A. Most clinical trials for vaccines evaluate the risks/adverse reactions associated with the use of an adjuvant in a vaccine on healthy people. However, when approved the vaccine may be given to elderly or sick individuals. Is repeated doses of the adjuvant containing vaccine likely to increase the risk of observing adverse reactions in a given individual? Why or why not? (Hint: think about the annual flu shot.)

B. Why are multiple vaccine doses still needed even if an adjuvant is present in the vaccine?

For this task you are required to produce a poster or flyer appropriate for display in a community service facility which identifies at least four different opportunities for community participation and social inclusion for people with disabilities, in your local area.

For each of the opportunities you have identified for community participation, describe the interests, abilities and requirements that are associated with the activities, as well as any other information that interested clients would like to know.

Also note if there are any cultural and religious needs that may impact on participating in the opportunity.

1. Identify four barriers you may come across for each opportunity identified. Detail a strategy to address and monitor the identified barriers.

• In what ways is vaccination different from other types of personal health decisions? Who should be involved in deciding whether children receive a specific vaccine?
• Should the government have the right to compel vaccination?
• Should parents have the right to refuse it? How does this decision effect others? Explain.

The earliest roots of HIT included envisioning it as a decision support system (DSS). Describe the current state of the followings as a DSS:

a. Watson Health

b. Telemedicine

c. Precision Medicine

What would be considered clinically significant about an infant hospitalized for diarrhea that has this for their general appearance

general appearance: irritable when awake, alternates with lethargy once quiet, when awake and crying, and tears are not present

I understand that this indicates pain and discomfort, why would the alternating between lethargy and crying, and no tears present specifically be clinically significant?

Thank you

Why are multiple vaccine doses still needed even if the adjuvant is present in the vaccine?

#1- Completion of in vitro fertilization with placement of the patient's fertilized ovum into the uterus. What is the correct code?

#2 - Chemical pleurodesis is performed by instilling a slurry of talc through a chest tube to cause adhesion of the parietal and visceral pleura. What is the correct code

#3- IV Glucarpidase into a peripheral vein. What is the correct code?

pathophysiology of a J -Tube placement. Please at least 8 to 10 sentences at minimum.

Part 1.

You are a nurse caring for a 26 year old male involved in a burn incident that involves the left upper limb and the left lower limb. What do you think will be the problems of the patient during the acute and rehabilitative phase? What can be implemented? How will you be able to help him recover from the incident and to fully regain his optimum health and functioning?

Formulate a plan of care for the patient (ADPIRE fomat).

As a nurse what will be your contributions to help prevent or minimize accidents that can cause burn injuries?

Part 2.
Nursing Care Plan (ADPIRE format) to address the following possible nursing diagnoses associated with AKI and ESRD.
1. Fluid volume excess
2. Decreased cardiac output
3. Risk for infection

⦁   for each of the following people involved in the planning of services in ageing support:
Note that you must provide:
⦁   Two (2) different health professionals
⦁   Two (2) differentComplete the table below by identifying one (1) role and two (2) responsibilities service delivery workers
⦁   Two (2) different service providers

Person’s assessor
Carers

Support worker

Primary service provider

Health professional 1

Health professional 2

Service delivery worker 1

Service delivery worker 2

Other service provider 1
Guidance: They are different from the primary service provider

Other service provider 2
Guidance: They are different from the primary service provider.

1. create teaching session about smoking cessation
2. Using evidence-based research findings that you apply to your topic, develop the following:
   1. Learning objectives
      1. Identify your students/audience; what information is most important for them to know/incorporate into their clinical practice?
      2. Consider the topic; what are the focused, critical learning components you must assure your students take away from your session? What “clinical pearls” can you teach them that would benefit their patient populations?
      3. Research your topic, define the key areas of information you wish to relate to your audience about this topic. Contemplate the value of the information and the time-frame in which you have to deliver this content when creating your outline. While you may want to share a considerable amount of valuable information with your students/audience, you must refine your content in order to provide them with useful content that stimulates critical thinking
      4. 1. Teaching strategies
            1. Consider your students and available resources when designing your teaching strategies. Look to the literature for ideas. Think about the types of learners in your classroom, are they visual, kinesthetic, or perhaps auditory learners, or are they a combination learner? Would the use of technology or simple lecture be most valuable for imparting information to this group? You may not have all the resources you wish to apply in this setting however you should minimally mention ones that you would use if available when crafting your summative report.
         2. Evaluation method
            1. How will you evaluate learning outcomes? Think about the brief amount of time you will have to present your topic, this time must include a method of evaluation for assessing learning- what method could you incorporate into your lesson to ensure that your audience grasped the key concepts you are trying to impart?

Pick an older adult you know and briefly describe their function (clue - think ADLs and IADLS) and overall health? What age related changes can you identify and what age associated conditions?   What recommendations to improve their health can you make. Based on what you have learned what steps might you take to help yourself age more successfully? How and why have the causes of death shifted from the turn of the century to the present time?

