Last night, there was this actress on TV talking about having colon cancer and saying that everybody over 50 should get tested. It brought back memories of my father’s cancer, how thin and weak he got before he went to the doctor, so that by the time they found the cancer it had already spread too far. But I don’t think I’m at risk. I only eat red meat two or three times a week, and I eat a piece of fruit or a vegetable at every meal. I don’t smoke, and I get plenty of exercise, sunshine, and fresh air working in the vineyard.

Which lifestyle factors reduce Gustavo’s risk for cancer? What factors increase his risk? Would you recommend he increase his consumption of fruits and vegetables? Why or why not? If Gustavo were your father, would you urge him to have the screening test for colon cancer?

Some health care providers make patients feel like there is a stigma attached to the use of medications for chronic pain. Discuss any barriers you see that might prevent your colleagues in your clinical practice from responding to a patient in this manner.

A 67-year-old retired businessman has a history of gastric ulcers and ulcerative colitis. He reports eating a well-balanced “mostly vegetarian” diet. He states he dislikes taking prescription drugs and prefers natural herbal remedies because they are “not toxic like drugs.” He takes a variety of herbal preparations to relieve his gastrointestinal problems although he admits he has not experienced any significant relief in symptoms. His doctor prescribed a proton pump inhibitor and sulfasalazine, which he states he takes “reluctantly.” He now reports frequent spells of nausea and occasional diarrhea and notes that he feels more tired than usual.

1. Based on his limited history, what are some common causes that may explain the patient’s nausea and diarrhea?

2. How would you caution him regarding the use of herbal products?

3. To whom would you advise this patient to report any problems or side effects he may experience with his medication?

A 71-year-old woman was recently diagnosed with hypercholesterolemia and depression following the sudden death of her husband of 47 years. Her medical doctor has prescribed simvastatin to help lower her cholesterol and an anti-depressant. During her doctor visit, the patient reports her diet has been erratic due to her emotional state, and decides to make some changes in her diet to improve her well-being. In addition to her usual glass of grapefruit juice at breakfast every morning, she decides to eat more vegetables with her meals. The patient’s friend has also encouraged her to try St. John’s wort to ease her depression. At her one-month follow-up visit with her medical doctor, the patient reports feeling better emotionally although she feels more tired than usual and reports occasionally feeling sick to her stomach. She is also surprised that, in spite of her improved diet, she has gained 5 pounds since her last visit. Her doctor also notes that her blood cholesterol level has decreased. And although she is on a normal dose of simvastatin, her doctor notes an unusually rapid drop in her blood cholesterol from 250 mg/dL to 155 mg/dL.

1. What may explain the patient’s weight gain?

2. What places the patient at increased risk for adverse effects from mediations?

3. What steps could Mrs. Miller’s health care team have taken to prevent adverse effects of her medications?

1. EXPLAIN How nebulizer and inhaler assist in early detection of asthma symptom changes in children and teenagers?

2. Describe How NEBULIZER AND INHALER assist in THE disease management education OF ASTHMA?

Decide what you would do in each of the following situations:

1.     Mary Thompson calls the office. She thinks her husband may be having a mild heart attack but he thinks it's heartburn. You are alone in the office. What should you do?

2.     John Ransom arrives with what appears to be a broken wrist. The physician is in an examing room with another patient.

3.     You are alone in the office but the physician should be arriving in about 15 minutes. Diane Sanchez calls and states that she has been having severe daily headaches. What should you do?

4.     Melissa Green shows up without an appointment. She tends to be a bit of a hypochondriac, always thinking something is wrong when she is perfectly healthy. Today she is complaining of severe pain in her lower right abdomen. The physician is with a patient in an exam room. What should you do?

5.     Mr. Anderson comes in for a routine blood sugar check and promptly faints in the Reception Area. The physician and nurse are busy suturing a cut on a patient. You and the insurance biller are the only ones in the front office. What should you do?

6. (Worth 5 points) This was an actual interview question given by a local medical center. Imagine trying to answer this during the stress of an interview! Many interviews now include scenario questions, but this is the most involved one I've ever come across. List the steps you would take in handling this situation:

Your employer has been delayed at the hospital but is expected in the office in 15-30 minutes. You are the only employee in the office. The following people are in your Reception Area:

Mrs. Smith who is with her 2 year old grandson.

Mrs. Jones who has come in for a routine injection.

Mr. Green who is a new patient.

Mr. Johnson who is there for a consultation.

The phone rings and it is Jane Simmons calling in a panic because her four-year-old son has swallowed some kitchen cleaner. While you are talking to her the door to the office opens and in staggers Mr. Franklin. He gasps that he has been "shot by a thief" and collapses on the floor. Seeing the blood coming from Mr. Franklin's chest Mrs. Smith faints. Her grandson starts crying.

How would you handle this situation?

1. You are a nurse preparing to receive a new patient, fresh from surgery, to your unit. The patient is a 71-year-old man who underwent a surgical repair of a fractured femur. As you receive a report from the postanesthesia recovery unit, you learn that his medical history includes hypertension, 40 pack-years of smoking, and COPD. His surgical repair was successful but complicated by excessive bleeding, and he is receiving IV fluids to compensate. He is widowed, and his three children are scattered throughout the United States. He lives alone, receives Meals on Wheels, and pays a cleaning service to keep his home clean. (Learning Objective #6)
   1. What data in this scenario are pertinent?
   2. What potential collaborative problem(s) could be applicable in this situation?
   3. Which nursing diagnoses would you expect to be applicable regarding the medical procedures in this situation?
   4. Which nursing diagnoses would you expect to be applicable regarding the nursing/medical history in this situation?
   5. Which nursing diagnoses would you expect to be applicable regarding the discharge planning in this situation?

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

Hand written not allowed

Draw table

• 1. Name the signs of the most urgent psychiatric emergencies

  2. Describe two nursing goals in managing a psychiatric emergency

  3. State three nursing interventions with rationale for this goal

  4. Discuss best practice standards of care in psychiatric emergencies.

Write from 400 to 500 words and hand written not allowed

Provide an example of changing a behavior using the components of the PRECEDE-PROCEED model to improve the health of individuals.

Hints:

1. Use the 2 attached examples as a guideline.
2. Create a similar example in a different topic - such as smoking, obesity, drug abuse, or any other health issue - to improve the quality of life

7 day meal plan for a 55 year old male following the DASH diet?

1. So, how does the Affordable Care Act work (ACA)?

2. What are the updates as of October 23, 2015?

3. What are the upcoming challenges of the ACA?

4. What, in your opinion, are the ethical issues surrounding the "repeal and replacement" of the ACA? (not discussed in the video).

HCOs are strongly oriented toward healing the sick, one person at a time. The first word of the body of this chapter—“patient”—is consistent with that tradition. Consider the following reasons for seeking care:

• Your grandmother, well into her eighties, wants a checkup. She has many of the limitations of age—her hearing, eyesight, and mobility are not what they were, and she has diabetes.

• Your father, 55, has acute chest pain that started a half hour ago and seems to be getting worse.

• You (or your partner) might be pregnant.

What constitutes an excellent result for each of these events? What care teams and clinical support teams are likely to be involved? How do the strategic teams help the clinical teams achieve excellence? If the HCO delivers that excellence, what other factors would be important to continued good health?