1. The problem or issue, intervention, quality initiative, educational need, orcollaborative interprofessional team project that will be the focus of thechange proposal

Bladder Scan: Description of Procedure, Indications, Interpretation of Findings, CONSIDERATIONS, Nursing Interventions (pre, intra, post), Potential Complications, Client Education, Nursing Interventions.

1. Identify how the concept of intracranial regulation and sensation relates to patients with dementia.

2. What is done to maintain the dignity of these vulnerable adults? Identify at least 2 nursing interventions that help maintain the dignity of vulnerable adults.

provide an example each for the protective factors for physical, emotional and mental health issues or health needs

CRITICAL THINKING

1. Julie is a new patient who brings a list of her current medications to her first appointment. She indicates in her health history that she has several conditions for which she is taking medications prescribed by her previous physician, but she is unaware of which medication is associated with a particular condition. Her medical records have been requested from her previous physician, but have not yet arrived. What steps can you take to attempt to match her medications with the disorders that she reports?

2. Phil arrives at the medical office complaining of fatigue, weakness, and mild discomfort in the chest. He also reports that his weight has recently decreased and he has difficulty sleeping because he feels feverish at night. The physician requests that you perform tuberculin testing to determine whether Phil has a tuberculosis infection. What general steps do you follow to administer a Mantoux test and to interpret the results?

Scenario

A.H. is a 70-year-old retired construction worker who has experienced lumbosacral pain, nausea, and upset stomach for the past 6 months. He has a history of heart failure, high cholesterol, hypertension (HTN), sleep apnea, and depression. His chronic medical problems have been managed over the years with benazepril (Lotensin) 5 mg/day, fluoxetine (Prozac) 40 mg/day, furosemide (Lasix) 20 mg/day, potassium chloride (KCl) 20 mEq (20 mmol) bid, and atorvastatin 40 mg each evening.

A.H. has just been admitted to the hospital for surgical repair of a 6.2-cm abdominal aortic aneurysm (AAA) that is now causing him constant pain. On arrival to your floor, his vital signs (VS) are 109/81, 61, 16, and 98.3 ° F (36.8 ° C). When you perform your assessment, you find that his apical heart rhythm is regular, and his peripheral pulses are all 2+. His lungs are clear, and he is awake, alert, and oriented. There are no abnormal physical findings; however, he has not had a bowel movement for 3 days. His electrolytes, blood chemistries, and clotting studies are within normal range, except his hematocrit is 30.1%, and hemoglobin is 9 g/dL (90 g/L).

1. A.H. has several common risk factors for AAA in his health history. Name and explain 3 factors.

2. How is testing used to diagnose an AAA?

7. During your assessment, you note a pulsation in A.H.’s upper abdomen, slightly left of the midline, between the umbilicus and the xiphoid process. True or False: You must palpate this mass as part of your physical assessment. Explain your answer.

CASE STUDY PROGRESS

A.H.’s aneurysm resection is successful, and he maintains normal leg movement and sensation. However, for the first 2 postoperative days he is delirious and needs one-to-one nursing care in the intensive care unit. After he becomes coherent and oriented again, he is transferred back to your floor.

9. What assessments do you need to make specific to his postoperative care?

10. List 6 problems that are high priorities in A.H.’s postoperative care.

11. When you perform A.H.’s abdominal assessment, you do not hear any bowel sounds when auscultating his abdomen. What should you do?

1, Identify nursing priorities/standards of care for these interventions

Administer Wrist Restraints/Standards of Care:

Nursing Standards of Care:        

Rationale:

Case Study on Basal Nuclei

A 55 year old man is seen by a nurse practitioner as his family reports that he has tremors at rest and difficulty walking. On evaluation, it is observed that he had difficulty initiating walking and stopping. He has a mask-like facial expression and displays no signs of dementia or depression. He is diagnosed with Parkinson’s disease. The patient is prescribed a course of L-Dopa to treat his disorder.

1. Which masses of gray matter are not able to perform their functions optimally, resulting in this

     patient losing proper muscle control?

2. Which structure in the midbrain secretes dopamine that affects skeletal muscle control?

3. What is the role of dopamine in the maintenance of resting muscle tone and muscle

     recruitment for movement?

4. The basal nuclei receive synaptic input from the primary motor cortex and sends their output to the

     thalamus which relays this information back to the motor areas of the brain. What would happen to

     muscle control if a person suffers a stroke that damages the basal nuclei?

5. Why are Parkinson’s patients not given dopamine but L Dopa, which is then converted to

     dopamine in the brain?

Identify the roles of thiamin, riboflavin, and niacin in energy metabolism and other body functions. pleas type it at least 10 sentences

Discuss the roles of iodine, chromium, manganese, and sulfur in energy metabolism please type and at least 20 sentences.

List six employment laws and select one to describe in-depth. US HEALTH SYSTEM

What are the certain factors alter folate digestion, absorption, and balance. please type at least 20 sentences.