A 66-year-old male with a history of COPD is admitted to the emergency department with shortness of breath. He is not currently taking any medication for his breathing. The patient states that he usually gets short of breath only upon exertion, but he developed a “cold” several days ago that made his breathing worse. He has been placed on oxygen. The doctor wants him to have breathing treatments.

What medication, dose, and route of administration would you suggest?

(a) How should the effectiveness of the treatments be monitored?

(b) After several days of breathing treatments and antibiotics, the patient is ready for discharge, but he still becomes short of breath during the night. What maintenance medication(s) do you suggest?

B. GLOMERULONEPHRITIS

A patient with cleft lip and bronchial asthma was brought to the emergency department with chief complaint of low-grade fever, puffiness of the face and eyes in the morning, +2 edema on both feet, and tea-colored urine. Urinalysis revealed numerous RBC and certain degree of proteinuria and Antistreptolysin-O titer reaches more than 300 todd units. The doctor came up with the diagnosis of Acute Glomerulonephritis (AGN).

Answer the following questions:
1. What history-taking question should be asked by the nurse to strengthen the diagnosis of AGN?

2. Explain the pathophysiological tracing on the development of AGN.

3. The doctor ordered hydrocortisone TIV, create a drug study specifying the following:
a. Drug classification
b. Mechanism of action
c. Indication (*for the case of the patient mentioned above)
d. Contraindication
e. Side effects
f. Nursing Considerations

D. RENAL FAILURE

A patient with uncontrolled Type 2 Diabetes consulted in the emergency department due to shortness of breath, bipedal edema, palpitation, and decreased urinary output during the past 2 days. The following laboratory test values are presented

Serum Creatinine –2.5 mg/dL
BUN level –30 mg/dL
Serum potassium –5.9 mEq/L
HBA1C –8%
A diagnosis of Acute Renal Failure secondary to DM Nephropathy was made by the doctor. Sodium polyesterene sulfonate (Kayexalate) was ordered to normalize potassium level. Oral hypoglycemic agents were revised, and insulin therapy was started to manage the blood sugar level. Urine output is closely monitored for possible hemodialysis.

Answer the following questions:
1. Explain the relationship of diabetes mellitus on the development of acute renal failure using a flow chart.

2. Identify three (3) nursing diagnoses pertinent to the patient’s condition and create hypothetical Nursing Care Plans (NCPs) for each nursing diagnosis.

3. Create a drug study for the medication: SODIUM POLYESTERENE SULFONATE specifying the following:

a. Drug classification
b. Mechanism of action
c. Indication (*for the case of the patient mentioned above)
d. Contraindication
e. Side effects
f. Nursing Considerations

write a two page reflective essay about the story of the geese focusing on teamwork and leadership as a nurse.

52 years old female who has difficulty sleeping and missing her work, she sleeps during day time and not night time.

I think she has insomnia and possible menopause because of her age.

• Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit of patient with insomnia, menopause.

How do you detect whether a certain prescription is violative, erroneous, impossible or not? What actions may be taken if the rx is erroneous, violative or erroneous? (15 pts)

• Violative
• Erroneous
• Impossible

what is health and illness ?

Each submission will focus on a portion of the final paper. In Part 1, you should submit the following sections:

• An introduction of the case study scenario.
• The Pathophysiology of Type 2 diabetes.

APA format; include additional references outside of text (journal, professional websites like .edu, or .gov).

Known Information:

UV is a 55-year-old man who is seen during follow-up after being diagnosed with type 2 diabetes. At the last visit, he was prescribed metformin 500 mg twice daily. UV states that he never filled his prescription, but instead took his neighbors advice and started taking cinnamon. He said that he googled the spice and found that it lowers blood sugar. Upon further questioning, he states that he grabs a spoon from the drawer and consumes baking cinnamon found in his kitchen cabinet.

