Chronic

 

Chronic Attendance Questions

Due: by the start of class 2

Please answer the 5 questions below for attendance credit. Submit your answers to the proper assignment folder. Please do not share work.

  1. Describe nursing interventions during the child’s hospitalization for failure to thrive.
  2. Describe an individualized education program (IEP).
  3. What are key components of nursing care for children with impaired cognitive function?
  4. Describe atlantoaxial instability in the Trisomy 21 (Down syndrome) patient. How is it diagnosed?
  5. Differentiate between palliative care and hospice care. What considerations should be made in providing hospice care to the pediatric patient that might be different from the adult?

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Your Nursing Destiny

This week your discussion posting will cover the following questions: oncology research nurse

1. In what professional nursing organizations do you currently participate? ANA 

2. What organizations might you think about participating in for the future?  ONS

3. What nursing certifications are you considering? Oncology already have research certification

4. How might consideration of continuing your education to pursue a graduate degree fit into your future plans? 

master in bussines or FNP 

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Narcissistic personality disorder

  

Assignment

Narcissistic Personality Disorder

  • Explain the diagnostic criteria for Narcissistic      personality disorder.
  • Explain the evidenced-based psychotherapy and      psychopharmacologic treatment for this disorder.
  • Describe clinical features from a client that led you      to believe this client had this disorder. Align the clinical features with      the DSM-5 criteria.
  • Support your rationale with references to the Learning      Resources or other academic resources.

Required Readings ( need 3 references)

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

· Standard 12 “Leadership” (pages 76-77)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

· “Personality Disorders”

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

· Chapter 68, “Paranoid, Schizotypal, and Schizoid Personality Disorders”

· Chapter 69, “Antisocial Personality Disorder”

· Chapter 70, “Borderline Personality Disorder”

· Chapter 71, “Histrionic Personality Disorder”

· Chapter 72, “Narcissistic Personality Disorder”

· Chapter 73, “Cluster C Personality Disorders

Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders. Psychiatry: Interpersonal & Biological Processes, 76(1), 32–52. doi:10.1521/psyc.2013.76.1.32

Rees, C. S., & Pritchard, R. (2015). Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52(1), 45–55. doi:10.1037/a0035158

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)

· Chapter 22, “Personality Disorders” (pp. 742–762)

· Chapter 13, “Psychosomatic Medicine” (pp. 465–503)

Optional Resources

Kernberg, O. (n.d.). Psychoanalytic psychotherapy [Video file]. Mill Valley, CA: Psychotherapy.net.

   

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Deliverable 6 – Using Business Visuals

 

Competency

Examine and design visual media communication to produce effective business materials.

Scenario

You are a website designer and are currently being considered as the designer for a complete redesign of a medical facility’s website page. They have not updated their website in over 15 years due to the lack of staff. The website needs the redesign to target the specific visual preferences of patients and medical clients. They have several other designers that they are interviewing, and you decide to create a video presentation to impress them to choose you as their website designer.

As you begin your presentation, you decide that your design will include the following visual concepts and elements:

  1. Visual Organization
  2. Visual Simplicity
  3. Visual Interactivity
  4. Charts and Graphs
  5. Images

In designing these visual elements, you keep the target audience of patients and medical clients as the main focus. You carefully consider what these types of people wish to see at a medical facility. You also consider what visual elements will attract the eye, and yet enhance a specific mood and emotional response for viewers.

After creating the website, you record your explanation of your visual design choices in an audio/video screen share.

Your presentation should be a maximum of 5 minutes.

Instructions

The presentation must include a visual and an audio recording using Screencast-O-Matic®, a free audio recording software compatible with PC and MAC computers. Follow these instructions to download and use this software to create your presentation

Resources

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Interaction Between Nurse Informaticists and Other Specialists

Interaction Between Nurse Informaticists and Other Specialists

Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

To Prepare:

  • Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.
  • Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.
By Day 3 of Week 3

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

By Day 6 of Week 3

Respond to at least two of your colleagues* on two different days, offering one or more additional interaction strategies in support of the examples/observations shared or by offering further insight to the thoughts shared about the future of these interactions.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

*Note: Throughout this program, your fellow students are referred to as colleagues.

