History:

Margaret Spezia is a married, 49-year-old Italian American with eight children whose ages range from 3 to 18 years. For the past 2 months, Mrs. Spezia has had frequent morning headaches, and occasional dizziness and blurred vision. At her annual physical Assessment 1 month ago, her blood pressure was 168/104 and 156/94. She was instructed to reduce her fat and cholesterol intake, to avoid using salt at the table, and to start walking for 30 to 45 minutes daily. Mrs. Spezia returns to the clinic for follow-up.

ASSESSMENT

While escorting Mrs. Spezia to the Assessment room and obtaining her weight, blood pressure, and history, Lisa Christo RN, notices that Mrs. Spezia seems restless and upset. Ms.Christos says, “You look upset about something. Is everything OK?” Mrs. Spezia responds, “Well, my head is throbbing, and I’m sort of dizzy. I think I’m just overdoing it and not getting enough rest. You know, raising eight children is a lot of work and expense. I just started working part time so we wouldn’t get behind in our bills. I thought the extra money might relieve some of my stress, but I’m not so sure that’s really happening. I’m not getting any better and I’m worried that I’ll lose my job or become disabled and that my husband won’t be able to manage the children by himself. I really need to go home, but first, I want to get rid of this awful headache. Would you please get me a couple of aspirin or something?” Mrs. Spezia’s history shows a steady weight gain over the past 18 years. She has no known family history of hypertension.

Physical findings include:

• height 63 inches (160 cm)
• weight 225 lb (102 kg)
• T 99° F (37.2° C)
• P 100 regular
• R 16
• BP 180/115 (lying)
• 170/110 (sitting)
• 165/105 (standing)
• Skin cool and dry
• capillary refill 3 seconds right hand, 3 seconds left hand.

Mrs. Spezia’s total serum cholesterol is 245 mg/dL (normal< 200 mg/dL). All other blood and urine studies are within normal limits. Based on analysis of the data, Mrs. Spezia is started on captopril 12.5mg twice daily and hydrochlorothiazide 12.5 mg and placed on a low-fat low-cholesterol, no-added 2gm sodium diet.

Highlight the data in the history and the assessment that needs to be addressed. Read the brief history and identify: concerning

1) subjective/objective data,

2) potential/actual problems,

3) what interventions,

4) Education

5) follow-up would be suggested.

6). Explain the prioritization of problems.

How would you prioritize these problems? Which two would you address first?   Why

1. The skin and its accessory structures such as hair and nails are called.

2. What are the functions of the integumentary system?

3. What is the outermost, thin cellular membrane of the skin?

4. What is the thick, fat-containing tissue layer?

5. What are at the root forming the color of one’s hair?

6. What functions does hair have?

7. Why do people have so many sweat glands?

8. Do sebaceous glands make hair feel oily?

9. What is a Person with skin deficient in a pigment called?

10. What is the large dermal exocrine glands in the axilla and genital areas called?

11. What is the deepest region of the epidermis; gives rise to all the epidermal cells?

12. What is the middle layer of the skin?

13. What is the outermost layer of the skin?

14. What is the skin pigment formed by melanocytes in the epidermis?

15. What is the hard protein material found in the epidermis, hair, and nails?

16. What is the oil-secreting gland in the dermis that is associated with hair follicles?

17. The Flat, scale-like cells composing the epidermis are called what?

18. Skin arranged in layers are called?

19. Which combining form refers to the same color as jaundice?

20. The absence of hair where it normally grows.

21. What are blue-black marks on the skin?

22. What are small pinpoint hemorrhages on the skin called?

23. What is an acute allergic reaction with red, round wheals on the skin?

24. What are papular and pustular eruption of skin with increased production of sebum?

25. An injury to tissue due to heat, chemical, electric shock, lightning, or radiation. Second degree burn (left) and third degree burn (right).

26. What is a diffuse acute infection of the skin?

27. What is the death of tissue with loss of blood supply?

28. What is chronic recurrent dermatosis with silver gray scales that itch?

29. What is : chronic and progressive disease of the skin with hardening of connective tissue?

30. What is an infection of the skin caused by a fungus?

31. What is loss of pigment in areas of the skin?

32. What is a callus?

33. What is a keloid?

34. What is a malignant tumor of the basal cell layer of the epidermis?

35. What is a malignant tumor of the squamous epithelial cells of the epidermis?

36. What are the ABCD’s of malignant melanoma?

37. What type of treatment destroys tissue with subzero temperatures using liquid nitrogen?

38. A type of treatment that destroys tissue by burning with electric spark.

39. All suspicious-looking tissues removed from the body are sent to the pathology lab for analysis. Why?

40. A doctor who specializes in skin care is called?

As you begin your clinical rotation, can you tell me what you expect from your clinical site?

