Bergalis was one of six patients infected with HIV after visiting David J. Acer, the Florida dentist who had AIDS. This incident is the first known case of clinical transmission of HIV. The claim asserted the Dr. Acer infected others with HIV and that his patients were unaware of his status. As a result, one of those patients, Kimberly Ann Bergalis, died of AIDS at the age of 23. In addition to being the first known clinical transmission , it also bears the designation as being the first known case of a transmission of the disease that was "innocent exposure" during a dental procedure. Investigation into this case, in the 1980's proved that Dr. Acer was not using universal precautions-he was working on patients without any gloves and reusing unsterilized instruments. As a result of this case, in 1985 OSHA began to require that all healthcare providers use universal precautions when treating any patients in any area of health care. With all the past and current AIDS/HIV education, we still have many people exposed and dying from AIDS/HIV.

1. Should it be mandated that healthcare workers with a positive HIV status must inform their patients?

2. What can be done, specifically, to prevent exposures?

3. What consequences should be facing a provider who takes these actions today?

Why do EOH practitioners (The Environmental and Occupational Health) need a firm grasp of basic epidemiological principles in their daily work? Integrate specific examples and supportive backing for your response

Discuss principles for building healthy places in the built environment of a developed country that may encourage healthy behaviors and thereby, have a positive impact in reducing chronic disease. Give supportive examples for your response at minimum 200 word response.

Write an essay on Sickle Cell Anemia and trait

Work from the Brown and Goldstein lab provided insights into cholesterol homeostasis that were used to develop several of the LDL cholesterol-lowering therapies, including statins that remain in use today. However, in some patients, statins were not as effective as expected, suggestive of additional mechanisms regulating the LDL receptor. Investigate other LDL cholesterol-lowering therapies (other than PCSK-9 inhibitors), select 1, and compare and contrast the mechanisms of action between the class of drug you select and statins. Include side effects for both types of drugs and information on their efficacy.

Considering the ‘causal web’ associated with disease transmission and health outcomes, discuss the importance of different levels of prevention (i.e., primary, secondary, tertiary) used in global/public health strategies for addressing risk factors for specific diseases or health issues. How might these strategies impact one of the health transitions (e.g., demographic, epidemiologic, or nutrition) at the population level? Be specific use examples to support your response.

Helio is a 48-year-old sedentary male diagnosed with prediabetes who is 250 lbs and 5’7”. Helio’s VO2max is 26 ml/kg/min. His total daily energy expenditure is 1700 kcal/d and his diet log indicates he eats ~1900 kcal/d (48% CHO, 17% protein, and 35% fat). His doctor prescribes the drug metformin to control his blood glucose and also recommends he see an exercise physiologist and nutritionist to prescribe a lifestyle program to control his weight and prevent the progression to type 2 diabetes. What type of exercise training program would you prescribe for Helio and why? Before exercise training, what substrate would be predominantly oxidized at rest? What fiber type would be most prevalent in his vastus lateralis if a muscle biopsy was performed? How would you expect your specific exercise training program to alter his fiber type and substrate oxidation? How would you measure Helio’s body composition before and after his intervention (justify your choice of measurement)? How would you expect his body composition to change? Describe 2 additional (choose from: neural, respiratory, endocrine or cardiovascular) changes that would occur in response to your specific exercise training program and their time course for adaptation.

Helio complains that he does not like doing structured exercise. Can increasing physical activity without exercise training improve Helio’s health and reduce his risk of developing type 2 diabetes? Are lifestyle and pharmacologic effects of metformin additive in terms of blood glucose control? Incorporate what you have learned throughout the semester into this case study.

Review various definitions of “ethnocentrism” as provided by other internet resources.

Create your own definition for this term.

Give an example of how ethnocentrism has had an affect (positive or negative) on a patient you have come into contact with in the delivery of healthcare services. Describe how ethnocentrism may have impacted the health and well-being of the patient and their future encounters with the healthcare system.

