Estimate the dose from CT for a prostate patient (total dose 78 Gy) who undergoes the following:

- 2 CT simulations

- 39 KVCT localization images

- 1 Midcourse Evaluation CT

- 1 Post Treatment CT

Please show all work.

Course: The U.S. Health Care System

While the US healthcare system represents around $3.5 trillion in annual spending and is the largest single sector of the overall economy, it also sits inside larger "macro trends" that help define the landscape of jobs. Factors to consider: globalization, the state of the general economy, the rapid pace of innovation, digitalization of medicine and genomic technology, and demographics of the U.S. population (e,g, aging population, and higher healthcare utilization) and changing values and beliefs.

Question: So what do you think? What human resources needs are you likely to be encountering – and managing -- in ten or so years?

TOPIC

Telehealth is the process of using electronic information and telecommunication systems to provide long-distance clinical healthcare, patient and professional related education, public health and health administration in the assessment and management of patients HRSA, 2012). The goal of telehealth is to provide healthcare services to areas of the country that need services in the process of increasing accessibility and decreasing cost.

total of four paragrap :no direct quotes

scholarly article published within the last three years from a peer-reviewed journal on telehealth that applies to ur area of practice

In two paragraphs, critically review the article. You must include the following points:

A statement of what was studied

A statement of what was the focus of the articleselected

A statement on what was identified or learned from the article

A statement of why the article is important to ur practice area.

In two additional paragraphs, brainstorm ideas on how the telehealth technology

u identified could affect your practice.(hospital setting)

Why would this technology be beneficial to ur practice?

What challenges would u face implementing the technology?

The nurse notes that a client's total serum calcium level is 6.0 mg/dL (1.5 mmol/L). Which assessment findings should be anticipated in this client? Select all that apply.

1. Tetany

2. Constipation

3. Renal calculi

4. Hypotension

5. Prolonged QT interval

6. Positive Chvostek's sign

This article is about immunizations and health disparities as an ethical discussion. This is full of ethical concerns, identify an appropriate provision from the nursing code of ethics, and what you think should or could be done to address it.

Vaccine Research and Testing

Ethical discussions also surround the research and testing of vaccines, including discussions about vaccine development, and study design, population, and trial location.

To be licensed, vaccines go through many years of research and must pass rigorous safety and efficacy standards.^[1] The vaccine development and research process include diverse experts in many scientific and social disciplines, including public health, epidemiology, immunology, and statistics, and pharmaceutical companies. These stakeholders may have conflicting priorities and motives, which contributes to various ethical discussions.^[10]

Sometimes researchers disagree about whom to include in vaccine trials. To properly test a vaccine’s effectiveness, a clinical trial including a control group that does not get the test vaccine is usually necessary.^[1] Failing to provide any adequate preventive option can be a difficult decision when the vaccine can potentially prevent serious, untreatable, or fatal infection, however. For instance, TB vaccine researchers have struggled to devise ethical control group procedures. Existing TB vaccines, called Bacillus Calmette-Guérin (BCG) vaccines, are not always effective to prevent TB and can cause infections in people with compromised immune systems, such as people living with HIV/AIDS. When they test the effectiveness of new strategies, researchers debate over whether or not it is safe and ethical to give control participants these vaccines.^[11]

Additionally, it is important to understand a vaccine’s safety and efficacy in various populations, but testing a vaccine in vulnerable populations, such as children, also raises ethical concerns.^[12] Researchers must balance the need to protect children’s safety with the need to adequately understand how a vaccine will perform and protect children when administered.

Similarly, it is important to understand how vaccines affect people in developing countries. Yet, conducting vaccine research in developing countries includes a list of ethical concerns such as how to provide necessary screening or treatment if diseases are detected; how to meaningfully involve local communities in the research design process; how to ensure the trial and vaccine can be supervised by local ethical review panels; and how to ensure that participants understand consent.^[11] For example, participants in a malaria vaccine trial in Mali reported difficulty understanding several concepts including withdrawal from the study, side effects from the vaccine, and the difference between a research study and therapy,^[13] suggesting that better communication strategies are required to ensure proper consent across cultures.

Ethical discussions are a key component of HIV vaccine research and development because HIV vaccines pose numerous unique ethical challenges. For example, AIDS stigma may put vaccine trial participants at psychological risk if they encounter discrimination. In addition, researchers have to figure out how to provide appropriate and adequate medical care and protection from stigma for participants who screen HIV positive. And, researchers have to consider that if participants misunderstand the trial, they may think that they are protected from the virus and put themselves at risk.^{[1], [10], [14-15]} The complexity of these issues places ethics analyses at the forefront of HIV vaccine research.

