Provide an overview of the interpersonal skills, personal qualities and presentation techniques that can contribute to the successful sharing of updated information and knowledge.

Clinical Note

Age     58             Sex           M        Date

Chief complaint "Pain on my chest" on and off for the past six months.

History of present illness Mr. Solomon is a 58 year old insurance broker who presents tonight in the office following an episode of "chest pain" that he experienced earlier in the day during a golf game. Although he minimizes the severity of the pain and attributes it to being "out of shape," his wife insisted that he see a physician because he has had similar episodes during the past six months.

Mr. Solomon describes the pain as being more of a discomfort or heaviness. It is localized to "my breast bone" and does not radiate. Today, following a brief rest, the pain subsided and he returned to his golf game. Previous episodes of the heavy feeling tended to occur following large meals and one occasion, while dancing at a wedding. None of the episodes lasted more than "several minutes."

Although Mr. Solomon did not experience nausea or vomiting today, he notes many episodes in the past of feeling a burning sensation in his chest. He describes the sensation as being "like acid behind my breast bone." This feeling occurs most often late at night when he lays down. Usually he has had a large meal or drank alcohol. The sensation does not radiate.

Patient's perspective: When asked about how he feels about these episodes, he admits to being concerned about his health and longevity, considering his father died at age 52 of "heart problems." He says, business is poor, my kid is always in trouble. "Who’s going to take care of things?"

Past Medical history: Not significant

Past Surgical History: None

Family History: Father died of "heart problems" at the age of 52.

Social History: Mr. Solomon smokes � to 1 pack of cigarettes per day. He drinks 2-3 cocktails per nights to "settle my nerves."

Medications: Vitamins

Allergies: None

Review of systems: No significant problems

Physical Examination

Mr. Solomon is a short, moderately obese man who appears somewhat anxious but is in no apparent distress. He is wearing clean casual shirt/pants. Vital sings: BP right arm 162/94; left arm 160/92. Weight 176lbs; Height 5’7". Respiratory rate is 16/minute. Temperature, 98.4� F.

Examination of cardiovascular system reveals a regular, apical heart rate of 86/minute. S1 is heard best at the apex; a loud S2 is heard best in the R2ICS and L parasternal border. A questionable S4 is heard at the apex. There are no murmurs or apical prominence. There is no peripheral edema.

Lungs are clear to percussion and auscultation. An indirect hernia is noted in the right inguinal region. The abdomen is examination is negative for abnormalities.

LABORATORY TESTS:

CBC: WBC = 5,600/mm3, hemoglobin = 15.2g/dL, hematocrit = 45%, platelet count = 320,000/mm3

Chemistries: Glucose 110mg/dL, Blood Urea Nitrogen (BUN) 11mg/dL, Creatinine 0.9mg/dL

Urinalysis: Specific gravity: 1.016; Protein, Glucose, Ketones = negative.

Chest X-ray: normal

QUESTION:

1. Describe the disease process with a minimum of 300 words: definition, epidemiology, signs and symptoms treatment and management.

2. Describe the significance of the laboratory examinations performed to the patient.

3. Trace the pathophysiology of disease.

4. Make a drug study with 6 columns.

   4.1. Generic name, brand name if any, classification, dosage, frequency, route of administration
   4.2. Mechanism of action
   4.3. Indications and drug rationale (why the drug is being given to patient

   4.4. Contraindication
   4.5. Common side effects
   4.6. Nursing considerations while taking the drug.

5. Make at least 2 nursing care plan based on your assessment that needs to prioritize.

6. What are your discharge plan or recommendation to C.D. using the mnemonic

   METHOD

a.M-Medication

b.E-Environment/Exercise

c.T-Treatment

d.H-Health Teachinge.

O-Observation/Out-patientf.

D-Diet

  In regards to "The Spirit Catches You and You Fall Down", discuss two (2) cultural differences between the Hmong culture and western medicine. Support these differences with sources and be comprehensive with your answers.

