Tag: Clinical Nursing & Patient Care

  • [Solved] policy

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  • [Solved] Quality Improvement project

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    – 2 years ago **files (1)** – ## QualityImprovementProject-Spring2025LeadershipinProfessionalNursingNURS-4561-01B-TexasAM-Commerce.pdf **## QualityImprovementProject-Spring2025LeadershipinProfessionalNursingNURS-4561-01B-TexasAM-Commerce.pdf** Quality Improvement Project Hide Assignment Information …

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    – 2 years ago

    **files (1)**

    – ## QualityImprovementProject-Spring2025LeadershipinProfessionalNursingNURS-4561-01B-TexasAM-Commerce.pdf

    **## QualityImprovementProject-Spring2025LeadershipinProfessionalNursingNURS-4561-01B-TexasAM-Commerce.pdf**

    Quality Improvement Project

    Hide Assignment Information

    Instructions

    Spring 2025 Leadership in Professional Nursing (NURS-… SD

    Assignments Quality Improvement Project

    The purpose of this assignment is to immerse the BSN student in an active quality
    improvement (QI) initiative on their assigned unit, critically analyze its
    implementation, and contribute meaningfully to its success. The student will explore
    the rationale behind the project, assess its effectiveness, and propose or participate
    in a small-scale audit or data collection effort to support the initiative.

    Assignment Details:

    1. Identify the Quality Improvement Project

    Meet with your unit preceptor or nurse manager to discuss the current quality
    improvement (QI) projects on your assigned unit.

    Select one project to analyze (e.g., reducing hospital-acquired pressure injuries
    (HAPIs), improving hand hygiene compliance, reducing fall rates, enhancing
    pain reassessment documentation, etc.).

    Provide a summary (300-500 words) of the QI initiative, including:

    The problem it addresses

    The goals and expected outcomes

    How the unit is implementing the initiative (e.g., new protocols, staff
    education, process changes)

    2. Review Best Practices & Evidence

    Conduct a brief literature review (at least two peer-reviewed sources within
    the last five years) related to the QI topic.

    Summarize evidence-based practices that support the initiative (250-300
    words).

    Compare the unit’s approach with best practices found in the literature.

    3. Participate in the Initiative

    Engage in the project by completing a small-scale audit, observation, or data
    collection process. Examples include:

    For a HAPI reduction project: Conduct audits on whether staff are
    adhering to the turning schedule and provide feedback.

    4/14/25, 9:30 AM Quality Improvement Project – Spring 2025 Leadership in Professional Nursing (NURS-4561-01B) – Texas A&M – Commerce

    https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=256109&grpid=0&isprv=0&bp=0&ou=181927 1/3

    [https://myleoonline.tamuc.edu/d2l/home/181927](https://myleoonline.tamuc.edu/d2l/home/181927)

    [https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folders_list.d2l?ou=181927](https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folders_list.d2l?ou=181927)

    For a falls prevention project: Observe whether fall risk precautions are
    consistently in place (e.g., bed alarms, signage, non-slip socks).

    For a hand hygiene initiative: Perform hand hygiene compliance checks
    during your shift.

    Record at least 10 observations and summarize your findings in a table or
    spreadsheet.

    Reflect on your observations: Are staff following the protocol? What barriers
    do they face?

    4. Provide Feedback & Recommendations

    Compile a one-page report summarizing your findings and submit it to your
    preceptor or nurse manager.

    Include:

    The number of audits conducted and findings

    Strengths of the process implementation

    Barriers or challenges you observed

    At least one recommendation to improve compliance or effectiveness

    5. Reflect on Your Role as a Future Nurse

    In a 500-word reflection, discuss:

    Your role in supporting QI as a student and future RN

    How frontline nurses can drive meaningful change

    What you learned from participating in this initiative

    Submission Format: Word document, submitted via LMS

    Evaluation Criteria:

    Component Points Criteria

    QI Project Summary 20
    Clearly describes the project, rationale, and goals
    (300-500 words)

    Literature Review 20
    Uses recent evidence; connects to unit initiative
    (250-300 words, 2+ peer-reviewed sources)

    Data Collection 20
    Completes audit with at least 10 observations
    (at least 10 observations)

    Manager Report 20
    Summarizes findings, identifies barriers, and gives
    recommendations
    (one page)

    Reflection 20
    Thoughtfully reflects on learning and role in QI
    (500 words)

