5. Some of the antimuscarinics can cross the blood–brain barrier. What are the properties of a drug that would make them more likely to cross the blood–brain barrier?

6. What symptoms could be reported as adverse side effects in a drug that was able to cross the blood–brain barrier?

7. Some of the antimuscarinic agents are metabolised by the cytochrome P450 enzymes. Drawing on your knowledge of these important metabolising enzymes, explain the effect of the cytochrome P450 enzymes

8. List some of the drugs or foods that could interfere with the metabolism of the antimuscarinic agents.

9. Bearing in mind Lorraine’s identification of the most bothersome urinary incontinence symptom, what would be your choice of first-line management for her?

10. With reference to their pharmacological properties, describe how antimuscarinics can lead to the side effects of dry mouth and constipation.

11. Contraindications to the use of antimuscarinic drugs are all of the following except:

a) Glaucoma

b) Myasthenia

c) Bronchial asthma

d) Paralytic ileus and atony of the urinary bladder


12. Adverse peripheral effects, such as loss of accommodation, dry mouth, tachycardia, urinary retention, constipation are related to:

a) Alpha adrenoreceptor blockade

b) Muscarinic cholinoreceptor blockade

c) Supersesitivity of the dopamine receptor d) Dopamine receptor blockade

13. Please create a drug card for:

Oxybutynin

Duloxetine

Imipramine

Mr. Wiggins is a 78-year-old African American male with chronic kidney disease, which requires dialysis. The etiology of his renal disease was multifactorial—long-standing uncontrolled HTN and DM nephropathy. He has been on hemodialysis for the past 10 years and has done relatively well. Four weeks ago, he had a major CVA and is minimally responsive. His condition is not expected to change, and the family is having a difficult time with his recent health changes. Advanced directives were discussed with them, and his wife is a durable power of attorney for his health care. The wife hates to see her husband this way and understands this is not how he would want to go on, but their children and many of the family members (his brothers and sisters) think the patient will return to himself. They want everything done in terms of life support measures—full code status. His family wanted a feeding tube placed, and he is now receiving 24-hour tube feedings. You are the NP caring for Mr. Wiggins. You have known and cared for him and his wife for several years. The wife pulls you aside, shares her dilemma, and asks you to make the decision regarding continuing medical care/support for her husband. How will you respond?

Post an explanation of potential outcomes of the patient in the case study you selected. Then, explain how care, treatment, and/or support may be facilitated for the patient. Include how you might address the needs of the patient’s family as well.

Think of a situation from clinical when the Provider needed to be informed of a change in patient condition. Using ISBARR write what you would report to the Provider. You can use the ISBARR form for guidance.

What does Performance Excellence mean to Healthcare organizations and what does it mean to you as a patient?

HH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.

Is the nausea vomiting from the IV antibiotics? Possible Cdiff infection? What is,if any, the drug interactions and comorbidities? Any other gi concerns?

Answer the question in 250 words

Explain the links between the rights of the child (Convention on the Rights of the Child) and reducing under-5 child mortality, a target for SDG 3.

What are leadership styles listed in effective leadership and management in nursing with reference page 8th edition

Search and review the assigned model of culture/transcultural/health and briefly describe the basic premise of the model. Give an example based on the model of how you can effectively use what you have learned to improve your cultural sensitivity and linguistics when interacting with patients of different cultures/ethnicities.

1.)Campinha-Bacote Model of Cultural Competence in psychiatric mental health nursing

Healthcare in the United States continues to grow at an unsustainable rate. Since 1971 there have been more than 30 reform pieces of legislation passed in an effort of cost containment. Describe the intent of the following programs 1) Medicare Catastrophic Coverage Act (1988), Tax Equity and Fiscal Responsibility Act of 1982, Social Security Amendments of 1972 and Health Insurance Portability and Accountability Act (HIPPA) of 1996. In your opinion has the legislation performed as designed? Provide rationale for your opinion.

You should be able to answer in 350 words. Give three reasons why health systems are important to attain the 'right to the highest attainable standard of health'? Use examples and explanations from the readings.

readings: https://www.nytimes.com/2015/03/10/health/ebola-stricken-countries-lagged-in-health-systems.html

video resource: https://www.youtube.com/watch?v=uB2EzlKcRIA

Long-Term Care Reimbursement The federal and state governments are the largest payers of health care services in the United States. The largest federal programs are the Medicare and Medicaid services. Using the information from the textbooks, lectures, and Internet resources, provide a brief summary of Medicare and Medicaid services in a Microsoft Word document. To get up-to-date information on the programs, review the information shared on the following websites: The Centers for Medicare and Medicaid Services The Social Security Administration In your summary, include the following points: An overview of the different Medicare and Medicaid services The population covered under Medicare and Medicaid services The services of long-term care covered under Medicare and Medicaid, including the restrictions placed on them REFERENCE: Title:Long-Term Care: Managing Across the Continuum Author: John Pratt Edition/Year: 4th Ed./2016 Publisher: Jones & Bartlett ISBN: 978-1-284-05459-0

Analyze the change in healthcare careers since the implementation of the Affordable Care Act. How does this shift affect cost and quality in hospitals?

Explore the implications of this shift for hospitals from the perspective of a future employee in a hospital environment. How will this impact your career choices?