what strategies will you use to holistically support an infant's development and learning?

During the examination of the abdomen a patient experiences right lower quadrant rebound tenderness. The nurse should do which additional assessment techniques for this patient?

-Assess the Murphy's sign

-Percuss to assess the organ's size

-Assess the Rovsing sign

-Test for a fluid wave

An 82-year-old female patient admitted in a long-term care facility tells the nurse that she became at least 2 inches shorter in the last couple years. The nurse understands that she became shorter because of the following: (SELECT ALL THAT APPLY)

A. Postural changes associated with aging

B. Lower back pain and joint stiffness

C. Intervertebral discs thinning

D. Bone resorption an ongoing osteoporosis

E. Possible untreated congenital deformities

Describe the mandated ratios and supporting rationale.

Glascow Coma Scale – Know how to calculate a score

What is decorticate posturing?

What is decerebrate posturing?

Review the types of brain injuries i.e. focal, coup contre coup etc.

The impact of hypoxia on brain cells

What is the difference between a hemorrhagic stroke and a thromboembolic stroke?   

Priority assessment for a patient on a ventilator

What are clinical manifestations of a patient with a DVT and a PE

What forms can carbon dioxide travel through the blood?

What is the process of moving air into the lungs called?

What is cor pulmonale and what are some of the causes?

What is a pneumothorax? Review the types of pneumothorax

Where is the brain’s respiratory center?

What is the purpose of surfactant?

Appropriate nursing interventions for emphysema

Purpose of the rescue inhaler for asthma patients

Clinical manifestations of bronchitis

What is polycythemia vera?

What causes pulmonary hypertension?

What lung disease causes destructive changes of the alveolar walls and enlargement of the distal air sacs

Adequate management of asthma

Clinical manifestations of a patient with acute respiratory failure (What would we expect the oxygen and carbon dioxide levels to be)

Clinical manifestations of a patient with cystic fibrosis

Know your normal ABGs.

Priority nursing intervention for a large wound

What is the impact of a myocardial infarction?

What lab values would a complete blood count (CBC) include?

Priority assessment for a patient with pneumonia

What is the significance of the hemoglobin?

What is polycythemia vera?

Hodgkin vs non Hodgkin disease

What is homeostasis and what are the 3 main parts of hemostasis? Know the steps in hemostasis

What is hematemesis?

What is erythropoietin?

What are erythrocytes and what are their functions?

What is the purpose of doing blood coagulation studies?

What is the role of the liver in clotting?

Priority assessment for a CHF patient

Priority assessment for a patient experiencing chest pain

What are the types of risk factors for patients with a hx of hypertension?

Cause of hypovolemic shock

Cause of septic shock

What is angina pectoris?

How do providers determine the causes of acute coronary syndrome (ACS)?

Effects of heart failure

Clinical manifestations of rt sided heart failure

The role of the lymphatic system in reducing edema

What is the difference between a MI and unstable angina?

What occurs in the late stages of shock?

What are some hypertension management techniques?

Two organs most affected by uncontrolled hypertension

What is the impact of increased intracranial pressure?

What is the area of the brain surrounding the area of infarct after a stroke called?

What is reperfusion injury?

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