    Total 100 (Pass 85-100 points)

    4/14/25, 9:30 AM Quality Improvement Project – Spring 2025 Leadership in Professional Nursing (NURS-4561-01B) – Texas A&M – Commerce

    https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=256109&grpid=0&isprv=0&bp=0&ou=181927 2/3

    Add a File Record Audio Record Video

    Due on Apr 27, 2025 11:59 PM

    Submit Assignment

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    Comments

    4/14/25, 9:30 AM Quality Improvement Project – Spring 2025 Leadership in Professional Nursing (NURS-4561-01B) – Texas A&M – Commerce

    https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=256109&grpid=0&isprv=0&bp=0&ou=181927 3/3

    **## QualityImprovementProject-Spring2025LeadershipinProfessionalNursingNURS-4561-01B-TexasAM-Commerce.pdf**

    Quality Improvement Project

    Hide Assignment Information

    Instructions

    Spring 2025 Leadership in Professional Nursing (NURS-… SD

    Assignments Quality Improvement Project

    The purpose of this assignment is to immerse the BSN student in an active quality
    improvement (QI) initiative on their assigned unit, critically analyze its
    implementation, and contribute meaningfully to its success. The student will explore
    the rationale behind the project, assess its effectiveness, and propose or participate
    in a small-scale audit or data collection effort to support the initiative.

    Assignment Details:

    1. Identify the Quality Improvement Project

    Meet with your unit preceptor or nurse manager to discuss the current quality
    improvement (QI) projects on your assigned unit.

    Select one project to analyze (e.g., reducing hospital-acquired pressure injuries
    (HAPIs), improving hand hygiene compliance, reducing fall rates, enhancing
    pain reassessment documentation, etc.).

    Provide a summary (300-500 words) of the QI initiative, including:

    The problem it addresses

    The goals and expected outcomes

    How the unit is implementing the initiative (e.g., new protocols, staff
    education, process changes)

    2. Review Best Practices & Evidence

    Conduct a brief literature review (at least two peer-reviewed sources within
    the last five years) related to the QI topic.

    Summarize evidence-based practices that support the initiative (250-300
    words).

    Compare the unit’s approach with best practices found in the literature.

    3. Participate in the Initiative

    Engage in the project by completing a small-scale audit, observation, or data
    collection process. Examples include:

    For a HAPI reduction project: Conduct audits on whether staff are
    adhering to the turning schedule and provide feedback.

    4/14/25, 9:30 AM Quality Improvement Project – Spring 2025 Leadership in Professional Nursing (NURS-4561-01B) – Texas A&M – Commerce

    https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=256109&grpid=0&isprv=0&bp=0&ou=181927 1/3

    [https://myleoonline.tamuc.edu/d2l/home/181927](https://myleoonline.tamuc.edu/d2l/home/181927)

    [https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folders_list.d2l?ou=181927](https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folders_list.d2l?ou=181927)

    For a falls prevention project: Observe whether fall risk precautions are
    consistently in place (e.g., bed alarms, signage, non-slip socks).

    For a hand hygiene initiative: Perform hand hygiene compliance checks
    during your shift.

    Record at least 10 observations and summarize your findings in a table or
    spreadsheet.

    Reflect on your observations: Are staff following the protocol? What barriers
    do they face?

    4. Provide Feedback & Recommendations

    Compile a one-page report summarizing your findings and submit it to your
    preceptor or nurse manager.

    Include:

    The number of audits conducted and findings

    Strengths of the process implementation

    Barriers or challenges you observed

    At least one recommendation to improve compliance or effectiveness

    5. Reflect on Your Role as a Future Nurse

    In a 500-word reflection, discuss:

    Your role in supporting QI as a student and future RN

    How frontline nurses can drive meaningful change

    What you learned from participating in this initiative

    Submission Format: Word document, submitted via LMS

    Evaluation Criteria:

    Component Points Criteria

    QI Project Summary 20
    Clearly describes the project, rationale, and goals
    (300-500 words)

    Literature Review 20
    Uses recent evidence; connects to unit initiative
    (250-300 words, 2+ peer-reviewed sources)

    Data Collection 20
    Completes audit with at least 10 observations
    (at least 10 observations)

    Manager Report 20
    Summarizes findings, identifies barriers, and gives
    recommendations
    (one page)

    Reflection 20
    Thoughtfully reflects on learning and role in QI
    (500 words)

    Total 100 (Pass 85-100 points)

    4/14/25, 9:30 AM Quality Improvement Project – Spring 2025 Leadership in Professional Nursing (NURS-4561-01B) – Texas A&M – Commerce

    https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=256109&grpid=0&isprv=0&bp=0&ou=181927 2/3

    Add a File Record Audio Record Video

    Due on Apr 27, 2025 11:59 PM

    Submit Assignment

    Files to submit

    (0) file(s) to submit

    After uploading, you must click Submit to complete the submission.

