You are

. . . a physician’s assistant (PA) in the Genetic Counseling Clinic at Fulwood Medical Center.

Your patient is

. . . Mrs. Patricia Bennet, a 52-year-old office manager with two daughters, aged 30 and 25. Mrs. Bennett’s sister, aged 55, recently had a mastectomy for breast cancer and is now receiving chemotherapy. Their mother died of ovarian cancer in her late fifties.

1. Bennet wants to know her risk for breast or ovarian cancer, what she can do to prevent it, and what her daughters’ risks are? Write a medical report to provide the information needed for Patricia Bennet

Describe the influences of the IOM, AHRQ, and Magnet status on healthcare systems. How does this influence the nurse leader?

Topic 4: Lab 3 Senses general and vision: discuss the functions and applications of the different aspects of the senses and tie it into the lab material.

Topic 5: Lab 4 smell, taste, and hearing: So think about it. you can include ideas to improve the lab in an online setting, explanations of exactly the why and how of sensation, in other words don't use the word for the different modalities but describe the process. why are balance and hearing tied together? what is the difference between conduction deafness and Sensorineural hearing loss, what are the different structures involved? why would the Rinne and Weber test tell you different things? Impress me with what kind of thinking you can do outside the box, be independent, be imaginative.

List the common pharmacology interventions for Acute inflammatory demyelinating polyradiculopathy and state the category the drug belongs as well as the actions and side effects

You are a RN working on an acute medical ward, looking after Oliver, an 80-year-old with painful cellulitis from hand to shoulder from a small left-hand scratch sustained while gardening. He is admitted for 7 days of QID IVABs via a right cubital fossa PIVC. Because of the cellulitis, PIVC and IVAB regime, Oliver’s mobility is limited.

5. Outline the normal changes of ageing on the respiratory system in predisposing Oliver to pneumonia during his hospital admission.

6. What are the benefits of increasing the mobility of an older adult during hospitalisation? How should the RN encourage incidental exercise during Oliver’s admission?

why should medical students study medical sociology?

What are the barriers to providing patient-centered care?

Why is professionalism integral to the field of healthcare reimbursement? Explain.

Physical Assessment interview guide: Head, Eyes,Ears,Nose, and Throat

1. Keeping in mind the major cognitive development of each age group, write a paragraph explaining how you would express the need for a surgical procedure to children aged 3, 10, and 15 years old.

2. What would you consider the three top-priority nursing diagnoses in an adolescent? Why? (please address each of the 3 diagnosis in your "why" statements).

3. Write down your feelings about being an adult and coping with new responsibilities and tasks. Explore how these feelings differ from perceptions you had about adults as a child. Discuss how the needs of middle adults differ from those of young adults.

Discuss the role of insurance in healthcare delivery and productivity in the United States. The discussion needs to include the critical role of health insurance in a cost-effective health care system and on consumer incentives and insurer behavior. Discuss the following concepts: market forces, competitive healthcare system, Value-based Purchasing, Promoting Healthy Behavior. What are the unique characteristics of the healthcare market in the United States?

You are presented with the following two scenarios. Choose one of these individuals and develop a fitness/wellness plan that will result in their specific goals. For the individual that you choose, evaluate their goals and apply the information you have learned in this course to create a program for that individual. That program should be part of a paper (at least two pages, double-spaced) submitted via Canvas. Please include ALL of the following items in the creation of that fitness/wellness plan.

1.) Name and description of individual and goals.

2.) Fitness activities in which to participate including activity name, frequency, duration, and intensity.

3.) Diet plan for the individual that will result in his/her specific goals.

4.) Other lifestyle choices and how they (and activities, diet, behaviors, choices) relate to specific potential health problems.

5.) Health-related fitness components and/or skill-related fitness components to be included in the plan.
6.) Full explanation of the benefits of fitness/wellness (at least one physical fitness activity must be identified) used in the plan.

7.) Outline for a plan for Behavior Modification

Scenario 1: Mary

Mary is interested in becoming more fit and healthy.Her goals include losing weight, toning her body,decreasing her physical size (clothing size), maintaining some kind of exercise and reducing/eliminating potential health problems. Develop a specific fitness/wellness plan that will result in these goals.