The mail discussion will need at least 3 references and also in APA 7 format

The discussion below will a reply with at least two references in APA 7 format. I will be attaching another discussion that will need a reply with the same requirement as the first.

Mikol’s discussion

Before the emergence of the computer system or the electronic health records, data entry and retrieval were manually done with paper and pen notations, a system that seemed efficient years back now becomes antiquated following the emergence of computers and upgrade in technological advancements to enhance safety and efficiency in the delivery of care to our respective clients. The paper and pen era of data entry and records management provided the necessary access needed to care for clients, but presented with numerous disadvantages. Some of the draw back to the manual way of data entry aforementioned above were; the lack of access to multiple providers across network, information on a chart can only be assessed in person since the chart can not leave the hospital or the nursing station, medical collaboration was not feasible since information dissemination was rather slow or not forthcoming.

     In this new age of computers and technological advancements in health care informatics, access to health care records, data, imaging and all other related patient information is easily accessible by the click of a computer mouse or simple operation of scanning and faxing of needed medical information across multiple discipline who are directly involved with the care of the client. An example is the laboratory inputting lab results that can be accessed by multiple auxiliary teams who are directly taking care of a particular patient, the information once entered is widely accessible by all teams who have legitimate access to the patients medical record. “Of these competencies, project management is one of the most important essentials identified since it impacts all areas of NI skills and provides an organizing framework for processes and projects including skills such as design, planning, implementation, follow-up and evaluation. Examples of job roles that specifically require project management skills as an essential part of the NI functions include management, administration, leadership, faculty, graduate level master’s and doctorate practicum courses.” (Sipes, 2016)

     Given the functionality of the electronic health records and the ease at which information is disseminated seamlessly across multiple disciplines and data bases, due to technological advancement in informatics and the need to incorporate more efficient cutting edge technology, some of the strategies that can be implemented to better serve our patient population is the implementation of a back up system that operates seamlessly in the event of a computer down time or when the maintenance team are doing certain upgrades, they should be some kind of allowance to the operability of the system instead of resorting to the antiquated way of managing operations using the pen and paper format. A perfect example is the experience I had on the unit of recent, where the informatics team set out to do an update but then the down time and shut down of the computer systems weren’t communicated to staff nurses on the night shift, so mid shift we were surprised when our systems powered down and we scrambled to look for answers only to be told the informatics team are doing updates, now we still have medications to give and orders to access alongside other disciplines have other numerous task to perform, the only resolve was going back to the paper and pen era which most of us were not familiar with to begin with, hence jeopardizing the efficiency and safety of patient care for the upgrade of systems. “Explicit knowledge is the knowledge that one can convey in letter, words, and number. It can be exchange or shared in the form of data, manuals, product specifications, principles, policies, theories, and the like. Nurses can disseminate and share this knowledge publicly or on the record and scientifically or methodically.” (McGonigle, 2017, p539)

     Following from technological advancements in the sector of health care and informatics, I believe continued evolution of the computer era in delivery of medical aid and interventions will only get better as the years go by. In this day and age, we do experience the ease and efficiency accorded by the advent of the electronic health records. Other benefits are its time saving and safety mechanisms across the board and the ease at which information is shared seamlessly across different disciplines in furtherance of patient care. In the near future technological advancement will make for even more safe and efficient ways of health care delivery in a timely fashion since innovations in the computer and informatics era presents with such hope given the level and the rate at which informatics and the health care system have merged inseparably. “The guiding principles of EBCD design were established to ensure that the final product enhanced and supported the process of patient care documentation, such as strict adherence to the style guide for consistency and alignment with the previously defined ideal workflows … In summary, we have developed a systems-level method that allows nursing executive leadership to organize, set up, and own processes related to the development nursing informatics solutions. Our organization has used this structure for several projects with positive results. Use and adaptation of the strategies of this method may offer a way for nursing leadership to guide and influence future solutions.” (Mosier, 2019)