    Comments

    4/14/25, 9:30 AM Quality Improvement Project – Spring 2025 Leadership in Professional Nursing (NURS-4561-01B) – Texas A&M – Commerce

    https://myleoonline.tamuc.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?db=256109&grpid=0&isprv=0&bp=0&ou=181927 3/3

  • [Solved] HEAD TO TOE

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    PLEASE SEE THE ATTACHED RUBRIC TO COMPLETE THIS HEAD TO TOE ASSIGNMENT NO PLAGIO MORE THAN 10% ALLOWED WILL BE SUBMIT IT BY TURNIN IN Assignment should be a narrative following the APA 7th edition format and must include: · Head-to-toe assessment tailored for the patient as RUBRIC REQUIRE · Diagnost…

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    Assignment Prompt & Instructions

    PLEASE SEE THE ATTACHED RUBRIC TO COMPLETE THIS HEAD TO TOE ASSIGNMENT

    NO PLAGIO MORE THAN 10% ALLOWED WILL BE SUBMIT IT BY TURNIN IN

    Assignment should be a narrative following the APA 7th edition format and must include:

    ·      Head-to-toe assessment tailored for the patient as RUBRIC REQUIRE

    ·      Diagnostic tests with expected findings and patient education about the test (i.e., fasting).

    ·      References from peer-reviewed resources within the past five years.

    CASE:

    34-y/o-Male, BMI 17

    Dx: Hodgkin lymphoma

    Hx: Infectious mononucleosis, seasonal allergies, current hydrocele

    DUE DATE APRIL 15, 2025

    – [\
    \
    RubricHeat-to-Toeassignment-MSN5600.pdf](https://www.sweetstudy.com/files/rubricheat-to-toeassignment-msn5600-pdf "RubricHeat-to-Toeassignment-MSN5600.pdf")

    – 2 years ago

  • [Solved] Health Assessment Discussion 5

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    – 2 years ago **files (1)** – ## HAdiscussion5.docx **## HAdiscussion5.docx** Take on the role of a clinician who is building a health history Chief Complaint **:**“neck swelling” History of Present Illness (HPI): A 42-year-old African American female who refers that she has been noticing slow and p…

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    – 2 years ago

    **files (1)**

    – ## HAdiscussion5.docx

    **## HAdiscussion5.docx**

    Take on the role of a clinician who is building a health history

    Chief Complaint
    **:**“neck swelling”
    History of Present Illness (HPI): A 42-year-old African American female who refers that she has been noticing slow and progressive swelling on her neck for about a year. Also she stated she has lost weight without any food restriction.

    PMH: Patient denies

    PSH: Surgical removal of benign left breast nodule 2 years ago

    Drug Hx: No medication at the time.

    Allergies: NKA

    Subjective: Mild difficult to shallow, Neck feels tight, Pt states she feels Palpitations

    **Objective Data**

    PE: B/P 158/90; Pulse 102; RR 20; Temp 99.2; Ht 5,4; wt 114; BMI 19.6

    General: 42-year-old female appears thin. She is anxious – pacing in the room and fidgeting, but in no acute distress.

    HEENT: Bulging eyes

    Neck: Diffuse enlargement of the thyroid gland

    Lungs: CTA AP&L

    A
    **bd:** benign, normoactive bowel sounds x 4

    GU:  Non contributory

    Ext: no cyanosis, clubbing or edema

    Integument: Thin skin, Increase moisture

    Neuro: No obvious deficits and CN grossly intact II-XII

    1.
    **What other subjective data would you obtain?**

    2.
    **What other objective findings would you look for?**

    3.
    **What diagnostic exams do you want to order?**

    4.
    **Name 3 differential diagnoses based on this patient presenting symptoms?**

    5.
    **Give rationales for your each differential diagnosis.**

    **500 words, APA style, 2 academic resources**

    **## HAdiscussion5.docx**

    Take on the role of a clinician who is building a health history

    Chief Complaint
    **:**“neck swelling”
    History of Present Illness (HPI): A 42-year-old African American female who refers that she has been noticing slow and progressive swelling on her neck for about a year. Also she stated she has lost weight without any food restriction.

