DIRECTION: Create an NCP in relation to the case scenario.

Case Scenario: This is a case of a patient referred to a specialty memory clinic at the age of 62 with a 2-year history of repetitiveness, memory loss, and executive function loss. Magnetic resonance imaging scan at age 58 revealed mild generalized cortical atrophy. He is white with 2 years of postsecondary education. Retirement at age 57 from employment as a manager in telecommunications company was because family finances allowed and not because of cognitive challenges with work. Progressive cognitive decline was evident by the report of deficits in instrumental activities of daily living performance over the past 9 months before his initial consultation in the memory clinic. Word finding and literacy skills were noted to have deteriorated in the preceding 6 months according to his spouse. Examples of functional losses were being slower in processing and carrying out instructions, not knowing how to turn off the stove, and becoming unable to assist in boat docking which was the couple’s pastime. He stopped driving a motor vehicle about 6 months before his memory clinic consultation. His past medical history was relevant for hypercholesterolemia and vitamin D deficiency. He had no surgical history. He had no history of smoking, alcohol, or other drug misuse. Laboratory screening was normal. There was no first-degree family history of presenile dementia. Neurocognitive assessment at the first clinic visit revealed a poor verbal fluency (patient was able to produce only 5 animal names and 1 F-word in 1 min) as well as poor visuospatial and executive skills. He had fluent speech without semantic deficits. His neurological examination was pertinent for normal muscle tone and power, mild ideomotor apraxia on performing commands for motor tasks with no suggestion of cerebellar dysfunction, normal gait, no frontal release signs. His speech was fluent with obvious word finding difficulties but with no phonemic or semantic paraphrasic errors. His general physical examination was unremarkable without evidence of presenile cataracts. He had normal hearing. There was no evidence of depression or psychotic symptoms.

Module 10 Case Studies

Chapter 11

KT, age 42, presents to the emergency department with a complaint of having a “heart attack”. She reports chest pain, apprehension, trembling, shaking, confusion, dizziness, nausea, and difficulty breathing. Her EKG is normal and she is found not to be experiencing a myocardial infarction. After further exploration, it is discovered that KT has a significant number of life stressors and a family history of anxiety. She is diagnosed with panic disorder.

1. Outline the process that is most likely occurring in this woman’s body.
2. What is the etiology of panic disorder?
3. How do the expected clinical manifestations match what she is presenting?
4. What diagnostic tests could be used?
5. What treatment measures would you anticipate?

Chapter 19

A.Z., a 65-year-old woman, was having a follow-up visit with her physician. She was concerned about a change in her sleeping habits, including taking at least 30 minutes to fall asleep. She woke up after only about 5 to 6 hours of sleep and found herself unable to fall asleep again. She consequently got sleepy in the afternoon and took frequent naps.

1. What are some causes of age-associated sleep disorders?
2. What are the typical changes in sleep patterns that occur in response to age?
3. What causes age-related changes in sleep patterns?
4. What are the risks related to the use of pharmacologic sleeping aids in the elderly?
5. What non-pharmacologic strategies can be used to help promote sleep

i) What are some similarities and what are some differences between the PSW and the OTA/ PTA roles and responsibilities? How did each role complement each other?

ii) Write a S.M.A.R.T. Goal on how you can guarantee your success when working with another member of an interdisciplinary team (detailed with explanation).

iii) What can a personal support worker, learn from the OTA and PTA

iv) How can you use the experience of an OTA and PTA to enhance PSW' s professional career

Identify a screening/measurement tool to assess for alcohol use disorder and alcohol withdrawal. Include a link or copy of the screening/measurement tool.

Write at least a 265-word response to the following. Your response must address all aspects of each question, must include your personal opinions, ideas, or thoughts; and must provide examples in any situation where it is warranted.

·       Describe a time or situation when you saw the impact of technology in health care. Why was this important?

