Using the following case study answer the questions,

A 76 year old male presents to the emergency department with shortness of breath and difficulty sleeping lying down.

Physical examination reveals a well nourished obese male with SOB with speaking and any exertion. Blood pressure is 160/90 and pulse is 90. Lungs- diminished in bilateral bases. Cardiovascular examination reveals a swooshing sound heard best over the 2nd ICS, RSB. The patient complains that SOB became much worse when he was asked to lie flat on the examination table. States a 71bs. weight gain in one week.  Productive cough that is clear to pink foamy sputum.

1. Distinguish normal from abnormal, and subjective and objective findings and list each. Link abnormal findings with common pathologic conditions.

2. Sequence disease processes.  (What caused what?)

3. Perform an assessment:

10 pertinent health history questions you would ask.

10 pertinent physical assessments would you perform.

john Graut

Locate a significant figure from the 1900s-2000; cut off year is 2000, who has contributed to the delivery of health care.

Name the significant figure - Please refrain from noting John Grant, John Snow, or other significant figure noted in Chapter 3 or the lecture notes.

Cite your source - provide the appropriate link(s)

Describe in 5-6 sentences why this figure is "significant" and the contributions made to health care delivery.

Beyond the contributions made by this figure, identify any other "interesting" item you found inspiring.

1. Describe vital signs of a healthy individual. What are the normal ranges?
2. What might the vital signs in a patient with COVID be? Use the scholarly sources to complete a brief search. Include the reference in APA format of the resources you utilized.
3. What causes oxygenation and subsequent pulse oximetry to be low in a patient with COVID?
4. What interventions do nurses employ with critically ill COVID patients?
5. Think about what you have learned so far in the semester. What other concepts can be applied to the care of a patient diagnosed with COVID?

A 64-year-old male patient diagnosed with atrial fibrillation is started on anticoagulant therapy with warfarin to lower his risk of stroke due to fibrin clots. Despite calculating initial warfarin dosing based on the patient’s age, weight, and sex, laboratory monitoring of anticoagulant activity after the first week of therapy shows that the patient is receiving too much warfarin (his INR was too high indicating he is “over anti-coagulated”). After several weeks of dose adjustment, the patient’s anticoagulant therapy is optimized at a warfarin concentration that is 10-fold lower than the initial dose.

             a. What is INR? What is normal INR? What does low INR mean? High INR?                                                                                                                                                                                              

Mr. King is 75 years old and lives alone. He has been slowly losing weight since his wife died a year ago. His height is 5’8” and he currently weighs 124 lbs. His previous weight was 150 lbs. prior to his wife’s death. In talking to Mr. King, you realize he doesn’t even like to talk about food, let alone eat it. “My wife always did the cooking before, and I ate well. Now I just don’t feel like eating.” He states he skips breakfast, eats soup and bread for lunch. For dinner, he eats a frozen dinner entrée or a cold-cut sandwich and a cup of coffee. He seldom sees relatives or friends. Mr. King has lost several teeth and doesn’t eat any raw fruits or vegetables because he finds them hard to chew.

1. Refer to the BMI table in your textbook. Is Mr. King at a healthy weight? Is his weight loss significant?

2. Discuss factors that contributed to Mr. King’s poor food intake. What nutrients are probably lacking in his diet?

3. What recommendations would you suggest to Mr. King to improve both his diet and lifestyle?

Mrs. Paula Johnson is a 65-year-old white woman with a previous history of a sedentary lifestyle, hypertension, hypercholesterolemia, and diabetes mellitus type II. She is a heavy smoker since she was 20 years old. She was brought to the emergency room because her family found her unresponsive on the floor. She was diaphoretic. Her family thought she had her diabetes decompensated. Mrs. Johnson’s daughter indicated her mother was complaining of nausea and epigastric pain the day before. Also, her blood pressure was high.

On the physical we found:

Remarkable Signs on Physical by Regions

• Chest: Palpitation

Remarkable Signs on Physical by Systems

• Integumentary system: Profuse diaphoresis, coldness, and pallor
• Respiratory system: Tachypnea
• Cardiovascular system: Weak pulse, tachycardia, and hypotension
• Nervous system: Unconsciousness. No other neurologic signs.

