Discuss the basis on which hospital in your community.
Length: 3-5 double-spaced pages with standard formatting (full pages) Assignment Goal: Students must observe a speech outside of class and evaluate the speech and speaker per the standards taught in the public speaking class. The speech may be viewed online (e.g. YouTube). Importantly, this paper is meant to be a critique and NOT a summary or synopsis of the speech. Students should refer to information from the speech they observe, but only to support arguments about the effectiveness (or lack thereof) of the speaker’s communication choices. Further, students are expected to identify both elements of the speech that were good and those that needed improvement. The questions below should guide the students in their evaluations. Event Information Provide the following information in your introductory paragraph. Name of speaker Type of event Date and Place of event Analysis and Evaluation What was the speaker’s desired response? How do you know? What was the occasion for this speech? Did the speaker seem to consider this? What was the demographic and attitudinal make-up of the audience? What were the main points of the speech? How did you identify them? Was the introduction effective? Why or why not? Was the conclusion effective? Why or why not? What types of support were used? How effective were the speaker’s choices? What types of organizational strategies did the speaker use? Were they effective? How credible was the speaker? Describe and evaluate the speaker’s use of language. Describe and evaluate the speaker’s use of the voice. Describe and evaluate the speaker’s use of other elements of non-verbal delivery. If this speech was intended to be persuasive in nature, address the following: Describe and evaluate the speaker’s use of emotional appeals. Describe and evaluate the speaker’s use of evidence. Describe and evaluate the speaker’s reasoning. Were you persuaded? Why or why not? What difference does this make? Explain your overall reaction to the speech and event. What, if anything, can you try to incorporate into your own speaking?
Please read the case study and answer the questions below:
Case Study:
Sarah Smith is a 28 y/o African American female who presents to the office with c/o wound to her left foot for the past few days. States she had tripped and fell while barefoot scraping the top of her foot on the pavement. She denies any other injury from the incident. Over the past 24 hours the wound has had “smelly†drainage. Has been experiencing generalized achiness, but denies fever and chills. Did not seek medical attention at the time of injury. Has been using hydrogen peroxide to clean her wound. Is unclear of her last tetanus vaccination. Patient PMHx significant for DM II. States that she takes her medications when she remembers, and does not always check her blood sugar.
PMHx:
Asthma: no hospitalizations for exacerbation.
DM II
PSHx:
Denies
SHx:
Former tobacco user: ceased smoking 2 years ago. Had smoked 1ppd x 5 years
ETOH: socially
Illicit drugs: denies
FHx:
Significant for paternal DM, otherwise unremarkable
Medications:
Metformin: 500mg BID po – did not take the last few days
Albuterol MDI: 2 puffs every 6 hours prn – last use just PTA
Singulair: 10mg po daily
Trinessa: 1 tab po daily – last taken this am
Allergies:
PCN: hives
LNMP: 2 weeks ago.
G0p0
ROS:
General: denies any weight changes, fatigue or fever; + body aches
Skin: denies any rashes; + wound to left foot
HEENT: denies headache, head injury, dizziness, lightheadedness;
Denies any vision changes
Denies any hearing changes, tinnitus, vertigo, earache
Denies any nasal congestion, discharge, nose bleeds or sinus tenderness
Denies any sore throat, difficulty swallowing
Neck: denies any swollen glands, pain
Breasts: denies any pain, discharge
Respiratory: denies any dyspnea; positive cough and wheezing
CV: denies any chest pain, edema
GI: denies any nausea/vomiting/diarrhea/constipation; denies bloody stools
PV: denies claudication, swelling to LE
GU: denies frequency, urgency, burning;
Denies vaginal discharge, itching, sores
Denies penile discharge, itching or sores
MS: positive pain to left foot
Psych: denies nervousness, depression
Neuro: denies Headache, dizziness, vertigo, syncope, weakness; + numbness to right LE
Heme: denies any easy bruising
Physical Exam:
Vital signs: 100.5 (tympanic), 162/88, 118, 22, O2 sat 95% on RA
Height: 5’5†Weight: 250 lbs.
Blood glucose: 230 (Fasting; states has not eaten yet today)
patient awake, alert, oriented x 4 in NAD
Skin: warm, dry, color WNL. 4 cm lesion noted to anterior left foot with crusting and purulent drng; + surrounding erythema extending up 7 cm proximally
HEENT: head nontraumatic, normocephalic
Pupils PERRLA, EOMs intact; disc margins sharp, without hemorrhages, exudates; no AV nicking noted
Ears: bilateral TM with good cone of light and intact
Nose: mucosa pink, septum midline; no sinus tenderness appreciated
Mouth: mucosa pink, moist; tongue midline; tonsils 1+ without exudate
Neck: supple; trachea midline; no LAD
Resp: regular and unlabored; lungs with end expiratory wheezing throughout
CV: RRR, S1 and S2 noted; no s3, s4 or murmur appreciated
Abdomen: soft, non-distended; Bs + x 4; no tenderness with palpation; no CVA tenderness with percussion
Genitalia: deferred
Rectal: deferred
Extremities: warm and without edema; calves supple, non-tender
PV: no LE edema
MS: + swelling to left foot; + tenderness of 2-4th left metatarsals; + left pedal pulse; CMS intact; Cap refill < 2 sec. Neuro: alert, cooperative; thought coherent; oriented x 4; cranial nerves II-XII intact Questions: 1. List your differentials for her current problems. Remember you should have at least three different differentials for each problem. Include rationale for each differential. 2. At this time what medical diagnoses are you most concerned about? Do they impact other diagnoses? If so, how? 3. What diagnostic images would you order? Provide your rationale. What are you trying to rule in or out? 4. What laboratory work would you order? What would you anticipate to be abnormal? Provide your rationale for each. 5. What is your comprehensive plan of care? Include your rationales.
