Hepatitis B Virus:

1. Describe the viral architecture

2. Nucleic acid composition

3. Enveloped or non-enveloped?

4. Host(s)? How does the virus gain entrance to host?

5. Mode of transmission(s)?

6. Organ System(s) affected?

7. Symptoms of viral disease.

8. Treatments?

9. Acute or persistent infection and why?

A guarantee of a right to healthcare hinges on the notion of justice and on the nature and extent of the “social contract” upon which a society agrees. First, contrast the libertarian and contractarian views of the social contract. Then, discuss what conclusions each of these perspectives reaches about the possibility of a right to healthcare.

John Summers is an office manager at Hillcrest Family medicine. The physicians at the office have voiced concern to John regarding the lack of professionalism among the office staff. They have asked John to conduct a staff meeting to focus on the importance of professionalism. The physicians have asked John to highlight five qualities of a professional in the health care setting. They have also asked John to create a dress code policy so that all employees project a professional image.

1. What five qualities do you think John should choose to discuss during the staff meeting? Explain why?
2. How might John go about creating a uniform dress code? What items might he want to include in the new policy?

what are nursing consideration for possible electrolyte disturbances and dehydration related to diarrhea in children

• Identify 1 resource in your community (new york) that addresses the chronic disease management needs of the population.
• Who is involved in this community-based model for the care of adults? MDs, RNs, dieticians?
• Describe the role of nurses in this community-based model of care.

A 5-year-old child who had been receiving dialysis treatments has undergone renal transplant and will now be taking prednisone. The parents are hopeful the child's development and overall health will normalize. The nurse should inform the parents that taking prednisone can result in some similar adverse effects as living with chronic kidney disease (CKD). Which effects should the nurse include? Select all that apply.

When explaining the role of the proximal tubule in terms of medication administration, the nursing instructor will emphasize that which medications are bound to plasma proteins and require the proximal tubule secretion of exogenous organic compounds to help with filtration? Select all that apply.

You are caring for a client who is being treated for pneumonia. You suspects the client has developed pleuritis. Which assessment findings support the your suspicion of pleuritis? Select all that apply.

A client diagnosed with a cerebrovascular accident (CVA) 5 months prior is now experiencing episodes of urinary incontinence. The client asks, "Why is this happening?" Which statement best captures the facts that would underlie the answer to this question?

You are in the respiratory unit of a hospital is providing care for a client with end-stage lung disease. Consequently, measurement of the client's arterial blood gases indicates increased PCO₂. Which associated consequence would the nurse anticipate?

You are caring for a client in emergent fluid overload requiring rapid diuresis. Which diuretic should the nurse be prepared to administer?

You are planning the care for a client with acute kidney injury (AKI). What should the nurse prioritize in the client's plan of care? Select all that apply.

Which individual is at the highest risk of developing a urinary tract infection (UTI)?

A dialysis technician is reviewing a textbook on kidney function. The technician would recognize which statements as characteristic of healthy kidneys? Select all that apply.

You are creating a care plan for a premature infant with respiratory distress syndrome. Which aspects of care should the nurse include in the plan? Select all that apply.

Which phenomenon is most likely occurring during a child's alveolar stage of lung development?

A client has a ureteral calculi in the proximal region. The nurse is planning to educate the client about the treatment of choice for removal of the stone in this location. For which intervention will the nuse eucate the client?

An older adult client is admitted with a stroke and has developed pneumonia. While auscultating the right lateral thorax, the nurse hears abnormal breath sounds. Which lobe of the lung is likely effected due to obstruction by thick secretions?

A patient has an IV of 0.9% Sodium Chloride infusing at 150 ml/hour. The patient weighs 160.6 pounds. How many milligrams/kilograms (mg/kg) of sodium choride will the patient receive in your 12-hour shift? Round to the nearest whole number.

The physician orders Solumedrol 55 mg/m² IVP. The patient weighs 140 pounds and has a body surface area of 1.9 m². The medication is provided in 5 ml vial with a strength of 25 mg/ml. What volume of medication will you administer? Round to the nearest tenth.

The patient is to receive an analgesic elixir that contains gr ¼ morphine per 5 ml. How many milligrams (mg) of morphine would be contained in 4 ml of the elixir?

The physician orders, "Metbur Suspension, 50 mg, orally, twice daily." The label states, "Metbur Suspension 1:500." What volume (ml) will the nurse administer?