Consider:

1. What additional information is needed prior to developing a mutually agreed-upon plan of care?
2. What information should UV be given concerning the use of cinnamon to treat diabetes?     (These two questions are just for consideration do not answer these questions ? )   (questions are on the top of the page introduction and pathophysiology of diabetes 2 )

You are caring for a 52-year-old female Muslim patient in the emergency room with a rule-out Cerebrovascular Accident (CVA). Based on your knowledge of the pathophysiology of a CVA address the following:

• Thoroughly explain the epidemiology of the disease process. Examine each of the following three elements:) The cultural; 2.) The financial; and 3.) The environmental implications related to this disease process. Support all three with a scholarly source!
• What would 3-5 priority nursing interventions be for the client with this disease process? This can include labs and diagnostics. What are the critical indicators? Support with a scholarly source.
• Provide three areas of patient education you feel are critical to teaching the client with a diagnosis of this disease. Consider medical product safety and the length of time the client has had the disease. Support with a scholarly source.
• What members of the interdisciplinary team need to be included for holistic patient-centered care? Provide a rationale and Support with a scholarly source.

1) Drug template of any of this drugs:

ANTIMYCOBACTERIALS, MACROLIDES, MONOBACTAMS, AMOXICILLIN, COTRIMOXAZOLE, DOXYCYCLINE, ISONIAZID, ERYTHROMYCIN

-Complications
-Therapeutic use
-expected pharmacological Action
-Medications administration
,-contraindication/precaution
-nursing interventions
-interactions
-client education
-evaluation of medecation effectiveness

Discuss the absorption and transport of iron into the protoporphyrin ring during erythropoiesis.

Evaluating Sources for writting research paper 200 words.

After looking at the two website images, write a post discussing everything you notice that makes them seem like a credible or not credible source. There are good and bad things about both sources, so look for that. Then, decide which source seems most worth using in an essay.

You are working as a nurse on a cancer floor in a large urban hospital. You come into work and learn that you will be working with several new patients during your shift change briefing meeting. One of those patients, Jane, has been admitted to the hospital due to issues related to a cancer diagnosis. She was given medication to address a cancerous tumor along with Propofol to sedate her for the procedure.  

During the shift change meeting, you learn that Jane had lost touch with reality after her procedure and the prior shift nurses made sure everyone knew that Jane was a real pain to deal with because she was non-cooperative and was acting irrationally. She was pulling out her IVs and trying to leave the hospital. Unfortunately, she was a bit like Houdini and could even slip out of the restraints. She also shouted at people that were not in her room and “folded her laundry” in mid-air. Jane also insisted that she was in tremendous pain.

One of the confounding issues is that Jane has a family member who recently showed up to direct Jane’s care, but she does not want any medical treatment for Jane because the family member is convinced that it is the medication that is creating the situation of Jane losing touch with reality. As you interact with Jane and her loved one, you begin to suspect that there was more to this situation than was being reported by the previous nursing shift. You then go to Jane’s complete medical history and find that there is a diagnosis of schizophrenia when Jane was admitted to the hospital for mental health issues almost 20 years prior.

You ask Jane and her loved one about the ways that Jane is handling her schizophrenia, and they explain that she doesn’t take any medication for it, but manages it using LSD and holistic treatments. Jane insists that she has not had any mental health episodes for almost 20 years because of the holistic treatments. Jane and her loved one are insisting that she not be given more medication because it just makes her mental state more confused and her behavior worse. She is obviously in pain, and you want to be able to help alleviate some of her suffering, while you work to stabilize her mental state.  

You realize that the prior nursing shift had just ignored Jane because she was just too difficult to deal with on a very busy floor. Given that Jane has not received any medication for the last 12 hours, you find that there are some problems with her quality of care due to her challenging behavior.  

Describe and explain the ethical issues that you identified in Jane’s situation. Provide evidence from the scenario and from your course materials this week as support of your claims.

• List and explain at least three ethical issues related to the care that Jane has received.
• What steps would you take to correct the issue of Jane’s medications?
• What steps would you take to address the quality of care provided?

Define levels of substance use and abuse.