Describe how pain is a subjective physical and psychosocial experience? How does the endocrine system affected when pain is present? I would like to know the answers explanation. Thank you.

A 65-year-old male admitted to the unit with a severe asthma attack. He has been experiencing shortness of breath since admission several hours ago. An ABG is ordered with these results:

Patient: Test Patient 1

Date:      April 10, 2007          1000

pH                   7.20

PaCO₂             58

HCO₃^-             24

Patient is in _____________________________________

Interventions may include: ________________________________________________

Classify and differentiate at least four types of stroke

Explain the pathophysiology and common clinical manifestations of Diabetes Mellitus Type 2

Case Study 139- Selecting a Birth Control Method

Difficulty: Beginning

Setting: Office or clinic

Index Words: contraception, birth control, oral contraceptives (OCs), injectable contraceptives, intrauterine device (IUD), natural family planning, condoms

Giddens Concepts: Reproduction

HESI Concepts: Sexuality/Reproduction

Name _________________________________       Class/Group _______________       Date _______________

Scenario

You are working in a busy obstetrics/gynecology (OB/GYN) office. The last patient of the day is P.B., a 27-year-old who is being married in 2 weeks. She wants to use birth control but is not sure what to choose. Her fiancé and she are both in graduate school and have limited health insurance, so she is anxious not to become pregnant right away. She asks you to review the various methods and help her explore what is best for her.

1. What factors influence the choice of the most appropriate method of birth control?

2. What past medical information will you need to obtain from P.B. and why?

3. What lifestyle information will help you aid P.B. in choosing a birth control method?

4. P.B. asks you about the effectiveness rating of available birth control methods. Describe the term efficacy.

5. What factors influence how effective a contraceptive method is?

6. Match the available contraceptive methods according to their efficacy ratings:

7. P.B. asks you to review the main advantages and disadvantages of the hormonal birth control methods first.

8. After reviewing the hormonal methods, you choose to discuss intrauterine devices. How would you describe the copper and levonorgestrel (Mirena) IUD systems to P.B.?

9. Next, you steer the conversation to barrier methods. What will you share with P.B. about the use of a diaphragm or cervical cap and condoms?

10. The major advantage of using a condom for birth control is that condoms:

1. Do not require monthly injections
2. Are easy to obtain and inexpensive
3. Reduce the risk for acquiring infections
4. Come in assorted styles, shapes, and textures

11. Describe what you would tell P.B. about the natural family planning method.  

12. P.B. wants to know about the associated costs with each method because she is on a tight budget. How would you respond?

13. She asks you which method you would pick. What do you tell her?

CASE STUDY PROGRESS

P.B. comes back in a week and tells you that she can get a low-cost oral contraceptive (OC) through a local store. You convey this information to the nurse practitioner, who examines P.B. and writes a prescription for a biphasic 28-day pill pack containing ethinyl estradiol and norethindrone. You are asked to discuss the use of the OC pill with P.B.

14. Explain how biphasic OC pills work.

15. When should P.B. take her first OC?

16. You tell P.B. that is does not matter what time of day she takes the OC, just that she takes it at the same time each day. Describe 3 suggestions you can offer to help her remember to take her pill.    

17. What should you tell her about missed pills

Amnah is a 55-year-old female patient who has been admitted to the medical ward with acute shortness of breath, chesty cough, wheezing and chest discomfort. Amnah’s vital signs were: SpO2 82% on room air, BP 150/90 mmHg, Pulse 110 beats/min, RR 28 breaths/min, and Temperature 38.7 °C. Amnah has a history of COPD and hypertension for 15 years. She was also diagnosed with heart failure 2 years ago. While doing the physical examination, the patient seemed to use her accessory muscles and have cyanosis in the lips and nose. She also started to get mixed up during the nursing assessment as she could not figure out that she was in the hospital. Amnah also complaint of weakness and fatigue and her lower limbs were very edematous. After a medical review, ABG was taken, CXR was done and venous blood samples were sent for complete blood count, chemistry and culture and sensitivity. Amnah’s lab results were as follows: Chemistry Potassium Chloride BUN Patient Value 148 4.4 68 streptococcus pneumoniae 7.8 Normal Values 136-146 mmol/L 7-22 mg/dl ABG & CXR Sodium pH 7.25 PaO2 49mm Hg PaCo2 58mm Hg HCO3 27mEq/L 106 3.5-5.3 mmol/L 98-108 mmol/L Creatinine 1.66 0.7-1.5 mg/dl Blood culture and sensitivity 8.9-10.3 mg/dl CXR: opacity of right lower loop with consolidation and pleural effusions with cardiomegaly Calcium Phosphorus 10.4 Hemoglobin 321 14.5 2.6-6.4 mg/dl Alkaline Phosphatase 30-110 IU/L 14-17 gm/dl Based on the medical review and the diagnostic tests results, Amnah was mainly diagnosed with impaired respiratory functions. She was also found to have some cardiac and renal abnormalities. The doctor ordered immediate treatment and requested very close monitoring of Amnah.

