What is the etiology of bronchitis?

Pathophysiology

Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. Through and extensive work-up, she is diagnosed with bronchitis.
  1. What is the etiology of bronchitis?
  2. Describe in detail the pathophysiological process of bronchitis.
  3. Identify hallmark signs identified from the physical exam and symptoms.
  4. Describe the pathophysiology of complications of bronchitis.
  5. What teaching related to her diagnosis would you provide?

In addition to the textbook (McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby. )utilize at least one peer-reviewed, evidence based resource to develop your post.

Financial Healthcare Management

 

Financial Healthcare Management

Case Study: You are assessing the payer–patient mix for a health care organization. Currently, your payer mix is 40% Medicare, 10% Medicaid, 25% traditional indemnity insurance, 20% managed care, and 5% self-pay patients. Complete the following:

 Using the most common office visit, CPT code 99214, determine the reimbursement from the Centers for Medicare and Medicaid Services (online fee schedule available for Medicare).
Using the same CPT code, 99214, determine the be possible to obtain actual reimbursement information from your personal insurance carrier. If the information is not available, assume reimbursement by traditional indemnity insurance is usually 200% reimbursed more than Medicare and Medicaid, and managed care is usually 133% more than Medicare and Medicaid.
Compose an accounts receivable benchmark from this information showing columns for current, 30–60, 61–90, 90–120, and greater than 120 days.
Assess the information for areas of improved reimbursement of at least 20% or more.
Evaluate the options available to change the payer–patient mix with consideration of related legal and ethical issues.
Propose a best strategy with justification and rationale based on effective decision-making tenets.
Spreadsheets demonstrating the accounts receivable analysis will be attached as appendices, and there will be at least 7 relevant peer-reviewed academic or professional references published within the past 5 years. Also attach appropriate fee schedules.

What are social determinants of health?

What are social determinants of health? How do social determinants of health contribute to the development of illness? What is a communicable disease chain? Are there steps that a nurse can take to break a link within the communicable disease chain? Give a specific example.

Readings within your text covering international/global health and the following websites will assist you in answering these questions:

U.S. Centers for Disease Control and Prevention (CDC) Global Health website: http://www.cdc.gov/cogh/index.htm
U.S. Department of Health & Human Services (HHS) Global Health website: http://www.globalhealth.gov/index.html
Families USA – Why Global Health Matters—Here and Abroad website: http://www.familiesusa.org/
World Health Organization (WHO) website: http://www.who.int

Globalization and Diversity Impact on Healthcare Organizations

Globalization and Diversity Impact on Healthcare Organizations

Unit outcomes addressed in this Assignment:

Explain the attributes of a successful health leader.
Describe issues related to globalization, power, followership, and culture change from a health leader’s perspective.

Course outcome addressed in this Assignment:

HA515-2: Evaluate approaches to leading individuals and teams, and eliciting support from senior principles.

HA515-3: Identify change management practices by discussing change sponsorship versus agency of change theory.

HA515-4: Evaluate leadership strategies essential to successfully accomplish change including interpersonal, organizational, and cultural dimensions.

Instructions

For this Assignment, outline issues related to globalization, power, followership, and cultural change from a health leader’s perspective. Identify at least three major global health issues that have impacted the U.S. health care system, and describe how this has affected and influenced stakeholders.

Relate the global leadership style differences and similarities within the constructs of transformational leadership. Discuss at least three critical elements of culture and diversity on the modern health care organization. Also, provide a table or list of cultural attributes to be cognizant of.

Finally, categorize global leadership differences according to a leader’s use of power, technology, and knowledge management. Provide at least two leadership approaches for implementing change.

Requirements

Your paper must be at least 5 pages in length.
Use a minimum of three academic references.
Cite all references using APA format.

Roles of each family member. Who is the leader in the family? Who is the primary provider? Is there any other provider?

COMMUNITY HEALTH NURSING

FAMILY HEALTH ASSESSMENT

After you have read chapter 29 and 30 choose a family in your community and conduct a family health assessment using the following questions below.

1. Family composition.

Type of family, age, gender and racial/ethnic composition of the family.

2. Roles of each family member. Who is the leader in the family? Who is the primary provider? Is there any other provider?

3. Do family members have any existing physical or psychological conditions that are affecting family function?

4. Home (physical condition) and external environment; living situation (this must include financial information). How the family support itself.

For example; working parents, children or any other member

5. How adequately have individual family members accomplished age-appropriate developmental tasks?

6. Do individual family member’s developmental states create stress in the family?

7. What developmental stage is the family in? How well has the family achieve the task of this and previous developmental stages?

8. Any family history of genetic predisposition to disease?

9. Immunization status of the family?

10. Any child or adolescent experiencing problems

11. Hospital admission of any family member and how it is handle by the other members?

12. What are the typical modes of family communication? It is affective? Why?

13. How are decision make in the family?

14. Is there evidence of violence within the family? What forms of discipline are use?

15. How well the family deals with crisis?

16. What cultural and religious factors influence the family health and social status?

17. What are the family goals?

18. Identify any external or internal sources of support that are available?

19. Is there evidence of role conflict? Role overload?

20. Does the family have an emergency plan to deal with family crisis, disasters?

Identify 3 nursing diagnosis and develop a short plan of care using the nursing process.

Please present a summary of your assessment in an APA format on a 12 Arial font, word document attached to the forum in the discussion tab of the blackboard title “family assessment” Please use at least 3 scholarly evidence-based practice references besides the class textbook to sustain your assessment. A minimum of 1000 words are required, excluding the first and reference page (Websites can be used but will not count toward grading). 2 replies to any of your peer’s assessment are required sustained by the proper references.

Due date: Saturday March 3, 2018 @ 11:59 PM

If you have any questions please contact me via e-mail as soon as possible.

Develop a hypothesis relating to the amount of dissolved oxygen measured in the water sample and the number of fish observed in the body of water.

Lab 1: Introduction to Science
INSTRUCTIONS:
· On your own and without assistance, complete this Lab 1 Answer Sheet electronically and submit it via the Assignments Folder by the date listed in the Course Schedule (under Syllabus).
· To conduct your laboratory exercises, use the Laboratory Manual located under Course Content. Read the introduction and the directions for each exercise/experiment carefully before completing the exercises/experiments and answering the questions.
· Save your Lab 1 Answer Sheet in the following format: LastName_Lab1 (e.g., Smith_Lab1).
· You should submit your document as a Word (.doc or .docx) or Rich Text Format (.rtf) file for best compatibility.

image1.png Exercise 1: Data Interpretation

Dissolved oxygen is oxygen that is trapped in a fluid, such as water. Since many living organism requires oxygen to survive, it is a necessary component of water systems such as streams, lakes and rivers in order to support aquatic life. The dissolved oxygen is measured in units of ppm (parts per million). Examine the data in Table 4 showing the amount of dissolved oxygen present and the number of fish observed in the body of water the sample was taken from; finally, answer the questions below.

image3.png

Post-Lab Questions

1. What patterns do you observe based on the information in Table 4?

2. Develop a hypothesis relating to the amount of dissolved oxygen measured in the water sample and the number of fish observed in the body of water.

3. What would your experimental approach be to test this hypothesis?

4. What would be the independent and dependent variables?

5. What would be your control?

6. What type of graph would be appropriate for this data set? Why?

7. Graph the data from Table 4: Water Quality vs. Fish Population (found at the beginning of this exercise).

8. Interpret the data from the graph made in Question 7.

image2.jpg Exercise 2: Experimental Variables

Determine the variables tested in the each of the following experiments. If applicable, determine and identify any positive or negative controls.

Observations

1. A study is being done to test the effects of habitat space on the size of fish populations. Different sized aquariums are set up with six goldfish in each one. Over a period of six months, the fish are fed the same type and amount of food. The aquariums are equally maintained and cleaned throughout the experiment. The temperature of the water is kept constant. At the end of the experiment the number of surviving fish is surveyed.

A. Independent Variable:

B. Dependent Variable:

C. Controlled Variables/Constants:

D. Experimental Controls/Control Groups:

2. To determine if the type of agar affects bacterial growth, a scientist cultures E. coli on four different types of agar. Five petri dishes are set up to collect results:

· One with nutrient agar and E. coli

· One with mannitol-salt agar and E. coli

· One with MacConkey agar and E. coli

· One with LB agar and E. coli

· One with nutrient agar but NO E. coli

All of the petri dishes received the same volume of agar, and were the same shape and size. During the experiment, the temperature at which the petri dishes were stored, and at the air quality remained the same. After one week the amount of bacterial growth was measured.

A. Independent Variable:

B. Dependent Variable:

C. Controlled Variables/Constants:

D. Experimental Controls/Control Groups:

Exercise 3: Testable Observations

Determine which of the following observations (1-6) are testable. For those that are testable answer the following questions:

Determine if the observation is qualitative or quantitative

Write a hypothesis and null hypothesis

What would be your experimental approach?

What are the dependent and independent variables?

What are your controls – both positive and negative?

How will you collect your data?

How will you present your data (charts, graphs, types)?

How will you analyze your data?

Observations

1. A plant grows three inches faster per day when placed on a window sill than it does when placed on a on a coffee table in the middle of the living room.

2. The teller at the bank with brown hair and brown eyes is taller than the other tellers.

3. When Sally eats healthy foods, her blood pressure is 10 points lower than when she eats unhealthy foods.

4. The Italian restaurant across the street closes at 9 pm but the one two blocks away closes at 10 pm.

5. For the past two days, the clouds have come out at 3 pm and it has started raining at 3:15 pm.

6. George did not sleep at all the night following the start of daylight savings.

Exercise 4: Conversion

For each of the following, convert each value into the designated units.

1. 46,756,790 mg = _______ kg

2. 5.6 hours = ________ seconds

3. 13.5 cm = ________ inches

4. 47 °C = _______ °F

Washington state passed the Death with Dignity Act (Links to an external site.)Links to an external site. in 2008, where it is currently legal under specific circumstances to request assistance from a physician in order to end one’s life (see the link for more specifics).

Washington state passed the Death with Dignity Act (Links to an external site.)Links to an external site. in 2008, where it is currently legal under specific circumstances to request assistance from a physician in order to end one’s life (see the link for more specifics). For this option, watch the Frontline documentary “The Suicide Plan” (Links to an external site.)Links to an external site. and research an area of death, dying and bereavement that interests you, and that you can share with others in your group on seminar day. It does not have to be a scholarly article, but it should be from a reputable source. Please answer the questions below:

1. Under what circumstances is it legal in Washington state for someone to request assisted dying? Do you think there are adequate safeguards in place? Why or why not?

2. Why do people explore this option? What are the effects of legalizing this option? How often is this option utilized, and by whom? Use the data from both Oregon and Washington:

Death with Dignity act data from Washington state (Links to an external site.)Links to an external site.

Death with Dignity act data from Oregon state (Links to an external site.)Links to an external site.

3. What topic did you choose to learn more about, and what did you learn? Please include a link and reference to the source. Were there any controversies raised? Were there differences in what the article and the documentary reported?

4. What is your reaction to studying this topic? What are your beliefs and feelings about death and dying, and how were your perspectives informed? Did the reading and documentary change your perspective? If so, in what way(s)? Feel free to share any personal experiences you have with death and dying, although you are not obligated. You may wish to also discuss your fears and concerns about facing end of life issues personally and for your loved ones.

Identify the theorist and rationale for the selection.

Leadership As A Vocation

Topic: Expert Practices

Benchmark Assignment: Applying Theory to a Practice Problem: Part 3: Application of Borrowed Theory to Problem and Conclusion

This is a Collaborative Learning Community assignment.

In your group, write a report on the chosen theorist/theory that includes the following:

1. Introduction: Identify the theorist and rationale for the selection.

2. Describe the theorist (short biography and major influences on the theorist).

3. Indicate the category under which the theorist falls (can use McEwen & Wills classification or other source).

4. Incorporate assumptions underlying the theory (including how metaparadigm concepts are defined).

5. Include major concepts of the theory.

6. Include major propositions of the theory.

7. Provide examples from the literature of how the theory has been used.

8. Describe how the theory will be integrated into practice at your institution (or how it will be used as a foundation, framework, etc.). This is an action plan.

9. Give concrete examples of how theory would be integrated (e.g., assessment guide) and what patient outcomes could be measured as a result of implementing the theory.

10. Conclusion: Contrast present practice with what would take place if the theory were guiding the practice.

Prepare this assignment according to the guidelines found in the GCU APA Style Guide, located in the Student Success Center. An abstract is not required.

is anyone surprised to find out that in some parts of America you can have an abortion at 9 months, and in other places are restricted at just 6 weeks?  

Abortion, The Interminable Debate Also Abortion, The Catholic Argument, And As A Structure…

   1) Abortion, the interminable debate

Contrary to what some believe, abortion policy does not vary just a little from state in the U.S.; it is not ‘legal’ or ‘illegal’ in a simple fashion.  Most people assume, for instance, that if a woman is 3 weeks late on her menstrual cycle, then she can terminate her pregnancy…because abortion is legal, after all….isn’t it?  But is she happens to live in North Dakota, she’s one week too late: the state house passed a law last year prohibiting any abortion 6 weeks or more after a woman’s last menstrual cycle.  And many of us were dismayed by the tastelessness and crassness of a debate between Hillary Clinton and Donald Trump last year, when Trump claimed that Hillary’s position (and by implication, the ‘pro-choice position generally) was that, “even on the operating table,” if a woman came in to deliver her baby, “she could change her mind at the last second,” and have an abortion.  He painted a truly vivid picture: of a basinet and a nurse waiting to care for the newborn on the left, and an doctor with a scalpel and a plastic bag on the right, and the woman in the middle of labour, still able to decide whether or not she will abort or give birth.  Pro-choice folks everywhere were quick to point out the next day that this literally never (as in we have no specific cases) has happened, but they were wrong about one thing: 9 states, including Alaska and Mississippi, have no restrictions whatsoever on when a pregnancy can be terminated.  As tasteless as Trump’s debate strategy may have been, it is theoretically possible in these states to abort in the late third trimester.  This New York Times graphic breaks down U.S. abortion laws by state; it’s a bit dated, being from 4.5 years ago, but it’s the only source I found that puts it all in one easy-to-read graph:

http://www.nytimes.com/interactive/2013/06/18/us/politics/abortion-restrictions.html (Links to an external site.)Links to an external site.

Question: is anyone surprised to find out that in some parts of America you can have an abortion at 9 months, and in other places are restricted at just 6 weeks?  This is because the famous Roe vs. Wade supreme court decision specified 24 weeks, and thus every state, depending on it’s politics, tends to push the restriction backwards and forwards.

At the heart of this debate are two completely deductively valid arguments.  On the pro-choice side, there is this one:

Premise 1: All women should have the right to make decisions regarding their own body, including medical procedures.

Premise 2: Whether or not to carry a pregnancy to term is a medical decision about a woman’s body, and thus it should be made by her and her alone.

Premise 3: Access to legal and safe pregnancy termination is obviously essential for a woman to be able to make decisions about whether or not to carry a pregnancy to term.

Conclusion:  Abortion must be safe and legal, or else we are violating women’s rights.

As covered in the first unit, in a deductive argument, if the premises are true, then the conclusion must be true.  If one were to disagree with the above argument, Premise 2 is clearly the one that the average Pro-life position disagrees with, as we see in their own deductively valid argument:

Premise 1: All people are equal under the law, entitled to not have their basic rights violated.

Premise 2: A fetus is a person.

Premise 3: An abortion terminates a fetus’ life, and thus is a violation of it’s basic rights.

Conclusion: Abortion violates the rights of the unborn child, AKA fetus, and thus should be legal.

This debate is, as presented here, unsolvable.  There are 4 short readings for this unit, two pro-choice and two pro-life.  We have basically different philosophical premises.  Question: how might, in theory, science weigh in on this debate?  Thus far, the primary way it has weighed in is to designate 24 to 26 weeks as the time when most fetsuses can survive outside the womb (with an incubator), and thus about half of U.S. states prohibit abortion after this time.  It has been suggested that perhaps cranial activity or a heartbeat could designate the start of life, but this, of course, happens at different times for different pregnancies.

In the readings, Peter Singer argues that from a utilitarian perspective, we should all obviously be Pro-choice, because in terms of human suffering, the suffering of the unborn child is not as significant as the millions of women, all adults with lives, families, hopes and dreams, who would die attempting to undergo illegal abortions.  Indeed, without language, without any sense of what he or she wants, even a most developed third trimester fetus, at 8 months, arguably doesn’t suffer much in simply not being allowed to live at all.  Many would argue that abortion is simply a fact of feminism, in some sense: every society that has a concerted movement for women’s equality and women’s rights has legalized abortion.

This would be my question to the pro-life side: What do you want?  If what you want is a modern, secular (meaning separatin of church and state) country, where abortion just happens to be illegal because at least 51% of people think it should be, can you not see that that has never exited, and for good reason?  We cannot change biology; we cannot change human sexuality.  Many women would argue that if you want to allow women equal access to politics, careers, money, and power, the ability to choose whether or not to be pregnant is simply part of that process.

To the pro-choice side, I would ask this: how exactly do we decide when, as a pregnancy develops, to restrict access to abortion?  Surely there is a difference between taking the morning after pill, and aborting at 8.5 months, when the fetus probably would not even require an incubator to survive, but in it’s most extreme form, pro-choicers advocate for the right to abortion at any point in the pregnancy.  Surely we are all smart enough to understand the philosophical position, even we disagree, that terminating a pregnancy in the third trimester is not a medical decision that involves only the woman’s body.  How do we decide when another body is involved?

The real question is truly this: in a society where this argument will continue, and we will each develop our own sense of right and wrong regarding it, how do we make the laws?

2) Abortion, the Catholic argument, as a structure…

A very conservative Catholic friend of mine introduced me to a style of argument regarding abortion that fascinated me.  It is basically thus:

Premise 1: The abortion debate is interminable.  It is a valid philosophical belief, widespread and no-doubt persistent, that life begins at birth, that a pregnancy is essentially a medical condition, and thus abortion should be legal.  It is equally philosophically valid to believe, however, that life begins at conception, which leads to the opposite conclusion.  Indeed, every single scientific attempt to create consensus around when, in the middle, life begins, has failed.

Premise 2: When democracies contain large constituencies that have an unsolvable philosophical disagreement, where no compromise is possible, the right thing to do is to put it to a vote.

Conclusion: We should allow states, and possibly even counties and cities, to vote on their own abortion policy.

That’s not a bad argument.

This is a fascinating strategy: he’s basically saying, “We’re not right, you’re not right; none of us will change out minds.  Therefore, let’s just vote on it.”  Instead, the supreme court decided.

For the pro-choice side, access to abortion has taken on a moral weight similar to the end of racial segregation.  Many southern U.S. states had populations that, if they were allowed to vote on it, would have preferred to have kept racial segregation, but the federal government said no: segregated schools, parks, and other public institutions is so wrong, that it simply doesn’t matter whether most people in a given state want it back: they’re not allowed to.

If this Catholic argument won the day, at least 20 U.S. states would probably outlaw abortion tomorrow.  What might be some other issues where this style of thinking–that Democracy doesn’t work, because smaller communities might do something too wrong for the country to allow–exists?  What are issues where we shouldn’t vote, because ‘the people’ are just too unpredictable?  How do we decide which issues to pick and choose?  Are there any that should be rolled back, in your opinion; in other words, are there issues where you think that a city, state, or county ought to be allowed to make it’s own policy?

A few suggestions: gun control; Texas already has armed teachers in 170 school districts; should states be allowed to set their own ‘armed teacher’ policy, or should the country decide for everyone?  Nutrition: should cities be allowed to try radical solutions to health problems, such as banning all sugary sodas?  Screen time: Should cities or counties be allowed to restrict, or even ban, portable electronic devices in order to create their own desired type of society?  Smoking: should this one be rolled back, perhaps?  Right now, even a small bar, run by smokers who exclusively employ smokers as bartenders and tend to attract smokers as clients, is not allowed to allow smoking inside their bar.

What are your own issues?  How radical should we allow local municipalities to be?

Somatic symptom disorders

Write a research paper (750 word minimum length) on the any of the psychological disorder covered in Chapter 15. You can view a list of these disorders on page xix of the Contents section of our textbook. You must include information on the:1.symptoms, 2.causes, and 3.treatments for the disorder you select. Use a minimum of three sources for your research (our course textbook may not be used as one of your sources and document them in as “works cited’ or in a bibliography.

List of disorders to choose from:

Mood disorders

Eating disorders

Substance related disorders

Psychotic disorders

Somatic symptom disorders