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?

1.) Among the medical treatments for lupus, which of these has no known long-term health implications or negative secondary effects?

   a.   corticosteroids

   b.   NSAIDs

   c.   antimalarial drugs

d. immunosuppresssant medications

2.) Which of the following describes chronic fatigue syndrome?

   a.   usually diagnosed in childhood

   b.   most frequently diagnosed in women

   c.   more likely to be found in individuals of higher levels of education

   d.   occurs in up to 15% of the population in the United States

1. Steven had a left ventricular wall infarction secondary to myocardial ischemia. This damage to the left ventricle compromised its function as a pump; the left ventricle could no longer generate enough pressure to eject blood normally. Draw the normal Frank–Starling relationship for the left ventricle. Superimpose a second curve showing the Frank–Starling relationship after the myocardial infarction, and use this relationship to predict changes in stroke volume and cardiac output.

7. What was the rationale for treating Steve with furosemide (a loop diuretic)?

8. A medical student in the coronary intensive care unit asked whether Steven should also be treated with propranolol (a β-adrenergic antagonist). The student reasoned that propranolol would reduce the myocardial O₂requirement and possibly prevent another infarction. Why does propranolol decrease the myocardial O₂requirement? The attending physician pointed out that there could be a risk associated with the use of propranolol. What is this risk?

9. Why was Steven sent home on a low-Na⁺diet?

You conducted the literature search above and identified examples of EHR terminology. What is the difference between EMR, EHR, and PHR?

Write a 3-5 page paper analyzing the program by answering the following questions, explaining what the specific health of smoking and why it needed to be addressed. Then, consider the resources and respond to the following:

• In which setting was the health promotion/prevention program implemented?
• What was the rationale for the selection of the setting and the population?
• Was there a theory that guided the program or study? If so, what theory or theories were used?
• What were the results of the program or study?
• In what ways did the program or study contribute to the field of health education?

Mrs. A. is an 84-year-old woman who was recently discharged from the hospital with a diagnosis that includes an exacerbation of congestive heart failure (CHF). She also has diabetes and hypertension. Mrs. A. was discharged from the hospital on multiple medications and lives alone. Home care services were initiated with skilled nursing care visits, some home health aide support, and orders to include daily telemonitoring of her vital signs. The telehealth device will remotely monitor Mrs. A.’s blood pressure, heart rate, oxygen saturation, and weight. In addition, the patient will answer customized questions about her disease on a daily basis. This information will then be transmitted daily to the home care agency, where the telenurse can determine appropriate clinical actions based on the data trends and preset baseline alerts that indicate when set parameters have been exceeded.

• What assessment information in the patient situation is the most important and of immediate concern for the nurse?
• What patient condition(s) are consistent with the most relevant information?
• Which possibilities or explanations are most likely to be present in the patient situation? Which are the most serious or a priority?
• What actions would most likely achieve the desired outcome for this patient?
• Which actions are the most appropriate and how should they be implemented?
• What patient assessment would indicate your actions were effective

1. What are some pros and cons of the AZ HB2582 from the perspective of the patient, family, or community and its role in reducing the cost for health care insurers.