Roberta is a 26 year old, 39 week pregnant woman who was just told by her doctor, at her office visit, that she needs a CESAREAN SECTION.

• What is a cesarean section?

• Why might a NON-LABORING pregnant woman need a cesarean section? Name and explain 3 reasons.

• Why might a LABORING pregnant woman need a cesarean section? Name and explain 2 reasons. You are her nurse in the pre-op area and are getting her ready for the operating room. She asks you to: describe briefly what will happen in the OR. She asks you about her recovery after the surgery

. • Describe for her how she will look and feel after surgery when she gets to the Post Partum Unit.

• Explain some of the medications that may be ordered for her to take. Name and explain 3.

You are reviewing discharge teaching of a cesarean patient with her. You tell her that compliance is important. Teach her 2 things that you hope she complies with.

What is the organizational structure they are working with Health and human services? What is the level of collaboration between the HHS and other organizations?

Monica is a 26 year old, G1P0, 38 week pregnant nursing student at Keiser Career College! She has been studying very hard lately for her ATI exam. For the past two days she has been having really bad headaches, blurry vision, and feels “fat”. She weighs herself and sees that she is 12lbs heavier than two weeks ago and sees her face and hands very puffy! Her OB just told her that she has PRE-ECLAMPSIA and has been sent to the hospital for bed rest.

• What is Pre-Eclampsia?

• How may this diagnosis affect the rest of her pregnancy? Her home life/ emotional/ financial/ sexual needs?

• What medications may be ordered to treat her pre-eclampsia? What antidote should you have at her bedside as well?

• Describe the condition of her hospital room. As the LPN, you are helping the RN watch Monica's condition closely. •What physical findings are you assessing her for probably hourly?

• Which changes in her assessment would you report to her doctor immediately???

• How will having pre-eclampsia affect the delivery of her baby?

• What concerns might you have about her delivery?

• What will her postpartum recovery be like afterwards?

• As her postpartum nurse, describe your plan of care for her including any medications/ labs/ nursing diagnoses that you feel may be relevant.

A health plan uses a four-tier formulary:

$10 generic; $35 brand; $65 brand non-preferred; $120 speciality

Cost of pharmaceutical products:

Drug A (generic)= $50/month

Drug B (brand)=$135/month

Drug C (brand non-preferred)= $230/month

Drug D (speciality)= $2000/month

If a person is a health plan member on all four medications, how much out-of-pocket must he pay? And how much does the health plan for the medications? Explain why.

Alzheimer‘s Disease

During the past 4 years, Mr. Ludwig has demonstrated rapidly progressive memory impairment and disorientation, as well as deterioration in his ability to function, related to Alzheimer’s disease. He is a 67-year-old man who retired at 62 years of age to spend some of his remaining “youth” with his wife and to travel, garden, visit family, and finally implement the plans they made over the previous 40 years. He was diagnosed with Alzheimer’s disease at 63 years of age.

Mr. Ludwig has been taken care of at home by his wife and his daughter Daisy. Daisy is divorced and has returned home with her two young daughters.

The family members find themselves progressively closer to physical and mental exhaustion. Mr. Ludwig has become increasingly incontinent when he cannot find the bathroom. He wanders away from home constantly, despite close supervision. The police and neighbors bring him back home an average of four times a week. Once, he was lost for 5 days after he had somehow boarded a bus for Pittsburgh, 1000 miles from home. He was robbed and beaten before being found by the police and returned home.

He frequently wanders into his granddaughters’ rooms at night while they are sleeping and tries to get into bed with them. Too young to understand that their grandfather is lonely and confused, they fear that he is going to hurt them. Four times in the past 2 weeks, he has fallen while getting out of bed at night, thinking he is in a sleeping bag camping out in the mountains. After a conflicted and painful 2 months, the family places him in a care facility for people with Alzheimer’s disease.

Mrs. Ludwig tells the admitting nurse, Mr. Jackson, that her husband wanders almost all the time. He has difficulty finding the right words for things (aphasia) and becomes frustrated and angry when that happens. Sometimes, he does not seem to recognize the family (agnosia). Once, he thought that Daisy was a thief breaking into the house and attacked her with a broom handle. Telling this story causes Daisy to break down into heavy sobs: “What’s happened to my father? He was so kind and gentle. Oh, God… I’ve lost my father.”

Mrs. Ludwig tells Mr. Jackson that her husband can sometimes participate in dressing himself; at other times, when he appears confused over what goes where, he needs total assistance. At this point, Mrs. Ludwig begins to cry uncontrollably, saying “I can’t bear to part with him, but I can’t do it anymore. I feel as if I’ve betrayed him.”

Mr. Jackson then focuses his attention on Mrs. Ludwig and her experience. He states, “This a difficult decision for you.” He says that he supports their decision to move Mr. Ludwig to the Alzheimer’s unit. However, he is also aware that families usually have conflicting and intense emotional reactions of guilt, depression, loss, anger, and other painful feelings. Mr. Jackson suggests that Mrs. Ludwig talk to other families with a cognitively impaired member. “It might help you to know that you are not alone, and having contact with others to share your grief can be healing.” One of the groups he suggests is the Alzheimer’s Association, a well-known self-help group.