                                                                                                         References

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Mosier, Sammie, DHA, MA, BSN, NE-BC, CMSRN, BC, Roberts, Wm., Dan PhD, RN, et al. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. Journal of Nursing Administration, 49, 543-548. https://doi.org/10.1097/NNA.0000000000000815

Sipes, C. (2016). Project Management: Essential Skill of Nurse Informaticists. Studies in Health Technology and Informatics, 225, 252–256.

Discussion for Gualn

RE: Discussion – Week 3COLLAPSE

I remember in 2009 when Electronic Health Record (HER) system was installed at a one of the organizations that I worked for. I was very happy, enthusiast and positive about the new changes in the facility. I made sure that I learnt the system very well, because I wanted to be comfortable with it. I was selected as one of the mentors for whoever needed assistance in the facility. I became a knowledge management tool! It was the beginning of EHR and it was a chocked for many nurses who had the attitude “this is the way it’s always been done here” (Melnyk & Fine-Overholt, 2019). From that day on nurse informatic and technology do not stop evolving around.

In the beginning of my nursing career, it was veery difficult to almost impossible for multiple care providers to access a patient’s chart all at once. I remember that everyone had to wait and passed the chart from one person to another. Today with HER we can have multiple providers accessing a chart and caring for a patient on site or at distance all at once. Nurse informatic era has changed health care delivery tremendously. Professional across the healthcare organizations had shown to have a better sharing of information. Knowledge management is better accessible through information technology (IT) as in intranet, extranet, blog, knowledge directories withing the organization (McGonigle, 2018).  Technology specialists within my organization interact with each other within a wide range of platforms for patient best quality of care delivery and planning, like Vital Connect monitoring devices, electrocardiogram EKG monitoring, laboratories test results, pharmacy department, radiology department just to name few. All specialists from theses specialties interact with each other by reviewing results, giving orders, sharing information while they don’t even meet most of the time. 

On the other hand, these interactions are not the best from my point of view and can be enhanced. It is wonderful that, every piece of information is accessible at the tip of a finger for everyone, but it does not take away the patient face to face interaction. It is not to forget that the reason of nursing is the patient. Patient centered care and be present for the patients are important part of their care. I have seen providers relying on the data a lot for patients’ treatment when patients have not presented any clinical signs to correlate the information displayed by the electronic gadget. It is always important to look at the patient first, then the data. 

In consequence, I believe that the continue evolution of nursing informatic, and new technologies will impact professionals’ interaction. The emergence of new technology will definitely provide a better system of delivery of care and increase nursing knowledge as the knowledge worker then able to share that knowledge and become part of the knowledge repository system of the organization as professionals acquired skills and build experiences and wisdom for tacit knowledge. I had mentioned about the vital connect that my organization is using for our cardiac patients. The vital connect provides a wireless cardiac monitoring at the bedside. It is a new technology that I have not had in the past. The nurses are aware that the cardiac rhythm is monitored, and any abnormal rhythm will be alerted to them. The devices definitely assist in monitoring and of course aid the physician in diagnosing patients. That is efficient time management that gives the nurses more time to be fully present with patients for nursing care and create a “tapestry” (McGonigle, 2018, p.538). The emergence of new technology will continue to improve communication accuracy and efficiency “Gone are the days of paper charts that had to be meticulously updated with handwritten notes” (healthinformatics.uic.edu). Although managing the knowledge across all the discipline with the emergence of technology in nursing can be challenging if there is no interprofessional collaboration within the organization. 

