Discussion: Assessing the Ears, Nose, and Throat

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes, but would probably perform a simple strep test.

In this Discussion, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case. 

Case 1: Nose Focused Exam Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he’s taken Mucinex OTC the past two nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous.

Case 2: Focused Throat Exam Lily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus over the past two weeks, Lily figured she shouldn’t take her three-day sore throat lightly. Your clinic has treated a few cases similar to Lily’s. All the patients reported decreased appetite, headaches, and pain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn’t sound congested.

Case 3: Focused Ear Exam Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked. He has complained to her about a mild earache for the past two days. His grandmother believes that he feels warm but did not verify this with a thermometer. James states that the pain was worse while he was falling asleep and that it was harder for him to hear. When you begin basic assessments, you notice that James has a prominent tan. When you ask him how he’s been spending his summer, James responds that he’s been spending a lot of time in the pool.

To prepare:

With regard to the case study you were assigned:

· Review this week’s Learning Resources and consider the insights they provide.

· Consider what history would be necessary to collect from the patient.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least 5 possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Week 5 Discussion”) with “Review of Case Study ___,” identifying the number of the case study you were assigned.

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each. 

Need an argumentative essay on Sugar Cane. Needs to be 5 pages. Please no plagiarism.

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Probably the most vital contribution of understanding the origins of the plant in world history is recounting the suppression of Africans who became slaves in the pursuit of supplying the needs for the plant’s products.

Sugar cane has been known for at least 2200 years dating back from the rise of Alexander the Greta when his army saw the plant during the conquest of India in 326 BC (Purseglove, 1979). The discovery of Arabs and Greeks on the potential of sugar cane juices to substitute to the popularly used honey was a turning point to the spread of the plant. Western expansion of Arabs in the 7th and 8th centuries marked the introduction of sugar in Europe and the West (Heiser, 1981). It is a sub-tropical and tropical plant that grows well on spots with robust supply of sunlight and water – so long as the plant’s roots are not waterlogged (Deerr, 1949). Purgloves (1979) accounts that sugar cane was originally grown for the sole purpose of chewing in vast territories of Asia and the Pacific. The rind was removed and the internal tissues sucked or chewed to extract the sugar and juice contents on it. According to the account, production of sweet products of the plant by boiling the cane juice was first discovered in India, most likely during the first millennium BC. It is in the purpose of this paper that sugar yield would characterize the sugar cane products to focus on the economics of the commodity on which the plant has been primarily known and used due to its properties to produce a sweet substance in whatever form.

Processing of sugar canes whether following the old procedures or the present modern technique starts with harvesting. Harvesting of the sugar cane is done through chopping down the stems. Where possible the cane is fired before harvesting to remove the dead leaf material and some of the waxy coating. The fire burns at quite high temperatures but is monitored to last only for a short period so that the cane and its sugar are not harmed ( Harvesting is done by hand during the earlier days but has been done with machine beginning 18th century. First stage of processing is the extraction of cane juice. Boiling was the main extraction procedure during the 15th century (Purseglove, 1979). With the upgrade of processes before the 19th century, extraction of sugar cane juice included the removal of excess water through the use of machines and cleaning up the juice with slaked lime ( As with the traditional way, evaporation comes next in the process by thickening up the juice in the syrup by removing the water through boiling. In earlier years, leaving it as syrup or drying up the water under the sun or through steaming and having unrefined crystals would have sufficed and the process of producing the end product would have ended (Heiser, 1981). With the advent of machines, even the simple traditional ones, crystallization takes place through painstaking procedures of boiling. After making the product fit for storage, affination comes next to continuously refine the end product characterized to be primarily as sweetener.

Consider the rivalry between Airbus and Boeing to develop a new commercial jet aircraft. Suppose Boeing is ahead in the development process and Airbus is considering whether to enter the competition. If Airbus stays out, it earns zero profit, whereas Boeing enjoys a monopoly and earns a profit of $1 billion. If Airbus decides to enter and develop the rival airplane, then Boeing has to decide whether to accommodate Airbus peaceably or to wage a price war. In the event of peaceful competition, each firm will make a profit of $300 million. If there is a price war, each will lose $100 million because the prices of airplanes will fall so low that neither firm will be able to recoup its development costs.