Lab Tests

• Complete blood count (CBC)
• Cardiac enzymes
• Glucose level
• Lipid panel
• EKG
• Cardiac catheterization

Diagnosis

• Silent myocardial infarction

Other Diagnoses

• Essential hypertension
• Dyslipidemia
• Diabetes mellitus

In at least 375 words, or 1.5 double-spaced pages, prepare a case report that addresses the following:

1. Based on the case study provided, respond to the following questions:
   • Mention the symptoms and signs you found in this patient.
   • Did you find any remarkable detail in the personal and social history of our patient that can help to make the diagnosis?
   • What is a silent myocardial infarction, and why did it happen to this patient?
   • What results do you expect to find in the tests ordered?
   • What are some differential diagnoses?
   • What are some complications of myocardial infarction?
2. The patient suffers from silent myocardial infarction, but there are other types of heart diseases. Consider these questions:
   • Describe the heart valvular disorders and how they can produce cardiac failure.
   • What is endocarditis, and what are the most common causes?
   • How many types of shocks are there? Explain them.
3. As a lifetime smoker, the patient is at risk of several respiratory disorders. Consider these questions:
   • What is COPD? What are the three most common diseases that produce a COPD? What are their causes?
   • What is asthma? Explain the origin of its symptoms.
   • What is a pneumothorax? What are its symptoms and signs, and what are its causes?

Q) Draw A table with 20 Medical terms Total

1. 20 word roots+ suffixes+ interpreting the meaning + giving Medical Term examples with interpretation
2. 10 prefixes+ interpreting the meaning of these prefixes+ Medical Term example for each prefix with interpretation

After reviewing the various theories of nursing, reflect on your personal philosophy of nursing. Discuss the major theorists who influenced you and identify the elements you incorporate into your philosophy.     

Medical Terminology Project: The project needs to be at least 300-word minimum and utilize 50 medical terms. The medical terms must be full medical terms. You may not use just prefixes, suffixes or word roots. The words must be from the Purple boxes in your book. They must be typed and medical terms must be highlighted but you may put this project together any way you like. You can write a paper, do a powerpoint or do something really creative. You have creative license! You may pick any topic you find interesting. Note: You are welcome to do this in groups too, be creative! Perhaps you could create a script and read the medical dialog in a skit? I love to have some collaborations when possible.

Discuss three different ways that poverty leads to poor health in three separate paragraphs (1 paragraph for each way health is impacted by poverty).

Close with a fourth paragraph describing how you think your medical facility should handle situations where parents cannot afford the needed medications for their ill children and how your facility can generally be more effective to the less fortunate in your community.

12)Review the side effects of long term corticosteroids use. What must you educate your patient about this long term use? Discus how to discontinue steroids.

13)Review what is meant by: primary, secondary, third wound intention.

14)Regulation of body temperature primarily occurs in what part of the brain?

15)Antibiotics

• Review the different types of antibiotics, their use, side effect, patient education key points
• Patients should be taught not to discontinue antibiotics prematurely, but rather to complete the entire course of therapy, even if symptoms improve or resolve.
  • Cephalosporins
  • Vancomycin
  • Erythromyecin
  • Sulfonamides
  • Fluoroquinolones

16)Review what medications can cause an anaphylactic reaction to penicillin

17)Medication dosage: Review how to calculate pediatric dose of penicillin based on weight.

18)Differentiate between chronic, referred, somatic, visceral pain, neuropathic, and phantom pain

19)Review the role of prostaglandins in relationship to injury and pain.

20)Review nonsteriodal antiinflammatory drugs (NSAIDs): what are they, when and why are they used, common side effects, maximum doses, and patient education key points

Recall a patient, with whom you interacted, who demonstrated a pain response that seemed to be predominantly culturally based, spiritually based or influenced by developmental level. Reflect on the reactions of other healthcare workers when the behavioral response to pain is atypical. Share what was meaningful and impacted you and your practice.  

What are some of the key things that Dr. Blaser recommends we do to reverse the current threats to the human microbiome?

2.Missing Microbes NPR Fresh air homework assignment

What are the significance of adults with Type 2 Diabetes that do not participate in Diabetic Self-Management Education (DSME) programs and adhere to treatment at the National Level? citation