Mr. Caesar Practice Prevention Case Study

Instructions: You will use the assigned case study to prepare this assignment. This assignment does NOT involve a live person–just the case study.

1. Make a complete Prevention Plan for the case study patient provided to you based on the information you are given in the case study. Focus on the A & B USPSTF recommendations and ACIP Adult Immunizations. However, also be aware of any special risks the patient may have that need to be considered that might not routinely be listed in the A & B recommendations or even in the USPSTF. FORor example, be sure to review the mini case study as a guide. Please put the Screening, Counseling, and Prevention meds/Immunizations interventions in the table provided for this assignment—-you must use the table. After listing the recommended intervention, in that same cell of the table, list your rationale for why the patient needs the service. For example, a service may be age recommended for this patient of 49 years or the patient may be a 20 pack year smoker. It is required that you also identify HOW you will do the screening–e.g., which lab test or specific screening tool.
2. You will upload the assignment when completed. Be sure to include the authoritative source that supports what you recommend as a reference at end of the table (e.g., A or B recommendation USPSTF or ACIP-CDC or any other).
3. Develop and include a timed/staged Prevention Plan to address the Prevention Plan you developed in #1. Be sure to indicate the time frame you would consider for your interventions (e.g., this visit, next visit (when), by 1 month, by 6 months, and by 1 year). You need to list the specific intervention in the time frame. This will be variable; you do not have to use the suggested time points we have listed. Cite your brief rationale for your staging of the interventions.

List references used in APA format at end of assignment (just after the table)
Use a cover page for assignments in APA format.

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Practice Prevention Case Study

Mr. Caesar

Identifying Data: age 78 yo, WM, DOB: 7-8-1944

HPI: New patient here for to establish his medical care. He has been living as a missionary in Africa and has had very irregular healthcare for years. Just moved back to USA.

Current Health Data:

Medications- daily baby ASA

Allergies- NKDA

Screening tests/last: last physical exam 2005. No recent tests of any kind.

Immunizations- none reported that he recalls except annual flu shot in the mission.

PMH:

Childhood illnesses: none

Adult illnesses: none known

Hospitalizations/ Surgeries: cholecystectomy 20 years ago.

Sexual Hx: sexually active on occasion in Africa with native females. Occasional sex now. Eight lifetime partners.

Psych Hx: no screening ever done

Family Hx: Father (97 yo) with HTN, Lipids, COPD, prostate cancer; mother (94 yo died) with HTN, CVA

Personal/Social Hx: quit cigarettes 5 years ago–was a heavy smoker (1 pack/day) for 40 years since age 25, alcohol daily: 3 beers. Retired from his work as a mailman at 60 and began missionary work. Spouse died 3 years ago and lives alone. Has Medicare insurance.

ROS: (selected)

General-see HPI.

Nutrition- eats small amounts—frequent eggs and toast. Six cup of coffee daily.

EENT- some seasonal allergy with runny nose, occasional sore throat

Respiratory-chronic cough but denies SOB, wheeze. No hx asthma but has frequent bronchitis and early morning sputum few times a week.

Cardiovascular-denies chest pain, pressure, tightness.

GI-denies N/V/D. Daily BM, no constipation, no blood in stool.

GU- denies pain, hematuria. Does report some difficulty starting stream and nighttime void x2 every night. Mr. Caesar Practice Prevention Case Study

MSK-Occasional LBP when activity is greater than usual. No pain radiation. denies any other joint swelling, pain, redness, no muscle weakness.

Psychiatric-no dx of depression or anxiety

Neuro has some memory lapses — “not a big problem”

PE: VS- P-70, R- 14, BP-142/88, BMI-32.4

Prevention Case Table & Timeline for Assignment

MUST BE USED

Increase or Decrease Rows as needed.

A and B USPSTF recommendations
Rationale for the screening, counseling, and prevention med you have chosen
List references used in APA format at end of assignment (just after the table)
Use a cover page for assignment in APA format

SCREENING TESTS	Indicate A or B Recommendation (or other if you believe it is indicated) PLUS Rationale for this patient





















COUNSELING AREAS	Indicate A or B Recommendation (or other if you believe it is indicated) PLUS Rationale for this patient














PREVENTION MEDS/Immunizations	Recommendation of USPSTF or CDC PLUS Rationale for this patient

Timeline for Implementing Prevention

A timeline must be negotiated with patient using shared decision-making: (use the timeframe YOU think is best based on patient needs and risks—e.g., you may think all outstanding prevention activities should be completed within 2 months and not use the 1 year timeline. This is up to you and the patient. For this assignment, assume the patient agrees with your recommended timeline. (Space things out as needed). Provide your rationale for how you have made your decisions. It is best to use bullets for the plan. Mr. Caesar Practice Prevention Case Study

Highest Priority: Today or within next two weeks:

2 weeks-1 Month:

2-3 Months:

4-5 Months:

6 Months:

By 1 year: