What is the definition of fishery

Health care maintenance items  A 45-year old African American female who was assigned male sex at birth, presents to the clinic as a new patient to establish care. She has no physical complaints, and is requesting medication refill as she has been out for 2 days. She is new to the area and recently had he belongings stolen while staying at a local shelter. she states the following ,medications are working well for her ad reports no intolerable side effects or adverse reactions :

Triumeq 1 tab PO QD

Estradiol 2 mg PO BID

Spironolactone 50 mg PO QD

Escitalopram 10 mg PO QD

Amlodipine 2.5 mf PO QD

1: Based on the in formation provided what are the differential diagnosis?

2: What history questions would you ask based on the information given?

PART 2

Ms. Copeland further details her history, She has struggled with her identity since her youth, also disclosing a history of depression she contributes to her years living in foster care. How ever 2 years ago she found comfort and clarity in a transgender support group in Seattle, WA. she states a concern for relapsing depression since she just moved to the ate and does not have a support group.

She started hormone therapy 1 year ago, and she has been happy since, and would like to continue treatment; she eventually would like to undergo gender affirmation surgery once her housing situation is stable.

She denies alcohol and recreational drugs, except for occasional marijuana. she is a tobacco cigarette smoker of 1/4 pps x 20 yrs. she discloses being in an open relationship with a male parter and is working as a prostitute. Her last STI check was aprox 6 months ago with no new abnormal results.

3: what screening tools would you use during today’s visit?

4: What focus physical assessment will you complete today?

PART 3

Objective

Bp: 12268, Pulse: 84, Temp: 97.2 F, Resp: 16, Ht: 6ft, wt: 164, BMI: 22.2.

PHQ9 total : 8, denies suicidal ideations

5: What is the diagnosis after physical exam and vitas?

6: will you fill her medications today?

7: What initial diagnose will you order? Include rational

8: what health care maintenance items should be addresssed.

9: what resources or patient education should you provide?

10: what is your follow up plan? what would Justify sending patient to higher level of care?

Thank you

You are assigned to take care of patient Ms. Marge during your shift from 0700 to 1900. She had a minor gastrointestinal surgery last night and you are required to monitor her intake and output. She has an indwelling foley catheter and a peripheral IV. Based on the information below, you will answer:

What is her total intake?

0700: The physician orders a new continuous infusion of normal saline at a rate of 75 mL/hr. You grab a 1 L bag of NS and program the pump. You begin the infusion at 0700.

0800: Ms. Marge has a diet order of clear fluids. For breakfast, she has ½ cup of black coffee, 6 oz of tea, and 100 mL of apple juice.

0930: Ms. Marge is feeling nauseous and has 200 mL of yellow emesis.

1130: Now that she is feeling better, she has ¼ cup of water.

1300: For lunch, she had ¼ cup of clear vegetable broth and 4 tablespoons of jello. You empty 750 mL of light-yellow urine from her indwelling foley catheter bag.

1500: You help Ms. Marge up to the bathroom. She has 220 mL of watery diarrhea.

1745: For dinner, she has ⅔ cup of chicken broth and 100 mL of cranberry juice.

1830: The doctor orders to remove the indwelling Foley catheter. You remove the indwelling Foley catheter and empty 800 mL of urine that was in the catheter bag.

1900: You calculate the total intake and output at the end of your shift to document in Ms. Marge’s chart.