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NRP511 Advanced Pathophysiology

Week 2 Assignment

Blood Count (CBC) Reports

Assignment Content

As an FNP, you will be expected to be proficient at interpreting complete blood count (CBC) results so that you can make an accurate diagnosis in identifying anemia, infection, and leukemia.

Review the 3 complete blood count reports below to answer the questions.

CBC Report #1

CBC Report #1

Question 1The above hemogram is most consistent with:

B12 or folate deficiency

Iron deficiency anemia

Anemia of chronic disease

Question 2The above hemogram RBCs are:

Microcytic, hyperchromic 

Macrocytic, hypochromic

Microcytic, hypochromic

CBC Report #2

CBC Report #2

Question 3The above hemogram is most consistent with:

Anemia of chronic disease

Pernicious anemia

Iron deficiency anemia

Question 4The above hemogram RBCs are:

Normocytic, normochromic

Macrocytic, normochromic

Microcytic, hyperchromic

CBC Report #3

CBC Report #3

Question 5The above hemogram is most consistent with:

Iron deficiency anemia

Anemia of chronic disease

B12 or folate deficiency

Question 6The above hemogram RBCs are:

Macrocytic, normochromic

Macrocytic, hypochromic

Microcytic, hyperchromic

 

NRP511 Advanced Pathophysiology

Week 3 Assignment

Signature Assignment: Patient Diagnosis Case Study: Metabolic Syndrome

This week you focused on cardiovascular health. Now it is time to apply your knowledge by completing a case study on metabolic syndrome.

For this assignment, you will use UpToDate from the Nursing Resources page to search for and locate evidence-based guidelines to answer the questions within the case study.

Complete the Patient Diagnosis Case Study: Metabolic Syndrome.

Submit your assignment. Use APA format. Do not type your answers into the attached document. Use in text citation and include a reference list.

Feel free to submit a draft to me via email BEFORE the assignment is due for comments

                                       

NRP511 Advanced Pathophysiology

Week 5 Assignment

Patient Diagnosis Case Study: Asthma

Based on the knowledge you have gained up to this point, it is time to apply your skills to complete a case study for a patient presenting with asthma exacerbation.

For this assignment, you will use UpToDate from the Nursing Resources page to search for and locate evidence-based guidelines to answer the questions within the case study.

Complete the Patient Diagnosis Case Study: Asthma. Use APA format. Do not type your answers into the attached document. Use intext citation. Include a reference list.

 

NRP511 Advanced Pathophysiology

Week 6 Assignment

Patient Diagnosis Case Study: Migraine

Assignment Content

Based on the knowledge you have gained up to this point, it is time to apply your skills to complete a case study for a patient presenting with a migraine.

Read the patient scenario and answer the following questions.

Patient Scenario

 A 34-year-old female patient presents to your primary care clinic and complains of a headache.

Note: You have two attempts. You can choose to just do it all on one attempt. However, because it is a case study, go in the first time and copy down the questions and answers work on it, then go back in later on your second attempt and answer the questions. Do not put in any answers on your first attempt. You should receive a 0. This should not be an opportunity to play with the correct or wrong answers. If you put in answers on the first attempt (or get a score other than 0) I will count this as your attempt.

Question 1As you consider potential diagnoses, select all options that are not considered to be possible serious and/or life-threatening etiologies.

Brain Tumor

Meningitis

Giant Cell/Temporal Arteritis

Cerebrovascular Disease (AVM)

Infection

Primary Migraine Dysfunction Disorder (PMDD)

Hemicrania

Question 2What is a possible cause for Cluster type headaches? Choose the best answer.

Occipital and/or Trigeminal Neuralgia

Trigeminal and Hemicrania Neuralgia

Overactivation of the Vagus and Occipital Nerve

Pineal dysfunction

Question 3You realize that you would like to evaluate this patient further for any “Red Flags.” Which of the following questions would not be appropriate to ask in the context of red flags? Select all that apply.

Is this your first/worst headache or is this different than previously?

Have you had any fever or weight loss?

Did it occur suddenly? (thunderclap)

Have you noticed difficulty moving your extremities or difficulty with speech or vision?

Have you had any nausea or vomiting?

Does this occur on both sides of your head?

Have you had recent trauma or injury?

Did your first headache occur before you were 30 years old?

Question 4You have determined that there are no redflags and want to better characterize her chief complaint. She states that her headaches are usually unilateral and can throb. She thinks she gets headaches about 15-18 days a month and they tend to last 1-2 days each episode. She appears to most likely be experiencing:

Atypical tension type headaches

Migraines

Uncomplicated cluster type headache

A slow brain bleed (subarachnoid hemorrhage)

Menstrual headaches with migraine feature

Question 5Before you discuss treatment, you decide you want to explore her symptoms and condition a bit further now that you have an idea about the diagnosis. You would ask all the following relevant questions except:

Do you have associated nausea/vomiting?

