A. Discuss the difference between a disability and a handicap and provide examples.

B. Describe the principles that a nurse should follow when he or she is caring for persons with disabilities.

c. Identify factors that most likely to contribute to homelessness.

d. Identify risk factors for suicide and how will the nurse assess a client at risk for suicide

Consider this theory: Papadopoulous and Taylor Model for Transcultural Nursing and Health and in a 2-4 page paper answer the below questions:

1. Who created the theory?
2. When was this theory created and what was the circumstances of its need for creation?
3. What are the main components of the theory?
4. Apply this theory directly to a scenario you have experienced (or read about) with patient care (direct or indirect).
5. Is this theory applicable to your current work environment? Explain.
6. How does the theory influence transcultural nursing practice?
7. How do transcultural nurses move cultural care to the forefront of nursing practice using the components of the theory?

Why is the concept of family health important? Consider the various strategies for health promotion. How does a nurse determine which strategy would best enable the targeted individuals to gain more control over, and improve, their health?

John Lopez, 36 years old, was a passenger in a car that was rear-ended while stopped at a red light. The vehicle that hit the car was traveling 40 mph on impact. Mr. Lopez was not wearing a seatbelt. Mr. Lopez's wife, who was driving the car and wearing a seatbelt, was not injured.

Mr. Lopez was taken to the Emergency Department (ED) of your facility where he was intubated and stabilized. Three-view spinal x-rays (anteroposterior, lateral, and odontoid views) and computed tomography (CT) scan revealed a C4-C5 spine fracture with displacement and spinal cord compression.

Skeletal traction with weights was applied with cervical tongs to reduce the fracture and realign the spine.

Answer the following questions:

1. Why do you think that Mr. Lopez was intubated and put on a ventilator?

2. What complications is Mr. Lopez at risk for in the first week after his injury? How can the nurse mitigate those risks?

3. What is autonomic dysreflexia? How can the nurse prevent it and/or treat it?

Problem #1

A patient newly diagnosed moderate asthma receives prescriptions for a metered dose inhaler (MDI) of albuterol and a dry powder inhaler containing the combination of salmeterol and beclomethasone.

· How do the uses of these two prescriptions differ from each other? What are the consequences of overusing each?

Assume the patient was in a hurry one morning, inadvertently grabbed her dry powder inhaler, and left her albuterol MDI at home. Later that day while at a friend’s house, she began feeling tightness around her chest and shortness of breath, which she correctly deduced were the initial phases of an impending asthma attack.

· If the patient confused her two prescriptions and attempted to use her salmeterol/beclomethasone inhaler as rescue therapy, what would you anticipate happening?

Create a 7-day dinner menu that meets recommendations by the Dietary Guidelines. Include serving sizes, and identify any allergen restricted from the menu i.e. milk--

Bariatric Surgery Case Study

Mr. McKinley is admitted for a Roux-en-Y gastric bypass surgery. He has suffered from type 2 diabetes mellitus, hyperlipidemia, hypertension, and osteoarthritis. Mr. McKinley has weighed over 250 lbs since age 15 with steady weight gain since that time. He has attempted to lose weight numerous times but the most weight he ever lost was 75 lbs, which he regained over a two-year period. He had recently reached his highest weight of 434 lbs, but since beginning the preoperative nutrition education program he has lost 24 lbs.

Height: 5'10" Weight: 410 lbs

McKinley, Chris, Male, 37 y.o. wt

Allergies: NKA

Pt. Location: RM 703 Admit Date: 2/23

Patient Summary: Patient is a morbidly obese 37-year-old white male who is admitted for Roux-en-Y gastric bypass surgery tomorrow morning. Patient has been obese his entire adult life with highest weight 6 months ago at 434 lbs. He has lost 24 lbs since that time as he has been attending the preoperative nutrition program at our clinic.

History:

Onset of disease: Lifelong obesity

Medical history: Type 2 diabetes mellitus, hypertension, hyperlipidemia, osteoarthritis

Surgical history: R total knee replacement 3 years previous

Medications at home: Metformin 1000 mg/twice daily; 35 u Lantus pm; Lasix 25 mg/day; Lovastatin 60 mg/day

Tobacco use: None

Alcohol use: Socially, 2–3 beers per week

Family history: Father: Type 2 DM, CAD, Htn, COPD; Mother: Type 2 DM, CAD, osteoporosis

Demographics:

Marital status: Single

Number of children: 0

Years education: Associate’s degree

Language: English only

Occupation: Office manager for real estate office

Hours of work: 8-5 daily—sometimes on weekend

Household members: Lives with roommate

Ethnicity: Caucasian

Religious affiliation: None stated

Admitting History/Physical:

Chief complaint: “I am here for weight-loss surgery.”

General appearance: Obese white male

Case Questions

1. Discuss the classification of morbid obesity.

2. Describe the primary health risks involved with untreated morbid obesity. What health risks does Mr. McKinley present with?

3. What are the standard adult criteria for consideration as a candidate for bariatric surgery? After reading Mr. McKinley’s medical record, determine the criteria that allow him to qualify for surgery.

