Question 1 Scenario 1: Polycystic Ovarian Syndrome (PCOS) A 29-year-old female presents to the clinic with a complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 11 years of age. She began to develop dark, coarse facial hair when she was 13 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted.  Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ?5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.   Question  1.What is the pathogenesis of PCOS?  Question 2  Scenario 1: Polycystic Ovarian Syndrome (PCOS) A 29-year-old female presents to the clinic with a complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 11 years of age. She began to develop dark, coarse facial hair when she was 13 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted.  Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ?5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.   Question  How does PCOS affect a woman’s fertility or infertility? Question 3 Scenario 2: Pelvic Inflammatory Disease (PID) A 30-year-old female comes to the clinic with a complaint of abdominal pain, foul smelling vaginal discharge, and fever and chills for the past 5 days. She denies nausea, vomiting, or difficulties with bowels. Last bowel movement this morning and was normal for her. Nothing has helped with the pain despite taking ibuprofen 200 mg orally several times a day. She describes the pain as sharp and localizes the pain to her lower abdomen. Past medical history noncontributory. GYN/Social history + for having had unprotected sex while at a fraternity party. Physical exam: thin, Ill appearing anxious looking white female who is moving around on the exam table and unable to find a comfortable position. Temperature 101.6F orally, pulse 120, respirations 22 and regular. Review of systems negative except for chief complaint. Focused assessment of abdomen demonstrated moderate pain to palpation left and right lower quadrants. Upper quadrants soft and non-tender. Bowel sounds diminished in bilateral lower quadrants. Pelvic exam demonstrated + adnexal tenderness, + cervical motion tenderness and copious amounts of greenish thick secretions. The APRN diagnoses the patient as having pelvic inflammatory disease (PID).   Question: 1.What is the pathophysiology of PID?  Question 4 Scenario 3: Syphilis A 37-year-old male comes to the clinic with a complaint of a “sore on my penis” that has been there for 5 days. He says it burns and leaked a little fluid. He denies any other symptoms. Past medical history noncontributory.  SH: Bartender and he states he often “hooks up” with some of the patrons, both male and female after work. He does not always use condoms.  PE: WNL except for a lesion on the lateral side of the penis adjacent to the glans. The area is indurated with a small round raised lesion. The APRN orders laboratory tests, but feels the patient has syphilis.   Question: 1.What are the 4 stages of syphilis    

  Part 1  Control Mechanisms in Health Services Organizations Control mechanisms facilitate pathways that health care administrators might consider when deciding how to direct, adjust, and mobilize resources as they apply to day-to-day and business operations. Additionally, control mechanisms assist health care administrators in determining areas where opportunities for improvement might exist in order to facilitate enhanced business and health care delivery practices. As a current or future health care administrator, understanding how to interpret and modify control mechanisms is an essential skill that will contribute greatly to your decision making for enhancing process improvement. For this Discussion, reflect on the Learning Resources for this week, and consider the findings in the Singer article. Then, select a control mechanism that is most appropriate for your HSO or an HSO with which you are familiar. Consider how this control mechanism might apply to promoting a culture of safety as a process improvement initiative in the HSO you selected. (Singer article) Reducing Hospital Errors: Interventions that Build Safety Culture Annual Review of Public Health Vol. 34:373-396 (Volume publication date March 2013) First published online as a Review in Advance on January 16, 2013 https://doi-org.ezp.waldenulibrary.org/10.1146/annurev-publhealth-031912-114439 Post a description of the control mechanism you selected and explain its relevance to your HSO. Then, explain how you as a current or future health care administrator might apply this control mechanism to promoting a culture of safety in your HSO; explain why you would apply the mechanism in this way. References. Part II  Design and Control in Quality Improvement Initiatives For this Assignment, review Case 3, “Barriers to an Effective QI Effort,” in Chapter 11 of the text, Managing Health Services Organizations and Systems. Reflect on how you as a current or future health care administrator might address strategies to implement a quality improvement initiative. Consider the following questions: What considerations should you keep in mind to address quality? How does one measure quality and identify strategies to improve quality in an HSO? Then, review the Week 6 Case Questions document in this week’s Learning Resources to complete the Assignment. The Assignment (2–4 pages): Complete the case questions presented. Be sure to provide support from the literature in completing the case questions. Week 6 Case Questions Design and Control in Quality Improvement Initiatives Chapter 11, Case 3: “Barriers to an Effective QI Effort” Questions: Use the principles of QI from Chapters 7 and 8 to outline a basic effort to improve quality in the ED.   Identify some control measures that Lester could use. Longest, B. B., Jr., & Darr, K. J. (2014). Managing health services organizations and systems (6th ed.). Baltimore, MD: Health Professions Press.Chapter 11, “Controlling and Allocating Resources” (pp. 497–548)  

Exectuive SummaryIn this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:The purpose of the quality improvement initiative.The target population or audience.The benefits of the quality improvement initiative.The interprofessional collaboration that would be required to implement the quality improvement initiative.The cost or budget justification.The basis upon which the quality improvement initiative will be evaluated.