1- Explain how lead inhibits heme synthesis.

2- Explain the difference in the chemical composition of hemosiderin and ferritin.

3- How is sideroblastic anemia confirmed by laboratory analysis? Explain your answer.

4- Differentiate primary and secondary hemochromatosis?

5- Explain the absorption and assimilation of non-heme iron into hemoglobin in the RBC.

For the scenario below, outline the appropriate patient teaching you would perform.

1. Fractures

An individual has a fracture of the ulna and radius at the wrist. A cast was placed on the area a few weeks earlier, and the patient is now requesting additional information about therapy for the hand, wrist, and arm. The physician has explained the anticipated therapy to the patient and asks you to review this information with him or her. How do you handle this patient-teaching opportunity?

Read the following article and complete a summary of minimum 125 words.

Summary

• Identify major claims and supporting details
• Use the author’s name + reporting verbs are used often
• Paraphrase only
• Avoid personal opinion

Supply of nurses falls in Canada for first time in almost 20 years: report

KELLY GRANTHEALTH REPORTER

HEALTH REPORTER

PUBLISHED JUNE 23, 2015UPDATED MAY 15, 2018

The supply of nurses in Canada has declined for the first time in almost 20 years, according to a new report that has prompted two prominent national nursing organizations to warn that the country needs to do a better job of managing the health-care work force.

The latest snapshot of the nursing field from the Canadian Institute for Health Information (CIHI) found that more nurses left the profession than entered it in 2014 – a 0.3-per-cent decrease from the previous year in the number of people holding active nursing licences across the country.

The supply of registered nurses – by far the most common nursing category – fell 1 per cent.

At the same time, the number of nurses actually working in the field continued to climb last year, up 2.2 per cent from 2013, in keeping with the stable growth of the past 10 years.

"The sum of all the numbers is a tightening nursing labour market," Karima Velji, president of the Canadian Nurses Association (CNA), said in a statement. "Immediate action is needed to stave off the potentially long-lasting trend of a shrinking [registered nurse] work force and its consequences for population health."

The CNA is a professional organization that advocates for nurse-friendly public policy.

Andrea Porter-Chapman, CIHI's manager of health work force information, said it is too early to say whether the dip in supply marks the start of a nursing shortage in Canada or a one-year blip thanks to a regulatory change in Ontario. Either way, health policy-makers will need to watch the trends closely over the next couple of years, she said.

"This is the first shift in almost two decades where we've seen a decline in the supply," Ms. Porter-Chapman said. "But the positive side of this is that our work force continues to increase. ... I think [the supply issue] is something that our health-care system just needs to be aware of and monitor."

When it comes to nursing in Canada, the term "supply" refers to the number of people holding active licences with the provincial bodies that regulate the profession.

But not all licensed nurses work in nursing. Some hold on to their licences after landing other jobs, going back to school or unofficially retiring.

Last year, the College of Nurses of Ontario, the self-regulating body that oversees the profession in Canada's most populous province, put in place a new rule that effectively bars members from renewing their licences unless they have practised nursing in the province in the past three years. That contribued to an unusually high number of nurses formally exiting the profession in Ontario – 15,836 in one year.

Still, the CIHI report identified some underlying trends that suggest there is more at play.

Across the country, a total of 27,757 nurses let their licences lapse last year, while only 25,397 registered anew with one of the provincial or territorial regulators – a net loss of 2,360.

The supply of nurses dropped in six jurisdictions: Newfoundland and Labrador (down 0.7 per cent), Prince Edward Island (down 3.5 per cent), New Brunswick (down 0.9 per cent), Ontario (down 2.6 per cent), British Columbia (down 0.9 per cent) and the Northwest Territories and Nunavut, which together saw a decrease of 3.2 per cent.

Canada's nursing schools are simply not graduating as many students. "We've seen the growth in the number of [nursing] graduates slow down, so it's just under 1 per cent now," Ms. Porter-Chapman said. "This is after five years where the growth was between 6 and 12 per cent."

As well, the number of students admitted to entry-level nursing programs actually fell between 2009-2010 and 2010-2011, the most recent year for which CIHI was able to obtain national figures.

"Will the workplace feel it yet? Perhaps not. It might take a year or two to see these changes trickle into work settings," said Linda McGillis Hall, a professor in the faculty of nursing at the University of Toronto. "I think this report will actually bring this issue to the forefront again."

The Canadian Federation of Nurses Unions (CFNU), an umbrella organization that represents almost 200,000 nurses and nursing students from eight provincial unions, said the decline in supply may already be leading to increased overtime and absenteeism.

The CFNU's latest report found that nurses across the country worked more than 19 million hours of overtime in 2014, 20 per cent of it unpaid. Absenteeism was up too.

