Respiratory

/in /by

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. Add questions to paper

CASE STUDY: 
Asthma

 

Patient Profile:

    Miss Winters, age 25, comes to the emergency department with severe wheezing, dyspnea, and anxiety. She was in the ED only 6 hours ago with an acute asthma attack, which resolved with nebulized albuteral treatments.

 

Subjective Data:

-Admits to use of albuterol inhaler several times weekly for the last few months 

-Asthma symptoms occasionally awaken her at night (about 3 times a week), and she has cancelled several outings with her family due to her symptoms

          -Can now only speak in one to three word sentences

          -Is allergic to cigarette smoke

-Began to experience increased shortness of breath and chest tightness when she returned home

-Used albuterol inhaler repeatedly at home without relief

-History of pruritic skin lesions that have come and gone since childhood.

 

Objective Data:

            Physical Examination:

                -Using accessory muscles to breath

             -Audible inspiratory and expiratory wheezing to auscultation with no air movement in lower lobes of l

                     lungs

             -HR = 126/min; Resp = 40/min

             -Areas of dry, scaling skin in antecubital areas bilaterally with evidence of scratching

            
Diagnostic Studies:

                        ABGs: PO2  = 80 mm Hg

                                    PCO2  = 35mm Hg

                                    HCO3  = 24 mEq/L

                                    pH = 7.48

                        PEFR: 150 L/min (Personal best: 400 L/min)

                        Continuous pulse oximetry: 82-85

 

CRITICAL THINKING QUESTIONS:

 

1. Why did Ms. W. return to the ED? Explain the pathophysiology of this second exacerbation of asthma.

 

2. Describe the progression of breath sounds auscultated from early in an asthma attack through very severe respiratory impairment. How do the sounds change as the patient improves?

 

3. What is the significance of her dry, scaling, pruritic skin lesions? What is your diagnosis (no nursing dx please)? How do these types of lesions relate to asthma? What is their physiologic cause ?

 

4. Analyze the ABG. What type of acid-base disorder is present? Why? Is there any compensation?

 

5. Discuss the four categories of asthma diagnosis advocated in the 
Guidelines for the Diagnosis and Management of Asthma from the National Heart, Lung, and Blood Institute of the National Institutes of Health. Which classification best describes Ms. W.'s asthma?

 

6. According to the asthma treatment guidelines from #5: the “Step up-Step down” approach, what is the recommended treatment strategy for a patient currently at Ms. W.’s classification level once this current exacerbation is controlled? When would it be appropriate to reevaluate the interventions and possibly adjust the medications?

 

7. She lost her Peak Flow meter during a recent house move. Why would you want to order a new one for her? How is it used and how can it help increase her ability to control her asthma? Explain the red, yellow, and green zones. What is the significance of her PEFR level on her return to the Emergency Room?

 

Advocacy Action Plan Part 2: PEST Analysis

/in /by

KINE 4354 Public Health Advocacy and Leadership

Assignment 4.1: Advocacy Action Plan Part 2: PEST Analysis

Adapted from:

Sample Templates
,

MindTools PEST Analysis Worksheet
, and

University of Bridgeport Career Development Timeline

Instructions

Use the template below as a worksheet/workspace. The question prompts provided are intended to help you to gain a better understanding of the public health issue or need associated with your advocacy action plan. As you complete this template, you are allowed to make informal notes, use bullet points and copy and past links to websites, articles and other resources that will help you to better identify factors related to your advocacy action plan.

As you complete this template, please keep in mind the following:

· Although it is important to consider macro-level factors (i.e., what is happening at the societal level), for the purposes of this assignment you are asked to place more emphasis on micro-level factors (i.e., what is happening at the community level).

· Although all questions may not apply to your advocacy action plan, be sure to answer each question under all four categories (Political, Economic, Socio-Cultural, & Technology).

Template Components

Step 1: Identify the
Political, Economic, Socio-Cultural and Technological Aspects of the Proposed Change in Your Advocacy Action Plan

KINE 4354 Assignment 4.1: Advocacy Action Plan Part II: PEST Analysis

Factor

Opportunity

Threat

POLITICAL

Political factors to consider:

·
When is the country's next local, state, or national election? How could this change government or regional policy?

·
Who are the most likely contenders for power in your community? What are their views on public health policy, and on other policies that affect your organization?

·
Depending on the country, how well developed are property rights and the rule of law, and how widespread are corruption and organized crime?

·
How are these situations likely to change, and how is this likely to affect you?

