Questions
What a good example of issue or problem to implement Kurt Lewin change management theory (unfreeze,...

What a good example of issue or problem to implement Kurt Lewin change management theory (unfreeze, change, and refreeze). Please provide references, thanks.

In: Nursing

Gary is an accounting major at a local college. At one point in his childhood, he...

Gary is an accounting major at a local college. At one point in his childhood, he was overweight. Other children teased him and called him “fatty hatty.” This made a deep impression on Gary, negatively effecting his self-esteem. In middle school, he felt isolated and was described as a “loner” by teachers. He did not join any clubs or engage in activities with peers.
In high school, his physical education teacher encouraged Gary to join the wrestling team. He thought Gary’s weight would not matter in this event. But, they needed a wrestler at a lower weight class. Gary’s coach encouraged him to lose weight and told the other boys on the team that they were counting on Gary. Gary felt significant peer pressure to make it to the lower weight class, and he really enjoyed wrestling. He began a strict diet after the coach has checked with his parents. He was eating lean protein and vegetables, some fruit, and drinking lots of water. He lost weight, and he was really good at wrestling. In fact, he lost enough weight to go down two weight classes and do a good job for his team. His identity, in high school, was totally wrapped up in wrestling. He still was quiet and shy and did not express much with peers, but he appeared happier and to have finally found a place for himself.
Gary was not able to make his college wrestling team, and he was sad. Also, he was finding it was difficult to socialize with others. He was still feeling like he was fat, even though, after all the dieting, he was quite thin. He was having difficulty losing more weight, and he turned to laxatives to help him lose weight. He was now significantly underweight. He eats one meal a day and exercises at least 90 minutes a day, often doing heaving cardio (e.g., running and jumping rope). He has a stress fracture in his ankle and is still jumping rope as part of his exercise regimen. Gary was recently diagnosed with anorexia nervosa, he is 30 pounds underweight.
Please answer the five questions about this case:
1. What are symptoms related to Anorexia Nervosa? List at least five symptoms related to Anorexia Nervosa.
2. Nutrition therapy is recommended in the treatment of Anorexia Nervosa. What are some ideas that you might have for nutrition therapy or improving nutrition for Gary? Also, address some ideas you might have for gaining Gary’s trust as this can be critical for nutrition therapy.
3. Gray faced teasing when he was younger and faced a weight stigma. What are your ideas for helping him cope with the after-effects of this weight shaming and the stigma he faced as a youngster? Do you thin our culture in America, emphasizes a “thin ideal?” Are there other body “ideals” for men (such as being muscular and athletic)? How can we combat these ideals?
4. Discuss some questions you can ask to determine if a client has an eating disorder. What might be a first step if you have a client you suspect has an eating disorder (i.e., whom is a referral source and whom could you try to contact)?
5. Should Gary continue his heavy exercise regimen? What type of education does he need in this area? What might you recommend for Gary, in terms of exercise?

In: Nursing

3. What is cachexia? 4. What are some oral or digestive side effects of chemotherapy? (i.e....

3. What is cachexia?

4. What are some oral or digestive side effects of chemotherapy? (i.e. metallic taste)

In: Nursing

Key terms Definitions Applicability Examples Comparing Epi Studies of Disease Etiology and Epi Research Evaluating Effectiveness...

Key terms

Definitions

Applicability

Examples

Comparing Epi Studies of Disease Etiology and Epi Research Evaluating Effectiveness of Health Services

Screening for Neuroblastoma

Mediator variable

Independent variable

Dependent variable

Randomized designs

In: Nursing

What is a geographic maldistribution? In addition to the National Health Services Corps, what other recommendations...

What is a geographic maldistribution? In addition to the National Health Services Corps, what other recommendations do you have to promote the equal distribution of physicians across the United States?

In: Nursing

Explain the benefits of public health practitioners using cultural competence and the harms of public health...

Explain the benefits of public health practitioners using cultural competence and the harms of public health practitioners not using cultural competence in practice as related to this issue and population.