Scenario 2: Billy

Billy is interested in becoming more fit and healthy. His goals include gaining muscle mass and bulking up, gaining muscle weight but loosing body fat, maintaining an exercise program that will promote muscle growth and reduce/eliminate potential health problems. Develop a specific fitness/wellness plan that will result in these goals.

         Drugs Affecting Blood Glucose Levels

CASE STUDY

Joseph Sanchez is a 70-year-old Hispanic man who presents to for a 3 month follow up visit. He states that he has been experiencing nocturia several times each night and increased hunger and thirst for the past month. He denies signs and symptoms of hypoglycemia. He is very concerned that his diabetes is not controlled. In reviewing his medication profile, he had been on glipizide which had been gradually increased over the past year to the maximum recommended daily dose of 40 mg/day. He was recently started on empagliflozin on his previous visit. His past medical history includes Type II diabetes mellitus (diagnosed 15 years ago), hyperlipidemia, chronic gouty arthritis, COPD, and HTN.

Data Obtained from Nursing Assessment

• Weight: 215 pound, Height 5feet, 4 inches, BMI 36.9
• Vital signs: temperature, 37.1°C; pulse, 71; respiration, 18; blood pressure, 112/72
• HEENT: PERRLA, discs flat—no hemorrhages or exudates; TMs intact; oral mucosa within normal limits
• Neck: thyroid within normal limits
• CV: NSR, normal S1 and S2; no murmurs, rubs, or S3 or S4 gallop
• Lungs: A & P clear
• Abdomen: soft, obese, BS all four quadrants, healed midline incision, no hepatosplenomegaly, complains of “nausea, bloating”
• MS/Extremities: pulses 2+, no joint aches/pains
• Neuro: A & O X 4, CN II–XII intact, DTRs (deep tendon reflexes) 2+
• History of smoking—40 pack-years
• Denies alcohol intake
• Walks three to four blocks around neighborhood one to two times per week

Lab Data

• Total cholesterol: 315 mg/dL (LDL: 238 mg/dL, HDL: 30 mg/dL)
• Triglycerides: 218 mg/dL
• Glucose: 303 mg/dL (Accucheck), 361 mg/dL (fasting); HgbA_1C: 13% (5 months ago) prior to medication change
• Electrolytes: sodium: 137 mEq/L, potassium: 3.8 mEq/L, chloride: 95 mEq/L
• BUN: 22 mg/dL
• Creatinine: 1.1 mg/dL

Current Drug Therapy

• Metoprolol 50mg PO daily
• Furosemide 80 mg PO daily
• Jardiance (empagliflozin) 10mg daily
• Indomethacin SR 75 mg PO daily prn
• Ipratropium bromide MDI two puffs four times daily
• Prednisone 20mg PO daily
• Albuterol metered-dose inhaler (MDI) two puffs as needed

CONSIDER THE CORE DRUG KNOWLEDGE FOR EACH OF THESE DRUGS

Provide the following information for each drug that the Ms. Sanchez is taking:

Action, Indication for use, Therapeutic dosage, Contraindications, Adverse Reactions

Drug/Drug Interaction related directly to the current drug regime (do not list all drug/drug interactions if not applicable)

Based on the new ADA guidelines and her current health status, what other antidiabetic drugs could be used to treat Mr. Sanchez’s Type II diabetes?

CONSIDER THE CORE PATIENT VARIABLES FOR THIS DRUG:

( consider the patient history including past medical history, social history, lifestyle etc.)

What patient variables are most important to consider for Mr. Sanchez when assessing his drug therapy? Address each of his conditions and related medications

What additional data (diagnostics etc.) is needed to determine proper drug therapy?

Which of the findings from the assessment demonstrate effectiveness of his drug therapy?

Which of the findings from the assessment demonstrate possible adverse effects from drug therapy?

CONSIDER THE MANAGEMENT NEEDED WITH THIS DRUG THERAPY

What teaching is required for Mr. Sanchez regarding each of his medications for each of his diagnoses?

If extensive retraining is not required to teach in an inclusive preschool or child care classroom, what do teachers need to ensure that children with developmental disabilities have a good learning experience?