The purpose of the Aquifer assignment is to teach you how to synthesize important patient information gathered during an office visit to select appropriate differentials and create subsequent diagnostic and treatment plans.

The Aquifer assignment is not a summarization of the Aquifer case, or an essay on the specific illness/disease presented.

The written portion of the Aquifer assignment should clearly outline your rationale for selecting your leading diagnosis and differentials, given the information collected for the patient presented.

While the write up needs to include an appropriately formatted title page per APA 7 guidelines, a formal introduction and conclusion are not needed.

An example outline of the written assignment should include would be as follows:

Leading Diagnosis
(this is the diagnosis for which diagnostic and treatment plan will be written)

The leading diagnosis for this patient is ****.  Leading diagnosis is supported  by patient’s presenting symptoms of ***** (citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference supporting findings). Supporting physical assessment findings include ****** (citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference supporting findings).

Differential Diagnoses (must have 2 differentials)

Differential 1 (e.g. Influeza)

The first differential in this case is **** supported by patient presentation of *** (citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference supporting findings). The differential is further supported by physical exam findings of **** (citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference supporting findings). *** is less likely however due *(here you would present s/s, history physical exam findings that rule out differential)* (citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference supporting findings).

Differential 2 (e.g. Viral pharyngitis)

*** is the second possible differential in this case. Differential is supported by patient’s presenting symptoms of **** (citation). Patient’s physical assessment findings of *** further support the differential however, differential is less likely due to *** (citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference supporting findings).

Diagnostics

Here you would outline your diagnostic plan including any pertinent diagnostic test(s) or exam(s) indicated for diagnosis (must include citation of a Clinical Practice Guideline unless not available. If no guideline is available may use a Problem Specific Peer Reviewed Reference). Brief statement regarding why test is being used, e.g. Positive RADT results are confirmatory for GAS in pediatric patients (Clinical Practice Guideline or Problem Specific Peer Reviewed Reference citation).

Treatment Plan

*** is the first line treatment for *** (must include citation of a Clinical Practice Guideline unless not available. If no guideline is available may use a Problem Specific Peer Reviewed Reference) Any medications should include name, route, dose, and duration (Clinical Practice Guideline or Problem Specific Peer Reviewed Reference citation). Supportive measures recommended, including ***** (citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference supporting findings). Follow up **** (citation of a Clinical Practice Guideline or Problem Specific Peer Reviewed Reference supporting findings)

References (documented per APA 7 guidelines)

Must include an appropriate clinical practice guideline unless there is not a written guideline for diagnosis. In the case no guideline is available a peer reviewed article written on the specific diagnosis selected may be used.

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Aquifer Case Study #18 Family Medicine: Migraine Headaches without Aura

Student

United States University

FNP 591: Common Illnesses Across the Lifespan

Professor Georgia Strong

June 01, 2022

Leading diagnosis

The leading diagnosis for S.P. is migraine headaches without aura. A diagnosis of migraine headaches without aura is supported by the patient’s report of unilateral and severe throbbing pain associated with nausea, photophobia, and hyperacusis occurring 2-3 times weekly (Cutrer, 2022).  S.P meets 5 of the ICHD-3 diagnostic criteria for migraine without aura, including 1) having 5 attacks 2) headache attacks that last 4-72 hours, 3) characteristics such as unilateral pulsating headache, 4) nausea, vomiting, and photophobia during headache, and 5) does not match other ICHD-3 diagnosis (Cutrer, 2022).

Differential Diagnoses

Differential diagnoses for this patient include cluster-type headaches and anxiety.

Cluster-Type Headaches

The first differential for S.P. is cluster-type headaches, supported by a debilitating unilateral and severe throbbing pain that’s associated with nausea, photophobia, and hyperacusis that occurs 2-3 times a week and results in the patient having to go home. However, this is ruled out due to lack of autonomic symptoms such as ptosis, miosis, lacrimation, conjunctival injection, sweating, and/or nasal congestion (May, 2022).
Anxiety

Another differential is headache due to anxiety supported by S.P. ‘s report of a stressful lifestyle with schooling, part time work, and recent breakup with a boyfriend who cheated. (Taylor, 2020). However, this is ruled out as the patient’s GAD-2 score was 2, testing negative (Taylor, 2020).

