Background: We are all survivors of some type of loss.  Everyone in this class has experienced some type of loss and accompanying grief.  Besides death of a significant other, there are many other types of losses that produce grief.  The purpose of this project is to analyze a loss you have experienced by using concepts you have learned in this course.

Listed below are examples of losses that you may write about:

1. The death of someone important to you:

   –   A parent, child, sibling, spouse, or other relative

   –   A close friend or someone you were romantically involved with.

   –   Someone famous that meant a lot to you.

    

2. The loss of a relationship through:

   –   betrayal, divorce, separation, or desertion

   –   kidnapping, murder, or disappearance

   –   mental illness

   –   substance abuse

    

3. The loss of a job (yours or someone you depended on for support)
4. Moving away from home, becoming homeless, becoming a refugee.
5. Loss of physical capacity or ability through illness, accident, the aging process.
6. The loss of a pet (through death, ran away, was stolen, etc.)
7. Loss of something valuable to you (home/property destroyed by fire, flood, natural disaster)
8. Loss of or denial of membership in a group that was important to you.
9. Loss of respect for, or sense of betrayal by a person, organization, or group that you had previously held in high esteem.  Loss of your reputation.
10. Loss of trust in others, or loss of self-esteem due to physical, emotional, or sexual abuse.

     

    Directions: Please Use These Sub-Headers

     

    Part 1: Description of the loss event.  2-3 pages in length.  Write this from the 3^rd person point of view to describe the events.

     

    Part 2: The Reactions to the Loss:Again, write this from the 3^rd person point of view.  Use concepts from the text and your class notes to describe the reaction to the loss.  Do this in 2-3 pages, double-spaced.  Use the APA format to cite specific concepts from the text.

     

    Questions to consider when writing Part 2:

1. When he/she experienced this loss, what emotions, feelings, thought, and physical symptoms did the person experience?
2. How did this loss affect the person mentally, emotionally, physically, spiritually, socially?

    

3. Did the person’s reactions to this loss mirror any of the theories of grief in the text?

If yes, describe the similarities.  If not, describe the differences.

Part 3: The Current Status. 2-3 pages.  Switch to 1^st person for this section.  Describe how you feel now.  How have your feelings, thoughts, reactions changed over time? How has your life changed due to the loss?  What did you learn from this?

Be sure to use concepts from chapters 9, 10, and 11 of the text, a website, class notes, magazine article, other book.  Use APA format.

Formatting Instructions:

1. Title page with your name, class name, class number, assignment name, and date.
2. Double-spaced. 1” margins on all sides.  12-point font size.  Number pages in top right hand corner.
3. Make sure you have three separate sections: Part 1; Part 2; Part 3.
4. Sections 2 & 3 must include connections to concepts found in chapters 9, 10, and 11, a web site that talks about grief/bereavement, or magazine articles, or other book. You should have a minimum of four references, or two for each of sections 2 and 3.
5. Use APA style to cite the text or other sources that you use.
6. Include a reference page that lists the sources that you have cited in the text.

After reading the Kaiser Family Foundation summary on the Patient Protection and Affordable Care Act, state why or why not you believe the act should remain in law, or which pieces should be reversed. Then describe two pieces of the act that you were unaware was part of the act and how that may affect you as a citizen.

Please follow the writing instructions below:

Must be in APA format

Minimum of 250 words

Minimum of two references

Must be original=will be checked for plagiarism

Masters level writing

All aspects of the questions must be answered

Diagnosing Gastrointestinal Disorders

In primary care settings, patients often present with abdominal pain. Although this is frequently a sign of a gastrointestinal (GI) disorder, abdominal pain could also be the result of other systemic disorders, making this type of pain difficult to assess. While abdominal pain is most common, many other GI symptoms also overlap multiple disorders, further increasing the difficulty in diagnosing and treating patients. This makes provider-patient communication essential. You must be able to formulate questions that will prompt the patient to provide the necessary information, as this will guide your assessment and diagnosis. For this Discussion, consider potential diagnoses for the patients in the following case studies.

Case Study 1:
A 49-year-old man presents to the office complaining of vague abdominal discomfort over the past few days. He states he does not feel like eating and has not moved his bowels for the last 2 days. His patient medical history includes an appendectomy at age 22 and borderline hypertension, which he is trying to control with diet and exercise. He takes no medications and has no known allergies. Positive physical exam findings include a temperature of 99.9 degrees Fahrenheit, heart rate of 98, respiratory rate of 24, and blood pressure of 150/72. The abdominal exam reveals abdominal distention, diminished bowel sounds, and lower left quadrant tenderness without rebound.

Case Study 2:
A 40 year-old female presents to the office with the chief complaint of diarrhea. She has been having recurrent episodes of abdominal pain, diarrhea, and rectal bleeding. She has lost 9 pounds in the last month. She takes no medications, but is allergic to penicillin.  She describes her life as stressful, but manageable. The physical exam reveals a pale middle- aged female in no acute distress. Her weight is 140 pounds (down from 154 at her last visit over a year ago), blood pressure of 94/60 sitting and 86/50 standing, heart rate of 96 and regular without postural changes, respiratory rate of 18, and O2 saturation 99%. Further physical examination reveals:
Skin: w/d, no acute lesions or rashes
Eyes: sclera clear, conj pale
Ears: no acute changes
Nose: no erythema or sinus tenderness
Mouth: membranes pale, some slight painful ulcerations, right buccal mucosa, tongue beefy red, teeth good repair
Neck: supple, no thyroid enlargement or tenderness, no lymphadenopathy
Cardio: S1 S2 regular, no S3 S4 or murmur
Lungs: CTA w/o rales, wheezes, or rhonchi
Abdomen: scaphoid, BS hyperactive, generalized tenderness, rectal +occult blood

Case Study 3:
A 52-year-old male presents to the office for a routine physical. The review of symptoms reveals anorexia, heartburn, and weight loss over the past 6 months. The heartburn is long standing, occurring most days during the week. He takes TUMS or Rolaids to relieve the discomfort. The patient describes occasional use of ibuprofen for back pain, but denies other medications including herbals. He has no known allergies. He was adopted so does not know his family history. Social history reveals that, although he stopped smoking ten years ago, he smoked for 20 years. He occasionally consumes alcohol on the weekends only. The only positive physical exam finding for this patient was slight epigastric tenderness. The remainder of his exam was negative and the rectal exam was negative for blood.

To prepare:

• Review this week’s media presentations and Part 12 of the Buttaro et al. text in the Learning Resources.
• Select one of the three case studies listed above. Reflect on the provided patient information including history and physical exams.
• Think about a differential diagnosis. Consider the role the patient history and physical exam played in diagnosis.
• Reflect on potential treatment options based on your diagnosis.

Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study that you selected. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis.