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Describe at least five problems and provide the rationale for each.

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Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control with sodium restriction. He current works at a catalog telephone center.

Objective Data

  1. Height: 68 inches; Weight 134.5 kg
  2. BP: 172/96, HR 88, RR 26
  3. Fasting Blood Glucose: 146/mg/dL
  4. Total Cholesterol: 250mg/dL
  5. Triglycerides: 312 mg/dL
  6. HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

  1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
  2. Ranitidine (Zantac) 300 mg PO at bedtime.
  3. Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

  1. Assess each of Mr. C.’s functional health patterns using the information given. (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance.)
  2. What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

Pharmacotherapy for Respiratory Disorders

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Discussion: Pharmacotherapy for Respiratory Disorders

To the untrained ear, most coughs sound the same. However, as you might recall from past clinical experiences, a simple cough can lead to a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive pulmonary disease (COPD). Although it can sometimes be challenging to diagnose a patient based on common respiratory symptoms such as congestion, coughing, and wheezing, it is important to be able to distinguish minor differences as even mild symptoms might require intervention with drug treatments. When recommending potential treatment options, advanced practice nurses must consider how individual patient factors might impact the effects of prescribed drugs.

To prepare:
  • -Review Chapter 26 and Chapter 27 of the Arcangelo and Peterson text.
  • -Select and research one of the following respiratory disorders: the common cold, pneumonia, or a chronic obstructive —-pulmonary disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.
  • -Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the respiratory disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

THE DISCUSSION IS IN APA, MINIMUM 3 REFERENCES NOT OLDER THAN 2013 AND CITATION.

Required Readings

Arcangelo,  V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.).  (2017). Pharmacotherapeutics for advanced  practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams  & Wilkins.
Chapter 18, “Otitis Media and Otitis Externa” (pp. 243-252)
This chapter compares the causes and pathophysiology of two common ear infections—otitis media and otitis externa. It also identifies types of drugs used to treat these ear infections.

Chapter 24, “Upper Respiratory Infections” (pp. 259-374)
This chapter explores the causes, pathophysiology, and diagnostic criteria of two upper respiratory infections—the common cold and sinusitis—as well as drug therapy for both infections. It also covers monitoring patient response and patient education of drug therapy for these infections.

Chapter 25, “Asthma” (pp. 377-392)
This chapter examines the causes, pathophysiology, pharmacogenomics, and diagnostic criteria of asthma. It also outlines suggested drug therapy plans for asthmatic patients.

Chapter 26, “Chronic Obstructive Pulmonary Disease” (pp. 395-406)
This chapter explains the causes and pathophysiology of chronic obstructive pulmonary disease (COPD). It also examines the process of selecting, administering, and managing drug therapy for COPD patients.

Chapter 27, “Bronchitis and Pneumonia” (pp. 407-424)
This chapter begins by examining the causes, pathophysiology, and diagnostic criteria of acute bronchitis, chronic bronchitis, and community-acquired pneumonia. It then explores the process of selecting, administering, and managing drug therapy for patients with bronchitis and pneumonia.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This website presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.

Political Analysis and Strategies

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Reaching out a Solution

This assignment is designed to assist you in developing a thoughtful process for advocating about an issue as a nurse, from identifying a problem that needs to be solved through articulating a process for doing so.

This assignment consists of answering each of the questions listed below from the “Political Analysis and Strategies” chapter of your course textbook. Write each question as a new topic area; then follow with a paragraph or two to answer the question. Be sure to use APA guidelines for writing style, spelling and grammar, and citation of sources, if any used. This project should be no longer than 4 pages.

Let us assume that you are a school nurse in a high school. At a recent school athletic event, a spectator suffered a cardiac arrest in the stands. A coach of the home team went into the high school to fetch the automatic emergency defibrillator (AED) only to find out that it was not readily available. In the meantime, an emergency squad arrived and resuscitated the spectator. On Monday morning, you learn of the absence of the AED only to find out that it had been locked in the custodian’s closet. Reflect on the following questions outlined in the “Political Analysis and Strategies” chapter:

  • What is the issue?
  • Is it my issue, and can I solve it?
  • Is this the real issue or merely a symptom of a larger one?
  • Does it need an immediate solution, or can it wait?
  • Is it likely to go away by itself?
  • Can I risk ignoring it?
  • What are the possible solutions? Are there risks to these solutions?
  • What steps would you need to take in order to solve the issue?
  • Does anyone else at the school need to be involved in the solution?
  • Where is the power leverage in the school to reach the preferred solution?

Reaching a solution requires the use of power vested in the nurse. Review Box 9-1 (Sources of Power) and determine which type(s) of power the school nurse has in this situation. State your reasons for your answer.

