For this task, you are to write a report about a time you have provided individualized support to a client in the community services industry. If you have not provided individualized support for a client in the community services industry, please complete this in conjunction with your observation task. Your report must include details on the following: All information regarding the reporting and documentation you completed as part of your support.
In: Nursing
In: Nursing
A 55 year old male present to the clinic for evaluation of progessive symptoms of increased fatigue, thirst, urination, and appetite of several weeks to months duration.
what are your primary concerns for this patient and what assessment and interventions would be associated with you concerns and why ?
In: Nursing
Patient in this case study is an elderly woman that is currently experiencing weakness accompanied by a fever of 100oF. Historically, this patient has experienced hypertension, aortic thoracic graft, and GERD. Just 3 weeks prior to this case, she was treated for a UTI. Her physician admitted her to the hospital for a diagnostic workup.
Her lab results are as follows: Urinary results:
Sodium | 129 mmol/L | Color/Clarity | Yellow/Hazy | |
Potassium | 3.7 mmol/L | Specific Gravity | 1.015 | |
Chloride | 97 mmol/L | pH | 5 | |
Carbon dioxide | 19 mmol/L | Blood | Large | |
BUN | 52 mg/dL | Protein | 2 | |
Creatinine | 3.2 mg/dL | Glucose | Negative | |
Hematocrit | 25.6% | Ketones | Negative | |
Hemoglobin | 8.5 g/dL | Nitrates | Negative | |
WBC | 9,700 | RBC | >25 | |
WBC | 1-5 | |||
Culture | Citrobacter spp. |
The patient's condition continued to decline, and she ended up on dialysis. A renal biopsy was performed that showed rapidly progressive glomerulonephritis. She continued to decline, multiple organ involvement, requiring surgery and blood transfusions, which ultimately lead to being put on life support. Patient died after the removal the life support.
Questions:
1. Looking at the patient's urinalysis results, what is the significance of the results of 2+ protein and >25 RBCs?
2. What is the most likely cause of glomerulonephritis?
3. Why was the patient put on dialysis?
In: Nursing
E-cigarettes and JUULs: Stopping a New
Epidemic
2019 was a landmark year for tobacco legislation. States passed
bills that increased the minimum sale age for tobacco products,
regulated the sale of flavored tobacco products, and increased the
price of tobacco products in statehouses across the country. This
work was capped off with the federal government raising the age to
buy tobacco products to 21 in December. ASTHO expects that states
will continue to propose bills to prevent youth consumption of
tobacco products, including e-cigarettes, in 2020. Other likely
tobacco proposals include: the implementation of sales restrictions
on tobacco products with specific nicotine concentrations;
prohibitions on the bulk sale of e-cigarette products; the
regulation of online sale and purchase of tobacco products and
e-cigarettes; and the incorporation of e-cigarettes in the
definition of tobacco products.
Discuss the argument for and against this health policy.
How would an epidemiologist aide in this debate?
In: Nursing
Based on the following scenario, which TMC stage should Lucy be classified in? Lucy likes to go out with her friends and binge drink every Friday and Saturday night. Lately, she also binge drinks on Thursday nights and often one other day each week. Lucy doesn't see this as a problem since she still makes it to work and school. It's just how she has fun and unwinds, she reasons. However, her grades are beginning to slip and she was so hung over at work one day last week that she had to go throw up in the bathroom during her shift.
Precontemplation |
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Action |
Based on the following scenario, which TMC stage should Lucy be classified in? Lucy likes to go out with her friends and binge drink every Thursday, Friday and Saturday nights, and sometimes even more often. Lucy feels weird about all of this and how it is progressing in her life. She realized recently that her grades are slipping. Also, she has started to blackout while drinking and doesn't remember large portions of the night. This was particularly disturbing to her on one occasion when she vaguely remembers talking to a guy at a bar, but doesn't remember what happened after that. She thinks she may have a problem. She starts to think through what she should do and realizes that she is more likely to lose control when she drinks liquor because she gets drunk faster. She also likes beer so she decides to try to just stick to beer in the future, and to set a limit for herself on how many beer she can have. To further reduce temptation, she also has the idea that she can bring only a certain amount of cash with her on nights out and leave her cards at home.
Precontemplation |
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Contemplation |
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Preparation |
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Action |
Based on the following scenario, which TMC stage should Lucy be classified in? Lucy likes to go out with her friends and binge drink every Thursday, Friday and Saturday nights, and sometimes even more often. Lucy feels weird about all of this and how it is progressing in her life. With her grades slipping and several recent blackouts while drinking, she has started trying to limit herself. She won't do shots anymore and she has a limit of 4 beers per night, which she realizes is still a lot but is much less than her previous consumption of 2-4 shots plus 6-8 liquor based cocktails per night out. She plans to cut down further after a few months of adjustment.