In: Nursing

How can legislation be an intervention? How can legislation impact on nutrition professional?

How can legislation be an intervention?

How can legislation impact on nutrition professional?

In: Nursing

What do you think is the best media method for Communicating Effectively with Patients, and why ?

 

PHC 212

What do you think is the best media method for Communicating Effectively with Patients, and why ?

In: Nursing

periodontal clinic simulation sessions reflection 1. What made this rotation a worthwhile experience? 2. How did...

periodontal clinic simulation sessions reflection

1. What made this rotation a worthwhile experience?

2. How did you achieve the learning and enrichment objectives?

3. What are the changes in your perceptions, abilities, beliefs or skills that are a result of the rotation?

4. Which cultural influences played a role in patient oral health at this rotation?

5. How did you manage any ethical dilemmas you experienced?

6. What inter-professional collaboration occurred at this rotation?

7. How does this experience contribute to your professional growth as a future dental hygienist?

8. What are your suggestions on how this rotation could be improved?

In: Nursing

A 2-month-old child is admitted to the ICU with fever, hypotension, tachycardia, and lethargy. The medical...

A 2-month-old child is admitted to the ICU with fever, hypotension, tachycardia, and lethargy. The medical history is notable for a similar hospitalization at 2 weeks of age. Physical examination is notable for a temperature of 102°F, oral thrush and rales in the right lung fields. Chest x-ray film reveals multilobular pneumonia. Given the history of recurrent severe infection, the pediatrician suspects an immunodeficiency disorder.

Explain the terms tachycardia, rales, and multilobular pneumonia.
What is the most likely immunodeficiency in this child? Why?
What is an underlying biochemical (genetic) defect in this patient?
Explain why this defect leads to the disease phenotype?
Explain the cellular defects associated with this disease?
What is the overall prognosis for patients with this disorder?

In: Nursing

Public Health: What are the two ways to determine if the outcomes chosen for measurement are...

Public Health:

What are the two ways to determine if the outcomes chosen for measurement are actually relevant?


In: Nursing

What do CHW's do and where are they employed? 2. What does Title VI of the...

  1. What do CHW's do and where are they employed?

2. What does Title VI of the Civil Rights Act of 1964 require?

3.What are some issues that can arise with the use of ad hoc interpreters?

In: Nursing

Your patient is an active 80-year-old woman with heart failure and chronic atrial fibrillation. You are...

Your patient is an active 80-year-old woman with heart failure and chronic atrial fibrillation. You are taking an angiotensin-converting enzyme inhibitor, a beta-blocker, a diuretic, and digoxin. During her evaluation, she tells him that she felt very dizzy this morning.

How would you approach your evaluation and why?

Identify some of the key evaluation factors.

What nursing interventions are necessary?

How would you change your evaluation and interventions if your patient also had chronic obstructive pulmonary disease and kidney failure?

In: Nursing

Read the following case study, then answer the questions that follow. Akot is an aged care...

Read the following case study, then answer the questions that follow.

Akot is an aged care coordinator. He conducts an assessment of Mrs. Brown using a falls assessment tool. Mrs. Brown tells him she is extremely confident she will not fall when carrying out all activities of daily living, circling 10 in response to all of the questions on the scale.

Later, Akot observes Mrs. Brown and notes she moves quite slowly and maintains contact with the handrail while walking down the corridor. A worker, Frank, tells Akot that Mrs. Brown has experienced episodes of incontinence as she waits until the last minute to go to the toilet.

Akot discusses his concerns with his supervisor to seek direction on what should happen next.

Question

  1. What indications are there that Mrs. Brown is at risk?
  2. What may have prevented Mrs. Brown from answering the falls assessment questions honestly?
  3. Describe the actions Akot should take in relation to his duty of care.

In: Nursing

C.O. is a 43-year-old woman who noted a nonpruritic nodular rash on her neck and chest...