Diagnostics

Diagnostic testing of MRI for migraine isn’t needed in this patient given her age of under 50 or having cognitive changes (Ng & Hanna, 2021). The patient would not need other laboratory tests given the negative physical examination (Cutrer, 2022).

Treatment Plan

S.P. ‘s migraine can be treated with oral sumatriptan 100 mg PO as needed for headaches and can be repeated in 2 hours, but do not exceed over 200 mg in a 24-hour period (Ng & Hanna, 2021). The patient can also take a combo therapy of acetaminophen 250 mg, aspirin 250 mg, and caffeine 65 mg orally PRN for tension-type headaches (Taylor, 2020). The patient should reduce her caffeine intake from other sources if it’s a trigger for her headaches.

S.P. should have a follow up appointment in 2 weeks to see if the medication worked. The patient in the meantime should keep a journal of headache triggers and patterns and reduce stressors in her life that could contribute to the tension-type headaches. She can also exercise four times a week, use relaxation therapies, and improve sleep (Schwedt & Garza, 2022).

References

Cutrer, M. (2020). Pathophysiology, clinical manifestations, and diagnosis of migraine in adults. UpToDate. Retrieved June 12, 2022, from https://www.uptodate.com/contents/pathophysiology-clinical-manifestations-and-diagnosis-of-migraine-in-adults?search=migraine&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

May, A. (2022). Cluster headache: Epidemiology, clinical features, and diagnosis. UpToDate. Retrieved June 12, 2022, from https://www.uptodate.com/contents/cluster-headache-epidemiology-clinical-features-and-diagnosis?search=cluster%20headache&source=search_result&selectedTitle=1~47&usage_type=default&display_rank=1#H6

Ng, J. Y., & Hanna, C. (2021). Headache and migraine clinical practice guidelines: A systematic review and assessment of Complementary and Alternative Medicine Recommendations. BMC Complementary Medicine and Therapies, 21(1). https://doi.org/10.1186/s12906-021-03401-3

Schwedt, T. & Garza, I. (2020). Acute treatment of migraine in adults. UpToDate. Retrieved June 12, 2022, from https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults?search=migraine%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H7

Taylor, F. (2020). Tension-type headache in adults: Acute treatment. UpToDate. Retrieved June 12, 2022, from https://www.uptodate.com/contents/tension-type-headache-in-adults-acute-treatment?search=tension%20headache&topicRef=3357&source=see_link#H8

This assignment is broken into three parts and you must complete each part of the assignment.

Part 2: Arrest and Trial Scenario

Each part includes a text or video scenario to which you will respond by writing a 1–2 page paper for each scenario that examines specific information regarding the events using your knowledge of the United States Constitution.

Part 1: Law Enforcement Officer Arrives at the Scene Scenario

An 18-year-old high school student walks to class carrying a backpack. He is stopped by the school security guard and his backpack is searched. A loaded handgun is discovered. The school security guard takes the student to the principal’s office. The principal calls the local police. In the state where the school is located, it is illegal to carry a concealed weapon without a permit and all weapons are prohibited on campus.

Officer Smith arrives at the school approximately 10 minutes later. Officer Smith takes a statement from the school security guard and searches the student’s backpack. He seizes the gun and places the student under arrest. Officer Smith then asks the student if he would like to make a statement to explain why he was carrying a concealed weapon on campus.

The student replies, “What weapon? That’s not my backpack and I never saw that gun before.”

The student is then transported to the local jail. However, on the way to the local jail, Officer Smith asks the student again why he brought a loaded gun on campus. The student admits that it was his gun and stated that he needed it for protection. Upon arrival at the local jail, the student is booked. Six hours later, the student is interviewed by a Detective Columbo. The detective reads the student his Miranda warning and asks the student if he would like to make a statement.

The student replies, “No, I want a lawyer.”

Write a 1–2 page paper in which you:

1. Examine the constitutional amendment or amendments that would relate to this situation.
2. Outline the appropriate procedures you would need to follow to comply with the associated amendments to ensure admissibility of evidence.
3. Evaluate the officer’s actions and determine whether his search, the student’s confession, and the weapon discovery were lawful and/or admissible. Provide a rationale for your opinion.
4. Use at least two sources to support your writing. Choose sources that are credible, relevant, and appropriate. Cite each source listed on your source page at least one time within your assignment.

