Diane is a 50-year-old woman with a past medical history of Type 2 diabetes, Rheumatoid Arthritis, and hypertension.

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Diane is a 50-year-old woman with a past medical history of Type 2 diabetes, Rheumatoid Arthritis, and hypertension. She presents to the Emergency Department due to intractable joint pain over the last 4 hours.

Diane currently works as a Social Worker and was recently transferred to a new job in Child Protective Services. She describes her workdays as long and highly stressful. Diane reports that her health conditions have been well-controlled for the past few months. However, she has been experiencing generalized pain and stiffness, swelling of her joints, and unintentional weight loss of 7 lbs over the last two weeks. She also states that her tolerance for activity has drastically decreased, and she is having difficulties completing her activities of daily living independently.

Assessment: The small joints of the hands appear nodular. There is articular joint swelling and warmth in the wrists, hips, and knees bilaterally. There is a mild effusion noted to the right knee. Guarding, rigidity, and facial grimacing was noted during ambulation. Her gait is unsteady and requires moderate assistance. There is decreased range of motion to articular joints. Her grip strength is diminished bilaterally. Vital Signs: BP 138/86, T: 38.1C, P: 104, R: 18, SpO2: 99% RA, Pain: generalized joint pain 7/10. Fasting Capillary glucose: 4.1 mmol/L

1. Identify a priority problem supported by relevant assessment findings.

2. Complete a client-centered Care Plan based on the priority problem using ADPIE (Assessment, Diagnosis, Plan, Intervention, Evaluation).

3. Write a reflective summary that demonstrates your analysis of the situation and how you determined the priority problem. (350-500 words)

Comparing and contrasting the types of macromolecules

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Complete the table below comparing and contrasting the types of macromolecules (a.k.a biomolecules, organic compounds, polymers) carbohydrates, lipids, nucleic acids, and proteins. In some of the boxes, there are questions. Be sure the information in your table answers the questions if a question does in fact appear. Macromolecule Elements Monomer Special Features Use (function) Examples, categories (subunit(s) types

The heterozygous genotype for sickle-cell anemia

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The heterozygous genotype for sickle-cell anemia has little survival value for North American blacks because ( 1) the sickle-cell allele is being transmitted to the non-black population. 2) immunization programs have nearly eliminated this disease. 3) malaria is uncommon in North America

 

 

Describe the specific mechanisms of enzyme function

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Briefly outline the cycle by which energy is stored in and released from ATP. Discuss how ATP is critically important to cellular chemical processes. Describe the specific mechanisms of enzyme function. Pick a specific enzyme and describe its function and the importance of that function to life. Discuss how the loss of that enzyme would disrupt living processes.

Understanding of the complex makeup of an emotion

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In considering what we learned about emotions (appraisals, physiological changes, expressions, subjective experiences, and action tendencies) – how would one go about increasing the likelihood of experiencing happiness? Be thorough in your response and demonstrate an understanding of the complex makeup of an emotion

Delusional thinking of a grandiose nature

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Mr. Joshua is a 55-year-old male with a long history of delusional thinking of a grandiose nature. He was brought to the ED on an emergency petition because he was found by the police to be argumentative with the salesman of a car dealership over the topic of buying a new car. This client proclaimed angrily that he had a special relationship with a movie star that he claimed sent him there to purchase a new BMW 2021, SUV. When the dealer called for a financial background check, the client’s credit score was below 200. It was determined upon investigation that this client is homeless and unemployed. He has been sleeping in a nylon tent sitting on the sidewalk over a subway train vent that provides warm steam. This client was noted as unkept with his hair and body. He also had a foul odor coming from his clothing which was dirty and he wore in 4 layers. This client became extremely angry with the salesman that told him that he did not meet the criteria through the credit bureau to be able to purchase a car.  Joshua also could not provide an address for the salesman except for the corner of Light and Holliday Street. He was noted invading the personal space of the sales manager that asked that he him leave his car dealership.   This client was hyperverbal with rapid pressured speech. He was constantly in motion noted swinging his arms and hands in the air as he spoke.

The policeman said that this client seemed to require medication to slow himself down and decrease his threatening behavior towards others. He was allowed to use the phone at the dealership to call the famous movie star he claimed to know personally to verify to sales that he would help Joshua pay for the BMW.  This client is angry in affect and laughs loudly at times. Joshua is labile in mood with elation at times. He has purchased a color television from a local store but cannot pick it up because he has no place to plug it up and watch it.   This client has an angry affect at times and mood swings. Has been unemployed for 1 year.

