should there be a legal right to healthcare in the U.S.? If so, what does that mean specifically with respect to affordability and availability? What does that mean with respect to payment and allocation of limited resources (experimental drugs or vital organs)?

List, locate, and briefly describe the function of the four hormones involved in the regulation of the reproductive cycle.

give an example of a medical intervention that might be justified by a patient's subjective quality of life judgment. (philosophy/ethic answer please)

Ms. Lear Thomson is a 47 y.o patient who comes in today complaining of heartburn that is no longer responding to TUMS and Mylanta. She complains of heartburn especially after lunch and dinner. She recently lost her job as bookkeeper for an auto parts store that went out of business. She is very stressed, as she is a single parent to two bright kids who are college material. She doesn’t know how she will afford college tuition, but is determined to make it possible for them. She denies melena or bloody stools, or nausea/ vomiting. She has gained about 22 lbs in the past 2 years. She has been working overtime as much as possible and has found very little time for exercising. She has no past history of heart disease, diabetes, or ulcerative colitis or Crohn’s disease. She has a normal CBC and has normal vital signs. You diagnose her with GERD.

What would be the appropriate medication to prescribe?

What education regarding the prescription would she need?

Explain why it is important to have an interprofessional health care team involved in the care of a person living with Cystic Fibrosis. In your answer explain what is meant by the term interprofessional health care team. What roles (professions) might be on this team and why, ie. how might they contribute to the care of the individual living with CF?

Client Profile

Mrs. Kidway is a 71-year-old Russian woman who lives at home with her daughter’s family. She only speaks Russian; her daughter speaks English and translates for her Mother. Mrs. Kidway has a history of Heart failure (HF, CHF); pneumonia; chronic obstructive pulmonary disease (COPD); gastroesophageal reflux disease (GERD). Her daily medications prior to admission include digoxin (Lanoxin) 0.125 mg once a day.

Case Study

Mrs. Kidway arrives in the emergency room with her daughter who explains, “She was fine this morning but then this afternoon she developed terrible abdominal pain and got short of breath.” Mrs. Kidway is lethargic. Her physical examination is unremarkable except for facial grimacing when palpating her abdomen. She is afebrile with a blood pressure of 105/50, pulse 60, and respiratory rate 18. Blood work on admission reveals a digoxin level of 3.8 ng/mL.

1. How does digoxin work in the body?

2. Why is Mrs. Kidway taking digoxin?

3. Given Mrs. Kidway’s digoxin level, briefly explain what electrolyte imbalance is of concern.

During a nursing assessment of Mrs. Kidway’s current medications, the nurse asks if Mrs. Kidway takes any over-the-counter medications or herbal remedies. Mrs. Kidway’s daughter says, “Is licorice considered an herbal remedy? My mother started taking licorice capsules about a month ago because we heard that licorice helps decrease heartburn.”

4. Does licorice interact with digoxin? If so, explain.

5. Discuss what the terms loading dose and steady state indicate.

6. What are the onset, peak, and duration times of digoxin when it is taken orally?

7. If Mrs. Kidway was having difficulty swallowing her digoxin capsule and her health care provider changed her prescription to the elixir form of digoxin, theoretically would she still receive 0.125 mg?

8. What is a medication’s “half-life”? What is the half-life of digoxin? Theoretically, if Mrs. Kidway took her digoxin at 8:00 a.m. on a Monday, when will 75% of the digoxin be cleared from her body according to the half-life? Since the half-life of digoxin is prolonged in the elderly, use the high end of the range of digoxin’s half-life.

9. What is the normal therapeutic range of serum digoxin for a client taking this medication?

10. What symptoms may be noted when digoxin levels are at toxic levels?

11. At what serum digoxin range do cardiac dysrhythmias appear and what is the critical value for adults?

Mrs. Kidway’s heart rate drops to 50 beats per minute. Her potassium is 2.1 mEq/L. She has the following orders:

1. Four vials of intravenous digoxin immune fab (Digibind), reconstituted with sterile water
2. Potassium chloride (KCl) 40 meq in 200 mL NS to run IV to run over 4 hours
3. Atropine sulfate (Atropine) 0.5 mg IV
4. Start a large bore IV.
5. Admitt to the intensive care unit for cardiac monitoring.

12. Prioritize the orders and provide your rationale.

13. Discuss how her digoxin toxicity will be treated.

14. What are the two highest priority nursing diagnoses appropriate for Mrs. Kidway’s plan of care?

) Much of the focus during the pandemic has been on physical health. Do you think mental health should take a more central focus? Why or why not? What are some things that can be done to address individuals’ mental

Scenario

John Doe has entered the ED complaining of:

• Dizziness
• Weakness
• SOB on exertion
• Loss of appetite

1.Complete a head to toe assessment

2.What questions would you ask John Doe

3.From the lab results what treatments would the physician order?

4.What education would you provide to John Doe?

5.Explain what these tests are and what the abnormal values mean and what would be your nursing management?