PPT Case Study- The Nguyen's... Create a plan of care based on the information and questions in the PPT.

Ma i Nguyens,Nam Ngugens mother has been experince blurred vision .What are possible causes of blurred vision?

She reports to the primary care clinic today, accompanied by Nam. Mai tells you, “I don’t know what happened. I was pulling into a parking space at the grocery store, and the next thing you know, I hear this loud boom. I don’t know how I did it, but I hit the car next to me. I just didn’t see it.” Nam is very concerned and questions whether his mother should be allowed to drive. Mai is visibly upset. “I don’t want to hurt anyone, but I don’t want to lose all my freedom.” Nam insisted on this appointment to discuss his concerns.

At a recent ophthalmology appointment, she was told she has bilateral cataracts that will require surgical removal.

•What data will you need to gather from Mai and Nam?

What assessments will you need to perform?

How will cataract surgery most likely affect Mai? You will need to learn about the surgery and recover to answer his questions.

What information would you offer to Mai and Nam?

Create a Plan of Care for Mai?

1. A nurse is reviewing the laboratory report of a client who has a panic disorder and is
taking clonazepam. Which of the following laboratory results should the nurse report to
the provider?
A. WBC count 8,000/mm3
B. Hemoglobin 16 g/dl
C. RBC count 4.9 million/mm3
D. Platelets 100.000/mm3

2. A nurse in a long-term care facility is caring for a client. The nurse should identify that
which of the following conditions places the client at an increased risk for developing
delirium?
A. Hypertension
B. WBC count 13,000/mm3
C. BUN 15 mg/dL
D. Neuropathy

3. A nurse is teaching a newly licensed nurse about contributing factors that can lead to the
development of conduct disorder. Which of the following factors related to family
dynamics should the nurse include in the teaching?
A. The client has several siblings
B. The client’s mother has asthma
C. The client is the oldest of their siblings
D. The client’s father lives in the client’s home

4. A home health nurse visits a client who lost their partner 2 years ago. Which of the
following behaviors by the client indicates a maladaptive grief response?
A. The client gives away some of the partner’s belongings.
B. The client expresses feelings of guilt
C. The client is unable to perform basic hygiene tasks
D. The client relocates from a house to an apartment

5. A nurse is caring for a client who has schizophrenia and is taking clozapine. Which of the
following finding is the priority for the nurse to report to the provider?
A. Nausea
B. Random blood glucose 130 mg/dL
C. Sore throat
D. Heart rate 104/mins

Tracy Moore a 29-year-old white female was transported by ambulance to the emergency room after being rescued from her burning house she was asleep at night when a spurt from the family fireplace started a fire leaving her trapped in her bedroom by the time the fire rescue squad arrived she had suffered severe burns vitals at the scene were as follows heart rate 110 blood pressure 150 over 90 respirations 22 temperature 100.1 spo2 96% room air a the back of her head is painful and sensitive to touch the area is white with moderate edema and her hair is missing in places B her right hand is black and brown with minimal sensation and the burning stands up the front and back of her right arm to the shoulder. c. her right leg is red with no blisters and extremely painful there is moderate edema the burn is covering the back of her leg from her ankle to her buttocks
1. what is the total body surface area burned based on the rules of nine for burns a b and c
2. for each of the Burns in a b and c indicate the type of burn based upon it's description
3.what type of pain management will Tracy require for each of the burns explain your answers
4. name two complications Tracy is at rest for due to her Pacific Burns and discuss how you will manage these complications
5. what is the classification of burn depth
6. during the emergent stage what is the nurses priority name three
7.. what is the rule of nines

Think back to when you were becoming an RN and how many times you were told to be an advocate for your patient. discuss how you as a nurse can advocate for ethical policies that promote access, equity, quality, and cost.

Vulnerable Populations

• Establish why children are more vulnerable to environmental toxins than adults.
• Identify any other vulnerable populations at the local, national, and international levels.
• From public and environmental health perspectives, what types of policies are needed to protect vulnerable populations from environmental hazards?

please provide reference and details

Development Goals and Environmental Health

What area of environmental health would you prioritize for intervention to improve the lives and health of most people worldwide? What environmental health concern would you prioritize for your proximate community? Are those priorities different? Why or why not?

Compare and contrast the course of illness, symptoms, and nursing interventions for the sub-types of schizophrenia and for associated disorders such as schizoaffective disorder.

Assess the situation of persons with schizophrenia and their families in the community

Evaluate the effectiveness of the various treatment modalities for schizophrenia in the clinical setting