1. What is Alzheimer’s disease? The answer is directly from the book
2. Compare and contrast Alzheimer’s disease and Lewy body dementia?
3. What are some current treatments for Alzheimer’s disease pharmacologic and non-pharmacologic?
4. What causes Alzheimer's disease?
5. What are the symptoms of Alzheimer's disease?
6. Do men or women have a higher risk and does aluminum play a role in developing Alzheimer's disease?

A new patient visits your office with several complaints that seem to have been increasingly problematic over the past several weeks. The patient says that she fears that she is very ill; for she has gained 5 pounds in the past month, has had difficulty getting out of bed in the morning, and has been experiencing terrible headaches. The patient asserts that her energy level throughout the day is low, that she has not been able to enjoy her usual activities for the past several weeks, and she feels anxious every time she leaves her home. She states that she believes that after doing online research, that she has a thyroid problem, and notes that there is a history of thyroid problems in her family. Her vital signs are within normal limits, and other than the aforementioned weight gain, there is nothing remarkable noted in her physical examination. However, as the physical is being performed, she does seem to be a bit confused. The patient also asks for a prescription to treat her headache. A) What other data, both subjective and objective might be important to gather in order to effectively diagnose this patient’s condition? B) What other laboratory tests would you request for this patient, and why?

if you are outside of the health weight category what lifestyle changes can you make to get to health weight?

B why might BMI not be a valid assessment of health status?

C do you believe it is helpful for individuals to know their BMi? why or why not

D reflect on how you felt completing the BMI assessment activity and what you take forward from this activity.

1. Provide a description of the nutritional challenges you have seen over the past months due to COVID-19. Think in terms of grocery shopping, changes in meal habits, mealtimes, meal offerings, unavailable foods, etc. What about those of you that have children at home? Are you preparing meals to take to school or meals for lunch at home? What is the health of your community? How is your health?

Scenario: A doctor has ordered a test or treatment that is, based on the best practices of your profession, incorrect or medically inappropriate.

1. What should you do when faced with this problem?

2. What policies and support mechanisms do you have in this situation?

3. What preparation do you need to make prior to taking action?

4. Think of one specific treatment/test from your discipline and tell us what you would say when you approach the physician to discuss it with him or her.

An IV containing heparin in 250 mL of NS is infusing at 40 drops per minute. The infusion set is a microdrop. What is the infusion time? ( 1 drop = 4 microdrops, 1 mL = 15 drops = 60 microdrops)

The Spirit Catches You and You Fall Down

"When you fail one Hmong patient, you fail the whole community" (p. 253). How does this perspective differ from your cultural perspective on health care? How does knowing this put pressure on the healthcare system to adequately treat those from a clan-based culture, in your view?

How do diseases of the urinary system affect other body systems?

D.G., a 72-year-old man whose wife died 6 months ago, is brought to the health care provider by his daughter because he is not eating much and has been lethargic and sleeping a lot. He has a history of hyperlipidemia for which he takes niacin–lovastatin 500/20 mg PO daily at bedtime. Subjective Data Has been unusually tired for the past couple of months Is frequently short of breath and sometimes feels like his “heart is pounding” Has lost weight because his wife always used to cook for him, and he doesn’t cook for himself Describes a typical daily meal as coffee and a donut for breakfast, a hot dog and lemonade for lunch, and a jelly sandwich on white bread and coffee for supper Objective Data Physical Examination Blood pressure 118/72, pulse 98, temperature 98.2°F, respirations 16 Oxygen saturation 92% on room air Height 5'6", weight 135 lb, BMI 21.7 kg/m² S1 and S2 auscultated and regular Bilateral radial pulses +3 and regular Lungs clear bilaterally Diagnostic Studies * RBC 3,300,000/µL * Hemoglobin 8.3 g/dL * Hematocrit 24% * MCV 73 fL * MCH 23 pg * WBC 9100/µL * Platelets 250,000/µL * Iron 28 mcg/dL * Ferritin 14 ng/mL * Cobalamin 600 pg/mL * Folate 10 ng/mL D.G. is diagnosed with iron-deficiency anemia

5. With D.G.’s loss of his wife who cooked meals for him, and based on his present living situation, what are a couple of ways or things that could be done to assists in his intaking of better rich ironed foods? List at least two:

6. The health care provider (HCP) has prescribed an iron supplement for D.G. What would

you teach D.G. about taking iron supplements? List at least four:

7. Evaluate D.G’s readiness to learn. What is one positive and one negative factor that might affect the chances of learning success?
   1. One positive factor:

2. One negative factor:

Reference(s):

Pick a character from movies, television, or books. Identify and explain a social determinant of health that influences the character's health.