Simulation Shirley Williamson

Answer

1. Date:

   Student Name:                                            ATI Health Assess Patient:

    

   1. What subjective data did you collect prior to beginning the physical assessment?

    

   ASSESSMENT DATA

   Subjective:                                             Comments/Responses:

    

   HEENT	Patient reports uncomfortable cramping, diarrhea and vomiting
   PULMONARY	Patient says she has no SOB
   CARDIOVASCULAR	Patient reports mild palpitations
   GI	Patient reports stomach discomfort, abdominal pain and occasional nausea. The patient denies diarrhea
   GU	Patient denies a burning sensation during urination, but reports mild abdominal pain
   NEURO	Patient denies effect from painful stimuli like bright light
   MUSCULOSKELETAL	Patient reports some mild joint pain especially after strenuous physical activity. Patient denies any strain in movement
   INTEGUMENT	Patient says, “I have periodic abnormal rise in temperature during which I heavily sweat”. Patient denies unusual skin dryness
   PAIN (use symptom analysis: PQRST)	Patient reports to feel a lot of pain in the stomach when they bend. The pain was severe when it started but has since reduced a little.

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   2. What objective data did you collect during the physical assessment?

   PHYSICAL EXAMINATION

   Objective:                                                        

    

   GENERAL SURVEY: Appearance:  Body Structure: Behavior	Patient displays visible pain in the stomach, nausea and abdominal pain. Added to the unusual bowel patterns, consistent with food poisoning. Visible signs of weakness and dehydration
   HEENT:	No drainage on eyes or nose. No palpable lymph nodes, tongue is midline, pink and moist buccal mucosa. Hearing within normal limits.
   PULMONARY:	Normal breath with no SOB whatsoever
   CARDIOVASCULAR:	Palpitations not beyond normal. Consistent with anxiety
   GI:	Visible signs of constipation. The stool has traces of blood. Abnormal bowel habits
   GU:	Urine has no cloudy smell. The urine does not smell bad or portray any signs of unusual features. There is fever or chills that may point at kidney infection. Diarrhea present
   NEURO:	No abnormal flexions, abnormal extensions, incomprehensible sounds, inappropriate words. No abnormal reaction to painful stimuli. Withdraws from pain and localizes pain. Words orientated and eye movement spontaneous
   MUSKULOSKELETAL:	Joints and muscles perfectly symmetrical. Bones well symmetrical as well. No visible swelling and redness. Palpation over the joint shows no areas of unusual warmth and tenderness. Little strain in movement.
   SKIN/MUCOUS MEMBRANES:	Some dryness of mouth. Warm skin with bilaterally equal temperatures. Good skin turgor. Face perspiration. Smooth and firm skin. No thinning or decreased turgor
   PSYCHO-SOCIAL:	Patient has friends and relatives very concerned with care and well-being. Very strong support system. Good decision-making. No drugs. Some unhealthy eating habits
   EDUCATION: What did you teach this client & family and how did they respond?	Client advised to drink a lot of water to sort out the visible dehydration. Counselling services recommended to reduce the levels of anxiety. Family told to reinforce healthy eating habits. Client pleased and family satisfied with the nature of care. They seemed eager to commence their role in pain management and promotion of healthy eating habits.

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   3. What did you chart in the EHR?

    

   Client’s Initials: A.G DOB: 12.05.1970Age: 50 Sex: F 

    

   Allergies: NA

    

   Ht: 5’2 Wt: 133 lbs     

    

   Culture/Religion: NA              

    

   Marital Status: Married

    

   Family support:  Yes            ETOH use: No           Tobacco: No

    

   Other disciplines/consults caring for the

   client Physiotherapy and counselling departments

    

    

   Vital Signs:   T 38.5     HR 95     R 18     BP120/80mmHg   Monitors: NA    Code Status: NA

   SPO2: 97% Oxygen Therapy: NA    Rate:

    

   Reason for hospitalization: Severe cramping, vomiting and diarrhea   

    

   Clinical Diagnosis: Food poisoning

    

   Nursing Problems: NA

    

   Summarize client’s past medical history & history of present illness:

   (i.e. Age, gender, chief complaint, Location: Quality:Severity: Duration: Timing:  Context: Modifying Factors: Associated Signs and Symptoms: Of Chief Complaints (PQRST), Past medical history, Past family history, Social History)

    

   The patient is a 50 year old female who mainly complains about cramping and vomiting. The pain is evidently severe and vomiting intermittent. Symptoms experienced after a dinner at a local diner shortly after 7pm. Cramping on the lower abdomen and abdominal pain. Has a history of food rejection and unusual bowel patterns. No severe cramping before.