Please read the case study and answer the questions below:
Case Study:
Sarah Smith is a 28 y/o African American female who presents to the office with c/o wound to her left foot for the past few days. States she had tripped and fell while barefoot scraping the top of her foot on the pavement. She denies any other injury from the incident. Over the past 24 hours the wound has had “smelly†drainage. Has been experiencing generalized achiness, but denies fever and chills. Did not seek medical attention at the time of injury. Has been using hydrogen peroxide to clean her wound. Is unclear of her last tetanus vaccination. Patient PMHx significant for DM II. States that she takes her medications when she remembers, and does not always check her blood sugar.
PMHx:
Asthma: no hospitalizations for exacerbation.
DM II
PSHx:
Denies
SHx:
Former tobacco user: ceased smoking 2 years ago. Had smoked 1ppd x 5 years
ETOH: socially
Illicit drugs: denies
FHx:
Significant for paternal DM, otherwise unremarkable
Medications:
Metformin: 500mg BID po – did not take the last few days
Albuterol MDI: 2 puffs every 6 hours prn – last use just PTA
Singulair: 10mg po daily
Trinessa: 1 tab po daily – last taken this am
Allergies:
PCN: hives
LNMP: 2 weeks ago.
G0p0
ROS:
General: denies any weight changes, fatigue or fever; + body aches
Skin: denies any rashes; + wound to left foot
HEENT: denies headache, head injury, dizziness, lightheadedness;
Denies any vision changes
Denies any hearing changes, tinnitus, vertigo, earache
Denies any nasal congestion, discharge, nose bleeds or sinus tenderness
Denies any sore throat, difficulty swallowing
Neck: denies any swollen glands, pain
Breasts: denies any pain, discharge
Respiratory: denies any dyspnea; positive cough and wheezing
CV: denies any chest pain, edema
GI: denies any nausea/vomiting/diarrhea/constipation; denies bloody stools
PV: denies claudication, swelling to LE
GU: denies frequency, urgency, burning;
Denies vaginal discharge, itching, sores
Denies penile discharge, itching or sores
MS: positive pain to left foot
Psych: denies nervousness, depression
Neuro: denies Headache, dizziness, vertigo, syncope, weakness; + numbness to right LE
Heme: denies any easy bruising
Physical Exam:
Vital signs: 100.5 (tympanic), 162/88, 118, 22, O2 sat 95% on RA
Height: 5’5†Weight: 250 lbs.
Blood glucose: 230 (Fasting; states has not eaten yet today)
patient awake, alert, oriented x 4 in NAD
Skin: warm, dry, color WNL. 4 cm lesion noted to anterior left foot with crusting and purulent drng; + surrounding erythema extending up 7 cm proximally
HEENT: head nontraumatic, normocephalic
Pupils PERRLA, EOMs intact; disc margins sharp, without hemorrhages, exudates; no AV nicking noted
Ears: bilateral TM with good cone of light and intact
Nose: mucosa pink, septum midline; no sinus tenderness appreciated
Mouth: mucosa pink, moist; tongue midline; tonsils 1+ without exudate
Neck: supple; trachea midline; no LAD
Resp: regular and unlabored; lungs with end expiratory wheezing throughout
CV: RRR, S1 and S2 noted; no s3, s4 or murmur appreciated
Abdomen: soft, non-distended; Bs + x 4; no tenderness with palpation; no CVA tenderness with percussion
Genitalia: deferred
Rectal: deferred
Extremities: warm and without edema; calves supple, non-tender
PV: no LE edema
MS: + swelling to left foot; + tenderness of 2-4th left metatarsals; + left pedal pulse; CMS intact; Cap refill < 2 sec. Neuro: alert, cooperative; thought coherent; oriented x 4; cranial nerves II-XII intact Questions: 1. List your differentials for her current problems. Remember you should have at least three different differentials for each problem. Include rationale for each differential. 2. At this time what medical diagnoses are you most concerned about? Do they impact other diagnoses? If so, how? 3. What diagnostic images would you order? Provide your rationale. What are you trying to rule in or out? 4. What laboratory work would you order? What would you anticipate to be abnormal? Provide your rationale for each. 5. What is your comprehensive plan of care? Include your rationales.
Health information managers/professionals have a variety of different roles that they are responsible for with regard to record keeping. Which role do you feel is the most important and why? Which one do you think will be the most challenging for you to implement and why? What steps could you take to address this challenge?