A. Kelly Biermann is 91 years old. She is currently living in a long-term health community. Kelly has lived her life on a farm. She is very particular about eating everything natural and home grown. Her family researched nursing homes because they wanted to make sure that the facility they chose respected and followed Kelly’s life plan. Kelly has been declining in her health gradually. 1. What if…Kelly’s family wants to make sure Kelly is getting proper holistic care? What types of things can you, as the nurse, tell the family that the facilities provide to ensure the patient is having holistic care?

What are the key barriers in addressing social determinants of health? Provide some recommendations to address these barriers.

Answer the questions below

1)What are normal vital signs for an elderly client? 2)What are normal heart sounds? 3)Where do you listen for heart sounds? 4)Where would you listen for an apical heart rate and why would you listen for an apical heart rate? 5)What nursing interventions may be used to correct fever in the elderly client? 6)What can a client have while on a 2-gram sodium, low-cholesterol diet? Develop a meal plan: breakfast, lunch, and dinner with snacks and beverages.

Case Narrative

Case details given to participants (can be given freely or must be asked for by participants)

Patient Description& Chief complaint:

A 68-year-old woman is admitted with fever, nausea, vomiting, and abdominal pain. She informs you that she is a “borderline diabetic” and “only has to watch what she eats.” She tells you that she has not eaten for 3 days and has had difficulty “keeping liquids down.” While doing the nursing history, she describes her urine as dark and foul smelling. Upon further questions, she states she does have some burning upon urination. She describes her abdominal pain as constant, generalized, and rates it as a 5 or 6 on a scale of 0 to 10.

Weight: 75

Height: 183

History of Current Illness: 3 days

Pertinent Past Medical History: Diabetes Mellitus

Past surgical History: Free

Family/Social History: Free

Medication History Profile and Allergies: Nothing known about

Lifestyle: (occupation, diet, income, educational level, marital statues): Nothing known about

Critical thinking questions: -

Pre starting any scenario the student will prepare to answer the following questions: -

1. Doctor orders IV fluids and an antibiotic with first dose to be given STAT. You have not obtained urine specimen yet. Which has priority (e.g., starting IV, administrating antibiotic, or obtaining urine specimen) and why?

2. Three days later, client has following laboratory results: Hct = 39.2 and WBC = 10.8 × 103/mL3. What do those results indicate to you?

3. Abdominal x-ray shows a possible mass. An MRI of abdomen is ordered. Client is quite anxious because she has heard from her friend that procedure is difficult for people who are claustrophobic. How will you respond?

Scavenger Hunt
Think about the three domains of development: biosocial or physical, cognitive and psychosocial and how they propel growth throughout our lives.
Choose only ONE stage of development: Infancy/Toddler (birth to 2 years); Early Childhood (3 to 6 years) or School Age (6 to 12 years).
Hunt for 2 items that promote the growth and development in each of the three domains: Biosocial, Cognitive and Psychosocial.
Justify/explain why you chose each item. Specify how it fosters development in the domain you have identified it is compatible to. Use small cards and type at least 3 skills that each item help to develop.
It is important that each chosen item it is age appropriate for the stage of development you identified and it is also appropriate for the domain of development.
Materials

• 6 safe, age and domain appropriate items.
• 6 index cards . Write at least 3 skills for each item that it will help to develop.
• 3 zip lock bags (optional) to keep items organized for each domain.
• 1 grocery bag (optional) to keep all items organized for this assignment.  
  
  Once you have identified your items, think critically about why they complement that stage of development and how they further development in the domain you have chosen.
  Write at least 3 skills that they promote for each domain: for example markers help development of the fine motor skills and eye and hand coordination, as well as writing.

Choose items in good repair and in a working condition. The standard is:" what would you like to receive as a gift on your birthday ?"

Take clear pictures of each item. Identify the age group and the 2 items for each domain.

Write clear skills appropriate for each item.

This are the biophysical profile. How they scored by Assessment,Instrument and criteria?

1.Fetal heart rate
Assessment :
instrument:
criteria:

2.Fetal breathing
Assessment:
instrument:
criteria:

3.Fetal movement
assessment:
instrument:
criteria:

4.Fetal tone
assessment:
instrument:
criteria:

5.Amniotic fluid volume
assessment:
instrument:
criteria:

Which of the following may be employed to treat NCS? Select all that apply.

a)Mineralocorticoids

b)Disopryramide

c)Beta-adrenergic blockers

d)ACE inhibitors

e)Alpha agonists

f)Alpha antagonists

g)Compression stocking

h)counter-maneuvers

view the National Culturally and Linguistically Appropriate Services Standards (CLAS) categories aimed at equity and quality care (HHS, n.d.). Notice how these standards overlap with many of the expectations and standards in professional nursing practice!

• In what ways are you and your peers using these standards in your areas of nursing practice?
• Discuss one nursing action you might incorporate to improve cultural competence in your organizatio

Week 5: Case Study: Pharmacology

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.

Test I.
•Immune system causes tissue damage as it fights off a perceived threat also known as allergies.
A. hypersensitivity
B. autoimmune diseases
C. immunodeficiency
D. antibodies

•The following are immune-deficiencies EXCEPT?
A. AIDS
B. SCID Syndrome
C Type I Diabetes
D. none of the above

•Types of hypersensitivities are determined by their time course and whether ______ cell are the principal element involved.
A. B
B. A
C. T
D. all of the above

•The following are all autoimmune disease except:
A. myasthenia gravis
B. multiple sclerosis
C. anaphylaxis
D. rheumatoid arthritis

•An inflammation-causing signal released by mast cell at the site of an infection is:
A. an interferon
B. lymphatic fluid
C. histamine
D. mucus

Test II.

a. A client's immunization is up-to-date. What type of immunity does this provide to the client?
b. Do not search, differentiate the types of immunity
c. What your thoughts about the "concept of Immunity and Inflammation" (10 sentences)

this is a reflection on the process and new learning from clinical reasoning cycle (critically discuss the role of the nurse in facilitating self-efficacy and self-management for patients (and their families) living with a chronic condition in order to achieve improved health outcomes and quality of life. Use the best available scholarly evidence to support your discussion).

hello, I am writing an article why pharmacists need to be utilized as precribers in the U.S in effort to help accessibility for women to obtain birth control?

any thoughts based on evidence?
please provide reference of articles.

Write a letter scheduling a debriefing session with a person named John who has experienced an accident in the workplace.