Have you missed any work or had limited ability to perform ADL’s due to this?

Do you have photophobia?

What remedies have you tried to make this better?

Do you have low back pain?

Do you notice worsening symptoms during or around menstruation?

Question 6Now that the patient’s condition is evaluated you begin to consider treatment options and recommendations. As a part of this,you will need to provide the patient with the following education during the visit. Which statements should not be included? Select all that apply.

You appear to be suffering from migraine syndrome and this is a chronic disease.

NSAID have been shown to provide benefit in improving attacks, take as much as you need.

There could be multiple triggers which you can try to minimize, such as avoiding certain foods.

Adequate sleep is important.

It may be possible to reduce or prevent your headaches with treatment.

Antidepressants probably won’t help at all.

 

NRP511 Advanced Pathophysiology

Week 7 Assignment

Patient Diagnosis Case Study: Pain Management

Read the patient scenario and answer the following questions.

Note: You have two attempts. You can choose to just do it all on one attempt. However, because it is a case study, go in the first time and copy down the questions and answers work on it, then go back in later on your second attempt and answer the questions. Do not put in any answers on your first attempt. You should receive a 0. This should not be an opportunity to play with the correct or wrong answers. If you put in answers on the first attempt (or get a score other than 0) I will count this as your attempt.

Patient Scenario

A 41-year-old male patient presents to your primary care clinic and complains of “pain all over my body”. He reports this has been ongoing for many years but now seems to be worsening in the last 3 months. There was no incident that seemed to trigger the symptoms.

Question 1Complaints of generalized body wide pain can be difficult to properly diagnose and likewise treat. From the list provided, which are not possible etiologies that would explain his pain? Select all that apply.

Complex Regional Pain Syndrome (CRPS)

Fibromyalgia

Autoimmune disease (rheumatism)

NSAID overuse disorder

Depression

Myofascial pain syndrome

Thyroid Disease

Peripheral Vascular disease

Question 2In order to narrow down the possible diagnosis you realize you should try to determine whether the pain is more of a central sensitization issue versus neuropathic versus nociceptive. Which of the following is an example of an etiology related to central sensitization?

Fibromyalgia

Degenerative Disc Disease (DDD)

Stroke

Pain secondary to a torn medial meniscus

Question 3Now that you have a short list in your mind of the possibilities, you decide to further explore the complaint of “body wide pain”. Based on the list of questions provided below, which 2 questions would you not ask to better characterize “body wide pain”? You decide you should ask all the following to better characterize the pain except:

Can you pinpoint where you feel your pain?

Do you have pain in your large or small joints or both?

Does the pain get worse with activity or at different times of day?

Do you want some pain medication today?

Do you have any family history of autoimmune disease?

Have you felt sad lately or had trouble sleeping?

Do you take your blood pressure medication as prescribed?

Question 4The patient has responded to your questions with the following:

My joints hurt sometimes but not every day. The pain does not travel, and it is more achy feeling. I seem to sleep fine and I’m not sad. The pain is usually worse with activity. I think my mom may have had Lupus or something.

Which 2 of the following options seem to be the most likely etiology?

Fibromyalgia

Spine etiology

Rheumatism

Osteoarthritis

Lyme Disease

Question 5Before you discuss treatment, you decide you want to explore in more depth the treatments the patient has already tried. You ask all the of following pertinent and appropriate questions except: (select 1)

Have you been to physical therapy in the last 6 months?

Do you use OTC medications to try to alleviate pain?

Have you seen a Chiropractor or tried acupuncture in the last 6 months?

Have you tried any injection-based therapy?

Have you tried ice/heat/stretching?

Are you addicted to opiates?

Question 6The patient responds “Nothing works” but does not seem to have tried anything you asked other than some over the counter (OTC) medication. Now that the patient’s condition is better evaluated, you begin to consider treatment options and recommendations.

Review the following statements which will serve as the patient education you will deliver during the visit. Which 2 statements should not be included as part of your patient education?

You may be suffering from spine pain secondary to degenerative disease. This is a chronic disease…

NSAID have been shown to provide benefit in improving this pain, take as much as you need.

The key to managing this type of disease is to engage in multi-modal treatment with the goal being to make slow steady progress.

Opiates are not indicated in managing this kind of chronic disease.

If you don’t improve after initial attempts at treatment, we may have you undergo further testing.

Medications should be the only thing you need to make your pain go away.

It is also possible you may have pain from rheumatological etiology. Should you fail to improve, we can consider consultation and further testing.

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