NARRATIVE GENITALIA ASSESSMENT

GENITALIA ASSESSMENT

Subjective:

• CC: “I have bumps on my bottom that I want to have checked out.”

• HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.

• PMH: Asthma

• Medications: Symbicort 160/4.5mcg

• Allergies: NKDA

• FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

• Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

• VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs

• Heart: RRR, no murmurs

• Lungs: CTA, chest wall symmetrical

• Genital: Normal female hair pattern distribution; no masses or swelling. Urethral

meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa

pink and moist with rugae present, pos for firm, round, small, painless ulcer noted

on external labia

• Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

• Diagnostics: HSV specimen obtained

Assessment: Chancre

PLAN:

 

 

 

Assignment: This is to be a NARRATIVE (PARAGRAPHS). Answer each question

¡ Analyze the subjective portion of the note. List additional information that should be included in the documentation.

¡ Analyze the objective portion of the note. List additional information that should be included in the documentation.

¡ Is the assessment supported by the subjective and objective information? Why or why not?

¡ Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?

¡ Would you reject/accept the current diagnosis? Why or why not?

¡ Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. Explain your reasoning using at least three different references from current evidence-based literature

 

 

Note: This is to be a NARRATIVE (PARAGRAPHS). Answer each question

 
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Sexual Tolerance: The Times They Are A’changing

People in the United States vary widely in their acceptance of the sexual and gender choices and orientations.   Recent changes in the legality of same sex marriage, the changing role of women in the military, and increasing awareness of transgender issues have highlighted how much has changed in recent months.

Choose one of these sources:

  • Find an article or graph that illustrates a recent change in law, attitude, or policy regarding sexual tolerance.
  • Joel Burns:  It Gets Better  https://www.youtube.com/watch?v=ax96cghOnY4 (transcript located on YouTube site)

Write a 5-paragraph essay that introduces the topic you’ve chosen, summarizes the various points of view, and concludes with the current status of the issue you are addressing.  Be sure to use at least 2 references to support your essay. Your paper must meet the minimum 750-word count requirements.

All assignments and forums in the class are designed for you to demonstrate your understanding and your knowledge of the material content.  It is never acceptable or appropriate to simply provide information that is copied and pasted from a source – any source.  Even if the information were cited properly, copying and pasting does not demonstrate knowledge.   <o:p>

All assignments are submitted to Turnitin, which is a plagiarism checking tool.  Any assignment receiving a score of 30% or better raises serious concerns about the originality of your work.  An originality score should generally be no more than 20%.  Originality scores between 20 and 50% will be graded with a point deduction.  Any originality score over 50% after review will be graded with a 0.  Please keep this in mind as you are submitting work. <o:p>

 
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Philosophy Final Paper

“Say, Saying, Said” Method

Paper Assignments

Intro to Philosophy

Professor LaMendola

 

What is the structure of a paper?

 

Introduction – Your first paragraph (Say what you’re going to say)

• Issue – What is the main issue your paper is about and why is it important.

• Thesis – What position are you going to take on the issue and why? o The thesis is the most important, and sometimes most difficult part of the paper.

Practicing writing thesis statements is an invaluable tool.

o Netflix movie descriptions; “Striving for an economy of language”

• e.g., In the following paper I will argue that we should stop eating at Torchy’s Tacos, specifically explaining how what is served should not be considered a taco.

 

o Write in first person. Using first person does not cause bias or confusion. If anything, first person allows you to speak to the reader in an authentic, immediate

and clear manner.

Road map – What will be the main sections of your paper?

• The Form – “First, I’m going to give an overview of the issue and position X; second, I’m going to explain and evaluate the first argument; third, I’m going to explain and evaluate

the second argument; fourth, I’m going to give my own argument; finally, I will conclude

that, based on the evaluations of the available arguments, X is not a very plausible

solution to/explanation of the issue, instead we ought to adopt an approach more like Y.

However, it is critical I begin discussing X.”