Reference

https://healthinformatics.uic.edu/blog/the-impact-of-health-informatics-on-nursing-practice/

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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Aging, patho and physiolgy ( Due 24 hours)

 

1) Minimum 7 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

Parts 1 and 2 must be different. Different writing, references and perspective, but always answering questions objectively

              Part 1: Minimum 1 page

              Part 2: minimum 1 page

              Part 3: minimum 1 page

              Part 4: minimum 1 page

              Part 5: minimum 1 page

              Part 6: minimum 1 page

              Part 7: minimum 1 page

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: Nursing and Aging 

Mental Health Disorders

Many older adults are prescribed psychotropic medications. 

1. What are the side effects of these medications and how do they impact the normal aging older adult?

2.  List and discuss two of these medications and their side effects.

Delirium and Dementia: 

3. Describe what should be included in an assessment of the older patient for common causes of delirium in older adults.

Have a great week. I enjoyed working with you. all the best going forward.

Part 2: Nursing and Aging 2

 

Mental Health Disorders

Many older adults are prescribed psychotropic medications. 

1. What are the side effects of these medications and how do they impact the normal aging older adult?

2.  List and discuss two of these medications and their side effects.

Delirium and Dementia: 

3. Describe what should be included in an assessment of the older patient for common causes of delirium in older adults.

Part 3: Physiology 1

 Topic : osteoporosis

1. Define the disease

2. describe the risk factors

3. pathophysiology

4. clinical manifestations

5. evaluation, 

6. prevention 

7. treatment.

Part 4: Physiology 2

 Topic: celiac disease

1. Describe the pathophysiology of celiac disease

2.  clinical manifestations

3. evaluation

4. treatment. 

4. What are the differences between non-celiac gluten sensitivity and celiac disease?

Part 5: Pharmacology 1

Topic: estrogen therapy

Hormone therapies offer many benefits and risks, but they may sometimes have side effects. 

Discuss:

1. Benefits

2. Risks

3. Side effects 

 

Part 6: Pharmacology 2

1. Discuss the current trend in the use of antibiotics for treatment of ailments such as sinusitis, bronchitis, and pharyngitis, the practice implications

2. Discuss possible health outcomes from their use.

Part 7: Financing Health care

1. What is the difference between a protocol, standard of care delivery, and policy at the practice, state, and federal level? 

2. What are the perceptions of the health care delivery system from the perspectives of:

a. patients

b. providers

c. payers

d. policy makers? 

3. Discuss at least one perception from one of the populations listed: patient, provider, payer, and policy maker.

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NURS490WEEK8PROMPT

This week, reflect on all that you have accomplished in this course( Nursing Capstone for post licensure students) and throughout your program(BSN).  Consider the following items for this week’s discussion, and discuss a minimum of two.  You are welcome, and encouraged, to discuss as many as you like.   

  • Do you think you will use the ePortfolio you created as a career tool or for other purposes? How can the ePortfolio support the professional goals you set? 
  • How have you evolved as a nurse throughout the course of your studies?  Were there any unexpected gains?  Did you achieve all that you hoped you would when you began the program?
  • What challenges did you overcome during your studies? How did you rise above them?
  • Will your professional role with your colleagues, formal or informal, change now that you have furthered your education and gained new insights into the profession? Explain.
  • Recall one of your most memorable and/or most challenging courses or assignments or academic experiences. Describe how this experience impacted you professionally and/or personally.
  • What recommendations would you have for other RNs coming into the program? What tips or words of advice would you offer?

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Assignment: Developing Organizational Policies and Practices,NURS 6053/NURS 6053N/NRSE 6053C/NURS 6053C/NURS 6053A/NRSE 6053A: Interprofessional Organizational and Systems Leadership

 

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

To Prepare:

  • Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
  • Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
  • Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

  • Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
  • Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
  • Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
  • Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
  • Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.

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Knowledge check

  

  1. CC: “I have been having terrible chest and arm pain for the      past 2 hours and I think I am having a heart attack.”

HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.

Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl

His diagnosis is an acute inferior wall myocardial infarction.