"The decrease in the nursing supply combined with an aging work force and fewer students admitted to [entry-level nursing] programs is a sign that our health-care work force is in transition," CFNU president Linda Silas said in an e-mailed statement. "To ensure patient safety and a sustainable health-care system, we need a national health human resources plan."

What is the difference between cardiac arrest and an MI?

What would be seen on an ECG to help you decide between Cardiac arrest and MI? What affect does chronic stress have on your body and how does that add to heart disease?

I have enjoyed a southern feast of deep-fried turkey, mac and cheese, and pecan pie. For spices there was salt, pepper, and Lipitor. For this assignment list your favorite holiday meal. For each item in this meal tell me: 1. Overall calories 2. Amount of fat 3. Saturated fat 4. Unsaturated fat 5. Protein 6. Carbohydrate 7. Sugar 8. Sodium What is the total nutritional content of the meal? What is the RDA for these nutrients? I would like you to break this down into what affect eating like this on a regular basis would have on your body. Example – Excessive protein intake on a constant basis leads to weight gain and kidney damage. Tell why and how this will affect heart disease. Do this for each nutrient listed.

A 42 year old male patient in ICU, 3 days s/p MVI with head injury, currently with respiratory failure, on vent support and induced coma. Patient has active bowel sounds, and the following order is in the patient's chart: Initiate Tube feeding: Jevity, start at 20 cc/hr, advance by 20 cc Q4h, as tolerated, until goal rate of 80cc/hr. It's your shift. It's currently 9 AM. Describe step by step, how you would initiate the tube feeding, what you will be looking out for, how you would be advancing the TF, etc.

please make sure to use your own words, OWN WORDS, our system will check.it with turn it in, and please do not use handwriting, i always have trouble to read it.

WEIGHT, NUTRITION AND EXERCISE: (Early Adulthood)

PART 1: Tell a story of an obese adult.

PART 2 : Provide teaching to this adult based on changing nutritional needs, and consequences of obesity. Include strategies for healthy nutrition/exercise and self-efficacy to improve outcomes.

PART 1 (Case study):

PART 2 (Teaching):

STRESS:

PART 1: Tell a story of an adult under stress including factors causing the stress. (This could be you or someone you know).

PART 2: Give advice with strategies to help the person in your case study r/t stress management. Give an example of how hardiness is used to overcome challenges. If angry/hostile, include anger management strategies in your teaching.

PART 1: (Case study):

PART 2 (Teaching) include discussion about stress management, hardiness, and anger:

EMERGING ADULTHOOD:

PART 1: Tell a story of an emerging young adult transitioning from adolescence to adulthood.

PART 2: Give advice to the person in your case study regarding how to successfully transition into adulthood, develop a positive identity and develop a world view. Include how resilience helps overcome barriers to success and increases life satisfaction.

PART 1: (Case study):

PART 2 (Teaching):

LEVINSON'S / VALLIANT'S THEORIES IN EARLY ADULTHOOD:

PART 1: Tell a story of a young adult's moving out of his/her childhood home, college, career, marriage and family. Discuss factors leading to the decision to leave or stay in the family home.

PART 2: Give advice to an emerging adult with strategies for success in early adulthood based on Levinson's and/or Valliant's theories.

PART 1 ( Case study):

PART 2 ( Teaching):

PARENTHOOD IN ADULTHOOD:

PART 1: Tell a story of young adult couple's parenting journey from pregnancy, new baby, young childhood, and adolescents. Include challenges for the various stages of parenting. Continue your story for theses parents in middle adulthood (adult children, grandparenthood, etc.)

PART 2: Give advice to the couple related to managing the changing responsibilities, roles, and relationships at various stages of parenting in young and middle adulthood.

PART 2: (Case study):

PART 2 (Teaching):

AGING PARENTS / SIBLING RELATIONSHIPS:

PART 1: Describe a story of an adult caring for his/her aging parents. Include details related to sibling relationships in the family.

PART 2: Include teaching related to coping with the stressors of caring for aging parents and changing sibling relationships.

PART 1 (Case study):

PART 2 (Teaching):

Have you ever looked at your diet and activity before this assignment? If so, what tools or methods did you use? What challenges did you encounter completing this assignment? What new perspective, if any, do you have now that you have used Diet & Wellness Plus to analyze your diet and activity level? Would you recommend a similar tool with others to help them to assess their diet and activity? Why or why not? Minimum 500 words required.