Construct the extensive form (tree diagram) to analyze this game. Label appropriately

Hi, I need help with essay on Preventing Terrorism: Understanding Radicalisation, Vulnerabilty and Improving Practice. Paper must be at least 3000 words. Please, no plagiarized work!

Several European Union member nations had imposed anti-radicalisation programs. The United Kingdom, Netherlands, Norway and Denmark imposed their own domestic anti-radicalization strategies (Vidino & Brandon, 2012). The government’s prevent strategy stops radical terrorist attacks.

Radicalism involves terrorists who are bent on implementing criminal acts.

The acts may include suicide bombings. One of the unforgettable radical attacks is the September 9, 2001 terrorists’ airplane attacks. The attack involved the hijacking of four civilian airplanes. The hijackers used the airplanes to ram into three highly populated targets. The targets include the Twin Towers of New York and two government facilities (UK Crown, 2011).

One of the radical terrorist groups is Osama bin Laden’s Al Qa’ida (UK Crown, 2011). The group espoused the overthrow of non-Muslim governments. The group spearheads the use of Jihad or holy war to impose the Muslim religion on the non-Muslim countries. The group brands the non-Muslim countries as apostate. The group insists Jihad is the duty of all Muslims. The Jihad includes attacking both Civilian as well as military targets.

Terrorists are not classified as ordinary law violators. Inside their prison cells, the leaders of the radical groups can still communicate with people from the outside world. The incarcerated prisoners can instruct the other group members to continue the terrorist attacks. Likewise, the serious radicals may convince the other prisoners to help the radical leader implement his or her terrorist plots (UK Crown, 2011).

The prevent strategy successfully reduces the threats of radicalization. The government focuses on resolving extremism and terrorism. The government focuses on several fronts to reduce radical attacks. The fronts include educating the radicals to engage in peaceful means to resolve their

I will pay for the following essay The legal drinking age should be lowered to eighteen. if this happen. The essay is to be 5 pages with three to five sources, with in-text citations and a reference page.

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Outline I. Introduction II. Eighteen is the age of adulthood A. Law extends many of the adult rights to an 18 year old B. Can marry, sign contacts, smoke, join army, etc C. An 18 year old is an adult and can act in a responsible manner III. Social influences A. Society moulds a person B. High legal drinking age deprives an individual of benign social influences C. Thereby it should be lowered to 18 to allow exposure to positive social Influence IV. Opposite views A. Misguided and emotive B. Unrealistic C. High legal age makes drinking a “forbidden fruit” V. Conclusion Rough Draft The Legal Drinking Age should be lowered to eighteen The legal drinking age is an issue that has raked in much controversy with contrary proposals being extended by warring sides, those arguing to raise the legal drinking age and those supporting a lowering of the drinking to 18. The thing that needs to be considered is that when it comes to fixing the legal drinking age, the attitude of the state and the law seems to have been guided more by the assertions and feelings of the masses, rather than being in consonance with the ground realities and a need for pragmatism. …

Now if the law thinks that an 18 year old has the emotional capacity and the reason to be able to decide on important issues as to who should govern the nation, or whether one should get married or to whom one should get married, or should one join the military, considering the risk that it involves, it is totally irrational and illogical to believe that an 18 year old cannot handle oneself while drinking. Thereby, the legal drinking age should be lowered to 18 as an adult person should have the right to make decisions about alcohol consumption in consonance with one’s beliefs and understanding. The other thing is that society is the potent and governing institution that helps the individuals and especially the adults to adapt and mould their behavior in tandem with the legal requirements and the dominant social expectations. Like many liberal and democratic societies, a responsible and recreational consumption of alcohol is an undeniable part of the American society. Thereby, by fixing the minimum legal drinking age at twenty one, the law deprives a large section of the adult population of the opportunity to adapt and mould their drinking behavior as per the legal requirements and social expectations. Lowering the legal drinking age to 18 will allow the young people to consume alcohol in the supervised and regulated environment of the bars, pubs and other licensed drinking locations, thereby allowing them to be responsible and tamed with their drinking behavior and attitudes.