Submission Details:

  • Submit your response in a 4-page Microsoft Word document.
  • Name your document SU_NSG4068_W4_Project_LastName_FirstInitial.doc.
  • Submit your document to the Submissions Area by the due date assigned.
  • Cite sources in the APA format on a separate page.

Strategic Plan Natural disaster

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Strategic Plan Natural disaster

Research Paper

The Research Paper is a ten- to twelve-page paper (excluding title and references pages) that provides the student the opportunity to investigate a specific natural disaster topic, apply graduate-level critical thinking to the presentation of the information, and utilize and synthesize appropriate current research for your selected topic. The Research Paper utilizes professional health care knowledge and skills and applies those proficiencies to the context of quality improvement and risk management by developing a natural disaster strategic plan for community health: Mobilizing For Action Through Planning and Partnerships (MAPP) Process. The three-part Strategic Disaster Plan will be developed in Weeks Two, Four, and Six. Review Chapter 3 in the textbook. In this final part, the students will take the strategic issues identified in Part II (Week Four) and formulate goal statements and strategies for addressing issues, resulting in development and adoption of an interrelated set of strategy statements. Lastly, an action plan with an evaluation timeline that identifies outcomes to be reached and what steps would be taken to ensuing adjustments in the strategy plan if needed. The final draft with all three parts will be posted together for a final grade.

Writing the Research Paper The Research Paper:

1. Must be ten to twelve double-spaced pages in length (excluding title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center.

2. Must include a title page with the following:

a. Title of paper

b. Student’s name

c. Course name and number

d. Instructor’s name

e. Date submitted

3. Must include an introductory paragraph with a succinct thesis statement.

4. Must address the topic of the paper with critical thought.

5. Must end with a conclusion that reaffirms your thesis.

6. Must use at least ten scholarly and/or peer-reviewed sources  published within the last five years, including a minimum of three from the Ashford University Library.

7. Must document all sources in APA style as outlined in the Ashford Writing Center.

8. Must include a separate reference page that is formatted according

What are three methods of disease transmission mentioned in the epidemiology animation on the Home page?  Provide some examples

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Module 3 – Case

PATHOGENICITY, IMMUNOLOGY AND EPIDEMIOLOGY

Case Assignment

In this Case Assignment, you will focus on the materials that you viewed on the Home page.  After reading the text and viewing each of the links provided there, address the following questions:

  1. What are three methods of disease transmission mentioned in the epidemiology animation on the Home page?  Provide some examples.
  2. What are the most common vectors mentioned in the tutorial on transmission of disease?
  3. Which pathogens were mentioned in the Virulence Factors animations (host tissues and defenses)?  List all of the pathogens mentioned and then choose two to discuss.  In your discussion include:
  • How do they hide from host defenses?
  • How do they invade or penetrate the host?
  • Research how they reproduce, and ID them using at least three phenotypic descriptions (you can refer to the dichotomous key from the previous module for phenotypic descriptions).
  1. Note whether the pathogen you chose was reported as a risk to the workplace in the Infectious Diseases in the Workplace article you read on the Home page.
  2. Note the total cases and related mortality reported by the CDC Stats in the linked report.

Assignment Expectations

Page Length: 2 to 3 pages

Format

TUI encourages all students to comply with APA style and format guidelines for proper citation of references.

Scholarly Content                  

Your case assignments are considered scholarly works. Your final work should include peer reviewed (scholarly) sources. Please use the formatting demonstrated in your Background section to cite the tutorials and readings from the Module Overview.

Please keep in mind that you should not use sources such as “Answers.com” or “Wikipedia” or “Wikianswers.”  None of these are scholarly sources and they can be “modified” by any registered user which makes them unreliable.

Appropriate Headings and Paper Flow

Remember that you are preparing a formal academic paper. Your paper should make use of appropriate headings and subheadings.  You should not cut and paste the questions posed and answer them like a “Question and Answer” session.  Your finished paper should read like an academic paper. Submit your final word document to the Case Assignment dropbox.

How is the causative agent transmitted to humans?

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Module 3 – SLP

PATHOGENICITY, IMMUNOLOGY AND EPIDEMIOLOGY

For this SLP, you will discuss the importance of epidemiology to public health. Research one current example of a disease outbreak and how knowledge of its epidemiology can help health care professionals protect people from disease. (HINT: The CDC and WHO websites are excellent sources of information for this topic). You will present your chosen disease outbreak as a Powerpoint presentation by addressing the topics below:

The following links are helpful guides on using PowerPoint.