 

• Example – First I will explain how Torchy’s Tacos come to be, highlighting those factors I believe lead to them serve hip taco recipes. Second, I will explain criteria for a taco and

how Torchy’s does not met that standard. Finally, I will explain how Torchy’s at best

serves ‘honky tacos’, but regardless we should not consider their food as genuine tacos. I

will conclude with a general approach to relieving taco ordering anxiety, as well as

alternative venues to purchase genuine tacos in the Houston and Austin areas. Let’s

begin our inquiry into taconess.

 

Body (Saying what you’re going to say) – Three Parts

 

Pt. 1 – Exposition

• The exposition can be done in two possible ways: One is to write this section in terms of the position you’ll be defending, the other is to focus on explaining the position you’ll be

arguing against. Either way is fine. About a page to a page and a half should be dedicated

to explaining precisely what the main issue is and what the points of debate are (i.e., sub-

 

 

issues). You don’t need to give the particular arguments for or against a position in

detailed form, but once you’ve outlined the contested sub-issues, you should, in a

sentence, state what the main positions are on that sub-issue. In this section, you should

also make clear any technical terms you or the author introduce which are relevant.

• Don’t cite the dictionary. There’s generally accepted definitions (which anyone can find), and there the way the assigned authors are using the terms in question. You should be

concerned with the latter.

Pt. 2 – Arguments and Dialectic – Following your roadmap, the second part of paper is the

nuanced bit where you must make clear to the reader the fine-grained points at hand.

• Your paper should clearly identify the following: o the main premises of the argument you’ll be evaluating. o the main objection(s) to this argument. o what position you’ll eventually side with and why

▪ Specifically considered in terms of whether the objections are successful or fail

Pt. 3 – Opinions and Solutions

• Depending on how you structure your paper, your own input might be in the form of (a) analysis or original reply/counter-argument within the context of the dialectic in Body Pt.

2; and/or (b) adding an innovation to or strengthening an existing argument or response.

 

• However, you may also, if you so choose, introduce your own original line of argument into the issue. If you choose to do this, you should follow this structure:

o Introduce your own line of argument for/against the main position. o Explain why your argument is relevant to the debate. o Consider objections to your argument. o Show why those objections don’t, on balance, defeat your argument.

▪ The last part might be difficult for the short papers you have been assigned. But if you have an idea, I would like to discuss it with you.

 

Conclusion (Say what you said)

• Restate the main issue and the position you were arguing for/against. o Thesis and Body Pt.1

• Summarize the main reasons for which position X should be accepted or rejected o i.e., your arguments/conclusions from Body Pt.2&3

• Suggest how your conclusion might have implications for other issues (Optional).

 
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Discussion: Classification of Young and Middle Adulthood

Discussion – Week 2 Discussion 1

Top of Form

Discussion: Classification of Young and Middle Adulthood

When did you become an adult? Was it the day you turned 18, the day you graduated high school, or the day you moved out of your parents’ or caregivers’ home? The authors of your course text, Zastrow et al., use the term young adulthood for ages 18 to 30, and middle adulthood for ages 30 to 65. Are these young and middle adulthood classifications useful? How do they compare to your own unique experience at these life stages? Indeed, your description of what it means to be an adult and how and when an adolescent transitions into adulthood may differ from that of Zastrow et al.—and from your colleagues.

For this Discussion, you analyze the author’s classifications of young and middle adulthood and consider how diversity might influence the common experience.

By Day 12/10/2021

Respond to two colleagues by comparing your experience with theirs. Then, address the dangers of generalizing young/middle adulthood experiences across all clients.

My experience with theirs

Classification of Young and Middle Adulthood

Environmental influences, genetic variances, and some degree of stochasticity are thought to impact biological ageing significantly. The genetic makeup of a population does not vary considerably from year to year, so changes in the rate of ageing over a short period are unlikely, but environments and behaviors do (Zastrow et al., 2019). For example, I was already working in a complete house with my mother by 13, missing school two days a week to help my mother pay the bills. By the age of 21, I was on my own. My father and mother divorced, and my mother was left to raise us alone. This made me mature faster as my environment facilitated the activities I engaged in when I was young to ensure we survived. 