Gastrointestinal Disorders.

T.H., a 57-year-old stockbroker, has come to the gastroenterologist for treatment of recurrent mild to severe cramping in his abdomen and blood-streaked stool. You are the registered nurse doing his initial workup. Your findings include a mildly obese man who demonstrates moderate guarding of his abdomen with both direct and rebound tenderness, especially in the left lower quadrant (LLQ). His vital signs are 168/98, 110, 24, 100.4° F (38° C); he is slightly diaphoretic. T.H. reports that he has periodic constipation. He has had previous episodes of abdominal cramping, but this time the pain is getting worse. Past medical history reveals that T.H. has a "sedentary job with lots of emotional moments," he has smoked a pack of cigarettes a day for 30 years, and he had "two or three mixed drinks in the evening" until 2 months ago. He states, "I haven't had anything to drink in 2 months." He denies having regular exercise: "just no time." His diet consists mostly of "white bread, meat, potatoes, and ice cream with fruit and nuts over it." He denies having a history of cardiac or pulmonary problems and has no personal history of cancer, although his father and older brother died of colon cancer. He takes no medications and denies the use of any other drugs or herbal products.

. 1. Identify four general health risk problems that T.H. exhibits.

2. Identify a key factor in his family history that might have profound implications for his health and present state of mind.

3.The physician ordered a KUB (x-ray study of the kidneys, ureters, and bladder), complete blood count (CBC), and complete metabolic profile. Based on x-ray and laboratory findings, physical examination findings, and history, the physician diagnoses T.H. as having acute diverticulitis and discusses an outpatient treatment plan with him. What is diverticulitis? What are the consequences of untreated diverticulitis?

4.While the patient is experiencing the severe crampy pain of acute diverticulitis, what interventions would you perform to help him feel more comfortable?

5. What is the rationale for ordering bed rest?

T.H. is being sent home with prescriptions for metronidazole (Flagyl) 500mg PO q6h, ciprofloxacin (Cipro) 500mg PO q12h, and dicyclomine (Bentyl) 20mg 4 tomes per day for 5 days.

6.For each medication, state the drug class and the purpose for T.H.

7.Given his history, what questions must you ask T.H. before he takes the initial dose of metronidazole? State your rationale

8.What is a disulfiram reaction?

9. What are the signs and symptoms of an allergic reaction

1.  Describe in point form what happens in the assessment, diagnosis, planning, implementation and evaluation stages of the nursing process.

2.  Provide a brief explanation of what data clustering is?

3. Provide one open ended question and one closed ended question that could be used in a client assessment interview?

Q: Write a paper analyzing a current issue impacting the health of the aging population worldwide?

The required answer is to "choose a health problem in the elderly such as nutritional deficiencies or osteoporosis problems" and explain it in an analytical way in general and how impacting the health of the aging population

Please Avoid Plagiarism , Don't use handwriting.

Please Do not copy and paste

Due Date: October 10, 2020

It should short essay (250-500 words)

Natalie Rodriguez is a clinical nurse on a 65-bed oncology unit in a large teaching hospital in Phoenix, Arizona. She is a new graduate from a baccalaureate nursing program and strives to provide the best possible care to each of her clients. Nurse Rodriguez checks in on a 90-year-old patient, Mrs. Marting, who has pancreatic cancer. She has only one granddaughter, Allie, to come visit and stay with her for long hours each day, and the two are very close. Mrs. Marting has said she does not want any resuscitation measures, but when Nurse Rodriguez offers her DNR forms to sign, she waves them away. “I’m too sick right now, dear,” she says. “Let me deal with paperwork some other time.” In the meantime, Nurse Rodriguez has other patients she must attend to, but even as she tries to perform other tasks, Mrs. Marting’s wishes are on her mind. However, before she can return to Mrs. Marting and Allie, Dr. Daly arrives on the unit with a list of demands. Dr. Daly has a reputation for wanting “what I want when I want it,” and he asks Nurse Rodriguez to complete a laundry list of tasks that are not particularly patient-centered. She is restocking a supply cabinet, at his request, when Allie calls for help. Dr. Daly gets to Mrs. Marting’s room first and by the time Nurse Rodriguez arrives, Allie is begging the doctor to “do whatever it takes to save my grandma!” Mrs. Marting has undergone cardiac arrest. Nurse Rodriguez explains Mrs. Marting’s wishes, but Allie says, “I know, but I don’t care now! Just save her!” and Dr. Daly starts resuscitation.

