Maggie is a 61 year old female referred to home health OT on October 29th with a diagnosis of R Colles fracture. Maggie fell while shopping at her neighborhood department store on October 27th. The physician has ordered OT to evaluate and treat.

Often times the OT will be given the client’s name and diagnosis and little else. The information given above is typical of the information you may be given to start a case. With this information, the therapist can start to think about how the case should be approached.  

The stage of reasoning development should also be considered (novice - expert)

Even though the information given is minimal, there is much that you may already know about the case. Think about what you know already and what you will need to know to effectively manage the case. Consider your developmental stage/experience. You may have learned this information from school and/or from life experiences. To guide your analysis of what you do or do not know, answer the questions below:

• Do you know what a Colles fracture is? (procedural reasoning)

• Do you know what the clinical signs and symptoms of a Colles fracture are? Complicating factors? (procedural reasoning)

• Do you know the medical management for a Colles fracture? Precautions? (procedural reasoning)

• What is the prognosis of recovery post-Colles fracture? (procedural reasoning)

• What might this woman “look like” (client factors/clinical presentation) and be able to do 2 days post-Colles fracture? (procedural reasoning)

• Do you have an image of the capabilities of a 61-year old woman who goes shopping? (narrative reasoning)

• Might this image give you some indication of her prior level of function and roles as well as an idea of her discharge situation and goals? (conditional reasoning)

• Do you know her perception or how the woman feels about this injury? (interactive reasoning)

• Do you know what resources are available? physical, social and financial (pragmatic reasoning)

Only 3 persons may use the same disorder, so choose wisely. Use the "More Tools", "Groups", tool to find a sign up sheet for several disorders to be discussed in this post. You will be composing an essay with different paragraphs addressing the information posted below. If the format of your post is in question/answer format rather than a coherent essay, you will lose points.

Disorder: Klinefelters syndrome

1. Perhaps you an /or your significant other is a carrier of a harmful recessive trait, such as cystic fibrosis. What would you do when considering having children? Would you hope for the best and ignore the situation or would you see a genetic counselor or what?

2. Select a genetic disorder from the "groups" list. Don't forget to sign up for it. Explain what type of genetic defect or disorder it is. Explain how this genetic anomaly occurs. Is it autosomal or sex-linked? Is it dominant, recessive or aneuploidy? You should include what the effects are for individuals, what are the survival rates, is there a higher risk in certain populations, and any other interesting information.

Discussion 5 - Controversy 5: Is Butter Really Back? The Lipid Guidelines Debate Using the information found at the end of Chapter 5 about the Controversy: Is Butter Really Back? The Lipid Guidelines Debate. Read first the content in the book, supplement the reading with the power point that emphasizes the main points of the controversy. Then, write a 200-250 word response of the controversy.

The Dietary guidelines for Americans had been emphasizing for decades on the importance of low fat eating. Great changes have been made in the production, and manufacturing of foods, and families have tried new low fat recipes, and lower their overall fat composition. But there is this new debate: besides all of the efforts to cut fat in the American diet, the efforts have been unsuccessful, and people have switched to add more sugar to their diets in order to keep the flavor that fats provided. So, do we need to go back to use more butter to cook, and manufacture foods, and snacks? Or, do we need to continue decreasing the amount of fat in our diets in order to decrease the risk for chronic diseases, especially for cardiovascular disease? In this context, while preparing your response keep in mind the following:

1. If fats are bad for people, why do we keep eating them? And, if fats are bad for people, what can we do in order to decrease the daily consumption of fat?

2. In your opinion, is the use of olive oil a good solution to start consuming healthier fats? And, about the use of fat substitutes such as apple sauce for baking? What do you do personally in order to have a low-fat diet?

3. What kind of lifestyle changes can be done in the U.S. population in order to decrease or, use in moderation the amount of fat in the diet, fast food restaurants, and snacks?

4. Application: share your own experience of trying to eat low fat and/or eating healthier in general. What kind of lifestyle changes have you had to make in order to eat healthy?

Discuss the mechanisms and structures of visual learning and discuss the mechanisms and structures of auditory learning.