It is possible that, despite the apparent variety in young adults, biological age has improved more for older adults. Biological age estimations may not differentiate individuals to the same degree as more youthful generations, assuming that negative impacts of the environment and genes accrue throughout a lifetime (Zastrow et al., 2019). For example, it may be more challenging to discern disparities in health early in life in a heterogeneous community; nevertheless, as age and damage rise over time, the physiological profiles of weak (accelerated ageing) and strong (decelerated ageing) individuals may diverge more. In my identity years, that is, teenage years, I did not find time to engage in some of the behaviors highlighted by Zastrow et al.’s classification of young and middle adulthood, like smoking; therefore, it depends on the activities one participates in that determine one own development.

Colleagues 1: Irene Lien

RE: Discussion – Week 2

Top of Form

Zastrow et. al. classify young adulthood to be from ages 18-30 (2019). During this period, individuals are seen to be in their physical prime, in excellent health, and have relatively positive health habits (Zastrow et. al., 2019). According to Zastrow et. al., young adults attain maximum muscular strength between ages 25-30 and decline thereafter (2019). Additionally, young adults have high levels of manual agility and have keep sight, hearing, and other senses (Zastrow et. al., 2019). I just turned 25, and personally, I feel as if I was physically stronger in my teen years because of the extracurricular activities, such as sports, that I maintained throughout high school. However, once I went to college and started working, I found less and less time to remain active, especially now working a more sedentary job. I do believe I have a high-performance speed with completing fast tasks and with manual agility, such as typing.

In terms of health status, young adults are generally healthier than in their childhood due to easier access to health insurance, an increased interest in measures that promote health, and an increase in using complementary medicine approaches (Zastrow et. al., 2019). Personally, this can be true in some aspects. I don’t get acute illnesses as often, such as the cold or flu, but I have started developing other health concerns, such as anxiety, hypertension, and more muscle aches and pain. Young adults are prone to similar health concerns due to increases in stress levels, lack of sleep, smoking, and alcohol use (Zastrow et. al., 2019).

Reference:

Zastrow, C. H., Kirst-Ashman, K. K., & Hessenauer, S. L. (2019). Understanding human behavior and the social environment (11th ed.). Cengage Learning.

Colleagues 2: Brianna Swopes

RE: Discussion

Zastrow et al explains that young/middle adulthood as a struggle to define, but ultimately defines it as a period of time between the ages of fifteen and twenty-five where people “focus on establishing their identities and idealistically trying to make their dreams come true”. From my own experience this classification doesn’t completely align with my development during this time. I struggled with establishing my identity in my younger years because I often couldn’t be myself around my family and after my high school graduation my parents went through a rather terrible divorce, from that day on I focused on survival in terms of money, where to live during school breaks while I had lived on campus and focused on what I wanted to do with my life.

I worked through some rather tumultuous friendships and at one point had to pack all my belongings into my car and drive to another state so that I could have a roof over my head. After that year I moved back to where I felt I belonged and found a job, my focus becoming work and school and even now, about five years later, I’m in a similar predicament. I’m focused on surviving, being able to afford living on my own while juggling school and other responsibilities. In these years I did go out and have fun, but to find myself I had to do a lot of soul searching and self-reflection.

Zastrow et al’s description almost seems whimsical to me and my years weren’t much like that, though there were moments that were similar in terms of becoming myself. Once on my own I was able to become the person I wanted to be, though my dreams and any hope of achieving them have become more realistic in terms of what I can actually accomplish. What impact my experience the most was my parents divorce, it forced me to grow up fast, I didn’t have a home to fall back on so my survival was based on my individual decisions and consequences that could only affect me, which did add a lot of stress in this time of my life but I am ultimately thankful for now, since I have become a very independent person.Bottom of Form

Reference

Zastrow, C. H., Kirst-Ashman, K. K., & Hessenauer, S. L. (2019). Understanding human behavior and the social environment (11th ed.). Cengage Learning.