Understanding the Nutrition Therapy

4. On post-op day one, Mr. McKinley was advanced to the Stage 1 Bariatric Surgery Diet.

This consists of sugar-free clear liquids, broth, and sugar-free Jell-O. Why are sugar-free foods used?

5. Over the next two months, Mr. McKinley will be progressed to a pureed-consistency diet with 6–8 small meals. Describe the major goals of this diet for the Roux-en-Y patient. How might the nutrition guidelines differ if Mr. McKinley had undergone a Lap-Band procedure?

6. Mr. McKinley’s RD has discussed the importance of hydration, protein intake, and intakes of vitamins and minerals, especially calcium, iron, and B12. For each of these nutrients, describe why intake may be inadequate and explain the potential complications that could result from deficiency.

III. Nutrition Assessment

7. Assess Mr. McKinley’s height and weight. Calculate his BMI and % usual body weight. What would be a reasonable weight goal for Mr. McKinley? Give your rationale for the method you used to determine this.

8. After reading the physician’s history and physical, identify any signs or symptoms that are most likely a consequence of Mr. McKinley’s morbid obesity.

9. Identify any abnormal biochemical indices and discuss the probable underlying etiology. How might they change after weight loss?

10. Determine Mr. McKinley’s energy and protein requirements to promote weight loss. Explain the rationale for the method you used to calculate these requirements.

IV. Nutrition Diagnosis

11. Identify at least two pertinent nutrition problems and the corresponding nutrition diagnoses.

V. Nutrition Intervention

12. Determine the appropriate progression of Mr. McKinley’s post-bariatric-surgery diet. Include recommendations for any supplementation that you would advise.

13. Describe any pertinent lifestyle changes that you would view as a priority for Mr. McKinley.

14. How would you assess Mr. McKinley’s readiness for a physical activity plan? How does exercise assist in weight loss after bariatric surgery?

VI. Nutrition Monitoring and Evaluation

15. Identify the steps you would take to monitor Mr. McKinley’s nutritional status postoperatively.

Write a response on a Professional Issue within Nursing of your choosing. Select a minimum of two (2) research articles from scholarly, peer-reviewed (refereed) journals regarding the Professional Issue and its relevance to current nursing practice. The assignment can compare and contrast the different sides to an issue, provide support to one side of an issue, or to create an action plan of how to manage a situation. Use critical thinking to analyze and evaluate the issue chosen. The articles must be current to within the past seven (7) years.

Some examples of Professional Issues within Nursing include, but are not limited to: • Access to healthcare • Nurse to Nurse Bullying • Disparities in healthcare • Health insurance coverage, health care financial concerns or fiscal responsibility • Importance of orientation to retention of nurses • Infections (CAUTI, sepsis), staffing needs, and scheduling practices and other safety concerns • Malpractice or other legal responsibilities • Withdrawing treatment vs. Advanced directives and other ethical concerns • The move toward more community care and other community concerns • Ideas on how to deal with conflict or have difficult discussions, how to use therapeutic communication in the workplace, giving specific examples.

Identify differences between resources and access to care, limitations etc related to minor care and adult care when it comes to Diabetes diagnosis?

Identify the transition from child related treatment into the adult health care system. Reference resources like hospital or outpatient programming related to your area. Address negative behaviors you might see related to a minor having a chronic disease as well as behaviors as an adult?

Describe the philosophical beliefs that drive quantitative research (positivists paradigm). How do these philosophical beliefs shape quantitative research?

Please be detailed- this is in regards to nursing research.

Name 3 causes of infant mortality. For each cause, suggest 2 or more public health measures aimed at reducing that risk. Discuss the barriers for achieving health equity for each cause.

Describe an injury that you, or your family member has sustained. Analyze the injury using host, agent, and environment.

Bridget is a 39 year-old female G1P0 and 24 weeks gestation with a history of Type II diabetes mellitus, who presents to her prenatal appointment for a routine scheduled visit. Her BMI is 34 and her most recent Hemoglobin A1C 9%. When discussing her recent A1C results, Bridget admits to being noncompliant in her diabetic treatment. Prior to her pregnancy Bridget managed her diabetes by taking Glyburide 5mg daily and diet control. As a result of Bridget’s history of noncompliance and an increase in her A1C, the physician switched her to insulin for the remainder of her pregnancy.

1. Identify the primary goal when caring for a pregnant woman with pregestational diabetes. (3 points)

2. Explain the standard of care in monitoring blood glucose levels in pregnancy. (2 points)

3. As the nurse, how would you counsel Bridget about her diabetes, regarding her noncompliance? (5pts)

4. Explain two (2) fetal and/or neonatal risks and complications associated to the mother’s poor management of her blood glucose levels. (5 points)

A student nurse is preparing a paper on coronary artery disease, including the risk factors and the clinical presentation. The paper must include a review of common antianginal agents: nitrates, beta-blockers, and calcium channel blockers.

1. What are the therapeutic actions, indications, and pharmacokinetics for nitroglycerin?
2. What are the indications and pharmacokinetics for metoprolol?
3. What are the therapeutic actions for diltiazem?
4. What are the considerations for the older adult for the use of antianginal agents?
5. What are the important teaching points for patients receiving antianginal nitrates?