·
Could any pending legislation or taxation changes affect your business, either positively or negatively?

·
How does government approach public health policy, areas of social justice or social responsibility, and environmental protection legislation? What impact does this have, and is it likely to change?

·
Are there any other political factors that are likely to change?

Factor

Opportunity

Threat

ECONOMIC

Economic factors to consider:

·
How stable is the current economy? Is it growing, stagnating, or declining?

·
What is the financial condition of the organization you plan to work with? Is the organization financially stable? Is there revenue to fund your idea? If not, how will you address this?

·
Are there any other economic factors that you should consider?

Factor

Opportunity

Threat

SOCIO-CULTURAL

Socio-Cultural factors to consider:

·
What is your target population's growth rate and age profile? How is this likely to change?

·
Are generational shifts in attitude likely to affect what you're doing?

·
What are your target population’s levels of health, education, and social mobility? How are these changing, and what impact does this have?

·
What social attitudes and social taboos could affect your advocacy action plan? Have there been recent socio-cultural changes that might affect this?

·
How do religious beliefs and lifestyle choices affect the population?

·
Are any other socio-cultural factors likely to drive change for your proposed advocacy action plan?

Factor

Opportunity

Threat

TECHNOLOGICAL

Technological factors to consider:

·
Are there any new technologies that you could be using?

·
In which areas do governments and educational institutions focus their research? Is there anything you can do to take advantage of this to address your proposed advocacy action plan?

·
Are there existing technological hubs that you could work with or learn from? THINK COLLABORATION!

·
Are there any other technological factors that you should consider?

Step 2: BRAINSTORM OPPORTUNITIES

Now that you have identified some of the changes that are taking place in the proposed setting for your advocacy action plan, look at each of those changes and brainstorm the potential OPPORTUNITIES that might be available for you or for the organization which you are proposing the advocacy effort for.

Potential Opportunities for Your Advocacy Action Plan

1.

2.

3.

Step 3: BRAINSTORM THREATS

Now think about the changes and think about how some of those might be barriers to the implementation of your advocacy action plan. How might you plan in a manner that the potential threats might be minimized, or avoided?

Potential Threats for Your Advocacy Action Plan

1.

2.

3.

Step 4: Notes for TAKING ACTION

Now it is time to TAKE ACTION! You will take this next step in Assignment 6.1 as you write up your final plan. Use the section below to write your main takeaways as you start to develop the main sections of your advocacy action plan.

My Advocacy Action Plan Notes:

nursing

/in /by

 What is your definition of spiritual care? How does it differ or accord with the description given in the topic readings? Explain. 

nursing

/in /by

 According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interactions with patients. How do you see this being applied in your workplace? In addition, how can you strive to make spirituality and self-care a practice for your patients as well as yourself? How does this practice align with the Christian worldview? 

mental health

/in /by

Rubric for NUR2488 A1&B1 Presentation on Criminal Minds

Be sure each section is clearly delineated and covered in a
3–5-page body paper, double spaced, Plus a Care Plan HINT:
Use the Headings provided – if you can’t find something, record as “unable to find” or guess as to what the answer may be (and say you are guessing).
References and citations in APA 7 format (see example link);

Reporter’s name (you):

Date:

Infamous Person:

___/30 points


1. Identify and present significance of: (Use these Numbered/ underlined headings)

A. childhood (2pts)

B. Late-adolescence (2)

C. Early 20’s (2)

D. Family Influence (2)

2.

Diagnosis/treatment

– (1)

3
.
Substance Abuse/ alcohol involved?
 (1)

4.

The Infamous Act/ Traumatic event/ Crime
 (2)

5
.
Incarceration/ Jail Where?
 (1)

6.

Death or current circumstances
 (1)

7
.
How are all the above events tied together?
 (2)

8
.
How do the effects of an underlying (often untreated) Mental Illness contribute to a Human Being’s demise?
 (2)

9.
What characteristics of a serial Killer do you see in your criminal?
Consider these characteristics:

(Antisocial behavior, Arson, Torturing small animals, Poor family life, Childhood Abuse, Substance abuse, Voyeurism, Intelligence [hi or low], Shiftlessness). (2)

10
. Where could health care personnel/teachers have intervened in this child’s life to prevent this tragedy if it were NOW? Paragraph of Your opinion. (2)

11
. Wanted poster (Like in the Old West) (1)

Example:
https://s3.amazonaws.com/thumbnails.venngage.com/template/044f0593-a7ec-48ad-8560-6edda19ad66c.png

12.Choose 3
priority(3 part) NANDAMental Health Nursing diagnoses. The nursing care plan should include (4)

· Use MH Care Plan template and complete

· HINT: See Varcarolis or Ackley (Care Plan book)

ARE

/in /by

Patient Data for NR226 RUA Patient:

Patient History:

Ben Smith is a 75-year-old retired farmer from Southern Illinois. He is widowed and has 3 adult children who live
out of state. He is in an LTC for rehab following hospitalization. He has a 60-year history of smoking 2 PPD of
cigarettes. He fell 3 months prior to his hospitalization but did not sustain any injuries.

