Please only answer to questions 5 and 6.

Patient Profile:

Gladys Young is a 68 year old female that resides in an Independent Living facility with her husband. She presents to her primary care physicians office with complaints of fever, chills, nausea and vomiting. She also states that she has had some mild hemoptysis occasionally with her persistent coughing. She has recently completed treatment with Chemotherapy for Breast cancer and is concerned that she may have an infection. You are the nurse caring for her.

You complete the following assessment:

Subjective Data:

She is able to complete a sentence in its entirety, but she is persistently coughing during the history. She is a former smoker, she smoked ½ pack of cigarettes per day for 30 years and quit when she was diagnosed with breast cancer 6 months ago. She denies shortness of breath or chest tightness. She has not yet gotten her influenza vaccine, but did receive the Pneumovax vaccine last year. She has had problems with persistent coughing at night which has prevented her from getting a good night’s sleep for the past two weeks. She also states that she has been waking up soaked in sweat in the morning.

Objective Data:

• Temp – 38.6 C; HR – 132 beats/min; RR—28; BP – 168/87; O2 sat – 90% on Room Air
• Auscultation: Lungs with faint crackles at bases bilaterally. No wheezing present.
• Patient is flushed and warm to touch.

Answer the following questions:

1. What additional questions would you like to ask this patient?
   Nurse can ask if the patient has sputum while coughing ,the color of the sputum.Did the patient experience any pain while coughing.Is the patient feeling weak ?Is there is any difficulty in breathing? How long is the cough and is there any breath sounds while breathing.Did the patient experience fever ?Did she has appetite?
2. What do you think the patient’s diagnosis is and why?
   This patient is suffering from pneumonia.A variety of symptoms like low oxygen saturation (90), persistent coughing,fever,chills, vomiting,crackles, decreased breath sounds,increased respiration rate ,increased heartbeat suggest pneumonia.This patient also has blood in the coughed up mucus.She has fever and chills.She also has persistent cough,with rapid shallow breathing.All this suggest she has pneumonia.A chest radiograph can confirm the diagnosis.
3. What is the pathophysiology of this disorder, in your own words?
   •entry of bacterium (streptococcus pneumoniae) into the lungs
   •inflammatory response by the body
   •encapsulation of the abscess in the cavity
   •necrosis of the lung tissue and parenchyma
   •appearance of clinical signs and symptoms (productive cough and purulent sputum)
4. What are the clinical manifestations of this disorder? Which manifestations is this patient exhibiting?
   clinical manifestations:
   •cough
   •purulent sputum
   •hemoptysis
   •fever
   •chills
   •night sweats
   •shortness of breath
   •malaise
   •chest pain
   •irregular breath sounds
   
   clinical manifestations experienced by patient:
   •fever
   •chills
   •night sweats
   •cough
   •hemoptysis
5. What complications do you want to be aware of if the disorder is not appropriately treated?
6. What pharmacologic interventions do you expect will be ordered for this patient? What routes of administration will be best indicated for this patient? (Include mechanism of action, indication for use and desired outcomes)

Discuss the current Coronavirus pandemic , the effects on pregnant women and how they can protect themselves from the virus. In addition, please answer the following questions listed below. You may use any reliable source. However, please make sure to visit the CDC website which has the most up to date, accurate information.

1. Can they pass the virus to the baby while they're pregnant?

2.Is breastfeeding safe if you have COVID-19?

3. What is the treatment of COVID-19 in pregnant women?

Please review Discussion Board Instructions, Etiquette, and Netiquette under Course Resources before you begin.

Write a minimum of two paragraphs, minimum 200 words. Your first response is due by midnight of the second day of the unit. Provide links to the resources you used to conduct your research. You must respond to at least two other classmates on a separate day by midnight of the last day of the unit for full credit.  

Answer the question(s) below:

Sun exposure and tanning booths - Is there harm when repeatedly exposed to UV rays of the sun or artificial UV rays? What are ways that we can protect our skin from being exposed to UV rays? What diseases can result from exposure to the sun or tanning booths?

oths?

Some cons with e-learning include lack of face-to-face contact with others, e-learning may not be the best option for all subjects especially classes with labs or clinical rotations, technical problems may make it difficult to connect to the class when needed and students may have to purchase other software programs to be able to participate in the class assignments. what do you think?

