Describe how a policy to expand medicare drugs/medicine coverage could be implemented to improve the United States' health care system, using the policy cycle. How would this policy go through the 5 steps of the cycle and explain in detail how it becomes a law? What happens in the legislative branch ( house and senate) through the executive branch including implementation, and what are the potential legal implications up to the Supreme Court?

Please Write Succinct: Fever

• Review of Systems: Associated symptoms and Risk Factors
• Findings on Focused Physical Ex
• Five Differential Diagnosis

See example below for question #1:

1. Sore Throat

ROS:

Associated symptoms: fever, redness or eye discomfort, sneezing, wheezing, cough, runny nose, postnasal drip, GERD like symptoms, fatigue, muscle ache, n/v, and diarrhea.

Risk Factors:

Smoking, new sexual partners, irritant exposure, medications, and chronic health problems.

Red flags:

drooling, unable to swallow, unable to lie down, restless, unable to stay still, and unable to talk.

PE findings:

Epiglottis- severe illness with signs of upper airway obstruction such as restlessness, stridor, difficulty breathing, drooling, inability to swallow and high fever signals epiglottis and requires immediate referral. Further examination with a tongue blade could trigger laryngospasms and lead to airway obstruction.

Peritonsillar retropharyngeal abscess- orthopnea, dyspnea, symmetrical swelling, abscess, trismus.

Viral pharyngitis: Erythema, edema of throat, tender posterior cervical nodes.

GAS: temp more than 101.5, exudate anterior cervical lymphadenopathy.

Mononucleosis: presence or absence of pharyngeal exudate, posterior cervical lymphadenopathy, splenomegaly.

Gonococcal pharyngitis: pharyngeal exudate bilateral cervical lymphadenopathy

Inflammation: sinus tenderness, pale or swollen pharynx, postnasal drainage visible, no fever or lymphadenopathy.

Aphthous Stomatitis: shallow ulcers, no vesicles; indurated papules that progress to 1 cm ulcers; ulcer has yellow membrane and red halo; no fever or nodes.

Herpes simplex Lesions: perioral lesions; lymph adenitis; vesicles on palate, pharynx gingiva.

Herpetic pharyngitis: vesicles, ulcers, or exudate of the oral and pharyngeal mucosa.

Candidiasis: curd like white plaques that bleed when scraped off.

Differential diagnosis:

Viral Pharyngitis, Streptococcal Pharyngitis, peritonsillar or retropharyngeal abscess, Mononucleosis, Epiglottis, gonococcal pharyngitis, Herpangina, Vincent angina, Aphthous stomatitis, HSV type 1, Candidiasis, GERD.

Please Write Succinct: Vision Loss

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• Review of Systems: Associated symptoms and Risk Factors
• Findings on Focused Physical Ex
• Five Differential Diagnosis

See example below for question #1:

1. Sore Throat

ROS:

Associated symptoms: fever, redness or eye discomfort, sneezing, wheezing, cough, runny nose, postnasal drip, GERD like symptoms, fatigue, muscle ache, n/v, and diarrhea.

Risk Factors:

Smoking, new sexual partners, irritant exposure, medications, and chronic health problems.

Red flags:

drooling, unable to swallow, unable to lie down, restless, unable to stay still, and unable to talk.

PE findings:

Epiglottis- severe illness with signs of upper airway obstruction such as restlessness, stridor, difficulty breathing, drooling, inability to swallow and high fever signals epiglottis and requires immediate referral. Further examination with a tongue blade could trigger laryngospasms and lead to airway obstruction.

Peritonsillar retropharyngeal abscess- orthopnea, dyspnea, symmetrical swelling, abscess, trismus.

Viral pharyngitis: Erythema, edema of throat, tender posterior cervical nodes.

GAS: temp more than 101.5, exudate anterior cervical lymphadenopathy.

Mononucleosis: presence or absence of pharyngeal exudate, posterior cervical lymphadenopathy, splenomegaly.

Gonococcal pharyngitis: pharyngeal exudate bilateral cervical lymphadenopathy

Inflammation: sinus tenderness, pale or swollen pharynx, postnasal drainage visible, no fever or lymphadenopathy.

Aphthous Stomatitis: shallow ulcers, no vesicles; indurated papules that progress to 1 cm ulcers; ulcer has yellow membrane and red halo; no fever or nodes.

Herpes simplex Lesions: perioral lesions; lymph adenitis; vesicles on palate, pharynx gingiva.

Herpetic pharyngitis: vesicles, ulcers, or exudate of the oral and pharyngeal mucosa.

Candidiasis: curd like white plaques that bleed when scraped off.