The Standards of Practice and NCLEX Style Questions

1. Describe four proven strategies used to answer NCLEX style questions

2. Discuss how the ANA Standards of Practice are tested using the NCLEX style of questions
3. Discuss how patient care needs can be prioritized using Maslow’s Hierarchy of Needs.
4. Identify how patient safety is often tested with NCLEX style of questions.
5. Identify NCLEX style of questions that are testing therapeutic communication skills.
6. Discuss how to eliminate options that indicate the use of poor therapeutic communication.
7. Discuss how to identify options that indicate appropriate therapeutic communication.
8. Identify three areas which often cause problems for NCLEX test takers.

Why interventricular foramen blockage would create an increase in intracranial pressure? Explain in one paragraph

Create a concept map using case scenarios as a guide. A conceptual map should include pathophysiology, medical diagnosis, signs and symptoms, and risk factors if any. Nursing diagnosis, nursing interventions, medical management (medication and procedures), expected outcomes.

Abe, a 14-year old boy who stoked a fire in a wood-burning stove and was hurt by a subsequent explosion. He was transported to the local burn ICU (BICU). He sustained an 82% total body surface area (TBSA) thermal burn. Abe’s burns included bilateral full-thickness circumferential burns to his legs and feet, arms, and hands, genitalia, and deep partial-thickness burn to his head and anterior trunk.

Before Abe’s arrival to the BICU, the medical team stabilized Abe by initiating cervical spine precautions, endotracheal intubating him, and providing fluid resuscitation and sedation and analgesia with I.V. propofol and morphine via two large-bore peripheral venous catheters.

Once Abe was admitted to the BICU, a right brachial arterial line was placed along with right internal jugular central venous catheter. Initial I.V. fluid resuscitation was calculated based on Abe’s weight of 79 lbs (36 kg), a urinary catheter was placed, and a tetanus injection was administered. The morphine drip was discontinued, an I.V. ketamine drip was started, and wound care began.

Upon reassessment, the nursing staff noted that Abe’s pedal and radial pulses were absent bilaterally, and emergent bilateral upper and lower escharotomies were performed. At this point of care, Abe’s clinical status was critical but stable.

After escharotomies were completed and Abe was stable, and enteral nasogastic tube was placed in the left nares and feedings began. Abe received standard wound dressing with silver sulfadiazine until his burn wounds were grafted (with the exception of his genital burns).

Abe experienced a slow recovery. Within 72 hours of his admission to the BICU, the first surgical excision and grafting onAbe’s hands, feet, head, and neck were completed. His anterior trunk also required surgical excision and grafting at this time. Nurses explained to Abe’s parents that further excisions and grafting procedures would be performed until all of Abe’s burn wounds were closed. The excisions and grafting on Abe’s arms and legs were completed over the next month. A conservative approach was employed to treat Abe’s genital burn. Initially, all obvious retained material (loose debridement) and contaminated remnants of Abe’s clothing were removed.

Next, the BICU nurses completed a prolonged cooling down procedure with water. During the duration of Abe’s admission, topical antibiotic ointments such as Mupirocin were impregnated into gauze and applied over the perineal area and changed every bowel movement. Scheduled as P.R.N. cleansing as accomplished using 4% chlorhexidine skin wash.

This approach led to the successful healing of Abe’s genital burns. Abe was weaned from the ventilator on the third attempt during his second week in the BICU, and solid foods were introduced gradually.

Ralp is a 13-year-old boy Black- American with sickle cell anemia. He has been attending a day camp this summer. He was playing flag footbal in 90 dgree wheather. All of a sudden he complain of severe knee pain bilateraly. His Mom took him to his Dr., who had him directly admitted to the hospital for a sickle cell crisis. Ralph was diagnosed with sickle cell anemia as a newborn with a routine screening. His vaccination are up to date and he recieves a flu vaccine yearly. He has had multiple hospitiozations for sickle cell crisis. On admission, he stated his pain was a 9 on a 1 - 10 pain scale. He is alert and oriented. Both of his knees are red, swollen, and warm to touch. His mucous membranes are slightly pale and slightly dry. Lung sounds are clear bilat., heart tones are normal but slightly tacy at 100. It is 3 pm and he says he only voided once to day. He denies priapism.

1. What is the relationship of Ralph's symptoms today and how it relates to his sickle cell anemia?

2. Why do you think he went into a crisis today? What could he have done to prevent this?

3. What is the sequalae for a child that has had many crisis episodes?

4. What treatments do you expect will be done?

5. Look up the normal value for hemoglobin and hematocrit for a healthy 13-yeasr-old boy, then look up the normal values for a 13 year-old boy with sickle cell anemia. Ralph's labs to day are: Hgb - 9.8 and Hct - .28. Are his values normal for him?

Imagine that you are a public health nurse, and you and your colleagues have determined that the threat of a deadly new strain of influenza indicates a need for a mass inoculation program in your community. What public health data would have been used to determine the need for such a program? Where would you locate public health data? What data will be collected to determine the success of such a program? How might you communicate this to other communities or internationally?

In your own opinion, why do you think many public health professionals regard John Snow as the father of epidemiology? Provide three reasons to support your position.