He was admitted to the hospital for an acute exacerbation of COPD. He also has a history of COVID in 2020,
HTN, and anxiety.

Medications:

• Acetaminophen 325mg PO Q6 hours PRN
• Albuterol inhaler, 2 puffs once daily
• Ipratropium bromide nebulizer Q8 hours PRN
• Lorazepam 5mg PO Q12 hours
• Nicotine patch, change every 72 hours
• Prednisone 30mg PO BID
• Multivitamin daily

Labs:

• Sputum culture and sensitivity- results showed no infection
• UA/UC- WNL
• CMP- WNL, except for potassium of 3.4 mEq/L
• CBC- WNL, except for platelets of 140k/mL

Imaging:

• Chest x-ray: shows focal consolidation in right lower lobe, suggestive of pneumonia
• Hyperinflation of lungs with flattened diaphragm consistent with long-standing COPD
• EKG: normal sinus rhythm with rate of 90 bpm

Assessment Data:

• Please be sure to fill in each system, including normal findings
• I will allow you to “make up” data that you would think would be abnormal in a patient like this, think of

findings especially in the following systems:
o Respiratory, cardiac, musculoskeletal, neuro

• Vital signs:
o Temp: 100.6 F, PO
o RR: 22 breaths/min, shallow
o HR: 90 bpm, regular
o BP: 145/90
o O2: 91% on 2L NC
o Pain: 7/10, intermittent, chest and upper back

Miscellaneous:

• The patient states that he hates hospitals and doesn’t belong in a nursing home. He says he needs to
get back to his farm

• He is impulsive and has tried to get out of bed numerous times, even though he is a stand by assist with
a history of falls

• He is non-compliant with medications and has felt nauseated. He does not want to take any meds and
“does not need that dang breathing thingy- it’s stupid!” (The nebulizer)

• He states he “will not quit smoking, I’ve been smoking since I was 15 and it hasn’t killed me yet!”

patient rights

/in /by

Describe an organizational environment that would facilitate the ethical practice of nurses caring for chronically ill patients. As you read about patients’ rights, describe one patient right that is often not fully implemented in the patient care environment. Identify specific strategies to help ensure that this right is supported within the patient care environment. Explain how the registered nurse can assist in protecting patient rights.

Catholicism Report

/in /by

Catholicism Written Report

Report Instructions
In your readings from the Catechism of the Catholic Church and the Compendium of the Catechism of the
Catholic Church you gleaned a better understanding of the what the Catholic Church’s teachings are on
specific theological topics.

You will now use the information gleaned in the text to delineate the teachings listed below in a concise
manner:

1. Catholic Understanding of God as Trinity
2. Salvation is Achieved through the Paschal Mystery of Jesus Christ
3. Eschatology – Death and the Afterlife
4. Freedom
5. Virtues
6. Sin

Formatting Guidelines
When completing this written report, the following guidelines must be followed. Failure to do so will result in
points being deducted from your grade:

a. This report must be typed in 12pt. font, double-spaced, & Times New Roman

b. Each section of the report must:
a. Include Section Title on a separate line

i. Ex: Freedom, Virtues, Sin, etc.

b. Be at least half a page in length

c. Incorporate at least 2 direct quotations with appropriate footnotes
1. First quotation must come from the specific section of the Catechism of the

Catholic Church in the required readings

2. Second quotation with accompanying footnote must come from the specific
section of the Compendium of the Catechism of the Catholic Church in the
required readings

– When citing your sources, you must use Chicago Manuel Style
o A Work Cited page is not required for this report

Case study HP

/in /by

  

Instructions: Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide citations/references for your answers in APA format with scholarly references no older than 5 years. 

CASE STUDY: Active Labor: Susan Wong 

Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy. 

She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information

. Reflective Questions 

1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs? 

2. How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views? 

3. With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future? 

Short Week

/in /by

I need some assist on this question