1. Nurse Rodriguez is devastated by Dr. Daly’s choice and wonders what she could have done to stop resuscitation, which has broken one of Mrs. Marting’s ribs. “I don’t ever want to see that happen to one of my patients if I have anything to say about it,” she says. What kind of stress is Nurse Rodriguez experiencing, and which category of obstacle created it?
2. Nurse Rodriguez has said that she does not want that to happen to any of her patients again, if she can do anything to prevent it. What stage or phase of the “change process” outlined by the AACN is she most strongly associating with, and what, if anything, should she do first before acting on it?

Why are good data essential to sound decision making, both clinical and business related

You have a fellow student with a history of stress incontinence. While sitting in the classroom someone states a funny joke and they start laughing so hard they “pee their pants”? What should be done to help this student? What is stress incontinence, the symptoms associated with it and who is at risk for having it? How do we treat this disorder?

Scenario

M.D. is a 50-year-old woman whose routine mammogram showed a 2.3- × 4.5-cm lobulated mass at the 3 o’clock position in her left breast. M.D. underwent a stereotactic needle biopsy and was diagnosed with invasive ductal carcinoma, estrogen and progesterone receptor positive, HER-2 negative. The staging workup was negative for distant metastasis. Her final staging was stage IIB. She had a modified radical mastectomy with axillary lymph node dissection. The sentinel lymph node and 4 of 16 lymph nodes were positive for tumor cells. An implanted port was placed during surgery.

1. What are the risk factors for breast cancer?

2. Describe the biopsy technique used to diagnose M.D.’s cancer.

3. Breast cancer is classified as noninvasive or invasive. Compare these terms.

4. Discuss the implications of a positive sentinel node.

5. What factors affect prognosis and treatment for breast cancer?

6. Is she a candidate for tamoxifen therapy? Explain your reasoning.

7. Surgical intervention is the primary treatment for breast cancer. Describe the surgical procedure that M.D. had.

8. Describe M.D.’s risk for lymphedema.

9. What actions will you teach M.D. to reduce her risk for developing lymphedema?

CASE STUDY PROGRESS

Eight weeks after surgery, M.D. is now beginning a prescribed chemotherapy regimen of 6 cycles of CAF (cyclophosphamide, doxorubicin, and fluorouracil).

10. M.D. asks you why she has to have chemotherapy with so many drugs if the surgeon removed all the cancer. How would you respond?

11. Name the common side effects experienced by patients receiving a chemotherapy regimen.

12. What information would you want to review with M.D. about the signs and symptoms of infection and when to seek treatment?

13. M.D. is ordered doxorubicin at 75 mg/m². Her height is 5 feet, 7 inches (170 cm), and her weight is 155 pounds. Calculate the dose she will receive.

CASE STUDY PROGRESS

M.D. has now completed three cycles of chemotherpy, with her last treatment 12 days ago. She comes to the emergency department with a 1-day history of fever, chills, and shortness of breath. On arrival, she is slightly confused and agitated. Vital signs are 100/60, 119, 26, 103.6° F (39.8° C), Spo₂ 86% on room air. The chest x-ray examination shows diffuse infiltrates in the left lower lung consistent with pneumonia. Her basic metabolic panel is within normal limits, except the blood urea nitrogen (BUN) 28 mg/dL (10.0 mmol/L) and creatinine 1.6 mg/dL (141 mcmol/L).

Chart View

Complete Blood Count

16. Interpret M.D.’s laboratory results and explain the reason for any abnormal results.

17. M.D.’s absolute neutrophil count (ANC) is calculated as less than 500/mm3, describe the significance of this value.

18. What is your nursing priority at this time?

19. What is the single most important nursing intervention for a patient with an ANC below 500/mm³?

20. When is neutropenia most likely to occur in a person receiving chemotherapy?

21. What type of isolation do you need to initiate for M.D.? Outline the guidelines for maintaining this type of isolation.

22. What collaborative care interventions do you expect for M.D.?

23. What immediate nursing interventions do you need to take?

24. What actions do you need to take because M.D. had a left axillary lymph node dissection and why?

25. The provider orders a 500-mL normal saline bolus now, with orders to infuse over 2 hours. You decide to use M.D.’s implanted port for IV access. After you access the port and connect the fluid, the infusion pump alarms that the line is occluded. What will you do?