   Summarize hospital course/events from admission to present:

   (i.e. When did they arrive. Through what means? When were they admitted? Why were they admitted? Why are they still in the hospital? What is the plan of care?)

   Patient arrived in the ER shortly after 7.30pm. She was brought in by a cab and immediately admitted. Her pain had to be managed immediately as it appeared severe. The patient is still to be observed for the symptoms especially the pain from cramping to abate. Her palpitations would require that besides the food poisoning medication, she gets some counselling especially in view of the fact that she has been on unhealthy diets in the past.

   Therapeutic orders for day of care:

    

   Diet: Ice chips, vegetable broth  

    

   Activity: NA      

    

   IV Type & Site: NA

    

   Other(dressings, etc.) NA

    

   Education needs/discharge planning:  (Include client and family)

   Patient and family to be taught on the benefits of a healthy diet and the need to offer more psychosocial support to the patient

    

   32.QUESTION

   Introduction of Sociology    

   Discussion Exercise 2

   * Choose a culture that you identify with and give an example of an important belief, value, and norm in that culture.
   * Identify a subculture (does not have to be connected to question 1). In what ways might this group’s values oppose dominant culture? Identify a counterculture. In what ways might this group’s values be incompatible with dominant culture?
   * What is cultural isomorphism? Provide an example.

   INTRODUCTION TO SOCIOLOGY

   The Christian Culture

   This paper focuses on Christianity, one of three Abrahamic religions (Judaism and Islam are the other two) anchored on the theological tenet that regards Jesus Christ as the only path to true fellowship with God, and God  as a father seeking a lasting communion with humanity, his children (Stott, 2017).

   The core belief of Christianity is the belief in one God, who through his Son, Jesus Christ, fashioned the universe. The divine being is delineated as the Godhead, consisting of the Father, the Son and the Holy Spirit (Stott, 2017). It focuses on such themes as resurrection of the dead, especially the coming back to life of Jesus after his death on the cross in conformity to God’s will.

   Christian doctrine focuses on a set of core values, including honesty, hard work, and industry.

   Popular norms in practical Christianity include daily prayers, bible reading, fellowship with fellow Christians, and fidelity to congregational worship at least once a week. Weekly services typically take place on Sundays, though some groups regard Saturday ads the Sabbath and correct day of worship (Stott, 2017).

   Subculture: Rastafarianism

   The last century saw the emergence of Rastafarianism as a new religious movement and a subculture within Christianity. The subculture emerged in the 1930s in Jamaica and Belize as a social movement in response to the deprecation of members of the black race worldwide. Though it has Judeo-Christian roots, its 1 million-strong membership believes in Jah, as the creator of the heavens and the earth, and in the designation of Africans as his chosen people and Africa as their “Promised Land, or Zion” (Petray, 2020). In modern times, Rastafarianism has propagated doctrines that openly contravene mainstream Christianity. For instance, in the past, the movement has participated in violent protests against the Christian doctrine that calls for submission to authority.  The beliefs in Haile Selassie as the messiah, mounting of dreadlocks, opium use, and consumption of natural foods from the ground are other notable points of departure from Christian dogma. Indeed, strict Rastafarians consider the consumption of pure food from the earth as a sacrosanct duty (Sutter, 2017). On the other hand, Christian culture advocates for respect for governing authorities, and a freedom to eat all food as long as they are received with thanksgiving (Mark 7:15).

   Counterculture within Rastafarianism

   From the late 1950s, the Bobo Shanti, an order within Rastafarianism has become the most noticeable counterculture within the movement. In contrast to typical Rastafarianism, the Bobo Shantis draw from chapter 5 of the book of Revelations to venerate Prince Emmanuel Charles Edwards as the modern reincarnation Christ and is widely regarded as the prince, “without Mother or Father, a Priest of Melchezidek, the Black Christ in the Flesh” (Merritt, 2017). Together with Haile Selassie, his scions are regarded as Gods, while Marcus Garvey is occupies the position of prophet (Meritt, 2017).

   Social isomorphism

   Social isomorphism is a sociological concept that describes the processes leading to the uniformity of organizational systems over time (Jaja, Gabriel & Wobodo, 2019). It is a phenomenon most noticeable when a “following” new entity, referred to as “subcontractor” tries to adopt a new culture, comparable to that of a “leading” entity or “user company” to gain acceptance among other players in the industry (Jaja, Gabriel & Wobodo, 2019). For instance, a new bank may enter a market with a different value proposition introducing flexible operating hours. Yet, in the final analysis, social isomorphism predicts that this bank will eventually operate like the others.