1. Suggest one main medical diagnosis for Amnah and give one rational behind your suggestion.

B. Explain why would you have chosen to use this treatment?

C. Identify two clinical symptoms that support the ABG results of Amnah.

4. Amnah was diagnosed with health issues other than respiratory.

Identify two of these issues and give one diagnostic finding for each.

4. You are the nurse looking after Amnah. Explain five immediate nursing interventions.

5. Name three complications that Amnah must be monitored for.

You are a nurse on an inpatient psychiatric unit. J.M., a 23-year-old woman, was admitted to the psychiatric unit last night after assessment and treatment at a local hospital emergency department for "blacking out at school." She has been given a preliminary diagnosis of anorexia nervosa. As you begin to assess her, you notice that she has very loose clothing, she is wrapped in a blanket, and her extremities are very thin. She tells you, "I don't know why I'm here. They're making a big deal about nothing:' She appears to be extremely thin and pale, with dry and brittle hair, which is very thin and patchy, and she constantly com-
plains about being cold. As you ask questions pertaining to weight and nutrition, she becomes defensive and vague, but she does admit to losing "some" weight after an appendectomy 2 years ago. She tells you that she used to be fat, but after her surgery she didn't feel like eating and everybody started commenting on how good she was beginning to look, so she just quit eating for a while. She informs you that she is eating lots now, even though everyone keeps "bugging me about my weight and how much I eat." She eventually admits to a weight loss of "about 40 pounds and I'm still fat."

1.Provide two nursing diagnosis and interventions along with objective data and short term and long term goals.

2.sbar

Disciplinary Process File Complaint Include in detail the process of filing a complaint. Process of an Investigation Describe in detail the process of the investigation. Process of a Hearing Describe in detail the process of a hearing. Types of Disciplinary Actions Do not simply list the types of disciplinary actions but include an explanation and/or example of each. New Mexico Board of nursing.

Nurse Practice Act This section should describe in detail the Nurse Practice Act (NPA) including what specifically it is and what its purpose is. Furthermore, please explain if there is one overall NPA or if they differ from state to state. The purpose and what it is should be specific to New Mexico (NM). Again, a minimum of one in-text citation is necessary for this section.

1. Describe how you can make mealtime more conducive to eating and more pleasant for the patient.

2. What can you do to help increase nutritional intake for the patient with a limited appetite?

3. Why is ensuring intake and output balance pertinent?

4. Describe the differences between a clear liquid and full liquid diet.

5. Explain what “advance as tolerated” means in relation to a diet order.

6. Why is it important to educate patients about potential food–drug interactions?

Identify 3 ethical and 3 legal issues regarding Genomics ? with examples?

Genomic services provided for gaining a better understanding of the interactions between genes and the environment but there are legal and ethical concerns ? given.3 examples for.possible legal issues related and 3 examples.for Ethical issues?

Based on your readings, consider the various leadership models described in your text. In light of the complexity of health care today, select one of the models that you feel is best suited to navigate this challenging environment. Briefly describe the model and why you feel it is best suited.

Consider various staffing issues such centralized and decentralized staffing, informal and formal networks, and the importance of forming relationships, networks and alliances within the health care delivery system. Describe the importance of these within your role as a future health care manager/leader and identify some key advantages/disadvantages associated with each.

Assess motivational factors, differentiate between intrinsic and extrinsic motivation. Identify factors that produce job dissatisfaction. Identify factors that motivate you and factors that have led to job dissatisfaction for you.