P: 110; RR: 23; SaO 2 : 87; BP: 150/100. Her weight is 214 lb, and her height is 6.3 inches.

    HEENT : Negative. Neck: Thyroid nonpalpable. No lymphadenopathy.

    Cardiovascular: A-fib rhythm. irregular and rapid heartbeat.

    Respiratory: Crackles and Wheezing.

    Abdomen: Mild tenderness in right upper quadrant. BS x 4 no bruits. Nondistended, soft. No organomegaly. No ascites.

    Neurological: A & O × 4, CN II – XII grossly intact.

    Depression scale: negative. Musculoskeletal: Full ROM. No deformities. Muscle strength is 5/5.

    **CRITICAL THINKING**

    **Which diagnostic or imaging studies should be considered confirm the**

    **diagnosis?**

    **What is the most likely differential diagnosis?**

    **What is your plan of treatment?**

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    The Roman Empire was one of the most fascinating civilizations in history. It started in 27 BCE and lasted until 476 CE in the West, but the Eastern part, known as the Byzantine Empire, kept going for much longer. It covered a vast area and had a significant impact on the world through impressive buildings, strong rulers, and a unique culture. From amazing roads and aqueducts to timeless contributions to philosophy and law, the Romans definitely impacted modern society.

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