1)The therapeutic action of13-adrenergic receptor blockers such as propranolol in angina pectoris is believed to be primarily the result of
a. Reduced production of catecholamine’s
b. Dilation of the coronary vasculature
c. Decreased requirement for myocardial oxygen
d. Increased peripheral resistance
e. Increased sensitivity to catecholamine’s

2Which of the following drugs is considered to be most effective in relieving and preventing ischemic episodes in patients with variant angina?
a. Propranolol
b. Nitroglycerin
c. Sodium nitroprusside
d. Nifedipine
e. Isosorbide dinitrate

3) A 69-year-old male with angina develops severe constipation following treatment with
a. Propranolol​
b. Captopril​
c. Verapamil
d. Dobutamine​
e. Nitroglycerin

1. It is one big chuck of our society that dictates how we are supposed to act in varying situations based on what is right and wrong, acceptable or not. AS our actions and perspectives are culturally constructed, so is our moral behaviour. How do you think your community influences your behaviour?

2. How does culture define moral behaviour?

3. Give one Filipino cultural practice that should never be tolerated and why

5. The quo warranto petition against Maria Lourdes Sereno, filed before the Supreme Court of the Philippines, led to the landmark case of Republic v. Sereno (G. R. No. 237428), which removed Maria Lourdes Sereno from her post as Chief Justice of the Supreme Court of the Philippines, finding that she never lawfully held the office due to a lack of integrity for failing to file certain required financial documents. The Court handed down its ruling on May 11, 2018. The case began with a filing before the House of Representatives of an impeachment demand, the accusations in which Solicitor General Jose Calida used as the factual basis for his quo warranto petition. What do you think would be your feelings if you were Sereno?

medical terminology)

case study for patient case

find and add more medical terms up to 100 and put underline each term)

Introduction:

The patient Mr. J, a 58 years old African-American, admitted in the Emergency Department with complaints of loss of balance followed by the altered level of consciousness (ALOC), left-sided hemiparesis, dysarthria, and facial droop. He denied chest pain, visual disturbances, cephalalgia, trauma, bowel incontinence, urinary incontinence, etc. He had stable vital signs except blood pressure of 150/90 mm of Hg, indicating hypertension. After necessary diagnostic tests, the physician diagnosed the case as a cerebrovascular accident (CVA).

Past Medical History:

Mr. J was diagnosed with diabetes mellitus (DM) type 2 at the age of 40 years. He was taking some herbal remedies at first, but is on antidiabetic agents as per physician's prescription for eight years. He is also on antihypertensives for three years. He also has a history of hypercholesterolemia and gouty arthritis, an inflammatory condition of joints, especially the hallux joint, due to deposition of urate crystals, but he is not on any medications for that. He is having a poor compliance with the medication regimen. Currently, he is taking ACE (angiotensin-converting enzymes) inhibitors, beta-blockers for his hypertension, and an antihyperglycemic agent, Metformin, for diabetes mellitus.

Family History:

Mr. J's father died from myocardial infarction (MI). He had a history of hypertension (HTN), coronary artery disease (CAD), and benign prostatic hyperplasia (BPH). Mother is suffering from diabetes mellitus (DM) and is on insulin. She also has a history of inflammatory bowel disease (IBD).

Assessment results:

revealed diagnostic evaluation with head CT scan showed ischemic stroke. Blood samples taken revealed hypercholesterolemia with cholesterol level 300 mg/ dL (milligrams per deciliter), high-density lipoprotein (HDL) 40 mg/dL, and low-density lipoprotein (LDL) 150 mg/dL. His fasting blood sugar (FBS), random blood sugar (RBS), or glycosylated hemoglobin were not obtained. He is on Metformin for hyperglycemia.

Results revealed that the patient is having an attack of right-hemisphere ischemic cerebrovascular accident.

Consent: Patient consent was obtained for a detailed eye examination referral.

****Disease condition:

Stroke (cerebrovascular accident): The loss of brain function arising from the sudden interruption of cerebral blood supply. It might be of two types; hemorrhagic CVA and ischemic CVA. Hypertension and hyperlipidemia are the two main risk factors of CVA. Other risk factors are smoking, obesity, family history, etc.

