A 42-year-old who is Gravida: 3, Para: 2-0-2 was admitted to the delivery unit in labor. Mother was diagnosed with gestational diabetes earlier and thyroid hormone medication required adjustment several times during the last two trimesters. On admission, the mother’s blood pressure was 130/70 and her pulse was 75. Fetal heart rate was 145 beats/minute. Four hours after admission, the mother delivered a 37-week, 7lb., and 2oz. baby girl. The baby had a healthy cry. The Apgar score was 8 at 1 minute and 9 at 5 minutes after birth. The healthcare provider and staff noted the baby had a small head with a flat occiput, a broad and flat nasal bridge, folds of skin in the corners of the eyes, an upward slant to the eyes, a protruding tongue, short fingers, and hypotonia to extremities. There also was an excess amount of skin on the back of her neck. As the mother holds her new daughter, she notices that her eyes, nose, and ears appear different from other babies. She also notices that the both baby’s hands also have very short fingers plus the fifth digit fingers are unusually curved.

1. Which of the following is suspected by the healthcare provider? Provide rationale for the correct response and explain why each other response is not the appropriate one.
   1. Klinefelter syndrome
   2. Turner syndrome
   3. Down Syndrome
   4. Cri du Chat syndrome
2. Explain the pathogenesis of the syndrome. In your response discuss the parent risk factor/s, nondisjunction, chromosomal abnormality, and identifies the infant’s karyotype.
3. Explain how methylation differs from acetylation. Provide an example of a comorbidity that can occur with Down Syndrome due to an epigenetic disturbance.
4. The patient (infant above) is now 31-years old and is experiencing increased episodes of hypotension. Explain the cellular injury that is derived from the hypotension and provide an example of a complication that may occur from the hypotension.
5. Explain why this infant and those with Down syndrome across the age span are at risk for respiratory infections giving examples using innate immunity and adaptive immunity (cell-mediated and humoral response).

What possible concept map for medical diagnosis “Induction of Labor secondary to postdates

Roles of Healthcare Professionals

Reflect on the roles of nurses and other healthcare professionals as the roles of physicians in the healthcare system moves from one of working in silos to a more progressive value based system.  Discuss in detail why a value based system may improve healthcare in the U.S and address the following questions:

 

– How has current policy transformed the current practice of nursing, physician, and other healthcare professionals?

– What distinction can you make between physicians/healthcare providers working in a fee-for-service system and a value based system?

-How do you view shared power between physicians and nurses in your healthcare system? How does it impact car

Reducing Gun Violence
Describe the topic you have selected with the following information:

The topic is Reducing Gun Violence

1. Include a problem statement in a single sentence.
2. State why this topic or problem is significant to nursing leaders
3. State one (1) overarching aim that identifies the expected final outcome of the advocacy work.