A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication?
A.   Hypoglycemia
B.   Red man syndrome
C.   Bradycardia
D.   Hypotension

66.   A nurse is planning to administer medication to an older adult client who has dysphagia. Which of the following actions should the nurse plan to take?
A.   Tilt the client’s head back when administering the medications
B.   Administer more than one pill to the client at a time
C.   Mix the medication with a semisolid food for the client
D.   Place the medications on the back of the client’s tongue

68.   A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?
A.   Oxygen saturation 96%
B.   PaCO2 30 mm Hg
C.   Decrease in protein
D.   Increased in BP

19. A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?
a.   Store the remaining half of the pill in the automated medication dispensing system
b.   Place the remaining half of the pill in the unit-dose package
c.   Dispose of the remaining medication while another nurse observes
d.   Return the remaining medication to the facility’s pharmacy

6.   A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler. Which of the following information should the nurse include in the teaching? (Select all that apply)
   “Rinse your child mouth following administration”
   “Soak the inhaler in water after use”
   “Have your child take one inhalation as needed for shortness of breath”
   “Shake the device prior to administration”
   “ A spacer will make it easier to use the device”

Salem is a 15-year-old male weighing 46.6 kg. He is known to have asthma and. He accidently fell down and broke his leg while playing football. For that reason he was admitted to the hospital for surgery. Since he was 6 year-old, he presented to the emergency department many times and had 4 hospital admissions for asthma, two of them were to the intensive care unit. He often required a course of oral steroids for one month every few months. However, in the last two years his asthma was well controlled on fluticasone (inhaled steroid) and salbutamol (inhaled β-adrenergic agonist) and he didn’t need any oral steroids. Also, he had not visited the emergency department or been admitted to the hospital for the last two years.

On the day of the accident, the patient had no signs or symptoms of asthma. When he and his father were asked if he had tried aspirin or NSAIDs in the past they said they were not sure. When pain control was discussed, the father wanted to avoid morphine for its addictive effects. Consequently, the doctor prescribed him ibuprofen and planned to give him the first dose in the hospital under close observation soon after the surgery.

The surgery and anaesthesia went fine. One hour later, the patient was given a tablet of ibuprofen 400 mg orally for pain control. 10 minutes after that he began to show symptoms of asthma (shortness of breath and wheezing). For that he used his salbutamol inhaler 8 times. However, his symptoms became worse over the next 20 minutes and he was not able to talk. Soon after that, the patient became cyanosed and needed oxygen by face mask. Salbutamol inhaler was repeated and Hydrocortisone 100mg IV was given. Within 20–30 minutes his condition started to improve. Salbutamol was given every 4 hours and oral Prednisolone 50 mg once daily was initiated (for 6 days). To control the pain of his surgery he was given Morphine 5mg/4h orally and was observed closely overnight for the symptoms of asthma. He was discharged after one week. That week Salem didn’t experience any further asthma symptoms and returned home on his usual inhalers.

1.       What is the most likely explanation (at the biochemical level) for Salem’s symptoms that developed after he was given the oral ibuprofen?

2.       How do you explain the successful relief of the patient’s ibuprofen-induced symptoms after he was treated with hydrocortisone and prednisolone?

3.       In this case study, β-adrenergic agonist and steroids were used to treat and/or prevent asthma symptoms. Mention the other two medication types useful in the treatment of asthma that are mentioned in eicosanoids metabolism chapter of your course. (0.5 mark for each medication type (1 mark total))

what are some psychosocial/holistic care priorities that need to be addressed for a hospitalized infant? Thank you

Medical Assistant:

Oral Medication Orders for Practice:

1. Order: Give phenytoin 100 mg cap i po bid with a full glass of water.  Take each dose at the same time every day.  Give first dose now.  

What is the dose to be given?

Write instructions for patient (if any) on how they should take the medication when they go home.

Practice giving this order to a patient and write the corresponding progress note.

2. Order: Give Prevacid 30 mg cap now. Rx at front desk.

What is the dose to be given?

Write instructions for patient (if any) on how they should take the medication when they go home.

Practice giving this order to a patient and write the corresponding progress note.

3. Order: Give Paxil 10 mg tab for anxiety.  i now, then ii qd for the next 7 days, then iii qd for the next 7 days.

What is the dose to be given?

Write instructions for patient (if any) on how they should take the medication when they go home.

Practice giving this order to a patient and write the corresponding progress note.

The corporate director of risk management is asked to review a patient’s health record in preparation for a legal proceeding for a malpractice case. The lawsuit was brought by the patient 72 days after the procedure. Health information contains a summary of two procedures that were dictated 95 days after the procedure. The physician in question has a longstanding history of being non-compliant with the organization’s record completion policies, and previous concerns regarding this physician’s record maintenance practices had been reported to the organization’s Credentialing Committee.

•Explain why this health information may not be admissible in court.

•What judgment, if any, regarding negligence could be made against the organization?