Precontemplation |
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Contemplation |
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Action |
In: Nursing
Which of the following terms best describes large patterns of normal cultural or social behavior, as well as laws and policy, that reinforce a given behavior within individuals?
meta-contingencies |
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reciprocal triadic causation |
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operant conditioning |
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social ecology |
Antonio is in the habit of eating chips and cookies and other snacks after dinner while watching TV. Recently he has begun to try to change this habit by instead either going for a walk or a run after dinner, or lifting simple hand weights and using exercise bands for strength building in front of the TV at night. Which process of change is Antonio engaging in?
Contingency Management |
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Counterconditioning |
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Stimulus control |
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self-liberation |
What is NOT true of Ecological Models of Health Behavior?
They describe and understand human behavior in terms of
human |
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Often address the root causes of disease or poor health |
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Considers the physical, social and cultural environments that
influence and |
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Target communities and group, but not laws or policy |
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Focus on the environmental influences that are modifiable in terms of intervention. |
In: Nursing
In: Nursing
Case study two D.J., a 67-year-old woman, is taken to the emergency department by her daughter. D.J. reports, “I’m feeling crazy and I’m very anxious.” She is hyperventilating and visibly sweating. Laboratory tests and a 12-lead electrocardiogram (ECG) have been ordered by the physician. She is on continuous ECG monitoring, and oxygen has been started. Baseline vital signs include the following: blood pressure (BP) of 175/105 mm Hg, pulse rate of 120 beats/minute, and respiratory rate of 34 breaths/minute. Question 1: If this patient is experiencing angina or myocardial infarction (MI), what cardiac findings are you likely to discover?
In: Nursing
Scenario
You are the nurse working in an anticoagulation clinic. One of your
patients is K.N., who has a long-standing history of an irregular
heartbeat, known as atrial fibrillation or A-fib, for which he
takes the oral anticoagulant warfarin. Recently K.N. had his mitral
heart valve replaced with a mechanical valve.
1. How does atrial fibrillation differ from a normal heart
rhythm?
2. What is the purpose of the warfarin in K.N.'s case?
CASE STUDY PROGRESS K.N. calls your anticoagulation clinic to
report a nosebleed that is hard to stop. You ask him to come into
the office to check his coagulation levels. The laboratory
technician draws a PT/INR test.
3. What is a PT/INR test, and what are the expected levels for
K.N.? What is the purpose of?
the INR?
4. When you get the results, his international normalized ratio
(INR) is critical at 7.2.
What is the danger of this INR level?
The health care provider does a brief focused history and physical
examination, orders additional laboratory tests, and determines
that there are no signs of bleeding other than the nosebleed, which
has stopped. The provider discovers that K.N. recently started to
take daily doses of an over-the-counter pro ton pump inhibitor
(PPI), omeprazole (Prilosec OTC), for heartburn.
5. What happened when K.N. began taking the PPI?
.
6. What should K.N. have done to prevent this problem?
The provider gives K.N. a low dose of vitamin K orally, asks him to
hold his warfarin dose that evening, and asks him to come back
tomorrow for another prothrombin time (PT) and INR blood draw. Why
is K.N. instructed to take the vitamin K?
You want to make certain K.N. knows what "hold the next dose"
means. What should you tell him?
K.N. grumbles about all the laboratory tests but agrees to follow
through.
What is potential S/S of bleeding that should be taught to K.N.?
(Select all that apply.)
a. Black, tarry stool
b. Stool that is pale in color
c. Paresthesia lower extremities
d. Bruising
CASE STUDY PROGRESS You know that sometimes the only needed action
is to stop the warfarin several days before the surgery. Other
times, the provider initiates "bridging therapy," or stops the
warfarin and provides anti coagulation protection by initiating
low-molecular-weight heparin. After reviewing all his
anticoagulation information, the provider decides that K.N. will
need to stop the warfarin 1 week before the surgery and in its
place be started on enoxaparin therapy.
Which nursing interventions are appropriate when administering
enoxaparin? Select all that apply.
a. Monitor activated partial thromboplastin time (aPTT)
levels.
b. Administer via intramuscular (IM) injection into the deltoid
muscle.
c. The preferred site of injection is the lateral abdominal fatty
tissue.
d. Massage the area after the injection has been given.
e. Inject two inches from belly button.
In: Nursing
D.J., a 67-year-old woman, is taken to the emergency department by her daughter. D.J. reports, “I’m feeling queasy, and I’m very anxious.” She is hyperventilating and visibly sweating. Laboratory tests and a 12-lead electrocardiogram (ECG) have been ordered by the physician. She is on continuous ECG monitoring, and oxygen has been started. Baseline vital signs include the following: blood pressure (BP) of 175/105 mm Hg, pulse rate of 120 beats/minute, and respiratory rate of 34 breaths/minute. D.J’s diagnostic studies are completed, and the results include the following: Elevated cardiac-specific troponin I level Cholesterol level of 8.03 mmol/L Question 3 What should be included in this assessment after the diagnostic studies are completed?
In: Nursing
In: Nursing
Describe how you will apply your acquired knowledge
out of psychology class to your patients when you start working in
your medical field of your choice?
My medical field of choice is Associates of Applied Science Medical
Assistant.
In: Nursing
In: Nursing
High and low symptoms: potassium, calcium, phosphate, magnesium, sodium ?
In: Nursing