Radiographic evidence of osteoporosis

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CASE STUDY

A 72-year-old female was walking her dog when the dog suddenly tried to chase a squirrel and pulled the woman down. She tried to break her fall by putting her hand out and she landed on her outstretched hand. She immediately felt severe pain in her right wrist and noticed her wrist looked deformed. Her neighbor saw the fall and brought the woman to the local Urgent Care Center for evaluation. Radiographs revealed a Colles’ fracture (distal radius with dorsal displacement of fragments) as well as radiographic evidence of osteoporosis. A closed reduction of the fracture was successful, and she was placed in a posterior splint with an ace bandage wrap and instructed to see an orthopedist for a follow-up.

Question:

What is osteoporosis and how does it develop? 

Pathophysiology of Myasthenia gravis

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Case study:

A 61-year-old male complains of intermittent weakness and muscle fatigue that has progressively worsened over the past month. He was an internationally known extreme mountain climber but now he says he has difficulty in getting his morning paper. Initially, he thought his symptoms of profound leg weakness and fatigue were due to his age and history of injuries from mountain climbing.

Over the past few months, he also reports having noticed “blurriness” when working on his antique train collection or reading for long periods of time. He has developed an intermittent double vision that seems to be worse when reading at bedtime. He also reports an occasional “droopy” eyelid. Past medical and social history  Physical exam reveals weakness of right extraocular muscle (EOM) with repetition. There is positive nystagmus and symmetrical upper extremity weakness with fasciculations. Lower extremities within normal limits (WNL).   The APRN suspects the patient has myasthenia gravis (MG).

Question:

What is the underlying pathophysiology of Myasthenia gravis?  

Theological Analysis of the Spiritual Concept of Comfort

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Theological Analysis of the Spiritual Concept of Comfort

Search the nursing and health care literature for your concept (e.g., CINAHL and PubMed databases).

Choose 25 articles to survey (this is a literature review)

Analyze these articles for their understanding of your concept

Write an analysis and synthesis of your concept based on the nursing and health care literature.

Note: This work will provide the content of the second portion of your final term paper. – It is the theological Analysis of the Spiritual Concept of Comfort.

The development of ethical codes and regulations for nursing

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Describe two historical events that have influenced the development of ethical codes and regulations for nursing and healthcare research. Explain how each event has impacted ethical codes and regulations.

Platelet and coagulation disorders

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Summarize the bleeding and thrombotic disorders: platelet and coagulation disorders in terms of etiology, pathogenesis, clinical picture, diagnosis, and treatment rationale.

 

The 5 General Topics of Disease Summary
1. Etiology & risk factors
2. Pathogenesis: The molecular mechanism of the disease process (How the disease process evolves)
3. Clinical Picture: Signs& Symptoms, Sequelae, and Complications
4. Diagnosis: Labs & tests (as well as screening tests and follow up tests whenever applicable)
5.Pathophysiologic rationale of treatment

 

Platelet Disorders: Talk about TWO DISORDERS: Low platelet count (Thrombocytopenia), increased platelet count (Thrombocytosis)

  • Thrombocytopenia:
  1. Etiology& Pathogenesis: different types of thrombocytopenia and what cause them, also talk about causes of defective platelet function including antiplatelet medication effects
  2. Clinical Picture: manifestations of low-platelet bleeding disorders. (in contrast to clotting factor deficiency bleeding disorder)
  3. Diagnosis: bleeding time, platelet count, Thromboelastography with platelet mapping.
  4. Pathophysiologic rationale of treatment: indications of platelet transfusion.
  • Thrombocytosis:
  1. Etiology& Pathogenesis: as a part of myeloproliferative disorder (essential thrombocytosis)
  2. Clinical Picture: Signs& Symptoms of thrombocytosis and complications
  3. Diagnosis:
  4. Pathophysiologic rational of treatment:

 

 

Coagulation Disorders: Talk about TWO DISORDERS: Hypocoagulability (Coagulopathy) and Hypercoagulability.

  • Hypocoagulability:
  1. Etiology& Pathogenesis: Acquired causes of bleeding tendency (other than genetic causes): including liver failure, uremia, vit K deficiency & warfarin overdose.
  2. Clinical Picture: manifestations of coagulopathy (in contrast to platelet disorder types of bleeding)
  3. Diagnosis: PT & PTT (how each can help diagnose extrinsic vs intrinsic pathway disorders)
  4. Pathophysiologic rationale of treatment:
  • Hypercoagulabilty:
  1. Etiology& pathogenesis: Factor V Leiden, Protein C deficiency, Protein S deficiency, antiphospholipid syndrome.
  2. Clinical Picture: Complications of hypercoagulability
  3. Diagnosis:
  4. The pathophysiologic rationale of treatment.

 

This is the textbook for information:

McCance, K.L., Huether, S. E. (2018) Pathophysiology: The Biological Basis for Disease in Adults and Children. (8th Ed) St. Louis, MO. Elsevier Mosby ISBN-13: 978-0323583473 ISBN-10: 9780323583473

Non-parametric tests in clinical trials

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ANOVA (Non-parametric tests in clinical trials) is a comparative analysis group that allows researchers to compare three or more independent variables at a time without increasing the margin of statistical error. The biggest way I could see ANOVAS used is if a researcher is looking for possible disparities in a topic. For example, which ethnicity has the most incidence for hypertension within a geographical area or healthcare facility?

