In two paragraphs please answer these questions. What does cultural competence mean to you and why is it important for the field. Acknowledging culture and diversity is the key to working with others. Have you provided a culturally competent environment for your patients? If so, how? As health care professionals recommend the skills needed for the field in order to provide culturally competent care?

how would you encourage a healthy lifestyle and/or health promotion for a patient with a view of time that may be negatively impacting their care and well-being? Please be specific and provide at least 2 examples giving reasons for your choices.

what are recent advances and rising new technology and ways that it can improve cardiac care? What are the obstacles or cons to this? Would you have any concerns using this for your personal care?

In hardwiring innovation culture, how can healthcare leaders have provided training and holding all staff accountable in promoting high-quality care?

How is relativism self-refuting? Provide examples

I. Identify an organization you have joined within your community/school, write the name of the organization, goals and objectives, duties of members and current activities/projects of the organization.

II.
1. In your own words, differentiate diffusion from osmosis.
2. How does the renal system maintain the body’s homeostasis?
3. Enumerate the IV fluids and classify them according to their tonicity.

Please select the ONE best answer.

Outline human development across the lifespan. (Word limit 250)

Answer should not be plagiarised.

Discuss the concept of self-actualisation. (word limit 200 to 250)

Answer should not be plagiarised.

Describe and apply leadership and change management theories, tools, and best practices.

1. Cirrhosis - Mr. Garcia is a 43-year old male who presented to the ED complaining of nausea and vomiting x 3 days. The nurse notes a large, distended abdomen and yellowing of the patient’s skin and eyes. The patient reports a history of IV drug use and alcohol use.

1. What initial nursing assessment should be performed?
2. What diagnostic studies might you anticipate for Mr. Garcia?

Mr. Garcia’s vitals are stable, BP 100/58, bowel sounds are active but distant, and the nurse notes a positive fluid wave test on his abdomen. The patient denies itching but is constantly scratching at his chest. He is oriented to person only and his brother at the bedside reports he has not been himself today. He keeps trying to get out of bed.

3. Which finding is most concerning and needs to be reported to the provider? Explain your response.
4. What further diagnostic and lab studies should be ordered to determine Mr. Garcia’s priority problem?

The provider places orders for the following:

Keep SpO₂ > 92%

Keep HOB > 30 degrees

Insert 2 large bore PIV’s

500 mL NS IV bolus STAT

100 mL/hr NS IV continuous infusion

Hydrocodone/Acetaminophen 5-500 mg 1 tabs q4h PRN for moderate pain

Hydrocodone/Acetaminophen 5-500 mg 2 tabs q4h PRN for severe pain

Diphenhydramine 25 mg PO q8h PRN itching

Ondansetron 4 mg IV q6h PRN nausea

Lactulose 20 mg PO q6h

Mr. Garcia’s LFT’s and Ammonia level are elevated. He is extremely confused, agitated and appears somewhat short of breath. The patient’s current vital signs are as follows:

                             HR 82                 RR 22

BP 94/56           SpO₂93%

                             Temp 98.9°F

5. Which order should be implemented first? Why?
6. Which order should be questioned? Why?
7. Why is Mr. Garcia so confused and agitated? Explain the pathophysiology of your answer.

The provider calls to tells you he wants to perform a paracentesis on Mr. Garcia. He will be gathering the supplies and will be at the bedside in 10 minutes.

8. Is it safe for Mr. Garcia to get a paracentesis currently?
9. What medication will help with Mr. Garcia’s confusion? What is the mechanism of action for this medication?
10. List 3 nursing diagnoses which are appropriate for Mr. Garcia

In two days, Mr. Garcia’s condition has improved. His wife is at the hospital and is inquiring about how to care for him at home.

11. What nutritional teaching should be included in the discharge teaching for Mr. Garcia?

1. Pancreatitis

Mrs. Miller presented to the emergency room with complaints of epigastric pain of 10/10 with nausea and vomiting. She is obese, a heavy smoker, and drinks alcohol. Mrs. Miller is being admitted with a diagnosis of acute pancreatitis.

1. Briefly explain acute pancreatitis and discuss its incidence.
2. What are the major causes acute pancreatitis?
3. Can a person have chronic pancreatitis? If so, what is the incidence, and how would you define chronic pancreatitis?
4. Discuss the common clinical manifestations of acute pancreatitis
5. Briefly discuss the diagnostic tests which help confirm the diagnosis of pancreatitis

Mrs. Miller is scheduled for a KUB asks “What is the test I am having done today?”

6. How would the nurse describe a KUB to Mrs. Miller?
7. Briefly discuss the treatment options for pancreatitis and explain why Mrs. Miller has an NG tube to low wall suction.
8. Discuss the complications which can arise if pancreatitis is not treated.

Identify 3 priority nursing diagnoses for a patient with acute pancreatitis

Benzodiazepines are commonly prescribed medications for several indications, including anxiety and sleep disorders. Let's discuss their use in our health care systems and the impact on our patients.

Things to consider might include :

Safety: How could the side effect profile affect your patients?

Efficacy: Are benzodiazepines efficacious for anxiety and sleep?

Use: Are they under or over prescribed? How can we ensure safe use of these medications?

Consider the following case:

A 49-year-old male who suffered a myocardial infarction one week ago. Upon discharge, it was noted that he appeared depressed. At a follow-up visit with his physician a week later, he met criteria for a diagnosis of major depressive disorder. His past medical history includes: treatment refractory hypertension, diabetes mellitus (type II), and severe uncontrolled narrow angle glaucoma

• How would you help him assuming he meets the criteria for Major Depressive Disorder?