The main causative factors are:

1. Thrombosis (clot formation) due to atherosclerotic plaques.

2. Embolism or cardiogenic emboli.

Actions taken:

1. Intravenous (IV) injection of TPA (recombinant tissue plasminogen activator).

2. Administration of antiplatelet blood thinners, aspirin.

3. Vital signs monitoring q.4 hours.

4. Management of intracranial hypertension (IH) with diuretics.

Nursing assessment:

1. Assessment of neurological status to know the severity of CVA.

2. Altered level of consciousness (ALOC).

3. Nuchal rigidity.

4. Assessment for any dysarthria (difficulty in articulating words) and dysphagia (difficulty in swallowing).

5. Skin color of face and extremities.

Results:

The wife said, he has now changed towards the better by incorporating healthier meals and less junk food items. She mentions that he has had a difficult time in the past few years with diabetes, hypertension, gouty arthritis, etc. Change in lifestyle along with therapies and the addition of a service dog aided improvements along with his family support system. The patient spends lots of time outside with his dog and has started working on small projects, which keeps him active. She also states that the patient’s HbA1c (glycosylated hemoglobin) has not been tested for almost three months and that it needs to be tested as his RBS (random blood sugar) is high. The patient visits his podiatrist regularly for peripheral neuropathy and is on B vitamins q. daily; however, his neuropathy is on remission since undergoing transcutaneous electrical nerve stimulation (TENS). The patient’s wife is also doubtful about his mental status with increasing forgetfulness pointing towards dementia. She also remembered that he once complained of visual aura while doing gardening and after that he had photophobia for a while. She says he needs to undergo a dilated eye examination to diagnose retinopathy as he is complaining of blurred vision and floaters occasionally with some dry eyes. She says he uses over-the-counter Visine eye drops as a remedy, which she understood is for keratoconjunctivitis sicca.

Activities Required Prior to Simulation: Pre-Simulation Questions 1. Discuss conditions that predispose patients to rhabdomyolysis. 2. What are the clinical findings and signs and symptoms of rhabdomyolysis? 3. What are the nursing responsibilities related to the care of the patient with rhabdomyolysis?

E .coli include recent outbreaks

who it affected ,what caused it, pathophysiology  and pediatric treatment and nursing intervention

States pain in her left calf area is a 3 on a 1-to-10 scale

Oxygen saturation 93% on room air

Lungs clear all lobes

Bowel sounds arepresent in all four quadrants

Apical pulse: 64, irregular

Alert and oriented to person, place, and time

Skin warm to touch bilateral lower extremities, slight erythema left lower extremity

No edema right lower extremity, 2+ left lower extremity

Pedal pulses 3+ right lower extremity, 1+ left lower extremity

Calf circumference: right, 8 cm; left, 10 cm

Left hip wound has staples; no signs or symptoms of infection

Last bowel movement was four days ago

Bisacodyl 10 mg PO daily

What do you suspect is occurring with D.R.? What data were used to make this determination?

What are the priority nursing interventions at this time?

Using SBAR, what would you report to the provider?

What diagnostic studies would be used to determine the existence, location, and extent of a DVT?

What risk factors for development of a DVT does D. R. have?

What measures can be taken to prevent a DVT in an at-risk patient?

Nursing actions when patient can no longer make decisions about his/her own care

Create a 15 slide PowerPoint presentation of the pediatric condition you selected. Ensure that your presentation addresses: Developmental dysplasia of the hip

1. Description and etiology  of the condition
2. Epidemiology for the condition
3. Pathophysiology
4. Clinical Manifestation
5. Diagnostic evaluation
6. Therapeutic Management: Be sure to address medication as well as surgical and non-surgical management if applicable
7. Care Management to include nursing intervention

The presentation should have a title slide and a reference slide. They are not included in the slide count.

Samuel is an 82-year-old male brought in by his daughter for complaints of low blood sugar. Samuel has a history of type II diabetes well-controlled with glyburide and diet. He was treated last week at an urgent care for a suspected staph infection to his arm with sulfamethoxazole and trimethoprim. He also takes lisinopril, Lipitor, Flomax, Paxil, Coenzyme Q10, and a multivitamin. His daughter also found old prescriptions for alprazolam, atenolol, and terazosin in his medicine cabinet. With what you know about drug-drug interaction in older adults, what could be the cause of his hypoglycemia? What questions do you need to ask the patient and his daughter about safe medication management? What education should be offered to this patient and his family?