The diagnosis of having hypertension would be an independent variable with two levels (yes/no). The ethnicity groups would be used as our dependent variable with three or more variable levels (Caucasian, African American, Hispanic, Native America etc). In using the ANOVA test (or their non-parametric equivalents) researchers would be able to identify groups that are at risk for disparities and begin to work to intervene.

The effectiveness of the interventions could also be evaluated by ANOVA tests as well, as they can be used in pre-test/post-test study designs as well. ANOVA has been shown to be fairly robust (Kellar & Kline, 2013). Even if the variables do not rigidly adhere to the assumptions required for the test, the results may still be close to the truth (Kellar & Kline, 2013).

 

1. What is the difference between a t-test and an ANOVA?
2. What does “homogeneity of variance” mean in relation to conducting a one-way ANOVA? Why do we want a high p-value for Levene’s test?
3. What is the difference between a Kruskal-Wallis test, a Friedman’s test, and the McNemar’s test? Under what conditions would you use each of these tests? How are these tests all similar? What do they all have in common?

The Statistical tests in Clinical practice 

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How do the Statistical tests in Clinical practice influence the choice of test used between t-tests, their non-parametric equivalents, and a chi-square? What do all have in common?

Discuss the appropriate use of t-tests and their non-parametric equivalents as well as the chi-square and its derivatives such as the Fisher’s Exact Test within clinical practice.

The macro-trends affecting the health workforce

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Prompted in part by the ideas presented for the technology innovation project, the Human Resources Committee of the Board of Directors has become increasingly concerned about the ability to identify, recruit, and retain the appropriate skill mix for the organization.

The CEO has designated an interdisciplinary team and asked it to prepare an analysis of current trends and their impact on the organization’s human resources in 2025. More specifically, the CEO relays that the Board Chair has expressed concern about workforce shortages in such key areas as nursing, medical technology, and long-term care.

1) Identifies and discusses the macro-trends affecting the health workforce in Washington, DC, the future of the US healthcare system, including such aspects as the overall economy, demographics, personal lifestyles and behaviors, technology (including biotechnology and smartphones), and federal and state government policies. Note that these factors are neither exhaustive nor are they offered as a mandatory framework; your research will identify macro-trends relevant to your findings.

2) Using the above analysis, identify current and projected occupational shortages for your selected region, efforts to address these shortages, and your recommendations for a solution. Be sure to explicitly link each aspect with the specific trends identified in your analysis.

Global Noncommunicable Disease Burdens

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Select one high-income country (Japan) and one low-income country (Somalia). Address the following points:

What are the top Global Noncommunicable Disease Burdens and five causes of mortality for each nation?

Which stage of the epidemiological transition do you think each country is in, and why?

What structural factors might be contributing to the disease burden experienced by each country? (Think about health systems-level problems, economic and political determinants, and social/cultural factors as well)

Finally, suggest a strategy for each country that could address their top causes of death (Can be as general or as specific as you’d like- think about investments in health education and health systems, vaccination programs, taxes on certain food products, and the many others brought up in the WHO profiles)

Quantitative methods of inquiry

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After you have completed the assigned readings and viewed the assigned videos, write a 500-750 word paper that addresses quantitative methods of inquiry. Use the data provided in the Topic Material, “H Cup State Inpatient Databases (SID) File Composition – Number of Discharges by Year,” and appropriate statistics to address the following:

Describe the different quantitative methods of inquiry.
Describe the mean, median, and mode of discharges by state in 2014.
Compare the number of discharges in 2010, 2012, and 2015 in all states. Are there significantly more discharges in 2015 versus 2010 in all states?
Compare the number of discharges in 2011 in northwestern states (Washington, Oregon, Idaho, Montana, Wyoming), southwestern states (California, Nevada, Utah, Arizona, New Mexico, Oklahoma, and Texas), central states (North Dakota, South Dakota, Nebraska, Kansas, Missouri, Iowa, Minnesota, Wisconsin, Illinois), southeastern states (West Virginia, Virginia, North Carolina, South Carolina, Georgia, and Florida), and northeastern states (Maine, Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, Washington D.C., New York, New Jersey, Pennsylvania, Delaware, and Maryland).
Summary of the paper.
View:

Clankie, S., & Mima, T. (2012). A brief comparison of qualitative and quantitative research methods [Video file].

URL:

Smcilquham. (2012). Quantitative vs qualitative research [Video file].

URL:

Healthcare Cost and Utilization Project. (2017). HCUP state inpatient databases (SID) file composition – number of discharges by year.

URL:
https://hcup-us.ahrq.gov/db/state/siddist/siddist_discharge.jsp
Read Chapter 12 in:

Flick, U. (2014). The SAGE handbook of qualitative data analysis. London, UK: SAGE. doi: 10.4135/9781446282243
References no older than 5 years
This is a nursing data analysis course.
Use subtitles for each portion of the paper.
This course uses use the SPSS program. SPSS makes it easy to analyze data using specific tests. This assignment will give you practice with means, medians, and modes.