PowerPoint 101: Everything You Need to Make a Basic Presentation (this resource is great for both Mac and PC users): http://computers.tutsplus.com/tutorials/powerpoint-101-everything-you-need-to-make-a-basic-presentation–cms-19541

The Microsoft Office link below has several tutorials on Powerpoint from how to get started to additional techniques for advanced users:

PowerPoint Links

Slide 1: Name and describe the microorganism (bacteria or virus) responsible for the outbreak. Briefly introduce your readers to the history of the disease outbreak. Provide an image of the causative agent (microorganism).

Slides 2-3: Where has the outbreak been found globally? Where has it been found in the United States? Describe the specific locations. Provide at least one image of its current distribution.

Slide 4: How is the causative agent transmitted to humans?

Slides 5-6: What are the symptoms of the disease caused by the microorganism? What does the clinical presentation look like in affected patients? What are the complications?

Slide 7: How is it diagnosed? What tests are used?

Slides 8-9: How is the disease treated? What preventative measures are being used locally or globally to control future outbreaks? What is the CDC doing to control the outbreak?

Slide 10: Include any additional interesting facts or figures about the disease outbreak or causative agent.

Slide 11: References.

SLP Assignment Expectations

For this SLP Assignment you will develop a PowerPoint presentation that is approximately 11 slides in length and addresses the requirements outlined above. Place the text containing the answers to the questions above in the slide area. Do a Google search to find images to support the data required and/or use images you have collected from the previous modules. Be sure your last slide includes the full references for any information or images used in your presentation. Please see the rubric for a complete description of grading criteria.

What is the Hygiene Hypothesis?

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Researchers are increasingly looking for answers as allergic diseases continue to rise in the population. The predominant explanation, coined the “hygiene hypothesis” by Professor David Strachan in 1989, states that a lack of early childhood exposure to microbes and other infectious agents increases susceptibility to allergic diseases by suppressing the natural development of the immune system. The idea was widely reported by the media that developed societies, like the United States, have become “too clean”.

Read the following article about the hygiene hypothesis to learn more, then answer the questions below in your initial post:

Bradford, A. (2016). What is the Hygiene Hypothesis? Live Science. Accessed at http://www.livescience.com/54078-hygiene-hypothesis.html on September 14, 2016.

  1. Conduct some independent research on the hygiene hypothesis. What contradictory evidence against the hypothesis can you find?
  2. Have any new hypotheses been proposed to explain the increase in allergic conditions? How does it support the original hygiene hypothesis?

Do you think the hygiene hypothesis needs to be renamed? Why or why not?

250 words

Do people choose their own health, particularly their own nutrition and physical activity?

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Just like on the midterm, the way this final works is that I have provided you 5 questions, one per week’s topic. You need to answer the questions to the best of your ability. I will randomly be selecting 2 questions to grade, and then you will have the choice of which 3rd question you want me to review. After everyone has submitted their final exams (on Wednesday morning 8AM of Finals Week), you will be allowed to go into Moodle and select the question number you want me to grade.

Responses will be graded based on 3 things .

1) How thoroughly and thoughtfully you explained the answer.

2) How feasible and creative your response was in terms of solutions, or options for solving problems. 3) How cleanly written it is. Please no typos and no grammatical mistakes.

You must provide links for all of your sources if you reference anything besides your textbook. You all know what reliable sources are, so make sure anything you are referencing is from a reliable, credible source.

*Hint: Each response should probably be at least ½ a page if you are answering thoroughly. Less than ½ a page means you probably didn’t provide enough detail.

Week 6 question

Do people choose their own health, particularly their own nutrition and physical activity? Whether you think the answer is yes, no, or somewhere in between, make a case for your answer. Build your case referencing at least 4 different factors that influence health from Chapters 13,14, and 16. Be specific and think about psychosocial factors and policies, systems, and environmental factors that are relevant to your response.

Week 7 question

Where does the U.S. rank in terms for infant and maternal mortality? Thinking about these rankings, explain the quote “maternal child health is not a health problem, it is a social problem with health consequences.” What are some of the social and economic factors that influence women and children’s ability to be healthy? What are some things that can be done to improve the health of women and children? What we can learn from tobacco prevention efforts to improve maternal and child health? What specific strategies could we use from tobacco? Or, are there things we could learn from other countries?

Week 8 question

Explain, in your own words, what the 3 levels of prevention are. Pick a specific mental health or injury area and discuss how we could intervene at each of the three levels of prevention to improve health outcomes. How would the strategies need to be different for each of the different levels of prevention? What is at least 1 thing that you think we can do to reduce stigma surrounding mental health or surrounding seeking help for mental health issues?