Differential diagnosis:

Viral Pharyngitis, Streptococcal Pharyngitis, peritonsillar or retropharyngeal abscess, Mononucleosis, Epiglottis, gonococcal pharyngitis, Herpangina, Vincent angina, Aphthous stomatitis, HSV type 1, Candidiasis, GERD.

a table, and add Terms Related to 1 Autoimmune Disorder (e.g. Symptoms, Causes, Side effects, Associated Disorders...etc.)

a- 10 of the terms stated should include a root, suffix and prefix (if available) in separate columns in the table

b- Meanings of 10 of the Medical terms

BY COMPUTER

CON'T COPY

Active Learning Template: Nursing Skill PREECLAMPSIA.

Use Active Learning Template: Nursing Skill PREECLAMPSIA.

Use Active Learning Template: Diagnostic Procedure PREECLAMPSIA.

What does it mean to be part of a profession? What is the difference between a profession and an occupation? Discuss the responsibilities of being a member of the nursing profession.

Marfan Syndrome

A 20-year-old female has been followed for high myopia by her optometrist for many years. She is nearly six feet tall and at an employment physical she was referred for evaluation for possible Marfan syndrome. She has been on the internet and is now worried about aortic dissection and wants to know what interventions are available to prevent and treat the life threatening complications of Marfan syndrome.

1. What gene is mutated in Marfan syndrome and where in the genome is the gene located? (2 pts)
2. Name the protein altered by this mutation and how does this altered protein produce the symptoms observed for Marfan syndrome? (4 pts)
3. Is Marfan syndrome inherited recessively or dominantly? (2 pts)
4. Since the patient is a female, would it be wise to advise extreme caution with pregnancy? Explain. (3 pts)
5. What interventions are available to prevent and treat the life threatening complications of Marfan syndrome? (4 pts)

A 2-year-old child is admitted to a hospital burn unit with partial- and full-thickness burns involving 35% of body surface area. After admission assessment and review of the primary health care provider's prescriptions, the priority nursing intervention should focus on which action?

The primary health care provider ordered erythromycin 600 mg orally in 4 divided doses for a child who weighs 9 kg. Erythromicin is available in a concentration of 200 mg per 5 mL.

The following 4 questions (a, b, c, and d) refer to this prescription.

a) What volume of erythromycin should the nurse prepare for a single dose?

b) The safe oral dose range is 30-50 mg per kg per day divided every 6 hours. Calculate the safe daily dose range for this child.

c) Calculate the safe minimum and maximum single doses for this child

d) Should the nurse administer this medication? Why or why not?

Location: Neurological Unit 0800

SBAR report from the night nurse:

Situation: Mr. Russell is a 55-year-old Native American male who was admitted with a stroke with mild left hemiplegia yesterday afternoon. He had a head CT and received thrombolytic therapy in the ED. He is nothing by mouth except for medications until the speech therapist has completed a bedside evaluation, which is scheduled for later this morning. He is scheduled for physical therapy later today.

Background: Mr. Russell has a history of hypertension, coronary artery disease, and diabetes mellitus type 2. He has smoked over a pack of cigarettes per day for the past 35 years and does not exercise.

Assessment: We have already checked his blood glucose level this morning. His vital signs have been stable and he slept well last night. He was able to get up to go to the bathroom with the use of a walker. His neurological checks are stable and he continues to have mild left hemiplegia. His hand grasps are almost equal but a little weaker on the left side. His pupils are equal and react to light. Swallow reflex is intact. He is oriented x3. I have already done a Morse Fall Risk assessment with a total high risk score of 60.

Recommendation: You should do a vital signs assessment, perform a neurological assessment, and talk about safety with Mr. Russell. You should also provide patient education on risk and prevention of aspiration. His morning medications are up and should be administered.

2 subjective data,

2 objective data

One nursing diagnosis

2 long term goals,

2 short term goals

4 interventions with rationales

4 evaluations of goals, 4 evaluations of intervention

Mrs. A, 53-years-old with a 17-year history of type 2 diabetes, hypertension and hyperlipidemia and a 35-year history of smoking. She presents in the ward with shortness of breath, pruritus, and pitting edema of bilateral extremities. Her blood pressure is 165/92 mm Hg, heart rate 94 beats per minute (regular rate and rhythm), and respiration 26 breaths per minute. She is 153cm tall and weighs 91kg (BMI: 38.9).

Mrs. A is diagnosed with stage 3 chronic kidney disease, with a GFR of 49 mL/min/1.73m² and profound microalbuminuria.

QUESTION:

Based on the the above scenario, organize relevant nursing care and management for Mrs. A in order to maximise her overall health and delay the progression of end stage renal disease (ESRD).