1 of 2 Questions:

Why is HDL considered the “good” cholesterol?

2 points   

QUESTION 2

  1. CC: “I have been having terrible chest and arm pain for the      past 2 hours and I think I am having a heart attack.”

HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.

Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl

His diagnosis is an acute inferior wall myocardial infarction.

2 of 2 Questions:

Explain the role inflammation has in the development of atherosclerosis.

3 points   

QUESTION 3

  1. A 45-year-old woman with a history of systemic lupus      erythematosus (SLE) presents to the Emergency Room (ER) with complaints of      sharp retrosternal chest pain that worsens with deep breathing or lying      down. She reports a 3-day history of low-grade fever, listlessness and      says she feels like she had the flu. Physical exam reveals tachycardia and      a pleural friction rub. She was diagnosed with acute pericarditis.

Question:

What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?

1 points   

QUESTION 4

  1. A 15-year-old adolescent male comes to the clinic with his      parents with a chief complaint of fever, nausea, vomiting, poorly      localized abdominal pain, arthralgias, and “swollen lymph nodes”. States      he has felt “lousy” for a couple weeks. The fevers have been as high as      102 F. His parents thought he had the flu and took him to an Urgent Care      Center. He was given Tamiflu® and sent home. He says the Tamiflu didn’t      seem to work. States had a slight sore throat a couple weeks ago and      attributed it to the flu. Physical exam revealed thin young man who      appears to be uncomfortable but not acutely ill. Posterior pharynx      reddened and tonsils 3+ without exudate. + anterior and posterior cervical      lymphadenopathy. Tachycardic and a new onset 2/6 high-pitched,      crescendo-decrescendo systolic ejection murmur auscultated at the left      sternal border. Rapid strep +. The patient was diagnosed with acute      rheumatic heart disease (RHD).

Question:

Explain how a positive strep test has caused the patient’s symptoms.

1 points   

QUESTION 5

  1. The APRN sees a 74-year-old obese female patient who is 2 days      post-op after undergoing left total hip replacement. The patient has had      severe post op nausea and vomiting and has been unable to go to physical      therapy. Her mucus membranes are dry. The patient says she feels like the      skin on her left leg is too tight. Exam reveals a swollen, tense, and red      colored calf. The patient has a duplex ultrasound which reveals the      presence of a deep venous thrombosis (DVT).

Question:

Describe the factors that could have contributed to the development of a DVT in this patient explain how each of the factors could cause DVT.

1 points   

QUESTION 6

  1. A 45-year-old woman is 10 days status post partial small bowel      resection for Crohn Disease and has been recuperating at home. She      suddenly develops severe shortness of breath, becomes weak, and her blood      pressure drops to 80/40 mmHg (previous readings ~130/80s mmHg). The pulse      oximetry is 89% on room air. The APRN suspects the patient experienced a      massive pulmonary embolus.

Question:

Explain why a large pulmonary embolus interferes with oxygenation.

1 points   

QUESTION 7

  1. A 45-year-old woman is 10 days status post partial small bowel      resection for Crohn Disease and has been recuperating at home. She      suddenly develops severe shortness of breath, becomes weak, and her blood      pressure drops to 80/40 mmHg (previous readings ~130/80s mmHg). The pulse      oximetry is 89% on room air. While waiting for the Emergency Medical      Service (EMS) to arrive, the APRN places EKG leads and the EKG      demonstrates right ventricular strain.

Question:

Explain why a large pulmonary embolism causes right ventricular strain.

1 points   

QUESTION 8

  1. A 12-year-old girl is brought to the Emergency Room (ER) by      her mother with complaints of shortness of breath, wheezing, tachypnea,      tachycardia, and a non-productive cough. The mother states they had just      come from a fall festival where the entire family enjoyed a hayride. The      symptoms began shortly after they left the festival but got better a      couple hours after they returned home. The symptoms began again about 6      hours later and seem to be worse. The mother states there is no history of      allergies or frequent respiratory infections. The child is up to date on      all vaccinations. The child was diagnosed with asthma. The nurse      practitioner explained to the mother that her child was exhibiting      symptoms of asthma, and probably had an early asthmatic response and a      late asthmatic response.