Page 2 Case Situation- Joshua

Has been sleeping on the sidewalk over a ventilator vent from the subway in a tent downtown. He is disheveled, wearing layers of clothing for the past 2 years. He eats his meals at a soup kitchen. He has family but claims that he cannot stay with them because they say that he is to hyper, loud, not sleeping and has unpredictable periods of anger. This client reports that the children of his family are frightened to be around him. Joshua reports not taking his drugs or seeking treatment for 3-4 months due to his complaints of the side-effects of the drugs prescribed.     He complains of the drugs cause him to have sexual problems and weight gain. This client has been living on the sidewalk or under a bridge. This client is pacing rapidly around the store . He was asked not to keep going into the store asking people for money and becoming angry when they did not give any to him. Joshua was seen in the Ed due to his aggressiveness, hyperactivity, and paranoid grandiose ideations  and was involuntarily  admitted to the inpatient behavioral health unit. Upon admission to the floor this client proceeded to hit the technician and was administered Haldol 10 mg. IM. The client agreed to stay in his room for an hour to let the medication help to decrease his agitation and anxiety.   After an hour, this client was at the nurses’ station complaining of thickness of his tongue, some drooling, and his eyes were going up in his head. The client was unable to make the eyes to stay own. All that could be seen was the whites of his eyes .   He was certified by the ED doctors after medical clearance. Joshua was given the diagnosis of Bipolar Disorder, Mania

Instructions:

1.     Identify what the client is experiencing.

2.     Define what was going on with his eyes and his tongue.

3.     What causes reactions like that?

4.     Use the SBAR format to provide a report to the Nurse Practitioner on duty.

Page 3 Case Situation-Joshua

5.    What medication might be ordered for this client?

6.    Would this client need to receive medication in po. or IM. form?

7.    What might this client’s psychiatric diagnosis be?

8.    Might this client be described as neurotic or psychotic, explain!

9.    Provide a Nursing Diagnosis?

10. What kind side effects is this client experiencing.   Name and define the classification of the drugs that

would be given (refer to Chapter 4 of Townsend and Morgan 10th. Edition.

Please fill in the Axis according to the DSM 5

Axis I_________________________________

Axis II ________________________________

Axis III ________________________________

Axis IV ________________________________

Axis V ________________________________

>>>Use a SBAR form to document what you would report to the oncoming RN about this client’s experience the shift.

 

Inborn traits and characteristics

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Raffy may still be in prison, as we speak. Given what you already know and what you have learned through this case, how must one live life? How must one develop? Does one need to be armed with inborn traits and characteristics strong enough to compel him/her to “compete” and stand despite adversities and trials to assure either survival, success, or post-traumatic growth? EXPLAIN

“Raffy” is a “crack baby”

Describe how socialized gender roles might contribute to generativity

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What is generativity?

Review the text and locate some generativity theories and theorist(s) you like the most (e.g., Erikson, Logan, McAdams). Explain why people connect with one or more of these. Describe how socialized gender roles might contribute to generativity Discuss how personality may or may not contribute to generative actions.•What are people currently doing that is generative? Share how future career goals and how think this might contribute to generativity. Explain other actions people can take to increase/maintain generativity throughout life

Feldman, M. P. (n.d.). Reader. BibliU. Retrieved August 19, 2022, from https://bibliu.com/app/#/view/books/9780077498276/epub/OEBPS/Coverpage.html#page_i

Intellectual disabilities are most often organic

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Intellectual disabilities are most often organic. However, many also have familial origins. Therapy for individuals with intellectual disabilities may include early intervention, behavioral, language, and social skills training, and always requires significant family involvement.

What is the importance of family involvement in therapy, and what is the importance of each of these intervention approaches?

Which is the most common familial cause of intellectual disability?
Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability worldwide. It is caused by a mutation of the FMR-1 (fragile-X mental retardation) gene located on the X chromosome.
How are cultural familial and organic intellectual disability different?
Members of this “organic” group often displayed IQs below 50 and co-occurring physical-medical conditions. The second, “cultural-familial” group, mostly showed IQs of 50-70, did not possess co-occurring physical or health problems, and often came from families of lower IQs and lower socioeconomic status.

Self-promotion on social media

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Describe how these qualities will serve you in your future career. How will they make you, as a brand, stand out from the crowd? How can those skills add value to your brand?

Identify two or three areas (skills or self-promotion on social media or style or perception of power) that you would like to develop to enhance your “personal brand”. Describe some concrete steps that you could take to achieve this. Be sure to explain why this development will be important for your future career success.