https://eds.s.ebscohost.com/eds/pdfviewer/pdfviewer?vid=1&sid=1e62a3ca-6320-4404-8ced-60224b163987%40redis

FOLLOW RUBRIC 

Initial Posting: Content

14.85 (49.5%) – 16.5 (55%)

Initial posting thoroughly responds to all parts of the Discussion prompt. Posting demonstrates excellent understanding of the material presented in the Learning Resources, as well as ability to apply the material. Posting demonstrates exemplary critical thinking and reflection, as well as analysis of the weekly Learning Resources. Specific and relevant examples and evidence from at least two of the Learning Resources and other scholarly sources are used to substantiate the argument or viewpoint.

Follow-Up Response Postings: Content

6.75 (22.5%) – 7.5 (25%)

Student thoroughly addresses all parts of the response prompt. Student responds to at least two colleagues in a meaningful, respectful manner that promotes further inquiry and extends the conversation. Response presents original ideas not already discussed, asks stimulating questions, and further supports with evidence from assigned readings. Post is substantive in both length (75–100 words) and depth of ideas presented.

Readability of Postings

5.4 (18%) – 6 (20%)

Initial and response posts are clear and coherent. Few if any (less than 2) writing errors are made. Student writes with exemplary grammar, sentence structure, and punctuation to convey their message.

Discussion – Week 2 Discussion 1

Top of Form

Discussion: Classification of Young and Middle Adulthood

When did you become an adult? Was it the day you turned 18, the day you graduated high school, or the day you moved out of your parents’ or caregivers’ home? The authors of your course text, Zastrow et al., use the term young adulthood for ages 18 to 30, and middle adulthood for ages 30 to 65. Are these young and middle adulthood classifications useful? How do they compare to your own unique experience at these life stages? Indeed, your description of what it means to be an adult and how and when an adolescent transitions into adulthood may differ from that of Zastrow et al.—and from your colleagues.

For this Discussion, you analyze the author’s classifications of young and middle adulthood and consider how diversity might influence the common experience.

By Day 12/10/2021

Respond to two colleagues by comparing your experience with theirs. Then, address the dangers of generalizing young/middle adulthood experiences across all clients.

 

My experience with theirs

Classification of Young and Middle Adulthood

Environmental influences, genetic variances, and some degree of stochasticity are thought to impact biological ageing significantly. The genetic makeup of a population does not vary considerably from year to year, so changes in the rate of ageing over a short period are unlikely, but environments and behaviors do (Zastrow et al., 2019). For example, I was already working in a complete house with my mother by 13, missing school two days a week to help my mother pay the bills. By the age of 21, I was on my own. My father and mother divorced, and my mother was left to raise us alone. This made me mature faster as my environment facilitated the activities I engaged in when I was young to ensure we survived.

It is possible that, despite the apparent variety in young adults, biological age has improved more for older adults. Biological age estimations may not differentiate individuals to the same degree as more youthful generations, assuming that negative impacts of the environment and genes accrue throughout a lifetime (Zastrow et al., 2019). For example, it may be more challenging to discern disparities in health early in life in a heterogeneous community; nevertheless, as age and damage rise over time, the physiological profiles of weak (accelerated ageing) and strong (decelerated ageing) individuals may diverge more. In my identity years, that is, teenage years, I did not find time to engage in some of the behaviors highlighted by Zastrow et al.’s classification of young and middle adulthood, like smoking; therefore, it depends on the activities one participates in that determine one own development.

 

Colleagues 1: Irene Lien 

RE: Discussion – Week 2

Top of Form

Zastrow et. al. classify young adulthood to be from ages 18-30 (2019). During this period, individuals are seen to be in their physical prime, in excellent health, and have relatively positive health habits (Zastrow et. al., 2019). According to Zastrow et. al., young adults attain maximum muscular strength between ages 25-30 and decline thereafter (2019). Additionally, young adults have high levels of manual agility and have keep sight, hearing, and other senses (Zastrow et. al., 2019). I just turned 25, and personally, I feel as if I was physically stronger in my teen years because of the extracurricular activities, such as sports, that I maintained throughout high school. However, once I went to college and started working, I found less and less time to remain active, especially now working a more sedentary job. I do believe I have a high-performance speed with completing fast tasks and with manual agility, such as typing.