1.A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Durante diagnoses ectopic pregnancy and orders ultrasonography. The midwife expects ultrasonography to reveal:

A. an empty gestational sac.

B. grapelike clusters.

C. a severely malformed fetus.

D. an extrauterine pregnancy.

2.In which of the following types of spontaneous abortions would the midwife assess absence of cervical dilatation and spot bleeding? *

A. Threatened

B. Imminent

C. Missed

D. Incomplete

3.A patient with eclampsia probably exhibits which of the following symptoms? *

A. hypertension, edema, and bradycardia

B. edema, hypertension, proteinuria +2

C. seizure, edema, hypertension, proteinuria +3

D. hypotension, edema, proteinuria +3

4.A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement? *

A. Auscultating for fetal heart sounds

B. Palpating the abdomen for fetal movement

C. Assessing the cervix for thinning

D. Initiating a gentle upward tap on the cervix

5.Gravida refers to which of the following descriptions? *

A. A serious pregnancy

B. Number of times a female has been pregnant

C. Number of children a female has delivered

D. Number of term pregnancies a female has had.

6.What is unexpected in a pregnant woman with gestational diabetes? *

A. she will be given OGTT as a diagnosis

B. she will give birth to a child who is LGA

C. she will give birth to a child with hyperglycemia

D. she will be monitored for hypertension

7.A patient with mild pre-eclampsia probably exhibits which of the following symptoms? *

A. hypertension, edema, and bradycardia

B. edema, hypertension, proteinuria +2

C. seizure, edema, hypertension, proteinuria +3

D. hypotension, edema, proteinuria +1

8.A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Charles diagnoses gestational trophoblastic disease and orders ultrasonography. The midwife expects ultrasonography to reveal: *

A. an empty gestational sac.

B. grapelike clusters.

C. a severely malformed fetus.

D. an extrauterine pregnancy.

9.A midwife is caring for a pregnant client with Preeclampsia. The midwife prepares a plan of care for the client and documents in the plan that if the client progresses from Preeclampsia to eclampsia, the first action is to: *

A. Administer magnesium sulfate intravenously

B. Assess the blood pressure and fetal heart rate

C. Clean and maintain an open airway

D. Administer oxygen by face mask

10.All of the following can predispose a pregnant woman to cervical incompetence except *

A. multiple pregancy

B. old age

C. habitual abortion

D. PCOS

11.The medication of choice for a patient diagnosed with rhesus incompatibility is: *

A. Methotrexate

B. Hydralazine (Apresoline)

C. Tylenol

D. RhoGAM

12.A pregnant woman at 32 weeks’ gestation complains of feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. The midwife’s initial response would be to: *

A. Assess the woman’s blood pressure and pulse

B. Have the woman breathe into a paper bag

C. Raise the woman’s legs

D. Turn the woman on her left side.

13.Which of the following conditions is usually associated with choriocarcinoma *

A. placenta previa

B. abruptio placenta

C. gestational trophoblastic disease

D. toxoplasmosis

14.In which of the following types of spontaneous abortions would the midwife assess dark brown vaginal discharge and a negative pregnancy test? *

A. Threatened

B. Imminent

C. Missed

D. Incomplete

15.Type of abortion that results to cervical dilatation and bleeding *

A. threatened

B. imminent

C. habitual

D. missed

16.Which of the following would the nurse most likely expect to find when assessing a pregnant client with abruption placenta? *

A. Excessive vaginal bleeding

B. Rigid, board-like abdomen

C. Titanic uterine contractions

D. Premature rupture of membranes

17.All of the following can be seen in a patient with HELLP syndrome, except *

A. bleeding

B. elevated AST

C. hypertension

D. elevated platelets

18.An expected cardiopulmonary adaptation experienced by most pregnant women is: *

A. Tachycardia

B. Dyspnea at rest

C. Progression of dependent edema

D. Shortness of breath on exertion

19.The antagonist for magnesium sulfate should be readily available to any client receiving IV magnesium. Which of the following drugs is the antidote for magnesium toxicity? *

A. Calcium gluconate

B. Hydralazine (Apresoline)

C. Narcan

D. RhoGAM

20.A pregnant woman with gestational diabetes is learning about diabetes. The midwife should instruct the woman that the best test to check for glucose control is: *

A. CBG

B. CBC

C. glycosylated hemoglobin

D. ABG

21.A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia and who is being monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of the Preeclampsia and the need to notify the physician? *