Allergy: No allergy to food and medication
Accommodation: Ward with Philhealth
Initial Diagnosis:
Measles, Pregnancy Uterine 33 5/7 weeks AOG G1P0 with Intestinal Complications (AGE)
Chief complaint:
Fever and productive cough
History of Present Illness:
The client was admitted to the San Lazaro Hospital last August 4, 2020. 2 weeks prior to
consultation: (+) undocumented fever, intermittent, no other associated symptoms no
consultation done, no medications taken. 1 week PTC: (+) onset of productive cough (yellow
mucus), colds, no fever or rashes, no consult done, no meds taken. Interval history revealed
persistence of cough and colds until 1 day (+) rashes, non-pruritic on abdomen which spread
to the trunk and face. Sought consult and was prescribed vitamins and sent home.
Past Medical/ Personal and Social History:
No previous hospitalizations and surgeries.
Past Medical History:
(-) PTB
(-) Diabetes Mellitus
(-) Asthma
(-) Hypertension
(-) Cancer
(-) allergy
Family History:
(-) Hypertension
(-) Diabetes
(-) Cancer
(-) PTB
(-) Asthma
Admission Order
The patient was admitted on August 19, 2020 at 7:00 am with a chief complaint of fever and
productive cough. Client was admitted to Emergency Room. Consent was secured for
admission. Client was the transferred to Adult Female Ward. Patient received with IVF D5LR
1L regulated at 150cc/hr. Client’s vital signs are (BP - 100/70 RR - 25 T - 38.3 HR - 116 O2
saturation - 95%) There is a presence of fever with macula-papular rash on the patient with
productive cough (whitish to yellowish mucus secretion). The patient also showed sign of body
weakness, poor appetite, abdominal pain and defecates a mushy consistency stool. Physician
ordered for CBC, BT, Measles IgG, IgM, CXR-PA view, Serum Creatinine, Na, K, SGPT, SGOT, and Stool exam. Paracetamol 1 tab PRN for fever >37.8, Hexetidine 10 ml for oral
gargle was given. Performed tepid sponge bath. Encouraged to increase fluid intake.
Maintained high back rest. Advised the watcher not to leave the client unattended. Kept
monitored the safety of the client by maintaining side rails up. Vital signs monitored q4 and
recorded. Intake and Output monitored. Watched out for (WOF) any signs of respiratory
distress such as dyspnea or increased respiratory rate. The following day, client was seen
awake and lying in bed. Client’s vital sign are (BP- 90/60 RR-23 T- 36.7 HR-97 O2 sat- 97%).
Client still manifested maculopapular rash with body malaise. Cough still productive with
crackles heard on both upper lung area. IVF D5LR 1L regulated at 150cc/hr was started.
Noted and referred Physician’s order for Isoxsuprine 10mg/tab, 2tabs PO TID and
Dexamethasone 6mg/amp TIV q6 x4 doses. . IVF PNSS 1L at 110cc/hr to follow. Advised not
to scratch the skin to prevent skin integrity impairment. Maintained HOB elevation at 30-40
degrees. Provided a quiet and calm environment. Instructed the watcher not to leave the
patient alone. Kept monitored the safety of the client by maintaining side rails up. Instructed
dietary intake as tolerated. Vital signs monitored q4 and recorded. Intake and Output
monitored. WOF vaginal bleeding and refer to the staff nurse immediately. Client was seen
awake and lying in bed. Client’s vital sign are (BP 100/60 RR-22 T-36 HR-85 O2 sat95%).
Client manifested conjunctivitis and still showed presence of rash in the skin. Cough still
productive. Acetylcysteine 600mg 1-tab dissolve in 50cc water ODHS were given. Patient was
ordered for discharge. Noted and instructed the patient regarding the following home
medications ordered by the Physician, Co-amoxiclav 625 mg 1tab TID for 7 days, Hexetidine
gargle 10ml TID, Multivitamins 1tab OD and B-Complex 1tab OD. Encouraged client to
increase oral fluid intake. Advised to follow-up to OPD after 1 week. Vital signs monitored and
recorded.

1 Conceptualize the pathophysiological alterations distinct to the case. (FLOW CHART)

* Establish the pathophysiological triad of Host – Agent – Environment specific to the
case.
* Trace the pathophysiological changes and highlight problems that are
experienced by the client.
* Connect the pertinent nursing care and medical – surgical management to the
various signs and symptoms presented by the client

Develop a training plan for new HIM employees that will ensure that they understand the HIPAA regulations and what their role is in maintaining them.

The plan should include:

Content (What will the content of the training include?)

Classes for employees - How will you break the students into different types of classes based on their role within the department (coder, ROI staff, etc.) ?

The skills that the trainers need

Amount of time needed for the course

Format of class

Resources needed

What is the main issue for your organization in addressing a solution to evidence-based nursing practice? Discuss what might be the first step in addressing and resolving this issue