In terms of health status, young adults are generally healthier than in their childhood due to easier access to health insurance, an increased interest in measures that promote health, and an increase in using complementary medicine approaches (Zastrow et. al., 2019). Personally, this can be true in some aspects. I don’t get acute illnesses as often, such as the cold or flu, but I have started developing other health concerns, such as anxiety, hypertension, and more muscle aches and pain. Young adults are prone to similar health concerns due to increases in stress levels, lack of sleep, smoking, and alcohol use (Zastrow et. al., 2019).

Reference:

Zastrow, C. H., Kirst-Ashman, K. K., & Hessenauer, S. L. (2019). Understanding human behavior and the social environment (11th ed.). Cengage Learning.

 

Colleagues 2: Brianna Swopes

RE: Discussion

Zastrow et al explains that young/middle adulthood as a struggle to define, but ultimately defines it as a period of time between the ages of fifteen and twenty-five where people “focus on establishing their identities and idealistically trying to make their dreams come true”. From my own experience this classification doesn’t completely align with my development during this time. I struggled with establishing my identity in my younger years because I often couldn’t be myself around my family and after my high school graduation my parents went through a rather terrible divorce, from that day on I focused on survival in terms of money, where to live during school breaks while I had lived on campus and focused on what I wanted to do with my life.

I worked through some rather tumultuous friendships and at one point had to pack all my belongings into my car and drive to another state so that I could have a roof over my head. After that year I moved back to where I felt I belonged and found a job, my focus becoming work and school and even now, about five years later, I’m in a similar predicament. I’m focused on surviving, being able to afford living on my own while juggling school and other responsibilities. In these years I did go out and have fun, but to find myself I had to do a lot of soul searching and self-reflection.

 

Zastrow et al’s description almost seems whimsical to me and my years weren’t much like that, though there were moments that were similar in terms of becoming myself. Once on my own I was able to become the person I wanted to be, though my dreams and any hope of achieving them have become more realistic in terms of what I can actually accomplish. What impact my experience the most was my parents divorce, it forced me to grow up fast, I didn’t have a home to fall back on so my survival was based on my individual decisions and consequences that could only affect me, which did add a lot of stress in this time of my life but I am ultimately thankful for now, since I have become a very independent person.Bottom of Form

 

Reference

Zastrow, C. H., Kirst-Ashman, K. K., & Hessenauer, S. L. (2019). Understanding human behavior and the social environment (11th ed.). Cengage Learning.

https://eds.s.ebscohost.com/eds/pdfviewer/pdfviewer?vid=1&sid=1e62a3ca-6320-4404-8ced-60224b163987%40redis

 

 

FOLLOW RUBRIC

Initial Posting: Content

14.85 (49.5%) – 16.5 (55%)

Initial posting thoroughly responds to all parts of the Discussion prompt. Posting demonstrates excellent understanding of the material presented in the Learning Resources, as well as ability to apply the material. Posting demonstrates exemplary critical thinking and reflection, as well as analysis of the weekly Learning Resources. Specific and relevant examples and evidence from at least two of the Learning Resources and other scholarly sources are used to substantiate the argument or viewpoint.

 

Follow-Up Response Postings: Content

6.75 (22.5%) – 7.5 (25%)

Student thoroughly addresses all parts of the response prompt. Student responds to at least two colleagues in a meaningful, respectful manner that promotes further inquiry and extends the conversation. Response presents original ideas not already discussed, asks stimulating questions, and further supports with evidence from assigned readings. Post is substantive in both length (75–100 words) and depth of ideas presented.

 

Readability of Postings

5.4 (18%) – 6 (20%)

Initial and response posts are clear and coherent. Few if any (less than 2) writing errors are made. Student writes with exemplary grammar, sentence structure, and punctuation to convey their message.

 
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