• WBC
• RBC
• HGB
• HCT
• Platelet Count

Write a short paper that responds to the following prompts. Your paper should be at least 2000 words in length.

1. Why is it important for today’s leaders to develop cultural intelligence? Assess your perceived personal barriers. What barriers stand in the way of you becoming an inclusive leader in a health care services organization? How can you increase your own cultural intelligence to be a better leader in health care services?

2. Evaluate both the positive and negative aspects of conflict including the identification of functional and dysfunctional aspects within a health care organization and the impact of your role as a leader. Include a personal example or one you have read about where barriers to organizational success went unaddressed when interpersonal conflict existed among teams.

3. Based on the readings in the course thus far and your understanding of a positive organizational culture, discuss how leaders can build an organizational culture to deliver patient outcomes, and retain employees. Include a real-life example from your experience as a patient or your work in a health care environment.

4. Reflect on the impact of a healthcare leader you have observed/experienced OR a hypothetical situation if you do not have a specific example and how the leader led and managed a change initiative. Based on the course thus far, analyze how you will grow in your leadership and in practicing change.

5. Evaluate diversity and inclusion (D & I) based on the readings in the course and apply your own understanding of D & I in a workplace. What can you do given your knowledge of the complexities in health care organizations to promote and implement a culturally competent, patient-centered health services organization?

6. Provide an example from your experiences where you were provided an opportunity for growth and development that impacted your success and effectiveness as part of a team. After discussing your example, analyze how you could take your learnings and hypothetically apply them to a health care setting.

Mrs. Brown, an 80-year-old female, is brought to the emergency room by her son who reports she

has been vomiting violently for the past 24 hours. The patient stated she had been vomiting for 2

days and had been unable to take food or fluids. She has been healthy and currently takes only a

diuretic for her blood pressure. On physical examination, the nurse notes the patient’s skin is dry

with decreased turgor, oral mucous membranes are dry, temperature is 99.7 degrees F, heart rate is

100 bpm, and blood pressure is 90/60 mmHg. Mrs. Brown is unable to void, so the nurse inserts a

catheter with a return of less than 50 ml of dark amber urine. When reviewing the patient’s

laboratory results the nurse notes the patient’s BUN is 75 and she has a serum creatinine of 3.2.

A. What do these findings most likely indicate? How does the BUN/creatinine ratio help to determine the type of AKI Mrs. Brown is experiencing?

B. What signs and symptoms noted by the nurse are characteristic of renal failure?

C. If the blood pressure continued to drop in this patient and the patient developed acute tubular necrosis, what would happen to the kidney tubule?

Study Guide: Topic 10 Functions of Effector T cells:

1)   Explain why classical activation of macrophages by T_H1 cells is needed in order to clear out some pathogens.

2)   Describe how perforin and granzymes released by CTLs activate apoptosis in target cells. Be detailed and specific in your response.

With given goal ,can you give me 3 interventions ?

Goal: Demonstrate proficiency in pharmacology ( with an emphasis on recognizing actions of drugs and administering drugs safely via various routes) on all assigned patients during clinical as nurse student, with minimal assistance.

H.M. is a 32-year-old female who presents for her annual physical examination and mentions to the health care provider that she has been having pain in her toes when she gets up during the night and first thing in the morning.

Subjective Data

• Wife and mother of a seven-month-old son
• Works part-time as a registered nurse
• Her mother recently passed away and she has been experiencing tension headaches
• States has been having difficulty walking, sometimes needing to crawl, due to pain in toes when she gets up during the night to go to the bathroom and the first couple of hours in the morning
• Has noticed pain in her fingers in the morning when she tries to open baby food jars

Objective Data

Physical Examination

• Temperature 98.6° F, pulse 76, respirations 16, blood pressure 114/68
• Swelling and tenderness to palpation of the proximal interphalangeal (PIP) jointof the bilateral second and third digits of hands, metacarpophalangeal (MCP) joint of bilateral thumbs, and the metatarsophalangeal (MTP) joint (Links to an external site.) of bilateral great toes

Diagnostic Studies

• Rheumatoid factor (RF) positive
• X-rays of bilateral hands and feet reveal soft tissue swelling; without any evidence of bone or cartilage destruction or joint deformities
• Bone density T-score of +1

Discussion Questions

1. The health care provider diagnoses H.M. with Stage I rheumatoid arthritis. Explain the pathophysiology of rheumatoid arthritis and the classification criteria that H.M. demonstrates that determined this diagnosis.

2. How could H.M.’s recent childbirth and death of her mother be related to her rheumatoid arthritis?

3. Describe some of the extraarticular manifestations of rheumatoid arthritis H.M. may develop.

4. a) What are some priority nursing diagnoses for H.M. at this time?

b) What are the overall goals of H.M.’s care?

5.

a) What treatment and inter professional care are involved in managing a patient with rheumatoid arthritis?

b) M. is started on methotrexate. What instructions should you give H.M. regarding this medication?