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?

Lidocaine (C14H22N2O) is a commonly used anesthetic. As a preliminary step when applying an IV to a child, lidocaine may be administered in order that the child not “feel” the pain caused by the insertion of the IV. In order to introduce the lidocaine in a way that will be localized but will not be painful, iontophoresis may be used. In this process, two electrodes are placed on the child’s skin; one near to the site of the IV and the other several cm away. Ionized lidocaine, C14H23N2O + , is placed under one of the electrodes. A DC current of 1.2mA is the applied to the electrodes.

a. To which electrode, positive or negative, should the ionized lidocaine be applied? EXPLAIN your answer. [POSITIVE]

b. For how much time should the iontophoresis continue in order that 5mg of the anesthetic will be introduced into the child?

c. What DOSE of lidocaine had been applied during this treatment?

Identify and describe the activity/game/toy and the age group it was developed for,

including colour texture, sounds and what material it is made from?with the assignment on assisting family, growth and development.

Conclusion:

 How would you price this creation and would it be something you would purchase or

is it something you would use as an activity or a particular age-group.

PM concepts, principles and process in project planning?

identify and briefly describe the two branching philosophies of knowledge in nursing (rationalism and empiricism) and how each underpins qualitative or qualitative research.

Disparities in Care at Southern Regional Health System case: Suppose Mr. Hank
wants to appoint a healthcare disparities committee to advise him on how to reduce
healthcare disparities. Decide and describe, in as much detail as possible, what you
think each of the seven structural characteristics should be for this committee. For
example, write the committee’s statement of purpose. Determine its size. Make up
job titles to list members of the committee. Decide what authority the committee
should have. Decide and describe the other structures.

Who is August Wilson? How does his plays in the Pittsburgh cycle particularly Fences reflect the society in which set?