    PMH: Patient denies

    PSH: Surgical removal of benign left breast nodule 2 years ago

    Drug Hx: No medication at the time.

    Allergies: NKA

    Subjective: Mild difficult to shallow, Neck feels tight, Pt states she feels Palpitations

    **Objective Data**

    PE: B/P 158/90; Pulse 102; RR 20; Temp 99.2; Ht 5,4; wt 114; BMI 19.6

    General: 42-year-old female appears thin. She is anxious – pacing in the room and fidgeting, but in no acute distress.

    HEENT: Bulging eyes

    Neck: Diffuse enlargement of the thyroid gland

    Lungs: CTA AP&L

    A
    **bd:** benign, normoactive bowel sounds x 4

    GU:  Non contributory

    Ext: no cyanosis, clubbing or edema

    Integument: Thin skin, Increase moisture

    Neuro: No obvious deficits and CN grossly intact II-XII

    1.
    **What other subjective data would you obtain?**

    2.
    **What other objective findings would you look for?**

    3.
    **What diagnostic exams do you want to order?**

    4.
    **Name 3 differential diagnoses based on this patient presenting symptoms?**

    5.
    **Give rationales for your each differential diagnosis.**

    **500 words, APA style, 2 academic resources**

  • [Solved] week 6-patho

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    **Musculoskeletal Function:** G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn…

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    **Musculoskeletal Function:**

    G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed.

    **Case Study Questions**

    1. Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
    2. Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
    3. Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
    4. How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.

    **Neurological Function:**

    H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week.

    Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.

    **Case Study Questions**

    1. Name the most common risks factors for Alzheimer’s disease
    2. Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
    3. Define and describe explicit and implicit memory.
    4. Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
    5. What would be the best therapeutic approach on C.J.

    **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.

    – 2 years ago

  • [Solved] AI

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    See attached – 2 years ago **files (1)** – ## ArtificialIntelligence.docx **## ArtificialIntelligence.docx** Artificial Intelligence Artificial intelligence is a rapidly growing field with applications in many areas of healthcare. Review the literature and find an application that can help healthcar…

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    See attached

    – 2 years ago

    **files (1)**

    – ## ArtificialIntelligence.docx

    **## ArtificialIntelligence.docx**

    Artificial Intelligence

    Artificial intelligence is a rapidly growing field with applications in many areas of healthcare. Review the literature and find an application that can help healthcare providers treat patients with chronic illness. Describe the specific condition and how AI might help manage the care. Specify if the AI resource is designed for the patient or the provider. What is at least one way AI might be used by the patient themselves to increase their self-efficacy and self-care for their illness and health promotion. Finally, what are the drawbacks or risks of using AI for this situation? Is there a cost associated with the usage? Include the AI application in your reference list, in addition to at least one high-level scholarly reference.

    Application: Sepsis Watch by Duke University Health System
    [https://physicians.dukehealth.org/articles/dukes-augmented-intelligence-system-helps-prevent-sepsis-ed](https://physicians.dukehealth.org/articles/dukes-augmented-intelligence-system-helps-prevent-sepsis-ed)

    **## ArtificialIntelligence.docx**

    Artificial Intelligence

    Artificial intelligence is a rapidly growing field with applications in many areas of healthcare. Review the literature and find an application that can help healthcare providers treat patients with chronic illness. Describe the specific condition and how AI might help manage the care. Specify if the AI resource is designed for the patient or the provider. What is at least one way AI might be used by the patient themselves to increase their self-efficacy and self-care for their illness and health promotion. Finally, what are the drawbacks or risks of using AI for this situation? Is there a cost associated with the usage? Include the AI application in your reference list, in addition to at least one high-level scholarly reference.

    Application: Sepsis Watch by Duke University Health System
    [https://physicians.dukehealth.org/articles/dukes-augmented-intelligence-system-helps-prevent-sepsis-ed](https://physicians.dukehealth.org/articles/dukes-augmented-intelligence-system-helps-prevent-sepsis-ed)

  • [Solved] Help

    ✓ Verified Academic Solution Available

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    In-depth study guidance and analytical solution covering Help.

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    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.