Explain what it means to say that vocal-fold vibration is a myoelastic aerodynamic phenomenon. Consider all three parts of the term (myo, elastic, aerodynamic) and state the role each component has in the voicing cycle

Food. List at least 3 food items that make up a meal; list the grams of carbohydrates, fats and protein in each food item, convert grams to calories for each component in these food items, calculate % calories from each component, the total calories from each food item and total calories from this meal. A table would help organize the information. Comment on this meal. List 4 dietary supplements that are commonly used and what is the presumed function of each

Research the major ways the immune system is compromised daily and discuss how this affects overall health. Consider the types of cells in the immune system and their function. How can altering these cells lead to disease? Include citation.

current surge in numbers of overweight and obese individuals.....
.......treatments for obesity i.e. bariatric surgery, stomach stapling, liposuction, the newly
released OTC version of orlistat, "ALLI" .....
.......the effects of media hype on "thinness"

Describe how neurotransmitters are produced, transported, and released.

Patient Name: Jennifer Markus                                                                                                                                   MR#: 45879

Attending Physician: Katrina McKenzie, M.D.

Consulting Physician: Erik Anderson, M.D.                                                                                                            Date: 12/4/11

Subjective: Mrs. Markus is a 33-year-old woman with a PMH [past medical history] significant for depression, asthma, hiatal hernia, and migraine headaches. She presents complaining of waking with a pulsing headache on the left side of her head, with 1 day of prior increased sensitivity to light and to noises, as well as nausea, no emesis. The patient notes that work has been increasingly stressful over the past couple weeks and she’s had trouble sleeping. She took two tablets of ibuprofen last night in the hopes of avoiding a migraine, with minimal relief. She is currently taking sertraline for her depression.

She denies any history of seizure, cluster headaches, or tension headaches. She does smoke approximately one half pack of cigarettes daily. She notes that she’s been getting these headaches more frequently, as in two to three times per month. She would like something to decrease the duration of the headache, as well as some suggestions for prevention of future headaches.

Objective: VS: BP 134/80, HR 76, Temp 98.4, wt 155. Physical Exam. General: The patient is sitting with her eyes partially covered by her hands, otherwise, no acute distress. HEENT: Normocephalic/atraumatic, conjunctivae noninjected, pupils equal and round, reactive to light and accommodation (PERRLA), ears with normal cone of light reflex, nose with clear discharge, throat nonerythematous. Neck: No lymphadenopathy, thyroid smooth and symmetric, no nodularity palpated. Lungs: Clear to auscultation bilaterally. Heart: Regular rate and rhythm, no murmurs/grunts/rubs. Abdomen: Soft, nontender, nondistended, no abdominal bruits. Extremities: Warm and well perfused at distal extremities, no edema bilaterally. Musculoskeletal (MSK): Strength of upper and lower extremities equal and 5/5, no loss of sensation at extremities, normal patellar reflexes bilaterally.

Assessment: Patient is a 33 yo female with symptoms and physical exam consistent with migraine headache.

Plan: Migraine Headache Treatment. Begin the patient on a combination treatment of sumitriptan 85 mg and naproxen 500 mg, daily, for the duration of the headache.

Prevention: Continue with the sertraline, as it can have protective effects. Begin a smoking cessation regimen, because smoking can worsen headaches. Recommend some manner of stress-reduction practice, whether it be regular exercise, meditation practice, or relaxation practice.

Follow-up in 3 weeks to evaluate progress and number of headaches. At that time, will reevaluate with the possibility of adding a beta-blocker or calcium channel blocker. Patient was advised that if this headache worsens or fails to improve in the next 24–48 hours, she should call the clinic.

Erik Anderson, M.D.

Discussion Questions

2.     The format of this note is a SOAP note. Using an online search or other research method, describe what a SOAP note is and how it’s used.

Take a 20-minute walk or ride (or do anything that involves some movement) and think about the organ systems described in the lecture. Take a break from your activity, and note the following:

• Name 4 organ systems that you feel are working during your activity.

• What roles are 2 of these systems playing in your activity?

• What is one system that you know is working but you’re not feeling it work?

• Name 1 way that your body is maintaining “homeostasis” during your activity.

Describe the electrical activity of the heart to include the electrical activity of the noncontractile auto rhythmic cells (pacemaker cells) and the depolarization and repolarization of the myocardium.

Discuss age-related changes that occur in the remainder of the axial skeleton

Starting with a fatty acid located in the cytosol of the cell, explain “mechanistically” how an iron deficiency may result in reduced acetyl CoA production from beta oxidation of palmitic acid