Week 9 question

In your own words, explain the differences and the relationship between medical care and public health. Why are the two sometimes in conflict with each other? How could we change our current system (either the medical care system or the public health system) to improve health outcomes for everyone in our society (Please provide at least 2 specific examples of changes we could make)? Are there any potential unintended consequences of making these changes?

Week 10 question

Which is the fastest growing age group in U.S. society? What are the potential effects as this big group of people ages? What are some of the challenges we will be facing with the younger generations not being as healthy at an earlier age? Can our focus simply be on trying to help people live longer, or do we also need to be focusing on improving quality of life? What are some specific strategies we can implement to help people age healthily? How can we strengthen public health efforts in the future to support older people and society as a whole?

Extra credit:

Please pick one of the news stories below and answer the following questions about it.

1. How/why is this topic a public health issue?

2. Who is most affected by the issue?

3. What are the larger societal implications of the issue, and what happens if things don’t change?

4. What do you think are some of the upstream prevention strategies that we could be implementing to address this problem?

5. What do you think are some of the policy, systems, or environmental changes that could be made to address the problem?

Story 1: The Opioid Crisis is Surging in Black, Urban Communities

Story 2: What If We Treated Gun Violence Like A Public Health Crisis?

Story 3: Increased Hours Online Correlate With An Uptick In Teen Depression, Suicidal Thoughts

Story 4: Scientists Start To Tease Out The Subtler Ways Racism Hurts Health

Story 5: Is There a Ticking Time Bomb Under the Arctic?

What is the importance of administering the FFP prior to the PRBC’s

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Blood Transfusion Case Study

Name: _____________________________ Date: _____________________ Class: NUR 438

Brief Patient History

Mr. S is a 75-year-old man who has a long history of chronic atrial fibrillation treated with warfarin, CHF, ESRD, and DM II. Over the past week, Mr. S has experienced intermittent epigastric pain and black stools. He is now dizzy and weak.

Clinical Assessment

Mr. S is admitted to the intensive care unit from the emergency department. He recently began taking ciprofloxacin for a urinary tract infection. He also has been taking an aspirin each day because he heard it was good for you. Also, he recently began taking over-the-counter ibuprofen for his stomach pain and general aches.

Diagnostic Procedures

Mr. S’s admission laboratory work reveals a hemoglobin level of 7 g/dL and an international normalized ratio (INR) of 7. His baseline vital signs include the following: blood pressure of 80/60 mm Hg, heart rate of 150 beats/min (atrial fibrillation), respiratory rate of 30 breaths/min, SPO2 92%, and temperature of 37.3 degrees Celsius.

Medical Diagnosis

Diagnosis is acute gastrointestinal bleeding

Nursing Actions

You have started and finished the FFP, and are currently transfusing the allogenic PRBCs. Ten minutes after starting the PRBC transfusion, Mr. S begins to C/O back pain, chills, and SOB. After taking his oral temperature you note it is now 38.8 degrees Celsius. He appears anxious, and is pulling at his lines and tubes.

1. What is this patient’s mean arterial pressure (MAP)? Is his MAP adequate, and why? Please show your work for the math equation.

2. What signs and symptoms may Mr. S exhibit secondary to his low H&H laboratory values?

3. What is the importance of administering the FFP prior to the PRBC’s in Mr. S’s case?

4. What should the length of time be to transfuse Mr. S’s PRBC’s, and why?

5. Mr. S is O positive blood type. What blood types can he receive, and what blood types can receive his blood type?

6. What is the importance of Rh factor when considered which type of blood to administer to patients?

7. What does allogenic mean? What does autologous mean?

8. What do you think is occurring with Mr. S?

9. What should be your immediate actions/interventions?

10. What nursing diagnoses should you give for this patient?

11. What education can be provided to this patient upon discharge?

Describe the types of ACOs recognized by the Centers for Medicare and Medicaid Services

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Urban and rural health care organizations throughout the industry are working together to coordinate care for Medicare patients. Accountable Care Organization (ACO) programs were established by the Centers for Medicare and Medicaid Services to help facilitate this cooperation.

Select a type of health care organization that would accept Medicare patients (e.g., family practice, hospital, urgent care, or nursing home).

Write a 700- to 1,050-word executive summary that discusses the purpose of joining an ACO and the funding available through one. Include the following:

  • Describe the organization you selected and the general services that would be offered to Medicare patients.
  • Describe the types of ACOs recognized by the Centers for Medicare and Medicaid Services.
  • Evaluate industry dynamics that would influence your organization’s decision to participate in an ACO.
  • Identify the steps needed to participate in an ACO.
  • Justify participation in an ACO for your organization.

Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

Format your assignment according to APA guidelines