Why is the lack of clinical manifestations in the ROS above significant? PE and Lab Tests General . Fair complexion and healthy-looking white male in no apparent discomfort. Red hair with green eyes . Appears pleasant, alert, and conversant but anxious Patient Case Question 2. Identify two risk factors for melanoma that this patient has.
Case study • Orla Ramos is 43-year old female admitted to the hospital due to increasing fatigue, weakness, chest pain, dyspnea, and shortness of breath (SOB). The chest pain as substernal, sharp, and radiating to both shoulders. The chest pain had been present for 2 days, but became progressively worse and was associated with dyspnea which prompted her to seek care. She reported a viral upper respiratory infection starting 1 week before the current symptoms began.
• She reports a personal history of smoking half a pack per day since her teens. She has no known allergies and no significant health issues. The only time she was hospitalized was for delivery of two children with no complications. She has a family history of Hashimoto thyroiditis. Physical examination and diagnostic test results
• General, neuromuscular: Mild obesity. Alert, oriented, cooperative, and anxious. Full ROM and strength 5/5 in all extremities • Vital signs: Temperature = 100.8 degrees Fahrenheit (oral); heart rate = 126 beats/min, sinus tachycardia; respiratory rate = 30 breaths/min, labored; blood pressure = 100/60 mmHg; oxygen saturation = 92% on a venturi mask with a flow rate equal to 40% fraction of inspired oxygen; pain = 7/10. Pain is substernal, radiating, and constant; but slight relief when she is upright and leans forward. Pain is worse with coughing and deep inspiration. She is unable to recline due to significantly increased SOB, dyspnea, and pain.
• Ears, nose, throat: Left tympanic membrane red, but not bulging. Posterior pharynx red and edematous, but no exudate noted. Tonsils reddened and 2+. • Cardiopulmonary: Bilateral chest expansion symmetrical. Breath sounds clear, but diminished at bases. S1 and S2 muffled with grating friction rub auscultated. Pedal pulses 1+ and slight pedal edema noted. Bilateral jugular venous distention noted. Extremities slightly cool and pale with capillary refill 3 seconds.
• Abdomen: Soft, non-tender, no masses, and normoactive bowel sounds in all quadrants. Voided 200 cc of clear, yellow urine. • Serum results: Abnormal serum results include total white blood cell count = 17 cells/mcL; c-reactive protein = 15 mg/L; creatinine = 1.5 mg/dl; blood urea nitrogen = 25 mg/dL. Troponin and brain natriuretic peptide levels within normal ranges.
• Other results: Chest x-ray positive for cardiomegaly, but lungs clear. Echocardiogram showed moderate pericardial effusion, reduced right ventricle wall motion, and reduced ejection fraction. Electrocardiogram showed sinus tachycardia with non-specific ST segment changes. Summer To answer questions 1-3, use the scenario above
1. Identify the likely disorder, the underlying pathophysiology (i.e., cellular and tissue changes), and relate the changes to abnormal findings to support your interpretation. (20 points) Hint: We are in the cardiovascular system ☺ !
2. Identify all nursing diagnoses labels (just the label!) that apply to this patient (e.g., impaired swallowing). Identify the priority (#1) nursing diagnosis label; and for the (#1) nursing diagnosis label, explain the nursing interventions to address the identified problem. Provide evidence-based rationale to explain the need and/or benefit of each intervention. For interventions, include what the nurse should “monitor/assess”, “do”, and “teach” to the client. (20 points)
3. Describe medical therapies used to treat the disorder and explain their specific mechanism of action and intended impact at the cellular and/or tissue level. (15 points)
To answer questions 4-5, choose ONE disorder from this week’s reading
4. For the chosen disorder, identify the disorder and describe the impact on the United States population including incidence, prevalence, costs, morbidity, mortality, and/or other appropriate issues. Be sure to identify the disorder, the population associated with the data, and the year(s) of data. (15 points)
5. For the chosen disorder, locate recommendations in a nursing journal article or professional nursing organization. Provide a brief summary of the information and specific recommendations for nursing actions to improve care for patients. (15 points) Hint: To increase the likelihood of locating a nursing journal or organization, look for some form of the word “nurse” in the journal or organizational name!
There is a growing concern about childhood obesity in your local community. The city is ranked 22nd as the most overweight and obese in the United States. Because of your expertise in obesity, you have been asked to lead an interprofessional team to analyze the community-level problem, develop a plan to address the issue, present your findings and recommendations at the next community-wide council meeting for this case study, suggest expected outcome for the plan and method of evaluation for the plan
Robert Johnson, a 55-year-old man, is married with two adult children and five grandchildren. He is the assistant president of a large bank. In the first session, he tells you that it is becoming more difficult for him to hide his homosexuality. He has kept his homosexuality a secret his entire life. He knew he preferred men when he married his wife thirty years ago, but he thought he needed to get married to hide the fact that he was gay. During his marriage, he has had affairs with many men. Because he has been very discrete, his wife and family do not suspect that he is homosexual and that he has had several affairs.
Now he is having a relationship with a man he loves and with whom he wants to grow old. Mr. Johnson’s lover threatens to leave him if Mr. Johnson does not get a divorce and makes their relationship public. Mr. Johnson is afraid because if he makes his homosexuality public, he may lose his job and the respect of his children.
He tells you that he is worrying so much about his over leaving that he is unable to concentrate at work. Being the vice president of the bank means a lot to him. He has worked very hard and sacrificed a lot to obtain this position. He does not want to lose it.
1. Provide a provisional DSM 5/ICD 10 diagnosis
2. Examine and discuss the psychotherapeutic modalities you would choose to use to treat this client. Choose between Psychoanalytic, Adlerian, existential, person-centered, gestalt, behavior, cognitive behavior, choice/reality, feminist, and postmodern therapy. You may combine therapies (integrative approach), but you must justify the combination. Be sure to include a list of the specific techniques (therapeutic processes and content), not just the theory you would use for this client. Be specific in how you would treat each client.
A study examined lower life satisfaction, active coping, and cardiovascular disease risk factors (diastolic and systolic blood pressure, body mass index, and circumferences) in older African Americans over the phases of an 18-month church-based intervention, using a quasi-experimental design. Participants (n = 89) were 45 years of age and older from six churches (three treatments, three comparisons) in North Florida. Lower life satisfaction had a persistent unfavorable effect on weight variables.
Active coping showed a direct beneficial effect on selected weight variables. However, active coping was adversely associated with blood pressure and did not moderate the association between lower life satisfaction and cardiovascular risk factors. The intervention had a beneficial moderating influence on the association between lower life satisfaction and weight variables and on the association between active coping and these variables. Yet, this pattern did not hold for the association between active coping and blood pressure. The relationship of lower life satisfaction and selected cardiovascular risk factors and the positive effect of active coping were established, but findings regarding blood pressure suggest further study is needed.
Discuss factors that affect intergenerational relationships between older adults and their adult children. What factors support good intergenerational relationships?
(Think from the life-span perspective; briefly analyze at least six different factors)
200-300 wds
Short-Answer Question
The term “emerging adulthood” is fairly recent in the field of developmental psychology.
(1) Explain why researchers felt it necessary to add this stage of development.
(2) Describe at least two new characteristics of cognitive development during emerging adulthood compared to earlier life stages.
200-300 wds
Develop a personal nursing philosophy narrative as to how your life moved towards meeting that goal of becoming a nurse.
In a 3-4 page, double-spaced, typewritten document, please respond to the following:
• Begin your paper with why you wanted to become a nurse
• Develop a narrative as to how your life moved along towards meeting that goal of becoming a nurse.
Include any work experiences (volunteer work, hospital, MD office, healthcare facility) that reinforced your desire to become a nurse and why.
What educational preparation has already taken place in your life prior to entering a formal nursing program? Were there any particular people or nurses who influenced your decision to become a nurse and what was the nature of that influence?
What plans did you make to become a nurse that either were delayed or actually occurred as planned? What keeps you focused on completing the program especially when obstacles present themselves? What has been the greatest sacrifice you have made to become a nurse?
• In the time you have been involved in nursing activities, what has given you the greatest satisfaction and why?
• How has the current health care arena affected your feelings about being a nurse?
• Look at the QCC statement of philosophy of nursing.
• Write a statement of your philosophy of nursing that should include the four (4) metaparadigms of: client, health, environment, and nursing. What are your beliefs about the client? How do you define health? In your opinion, what makes up the environment? How does nursing impact all of these? NB. Philosophy of Nursing can be found in your STUDENT HANDBOOK located under “Course Information.”
• How is your philosophy the same as or different than the QCC philosophy of nursing? • What nursing theory/theorist has influenced your personal philosophy the most and why?
• What will finally becoming a professional registered nurse mean to you?
• Where do you see yourself five years after graduation?
Here is the nursing school’s Philosophy: Philosophy of the Department of Nursing The philosophy of the Department of Nursing is based upon the relationships among the concepts of the individual/ patient, environment, health, and nursing. The Individual is a biopsychosocial and spiritual being who functions within the context of the family, culture, and community.
Individuals have basic physiological, psychosocial, and developmental needs across their lifespan. These needs must be fulfilled in order for a state of health to exist. An individual or group of individuals becomes a Patient upon entry into a healthcare system for assistance in achieving maximum self-care potential.
The Environment is the aggregate of biological, physical, spiritual, social and cultural conditions that influence the life of the patient. The health of the patient is affected by the local and global environment. Health is living within one’s environment while achieving the greatest level of functioning.
Therapeutic support of the patient leads to a state of health, wholeness, well-being and integrity of the individual. The ability to maintain optimum wellness varies among individuals based on developmental stage, life experiences, health alterations, level of knowledge, values, culture and environment.
Alterations emerge when the individual cannot meet their needs as a result of disease, injury or life cycle events. When individuals cannot meet their own needs, they have the right to receive patient-centred assistance in moving towards their highest level of functioning and health.
Discuss the ethical and legal controversy over the application of genetic modification in vitro. Provide a rationale for why genetic modification is such a contentious issue. What is one healthcare policy you would implement to minimize the controversy over genetic modification if you were in charge?
Thermoregulation Nursing Interventions to Problem/Complication Monitor for What to do Should the Concept that can Occur with Complications & Complication Occur Signs and Symptoms |Nursing Interventions to Prevent Complications Thermo- regulation For each of the nursing interventions to monitor or prevent complications, prioritize them according to the most important to do as number 1. *Insert more rows as needed Infection Nursing Interventions to https://my.hondros.edu/cmSPDocuments.asp?
A nurse has a chronic disability due to her hearing loss, and she is using adaptive devices to deliver efficient care. Before she got this specialized stethoscope, she was removing and replacing her hearing aids repeatedly during her shift. Her headphones have eliminated these extra steps. How would you explain the need to use an adaptive device for a chronic condition to your patients If you were in a situation such as this? Do you think that it might influence your patients ‘ attitudes toward you?
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