Week 5  Discussion Forum

Michele Seibler

Yesterday Oct 11 at 8:42am

Option 1

I was a bit unclear on what a bureaucracy was until this week's lesson and readings. From what I understand and according to the text, a bureaucracy is a complex and hierarchal organization where several offices, each with a specific task, have a clear chain of command, and appointment and advancement of personnel are based on merit. A bureaucrat is someone who works for a bureaucracy (Greenberg & Page 2019, pg. 366). Bureaucracies are all around us – the DMV, financial organizations and insurance companies are a few examples. After understanding what a bureaucracy is, I think they can both help and hinder my life. Bureaucracies are something that we need to live as citizens of the United States, but often they have rules and regulations that can be a hinderance in many aspects of our lives. The rules and decisions of bureaucracies seem to be made without the public's best interest in mind, and the public often isn't involved in decision making. They all revolve around money. They are often unclear with the public, leaving people confused and overwhelmed with things they don't understand. It can take months to resolve certain issues or get question answered. Processes that should be simple can be very stressful. John Launer wrote an article titled “Battling Bureaucracy,” which is what it feels like sometimes. He explains how he jumped through hoops with bureaucracies trying to help a friend get money back. One of the things he said a couple of times in the article was “money problems figure more in peoples' lives than medical problems, especially now that we're in a serious cost of living crisis” (Launer 2023). One thing that is a large issue in bureaucracies is communication. These organizations are not good at communicating with the public; it often feels as if you're trying to talk through a wall. You could talk to one representative and have them tell you one thing, then speak to another and find out something completely different. This makes everyday things, like dealing with insurance companies, very stressful and difficult. If these bureaucracies can become more transparent with the public, it would help tremendously and there would be less confusion and frustration. 

References

Greenberg, E. S., & Page, B. I. (2019).
The Struggle for Democracy, 2018 Elections and Updates Edition (12th ed.). Pearson Education.

https://ambassadored.vitalsource.com/books/9780135246863

Links to an external site.

Launer, J. (2023). John Launer: Battling Bureaucracy.
BMJ: British Medical Journal (Online).

https://doi.org/10.1136/bmj.p206

Links to an external site.
 

Reply

 The patient is a 71-year-old widowed man who is seen regularly in the clinic for health maintenance and follow-up of his chronic insomnia and anxiety. He has regular prescriptions for triazolam (Halcion) and clonazepam (Klonopin) for these problems. Recently he has been reporting frequent episodes of losing his balance and falling, and eight weeks ago was hospitalized for a hip fracture sustained during one of these falls resulting in hip surgery. On this visit, he also complains of becoming increasingly confused. 

Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. 

Renal Failure

Patient Profile:

J.M. is a 37-year-old woman transferred to a large medical center from a small rural hospital for further evaluation of lower abdominal pain, nausea, vomiting, and progressive deterioration of urinary output.

Subjective Data:

-Long history of ETOH Abuse with a drinking binge two days ago

-Arthritis with heavy use of ibuprofen

-HTN for three years, treated with hydrochlorothiazide and a calcium channel blocker

-Borderline NIDDM for three years, does not want to take medications and has been trying

to lose weight and “watch her sugar intake.”

Objective Data:

B/P: 160/110 K: 6.3 mEq/L Urinary output: <15ml/hr Na: 149 mEq/L Lethargic Hgb A1C: 9.2%

Creatinine: 9.6 mg/dL BUN: 121 mg/dL

CRITICAL THINKING QUESTIONS…

1. Address how the various factors in her past medical history could have contributed to her present renal problem.

2. Is her acute renal failure likely to be prerenal, intrarenal, postrenal, or a combination? Why?

3. Discuss each of the laboratory values and how they reflect the pathophysiology that occurs in renal failure. What is the significance of her Hgb A1C level?

4. What are the specific priorities of treatment for J.M.?

5. Explain the types of dialysis available, their indications, and their advantages/ disadvantages. What type of dialysis will most likely be used for J.M?

6. After two weeks of intensive support and dialysis, J.M’s urinary output returns. Explain the diuretic phase of recovery in Acute Renal Failure, and what complications can occur.

7. Do you think she needs intervention for her diabetes? What guidelines did you consult? How would you start in treating a patient with newly diagnosed Type 2 diabetes? Which medication(s) might you want to start first? What patient education issues would you emphasize in the initial period?

Hum Ecology & Environment week 1 discussion.

Instructions

Pick any one question and respond in an original discussion post by midnight, Day 4 of Week 1.

After the initial post, you must provide substantive responses to 
at least 2 of your classmates’ posts and remain 
active on at least 2 additional days during Week 1.

There are 2 parts to this week’s discussion forum – Answer both parts in the same post.

First:

Introduce yourself to your peers. State how far along you are in the program, where you work, your future goals, and any experiences you would like to share. Brief info about me so you can develop a brief introduction: (Heidi Lugo, I’ll be graduating in March 2024, I work at Mercy Hospital in 7c med-surgical floor, goals (become a nurse practitioner))

Next, pick 
one of the two questions and answer.

1. How would you explain climate change to someone? What aspects would you include, and why? Next, how does climate change intersect with race and gender in its impact on people's health? Support your post with data. Lastly, can you think of areas impacted by climate change that the unit did not cover? How can nurses help in addressing this environmental concern? (USLOs 1.1, 1.2, 1.3, 1.4)

OR

2. Pick two recent events in the past five years that you think are climate-change-related and describe them briefly. Next, discuss why you consider them as environmental concerns. What measures could be taken at individual and institutional levels to prevent such events from occurring again? And how can nurses advocate for addressing this ecological concern? (USLOs 1.1, 1.2)

 

Each week, your discussion will be graded on a point scale. To successfully complete each weekly discussion assignment, you will need to address all items included in the discussion topic/question 
thoroughly.

Your input should be in your own words (to avoid plagiarism), demonstrating your understanding and comprehension of the topic. Be sure to support all your posts (initial post + responses) with specific references to the assigned readings, lecture material, and other relevant research you find appropriate in APA format.