SITUATION: Johti Singh is a 39-year-old secretary who was admitted to the hospital with an elevated temperature, fatigue, rapid, labored respirations; and mild dehydration. The nursing history reveals that Ms. Singh has had a “bad cold” for several weeks that just wouldn’t go away. She has been dieting for several months and skipping meals. Ms. Singh mentions that in addition to her full-time job as a secretary she is attending college classes two evenings a week. She has smoked one package of cigarettes per day since she was 18 years old. Chest x-ray confirms pneumonia.

Physical Examination

Height: 167.6 cm (5960)

Weight: 54.4 kg (120 lb)

Temperature: 39.4°C (103°F)

Pulse: 68 beats/min

Respirations: 24/min

Blood pressure: 118/70 mmHg

Skin pale; cheeks flushed; Chills; use of accessory muscles; inspiratory crackles with diminished breath sounds right base; expectorating thick, yellow sputum

Diagnostic Data

Chest x-ray: right lobar infiltration

WBC: 14,000

pH: 7.49

PaCO2: 33 mmHg

HCO3 -: 20 mEq/L

PaO2: 80 mmHg

O2 SAT: 88%

Applying Critical Thinking and provide a thorough explanation:

1. The client already has some signs of respiratory distress. What signs might indicate that her condition was deteriorating into a more emergency situation? How would you handle this?

THANK YOU!

what does it mean to ethical accompany someone who is dying? what challenges do you think you would face in accompanying a patient that was dying? what resources might

what is the best argument in favor of increased use of technology in medical organizations, and what is the best argument against increasing the use of technology in medical organizations?

1. What significance does the case of Ethics of Administering Anthrax Vaccine to Children have regarding disease prevention and control? Explain your answer.

What significance does the case of The Prohibition of Smoking in Public Places in Bulgaria have regarding chronic disease prevention and health promotion? Explain your answer

Give at least 5 nursing interventions (with rationale) for pain related to primary breast engorgement.

a.How does severe hepatic disease such as liver cirrhosis, contributes to the development of oedema?

b. Describe all the likely sequelae following thrombus formation

c. . A patient develops a localized bruise and it changes colour over a few days. State the three colour changes that can occur and the pigments that are responsible for each change.

COMPLAINT: "My blood sugars have not been very good lately. I’m doing everything I am supposed to be doing."

HISTORY: A 24-year-old male patient comes to your primary care clinic to establish care. He has type 1 diabetes mellitus diagnosed at age 11. He has not seen a provider in about 9 months. Currently, he is taking NPH insulin 30 units bid (8 a.m. and 6 p.m. with 10 units Humalog before each meal. He does not use tobacco products but does drink alcohol on the weekends. He reports checking blood glucose (BG) levels three to four times daily but did not bring his glucose log or meter. He reports his fasting blood sugar runs 150 to 190 and prandial glucose readings are 140-250. He reports hypoglycemic episodes one to two times week. He exercises intermittently but is not on a regular schedule. He does not eat on a regular schedule every day although he says he knows that he should. He works at a light-activity job 8 hours daily. His height is 5’10" and he weighs 200 pounds. His blood pressure is 128/78 mm Hg and is pulse is 76 and regular. A random fingerstick glucose is 240 and point of care A1c is 9.8. Fasting chemistry and lipid panels, thyroxine (T4) and thyroid-stimulating hormone (TSH), and random urine for microalbumin are ordered.

ASSESSMENT:

1. Fasting BG: 203

2. Lipid profile: high-density lipoprotein 55; low-density lipoprotein 103; triglycerides 180; total cholesterol 209

3. Thyroid within normal limits

4. Creatinine 1.0; albumin 5.0

5. Microalbumin 17

Your patient is uncontrolled type 1 diabetes mellitus and borderline hyperlipidemia, with normal blood pressure and body weight.

1. How would you treat this patient?

2. What would initial instruction include?

Compare in your own words hospital based ambulatory care services and private medical office practices including patient-centered medical homes.

What significance does the case of Can Asylum Seeking Be Managed Ethically? have regarding vulnerability and marginalized populations? Explain your answer.

What significance does the case of Internet-Based HIV/AIDS Education and Prevention Programs in Vulnerable Populations have regarding international collaboration for public health research? Explain your answer.

Case Study: Muscular Fitness Assessment and Exercise Prescription

Harold is a 40-year-old biology professor who teaches at the university and does research on cellular aging of skeletal muscle in dogs. Harold weighs 180 lb (81.6 kg). He recently purchased a new townhome that requires very little household or yard maintenance. His primary recreation consists of playing chess, reading, and playing classical guitar. For physical exercise he regularly puts the garbage out on Monday, presses remote control buttons for the TV and CD player, and rides his bicycle to work (2 miles [3.2 km] round-trip) 5 days per week. His research on aging prompted concern about his own muscular fitness. He contacted you to assess his strength and to design a resistance training program to increase his strength in an attempt to retard the degeneration of his muscular system. The results of his strength assessment were as follows:

Question

Harold's goal is to improve strength. If you were to design a resistance training program for him that uses free weights and exercise machines (Table 7.3 and Table 7.6), what would week 1 of the program entail. Be sure to complete this in the table below (it is not necessary to use the entire table below to complete week 1 of his program). How will you know when it is time to increase Harold’s resistance?

Weekly Workout Plan

Week:

Phase:

Goals:

Resistance Exercise Prescription:

What steps can police and criminal justice authorities take to reduce the chance of abuse, similar to that inflicted by Larry Nassar, on the public? Explain your answer.

Give at least 5 nursing interventions (with rationale) for Health-seeking behavior related to future breast health

Give at least 5 nursing interventions (with rationale) of nursing diagnosis: Health-seeking behaviors related to patient’s desire to return to prepregnant weight and appearance