Part 2: Arrest and Trial Scenario

Tyler, a well-known escort service provider in his community, is suspected of the murder of an escort who worked for him. The local police meet Tyler at the airport when he arrives from a trip to Cancun. He is arrested for his suspected connection to the murder of the escort. The police do not inform Tyler of his right to remain silent or his right to counsel. They immediately begin to interrogate him. They continue to question him until he admits that he knew the prostitute and that she worked for him. He also admits that he was with her the night of the alleged murder. Tyler is transported to the local jail and booked. The prosecutor files charges of first degree murder against Tyler. Tyler does not waive his rights to a speedy trial. He asks that an attorney be appointed and demands a trial by jury.

Write a 1–2 page paper in which you:

1. Examine the constitutional amendment or amendments that would relate to this situation.
2. Identify and discuss four elements of arrest.
3. Describe the appropriate procedures to comply with Tyler’s rights to due process.
4. Examine any consequences that might occur if his right to due process is violated.
5. Use at least two sources to support your writing. Choose sources that are credible, relevant, and appropriate. Cite each source listed on your source page at least one time within your assignment.
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Part 3: Correctional Officers and Rights of Inmates

Hudson v. McMillian is a U.S. Supreme court case involving the excessive force resulting in a claim of cruel and unusual punishment under the Eighth Amendment. The court’s decision resulted in the five-pronged Hudson test, also known as PANAM:

• (P)erceived threat by correctional officers;
• (A)ny and all efforts to de-escalate;
• (N)eed for the application of force;
• (A)mount of force that was used and;
• (M)edical issues, and extent of any injuries, that are used to evaluate cases involving any use of force before trial and after conviction.

The test helps the courts determine whether correctional officers’ actions were reasonable, necessary, and conducted in good faith.

Watch the video scenario and take notes as you watch: CJ in Practice Constitutional Issue: Deprivation of Inmates’ Rights

Write a 1–2 page paper in which you:

1. Summarize the events of this scenario and the persons involved.
2. Examine the constitutional amendments related to this situation and whether the rights of the inmates in this scenario were violated. Support your opinion.
3. Determine whether the incidents pass the five-pronged Hudson test discussed above.
4. Recommend how the sergeant should respond to the officer’s behavior. Support your response.
5. Use at least two sources to support your writing. Choose sources that are credible, relevant, and appropriate. Cite each source listed on your source page at least one time within your assignment.

Create an Instructor’s Presentation to Teach Students about Qualitative Research Designs

Create an instructor’s presentation to teach students about qualitative research designs. This week, you were presented with three different qualitative research designs. Determine the value of each of the five designs explored over the last two weeks, and then critique the utility of each one relative to your research problem. Create a narrated PowerPoint presentation that includes the following:

• Cover and references slides (these do not contribute to sliding count)
• The problem to be investigated (your problem statement from Week 1)
• A critique of five qualitative research designs
• Comparison and contrast of the value of these designs
• Defense of your selection of one of the designs covered this week for your proposed dissertation research study.
• Note: This presentation should be usable in a teaching environment
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Length: 8 slides PowerPoint narrated presentation. Speaker notes (minimum 200 words per slide)

Your presentation should demonstrate thoughtful consideration of the ideas and concepts presented in the course and provide new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards. Be sure to adhere to Northcentral University’s Academic Integrity Policy. Upload your document and click the Submit to Dropbox button.

1) In your own words, define intersectionality and describe it’s importance within the context of public health:

2) Using the DSM-5 (use this link, you will need to be on UCSD VPN), find a mental disorder that interests you and briefly describe the disorder and clinical symptoms (2-3 sentences):   (https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596 Links to an external site.)

3) What are the types of risk factors for substance use? Give 1 example for each.

4) What are the three types of prevention strategies for control of drug abuse? Briefly describe each in 1-2 sentences.

5) Find a harm reduction program of interest and briefly describe the goals/objectives, target population, and scope of the program (i.e., is it based in a city, state-wide program).

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