85 yr old male with a history of HTN, DM, hypothyroidism, and depression presented to the Emergency Department from an ECF with acute change in mental status. Staff at ECF described patient as “confused” “not acting himself” and “incoherent”. He was refusing food, fluid, and medications X 4 days prior to coming to the hospital. He became agitated in the ED requiring sedation with 1 mg of haloperidol – IM. Family not available for collateral information. Prior to receiving haloperidol patient was alert, oriented to person, month, and year. He was not oriented to place, situation, or date/ day of week. Reduced attention and very distracted- often looking from side-to side. On one occasion he commented “did you see those dogs run by”. He was not able to provide a coherent history due to disorganized, illogical thoughts. He thought he was in a “torture chamber” and he was being poisoned. Speech was rambling with avg volume, and at times difficult to comprehend. Unable to test memory. Demonstrates poor insight and judgment. He is admitted to the hospital and placed on a medical hold.

Abnormal Labs: BMP- Na+ 128; CBC- WBC 15,000; UA + nitrites and leuk esterase

EKG- QTc 515

VS: B/P 162/100, P- 112, T- 99.2, R-12

Medications: citalopram 40 mg qd, carvedilol 25 mg bid, hydrochlorothiazide 25 mg qd, metformin - dose not known (does have normal renal function)

1. What are some of the possible causes of delirium? (use the mnemonic I WATCH DEATH)
2. What are the signs and symptoms of delirium in this patient?
3. What are some additional labs/ tests that might be performed?
4. What medications may need to be held with QTc > 500?
5. What are pertinent nursing diagnoses?
6. What are pertinent short- term goals for this patient and diagnoses?
7. What are the most important nursing interventions for this patient?
8. Are there any legal, religious, or spiritual issues?

In a detailed paragraph please write about the history of covid 19 .

Please be as detailed as possible from how this virus has started and evolved to where it is today.

Thank you

IMPORTANT: If you are going to write please make sure your writing is neat, legible, and easy to read. Please write in print (not cursive). Thank you

In a detailed paragraph please write about covid 19 - prevalence of the problem ... I need a detailed paragraph on prevalence of the problem regarding to covid 19

Please be as detailed as possible! Please do not just write anything that doesn't Make sense

IMPORTANT: If you are going to write please make sure your writing is neat, legible, and easy to read. Please write in print (not cursive). Thank you

In a detailed paragraph please write about behaviors that contribute to the prevalence of covid 19.

Please be as detailed as possible

IMPORTANT: If you are going to write please make sure your writing is neat, legible, and easy to read. Please write in print (not cursive). Thank you

1. design your own nutrient dense, fiber rich 200-300 calories snack.
2. Evaluate the macronutrients, vitamins, fiber, calorie and desirability of the snack.
3. comment on a minimum of two fellow students snack options.

head to toe assessment of 13 years old female with polycystic ovarian syndrome

A decompression fasciotomy of the right forearm was performed using the operating microscope to explore the brachial artery.

Which intervention will the nurse include in the care
plan for a patient hospitalized with viral hepatitis?

a) Bland diet
b) Administer antibiotics as ordered.
c) Increase fluid intake to 3000 mL per day
d) Adequate bedrest

Patient is a 68 year old male with hx of CVA (no residuals), HTN, IDDM (type 2), COPD, asthma, CHF, CKD (stage 3), last seen in the ED on 10/4/20 for evaluation of altered mental status. He was admitted with dx of right foot gangrene. He was discharged in 10/20/20. On 10/22/20 the patient presented to ED again via AMR from restorative care center for complaints of SOB, hypoxia, and was found to have evidence of pneumonia. He was placed on oxygen 2L via nasal cannula at facility with O2 sat in the 80's. Started on diuretics. Pt was downgraded on 10/29, upgraded on 10/31 due to acute hypoxic hypercapnic respiratory failure and increasing anemia (hgb <7).

Physical findings: Pt is 253 lbs. VSS. On telemetry reading 109-111 HR. Falls precaution. Bedside commode with assist. Scrotal swelling. Skin is cool, dry; 2+ bilateral LE edema, bilateral lower extremity cellulitis, right lower extremity wound--  pressure ulcer to right heel extending unto left posterior ankle with good granulation tissue, no purulent drainage; pressure ulcer to left posterior calf with good granulation tissue, also no purulent drainage. Dressings changed per orders. On q2hr turn. Respirations labored. Crackles to all lobes, decreased breath sounds to right lower lobe. Pt has intermittent coughing, small, clear sputum (uses yankauer suction independently). Encouraging pt to deep breathe and cough. On consistent carb diet (chopped).

Medications:

Budenoside INH

Novolog Flx Pen (None were administered throughout shift; providers parameter)

Levalbuterol HCL Nebulizer

Tamsulosin HCL PO daily

Potassium Chloride PO daily

Furosemide IV daily

Levoflaxicin PO Q48hr

Guaifenesin PO BID

Pantoprazole PO BID

Zinc Oxide 1 applic. TP BID to sacrum

Febuxostat PO daily

Nystatin PO QID (swish and swallow)

Labs: (only noted the abnormal)

WBC: 3.16L

Hgb: 8.0L

Hct: 27.1L

MCH: 25.3L

MCHC: 29.5L

RDW: 19.9H

Neutrophils: 74.9H

Lymph: 12.3L

Mono: 10.6H

ABG PO2: 78L

BUN: 42H

Creatinine: 1.95H

AfAM 40L

NonAfAM 34L

Glucose: 166H (Average: providers parameter)

Calcium: 8.4L

Platelet count: 292 (normal)

Question

- Discussed how the labs relates to the patient’s specific condition. Be specific.

• first identity a global health issue. consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.

Create a plan of care for the person experiencing AIDS dementia complex. Include common medications used for ADC.

Identify 3 key reasons why a student needs to use the library databases to research papers and Why shouldn’t a student locate material from the web to use in a research paper?