John J. is a school nurse at Jackson Elementary School, which was built in 1960. Nurse John hasnoticed that many students from Ms. Zee’s second grade class have come to the clinic
complaining about coughing, sneezing, runny nose, and watery eyes. Nurse John has also observed that Steven Tea, the only asthmatic student in Ms. Zee’s class, has had more asthma
attacks this year than he did last year. Because the rest of the school is not experiencing the same respiratory problems, Nurse John is concerned that something in Ms. Zee’s classroom is
causing students to feel ill.
Nurse John decides to visit Ms. Zee’s classroom. Upon entering the classroom, one of the few located in the school’s basement, John is struck by the powerful musty smell that inhabits the
room. While talking to Ms. Zee, John learns that the classroom has “smelled bad for years,” and that students from previous years have complained about respiratory problems. Nurse John notes that Ms. Zee has stuffed a blanket at the base of the classroom’s small rectangular window near the ceiling because the window does not close completely. John suspects that Ms. Zee’s classroom walls are contaminated with mold. Upon further research, Nurse John learns that if water gets between the exterior and the interior of a building’s wall, mold can grow in the moist environment. This situation can occur as the result of construction defects in the building (e.g., leaky windows). Nurse John also learns that people who are exposed to extensive mold growth may experience allergic reactions, such as hay fever-like allergy symptoms, and that people who already have a chronic respiratory disease, such as asthma, may experience difficulty breathing when exposed to mold. Nurse John is concerned about the possible mold contamination effect on his asthmatic student, Steven.

DIRECTION: Using Nursing process you are assign to make a Community Care Plan, your main focus Of your nursing care plan is to facilitate standardized, evidence-based and holistic care.

Format

Introduction
- Introduction about the problem

Body
- Assessment
- Community Diagnosis or statement of the problem:

Recommendation:

What is implicit bias? Who has implicit bias? How does implicit bias impact education, mental health, employment, socioeconomic status, and cultural and racial disparities?

1. E. H. states she doesn’t understand how her taking steroids has caused her body to lose it’s ability to produce the “the real thing.” How would you explain this paradox in terms she can understand?
2. People receiving steroid replacement should be taught sign/symptoms that signal the dosage is too low. What are the signs/symptoms of inadequate steroid replacement?
3. What would you teach someone like E. H. about the nutritional implications of adrenal insufficiency?
4. Explain why the AM dosage of prednisone is higher.
5. E. H. confides in you that she is afraid of taking steroids any longer because she has read about the deleterious effects of steroid abuse by athletes. How would you counter this misconception and alleviate E. H.’s concern?
6. How would teaching differ for this patient (on replacement therapy) as compared with teaching required for the patient taking therapeutic doses of glucocorticoids?
7. The patient states she is under a lot of stress because of her son’s recent diagnosis of cancer and her husband’s upcoming retirement. What are the teaching implications of this information?
8. You realize that taking exogenous cortisol can result in a variety of pathophysiologic alterations often described as Cushing’s syndrome. Since E. H. will be taking lifelong steroids, would you expect to see the signs/symptoms associated with Cushing’s syndrome in this individual? Explain your answer.
9. What signs/symptoms should you teach E. H. to monitor that would indicate excessive drug therapy?
10. You instruct E. H. on administration of a parenteral form of hydrocortisone. Under what circumstances should she take the parenteral form of the drug?
11. What measures should E. H. take to prevent an acute episode of adrenal insufficiency?
12. E. H. tells you she never used to take pills at all. She says she hates to be “addicted to a drug.” What will you tell her?

I need an article refection paper 1-2 pages, Here is the Article To Vaccinate or Not: The Relative Impact of Attitudes toward Autism Spectrum Disorders and the Ability to Interpret Scientific Information on Vaccination Decisions Einar B. Thorsteinsson. Please I really need help with this. Thank you.

Instructions:

• The 6 Essential Questions (who, what, where, when, why, how)
• An article summary with Critical Analysis
  • The credibility of the authors
  • Key points related to the research study (who, what, where, when, why, how)
  • A brief description of the research findings and recommendations.
  • Evaluation of the research and article.
  • Any missing information from the article

If a patient is having a pulmonary embolism what diagnostic tests should be done immediately. Please put your reference down. Thank you!!

physicians collect data for medical purposes. why do nurses collect data

how can active listening be demonstrated