CASE STUDY

Christopher aged 12 (White UK), Amy aged 8 (dual heritage Caribbean/White UK) and Kerry aged 3(dual heritage Caribbean/White UK) have been removed from their mother (White UK) who is an alcoholic and who attacked Christopher in a drunken rage after Amy disclosed sexual interference by him.

The children do not have the same father and Kerry’s father, Andy (UK born Caribbean) recently left the family home after social services discovered he has sexual offences against children. (This was brought to light when Andy’s other child Mary aged 14 went to social services and informed them about her father and abuse in the family. This is the basis of the previous task above). Their maternal grandfather (White UK), is also a sex offender and it is suspected that he has had unsupervised contact with the children. The maternal grandmother (White Irish), suffered from psychotic illness throughout her life and is currently in hospital.

Amy and Kerry are also displaying sexualised behaviour and Christopher is vey aggressive. He has bitten the foster carer and has been excluded from school for hitting other children and sexual interference with another child.

Amy and Christopher are not doing well in school in any event. They are not learning and are shunned by the other children. The foster care finds faeces about the house and suspects it is Christopher, who has also been discovered hording food in his bedroom.

Kerry is showing signs of developmental delay. She does not give eye contact, she head bangs and does not like to be touched. She was extremely distraught to be removed from her mother and absolutely will not accept comfort from the foster carer, but occasionally will do so from Christopher and Amy.

USING THE SYSTEMIC THEORY AND ANSWER THE QUESTIONS BELOW

1. An exploration of the risk factors in the case scenario with reference to the appropriate literature on risk, safeguarding and assessment.​

2, A consideration of the legal and ethical issues that arise from this case

3. A critical exploration of one method of intervention that might be appropriate to use with this family and a consideration of its relative strengths and limitations​

4, A critical exploration of one theory or perspective that might help social workers understand individual family members or the family as a whole, and their particular circumstances​

5. A critical exploration of the family’s cultural background and the impact of any structural oppression and discrimination​

6. A consideration of any value issues this case raises for you

What is the diagnostic procedure for glucose tolerance?

ACTIVE LEARNING TEMPLATE:Diagnostic Procedure

STUDENT NAME _____________________________________

PROCEDURE NAME ____________________________________________________________________ REVIEW MODULE CHAPTER ___________

ACTIVE LEARNING TEMPLATES                                                                                                                                                                 TherapeuTic procedure A3

What is the distribution of the various immunoglobulins in an adult versus a fetus

How do the immunoglobulins “cooperate” with complement to clear a pathogen

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.

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 ?

Patient in this case study is an elderly woman that is currently experiencing weakness accompanied by a fever of 100^oF. 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:  

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?

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?

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.

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.

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.

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?

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?

What is NOT true of Ecological Models of Health Behavior?

• Why is the concept of organizational ethics important to health care organizations?
• Who should set them?
• What’s your experience with organizational ethics?
• Do you think a solid mission statement will help guide employees to act ethically? Does your organization have a mission statement and do you know it?

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?

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.

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?