Discuss two challenges faced by individuals who must use durable medical equipment (DME, also known as “assistive devices”), such as a cane, walker, or wheelchair, to perform their activities of daily living (ADLs). Describe how these affect their quality of life (QOL)

What are the consequences of using advanced access in multi-specialty clinic? How might these tools be applied to provide same-day scheduling?

Reaction paper about Provisions of the Healthcare Reform and Healthcare Inequalities and Health Inequities

When enacting the strategy of ______ nurses are able to have input into the decision-making process like equals, but in a way that doctors are unaware of their contributions, thus maintaining the perception of the nurse’s role as subordinates.

1. A concern on social media is

   	A.	access.
   	B.	privacy.
   	C.	the EHR.
   	D.	the proliferation of apps.

6.25 points   

QUESTION 15

1. Social networking may be used by

   	A.	families.
   	B.	all of the answers are correct
   	C.	nurses.
   	D.	patients.

6.25 points   

QUESTION 16

1. ______ are defined as unexpected occurrences involving death or serious physical or psychological injury, or the risk thereof.

   	A.	Medical errors
   	B.	Socializations
   	C.	Power conflicts
   	D.	Memorable messages

6.25 points   

QUESTION 17

1. Which of the following is not an approach to conflict resolution?

   	A.	Avoidance
   	B.	Collaboration
   	C.	Authority
   	D.	Competition

6.25 points   

QUESTION 18

1. The _____ involves the contradiction of attempting to be regarded as a competent peer of physicians, while at the same time conforming to the traditional hierarchical structure that relegates nurses to an inferior status position within the physician-nurse relationship.

   	A.	detached-attached role dialectic
   	B.	denying the hierarchy
   	C.	equal-subordinate dialectic
   	D.	superior–equal role dialect

6.25 points   

QUESTION 19

1. _____ is crucial to contribute to the effective functioning of nursing organizations and consequently, to the excellence of nursing care.

   	A.	Evaluation
   	B.	Managing Conflict
   	C.	Background
   	D.	Dominance

Reaction about The Ethics of Epidemics and the current global pandemic

Reaction about The Ethics of Disaster and Domestic Violence

Mr. Franklin is a 60-year-old patient with a history of a thrombotic cerebrovascular accident two years ago. After the stroke he started with seizure attacks. He has been suffering from hypertension for the last ten years and ulcerative colitis since last year. He currently takes lisinopril, hydrochlorothiazide, aspirin, carbamazepine, and a low dose of prednisone.

Mr. Franklin has been suffering from epigastric pain, sensation of fullness, and occasional nausea for the last six months. This time, he was brought to the ER because, while he was talking to his son, he had a dizzy spell and fell to the floor. He is conscious and is complaining of severe epigastric pain. He began with mild abdominal pain two days after he started taking a new cycle of prednisone for his colitis, around seven days ago. The pain increases when he eats or drinks something. He is also complaining of suffering from pyrosis, malaise, and dizziness, and he has noticed that his feces are dark.

The patient was a heavy alcohol drinker until he had the stroke. He is a cigarette smoker since he was 20 years old. His mother suffered from Alzheimer's disease and died of colon cancer, and his father died of cirrhosis of the liver.

• Abdomen: Pain on palpation on epigastric region
• SOMA: Right hemiplegia and hyperreflexia
• Integumentary system: Pallor, diaphoresis, coldness
• Cardiovascular system: Tachycardia. Blood pressure 70/50 mmHg. Radial pulse 110.
• Digestive system: Tenderness of epigastric region. Rectal exam showed melena.
• Neurologic system: The patient is conscious and well oriented to time, place, and person. Right hemiplegia and hyperreflexia

Respond to the following?

1. According to the patient's previous medical history, it is possible that he has cirrhosis of the liver? Why? Can cirrhosis of the liver be a cause of upper digestive bleeding? What is the prognosis? Explain.
2. Are there any specific risk factors of diseases of the gallbladder or pancreas? If so, why, and what is the prognosis?
3. What specific sign on the physicals is characteristic of upper digestive system bleeding?