Briefly describe the Hayflick limit and how it might related to telomeres?

What is a biological explanation for how a healthy lifestyle might affect aging?

In your opinion Is aging a disease? (not all agree about this) Why or why not?

Pick one organ system and discuss one age-related change and one age-associated disease.

Your grandfather’s best friend was diagnosed with dementia. Briefly describe what dementia is to your friend and some examples of behaviors your best friend might notice.

Name one thing you feel that you might do to help your age gracefully and why you believe this will be of help to your future health.

What are the quality control requirements for Glucose tolerance testing and fasting blood glucose test?

What is the level of sensitivity for both tests?

What advantages and disadvantages of the tests have?

NURSING DIAGNOSIS- " Impaired Skin integrity related to frequent scratching and dry skin"

MAKE NURSING CARE PLAN FOR THE GIVEN DIAGNOSIS

MT is a 4 year old male that was referred from Dermatology to our allergy clinic at Steve Biko Academic Hospital on the 7th of July 2014.

Further history and symptomatology
 The rash started at 1 year of age and worsened as time went on.

 The rash was extremely itchy and the child was constantly scratching the affected areas.

 The child’s quality of life was affected as the child often wakes up at night to scratch the affected areas.

 The child was seen in Dermatology since February this year, he had received 4 courses of oral prednisone for a week and had been started on cyclosporine a month before presenting to us in the allergy clinic. The mother did report that there is a temporary response to the oral prednisone initially but the rash soon recurred. She had not noticed an improvement after cyclosporine had been commenced.

 There were no specific food items that the child avoided or disliked and there were no particular foods that made the rash worse.

Family history:
No family history of atopy

Birth history and Road to Health Chart:
The patient was born at term via normal vaginal delivery with no complications post delivery

Surgical History:
None

Medical History:
The patient is HIV negative and has had no previous admissions to hospital
He is not on any chronic medication.
In terms of the allergic march, there were no overt food allergies as an infant on history. The child did not display evidence of allergic rhinitis or asthma on history.
  

Feeding history:
The child was exclusively formula fed until 7 months of age at which weaning to solids had commenced.

On Examination
This is a healthy looking 4 year old child, with no evidence of allergic facies.
Anthropometry Within normal limits, no evidence of failure to thrive
ENT examination No inflamed turbinates
Eyes No evidence of conjunctivitis
Skin hyperpigmented, lichenified diffuse rash involving the flexural surfaces of the elbows and knees. Severe dermatitis of the scalp, neck, trunk and lower limbs
The rest of the systems were within normal limits.

Assessment
1. Severe atopic dermatitis refractory to conventional treatment
Discussion and plan:
This child had severe atopic dermatitis which affected his quality of life. There seemed to be no particular food allergens implicated. Skin prick tests were deferred due to severity of the skin lesions. Due to the early onset
of presentation together with the fact that it was refractory to conventional treatment- an FX5 screen was performed which revealed no positive food allergens.
The cyclosporine was discontinued and the child was admitted for wet wraps. The wraps were changed every 48 hours and a dramatic improvement was noted. No foods were excluded from the diet. After just two sets of wraps, there was a dramatic improvement as depicted below.
The child was subsequently discharged with education on pharmacological and non-pharmacological measures to control atopic dermatitis.
Non pharmacological measures included the avoidance of soaps during lukewarm baths, the use of emollients, avoidance of woollen clothing, keeping skin well covered and protected in addition to other measures.
Pharmacologically, the child was discharged on a moderately potent steroid agent for the body and a mild agent for the face. The importance of weekly or twice weekly topical steroid use for maintenance therapy was also stressed.

Wet wrap therapy

Atopic dermatitis is a chronic inflammatory skin condition that generally begins during infancy and is the most common skin disease in children under the age of 11 years. Potential causes include irritants such as soap and detergents, food allergens, contact allergens, and skin infections.1
The aim of topical therapy is to protect the skin from scratching and environmental factors and to suppress the inflammatory changes and infection if present. Emollients inhibit water loss and provide a protective coating; they are recommended in all patients with atopic dermatitis. Additionally, emollients may reduce the need to use topical corticosteroids.2
Wet wrap therapy refers to wet bandages applied over emollients and/or topical steroids. The use thereof is indicated in acute flares of atopic dermatitis in cases that are severe and refractory to conventional topical corticosteroid treatment. The main advantages of wet wrap therapy is that it rehydrates the damaged skin, reduces itching and erythema, cools the skin, and enhances the penetration of topical medication utilised. It also provides a physical barrier against scratching, which in turn prevents secondary infection. However, wet wrap therapy is time consuming and there is a risk of enhancing the systemic side effects of topical corticosteroids.3 Wet wrap therapy has been shown to be more beneficial if topical corticosteroid added to the emollient and the side effect profile minimal if used for less than 14 days

Identify one factor (person or event) that facilitated the ethical process or the healthcare process in the film (my sisters keeper). Describe why it was an important part of the process