  • [Solved] Help

    ✓ Verified Academic Solution Available

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    In-depth study guidance and analytical solution covering Help.

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    Assignment Prompt & Instructions

    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.

  • [Solved] MINI SOAP NOTE

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    DON'T USE CHATGPT, OR COPY AND PASTE ANYTHING. I AM ASKING FOR HELP, I CAN COPY AND PASTE MYSELF. – 2 years ago **files (1)** – ## Week6MiniSoapnote1.pdf **## Week6MiniSoapnote1.pdf** Submit 1 Mini-SOAP note on a patient that you saw in clinic this week. Submit as a Word Document. See example templa…

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    DON'T USE CHATGPT, OR COPY AND PASTE ANYTHING.

    I AM ASKING FOR HELP, I CAN COPY AND PASTE MYSELF.

    – 2 years ago

    **files (1)**

    – ## Week6MiniSoapnote1.pdf

    **## Week6MiniSoapnote1.pdf**

    Submit 1 Mini-SOAP note on a patient that you saw in clinic this week. Submit as a Word
    Document. See example template below for required format.

    Review the rubric for more information on how your assignment will be graded.

    Demographic Data

    • Age, and gender (must be HIPAA compliant)

    Subjective

    • Chief Complaint (CC) unless an Annual Physical Exam (APE)
    • History of Present Illness (HPI) in paragraph form (remember OLDCART: Onset, Location,

    Duration, Characteristics, Aggravating/Alleviating Factors, Relieving Factors, Treatment)
    • Past Med. Hx (PMH): Medical or surgical problems, hospitalizations, medications, allergies,

    immunizations, and preventative health maintenance as applicable
    • Family Hx: As applicable
    • Social Hx: Including nutrition, exercise, substance use, sexual hx, occupation, school, etc.
    • Review of Systems (ROS) as appropriate: Include health maintenance (e.g., eye, dental, pap,

    vaccines, colonoscopy)

    Objective

    • Vital signs
    • Physical findings listed by body systems, not paragraph form

    Assessment (Diagnosis/ICD10 Code)

    • Include all diagnoses that apply for this visit

    Plan

    • Dx Plan (lab, x-ray)
    • Tx Plan: (meds)
    • Pt. Education, including specific medication teaching points
    • Referral/Follow-up
    • Health maintenance (including when screenings, immunizations, etc., are next due):

    **## Week6MiniSoapnote1.pdf**

    Submit 1 Mini-SOAP note on a patient that you saw in clinic this week. Submit as a Word
    Document. See example template below for required format.

    Review the rubric for more information on how your assignment will be graded.

    Demographic Data

    • Age, and gender (must be HIPAA compliant)

    Subjective

    • Chief Complaint (CC) unless an Annual Physical Exam (APE)
    • History of Present Illness (HPI) in paragraph form (remember OLDCART: Onset, Location,

    Duration, Characteristics, Aggravating/Alleviating Factors, Relieving Factors, Treatment)
    • Past Med. Hx (PMH): Medical or surgical problems, hospitalizations, medications, allergies,

    immunizations, and preventative health maintenance as applicable
    • Family Hx: As applicable
    • Social Hx: Including nutrition, exercise, substance use, sexual hx, occupation, school, etc.
    • Review of Systems (ROS) as appropriate: Include health maintenance (e.g., eye, dental, pap,

    vaccines, colonoscopy)

    Objective

    • Vital signs
    • Physical findings listed by body systems, not paragraph form

    Assessment (Diagnosis/ICD10 Code)

    • Include all diagnoses that apply for this visit

    Plan

    • Dx Plan (lab, x-ray)
    • Tx Plan: (meds)
    • Pt. Education, including specific medication teaching points
    • Referral/Follow-up
    • Health maintenance (including when screenings, immunizations, etc., are next due):

  • [Solved] discussion 5 pharm

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    – 2 years ago **files (1)** – ## DISCUSSION5Module5Pharm.docx **## DISCUSSION5Module5Pharm.docx** ![A screenshot of a medical discussion AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/discussion-5-pharm-20899491) ![](https://www.sweetstudy.com/questions/discussion-5-pha…

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    – 2 years ago

    **files (1)**

    – ## DISCUSSION5Module5Pharm.docx

    **## DISCUSSION5Module5Pharm.docx**

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    **## DISCUSSION5Module5Pharm.docx**

    ![A screenshot of a medical discussion AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/discussion-5-pharm-20899491)

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