C.O. is a 43-year-old woman who noted a nonpruritic nodular rash on her neck and chest about 6 weeks ago. The rash became generalized, spreading to her head, abdomen, and arms, and was accompanied by polyarticular joint pain and back pain. About 2 weeks ago, she experienced three episodes of epistaxis in 1 day. Over the past week, her gums became swollen and tender and she was severely fatigued. Because of the progression of symptoms, she sought medical attention. Lab work was done, and C.O. was directly admitted to the hematology/oncology unit under the care of a hematologist for diagnostic evaluation. Skin biopsy showed cutaneous leukemic infiltrates, and bone marrow biopsy showed moderately hypercellular marrow and collections of monoblasts. Her lumbar puncture specimen was free of blast cells. The final diagnosis was acute myeloblastic leukemia.
C.O. is to begin remission induction therapy with cytarabine 100 mg/m2/day as a continuous infusion for 7 days and idarubicin 12 mg/m2/day IV push for 3 days. She is scheduled in angiography for placement of a triple-lumen subclavian catheter before beginning her therapy.
Laboratory Test Results
Complete Blood Count (CBC)
White blood cells (WBCs) 39,000/mm3 (39 x 109/L)
Monocytes 64%
Lymphocytes 15%
Neutrophils 4%
Blasts 17%
Hemoglobin (Hgb) 10.4 g/dL (104 g/L)
Hematocrit (Hct) 28.7%
Platelets 49,000/mm3 (49 x 109/


CASE STUDY PROGRESS
On the ninth day of continuous infusion of chemotherapy, the UAP reports C.O.’s vital signs to you.
Vital Signs
BP 110/54 mm Hg
Heart rate 115 beats/min
Respiratory rate 26 breaths/min
Temperature 101.6° F (38.7° C)



CASE STUDY PROGRESS
Your assessment findings are unremarkable and you notify the intern on call of C.O.’s vital signs. After evaluating C.O., the orders shown in the chart are written.
Physician’s Orders
Blood cultures now × 2 sites
CBC with differential now
Acetaminophen suppository 650 mg q4-6h prn
Imipenem/cilastatin sodium 500 mg IV piggyback q8h
Notify hematologist for temp over 100.0° F (37.8° C)


Laboratory Test Values
WBCs 1200/mm3 (1.2 x 109/L)
Monocytes 25%
Lymphocytes 65%
Neutrophils 5%
Blasts 5%
Bands 0%
Hgb 6.8 g/dL (68 g/L)
Hct 21.3%
Platelets 17,000/mm3 (17 x 109/L)


10. Considering the previous data, what blood products will most likely be given to C.O.?

CASE STUDY PROGRESS
With continued blood product support and antibiotic coverage, C.O. is able to complete 14 days of therapy and a bone marrow biopsy shows she is in complete remission. HLA typing has been done on all her siblings. Her oldest brother is a perfect HLA match and has agreed to donate bone marrow. C.O. is being discharged with plans to readmit her to the bone marrow transplant unit within the next few weeks.

11. What does “complete remission” mean for C.O., and what effect did it have on the decision to perform a bone marrow transplant?

12. What type of bone marrow transplant will she have? Briefly describe this transplant process.

13. Name 4 priority problems C.O. will face in undergoing a bone marrow transplant. Put a star next to the most important priority

14. What is the most important intervention post-transplant?
A. Giving analgesics for postprocedural pain
B. Monitoring for signs of infection and bleeding
C. Weighing her daily and offering small, frequent meals
D. Offering emotional support to C.O. and her family during recovery
15. What type of isolation will C.O. need? Outline the guidelines for maintaining this type of isolation.

16. Undergoing a bone marrow transplant is challenging. Describe how you would provide emotional support to C.O. and her family.

17. Name 3 complications C.O. will be at risk for after the transplant.

18. Describe graft-versus-host disease.

19. True or false. If the transplanted cells do not engraft, C.O. will die unless another transplant is tried and successful. Defend your response.

In: Nursing