Question 1 of 2:

Explain early asthmatic responses and the cells responsible for the responses.

2 points   

QUESTION 9

  1. A 12-year-old girl is brought to the Emergency Room (ER) by      her mother with complaints of shortness of breath, wheezing, tachypnea,      tachycardia, and a non-productive cough. The mother states they had just      come from a fall festival where the entire family enjoyed a hayride. The      symptoms began shortly after they left the festival but got better a      couple hours after they returned home. The symptoms began again about 6      hours later and seem to be worse. The mother states there is no history of      allergies or frequent respiratory infections. The child is up to date on      all vaccinations. The child was diagnosed with asthma. The nurse      practitioner explained to the mother that her child was exhibiting      symptoms of asthma, and probably had an early asthmatic response and a      late asthmatic response.

Question 2 of 2:

Explain late asthmatic responses and the cells responsible for the responses.

2 points   

QUESTION 10

  1. A 64-year-old man with a 40 pack/year history of cigarette      smoking has been diagnosed with emphysema.  He asks the APRN if this      means he has COPD.

Question 1 of 2:

Explain the pathophysiology of emphysema and how it relates to COPD.

2 points   

QUESTION 11

  1. A 64-year-old man with a 40 pack/year history of cigarette      smoking has been diagnosed with emphysema.  He asks the APRN if this      means he has COPD.

Question 2 of 2:

Explain the pathophysiology of chronic bronchitis and how it relates to COPD.

     

 

 

2 points   

QUESTION 12

  1. Mr. Jones is a 78-year-old gentleman who presents to the      clinic with a chief complaint of fever, chills and cough. He also reports      some dyspnea. He has a history of right sided CVA, COPD, dyslipidemia, and      HTN. Current medications include atorvastatin 40 mg po qhs, lisinopril,      and fluticasone/salmeterol. He reports more use of his albuterol rescue      inhaler.

Vital signs Temp 101.8 F, pulse 108, respirations 21. PaO2 on room air 86% and on O2 4 L nasal canula 94%. CMP WNL, WBC 18.4. Physical exam reveals thin, anxious gentleman with mild hemiparesis on left side due to CVA. HEENT WNL except for diminished gag reflex and uneven elevation of the uvula, CV-HR 108 RRR without murmurs, rubs, or click, no bruits. Resp-coarse rhonchi throughout lung fields. CXR reveals consolidation in right lower lobe. He was diagnosed with community acquired pneumonia (CAP).

Question:

Patient was hypoxic as evidenced by the low PaO2. Explain the pathologic processes that caused this patient’s hypoxemia.

  

1 points   

QUESTION 13

  1. A 64-year-old woman with moderately severe COPD comes to the      pulmonary clinic for her quarterly checkup. The APRN reviewing the chart      notes that the patient has lost 5% of her body weight since her last      visit. The APRN questions the patient and patient admits to not having      much of an appetite and she also admits to missing some meals because it      “takes too much work” to cook and consume dinner.

Question:

The APRN recognizes that COPD has a deleterious effect on patients. Explain why patients with COPD are at risk for malnutrition.

  

1 points   

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Nurs435promptweek8

The Negotiator’s Dilemma

Sometimes when parties negotiate, they are fixed in their position. In this positional approach, parties treat conflict as a contest of wills; an integrative approach is a more cooperative, open dialogue between parties. A negotiator’s dilemma is the choice one must make to produce a successful negotiation. Research the negotiator’s dilemma further and discuss the following:

  • Share a scenario or a personal experience and present a negotiator’s dilemma to the situation.
  • Compare the advantages and disadvantages of different approaches to reach a resolution.
  • Share the approach you might adopt and explain your reasoning.

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