A. Blood pressure reading is at the prenatal baseline

B. Urinary output has increased

C. The client complains of a headache and blurred vision

D. Dependent edema has resolved

22. A woman with preeclampsia is receiving magnesium sulfate. The midwife assigned to care for the client determines that the magnesium therapy is effective if: *

A. Ankle clonus in noted

B. The blood pressure decreases

C. Seizures do not occur

D. Scotomas are present

23.Which of the following would the midwife assess in a client experiencing placenta previa? *

A. Bright red, painless vaginal bleeding

B. Concealed or external dark red bleeding

C. Palpable fetal outline

D. Soft and nontender abdomen

24. Which of the following is treated with tracheloplasty? *

A. Placenta previa

B. Ectopic pregnancy

C. Incompetent cervix

D. Abruptio placentae

25.The midwife teaches a pregnant woman to avoid lying on her back. The midwife has based this statement on the knowledge that the supine position can: *

A. Unduly prolong labor

B. Cause decreased placental perfusion

C. Lead to transient episodes of hypotension

D. Interfere with free movement of the coccyx

26.What condition causes ecchymosis on the periumbilical region? *

A. Placenta previa

B. Ectopic pregnancy

C. Incompetent cervix

D. Abruptio placentae

27. Which of the following is found in the urine of a patient with uncontrolled gestational diabetes? *

A. bicarbonates

B. ketones

C. hemoglobin

D. protein

28. Which of the following would the midwife identify as a classic sign of PIH? *

A. Edema of the feet and ankles

B. Edema of the hands and face

C. Weight gain of 1 lb/week

D. Early morning headache

29.Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage? *

A. Placenta previa

B. Ectopic pregnancy

C. Incompetent cervix

D. Abruptio placentae

30.A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further education? *

A. “I will maintain strict bedrest throughout the remainder of the pregnancy.”

B. “I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding.”

C. “I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad.”

D. “I will watch for the evidence of the passage of tissue.”

31.Type of abortion that can lead to septic shock and DIC *

A. threatened

B. imminent

C. habitual

D. missed

32. A patient with severe pre-eclampsia probably exhibits which of the following symptoms? *

A. hypertension, edema, and bradycardia

B. edema, hypertension, proteinuria +3

C. seizure, edema, hypertension, proteinuria +2

D. hypotension, edema, proteinuria +1

33. The medication of choice for a patient diagnosed with H-mole is: *

A. Methotrexate

B. Hydralazine (Apresoline)

C. Tylenol

D. RhoGAM

34. A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? *

A. Activity limited to bed rest

B. Platelet infusion

C. Immediate cesarean delivery

D. Labor induction with oxytocin

35. Which of the following symptoms occurs with a hydatidiform mole? *

A. Heavy, bright red bleeding every 21 days

B. Fetal cardiac motion after 6 weeks gestation

C. Benign tumors found in the smooth muscle of the uterus

D. Excessive vomiting and fast-growing abdomen

36. A 21-year old client, 6 weeks’ pregnant is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will often result in which of the following conditions? *

A. Bowel perforation

B. Electrolyte imbalance

C. Miscarriage

D. Pregnancy induced hypertension (PIH)

37. A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension (PIH). The midwife who is caring for the client is performing assessments every 30 minutes. Which assessment finding would be of most concern to the midwife? *

A. Urinary output of 20 ml since the previous assessment

B. Deep tendon reflexes of 2+

C. Respiratory rate of 10 BPM

D. Fetal heart rate of 120 BPM

38. Dr. Durante diagnoses ectopic pregnancy in a pregnant patient and orders ultrasonography. The midwife expects ultrasonography to reveal: *

A. an empty gestational sac.

B. grapelike clusters.

C. a severely malformed fetus.

D. an extrauterine pregnancy.

39. Which of the following would the midwife assess in a client experiencing abruptio placenta? *

A. Bright red, painless vaginal bleeding

B. Concealed or external dark red bleeding

C. Palpable fetal outline

D. Soft and nontender abdomen

40. A woman who had 3 or more abortions is described as: *

A. threatened

B. imminent

C. habitual

D. missed

A 13-year old girl is brought to hospital by her mother. She is reported to have a sudden onset of fever (103⁰ F), lightheadedness, nausea, vomiting and watery diarrhea. Physical examination reveals a desquamating rash of her palms and soles. She has no sick contact and there is no evidence of food poisoning. Upon questioning the patient says she started menstruating (menarche) a little over a month ago and she currently just finished her periods.

1. What is the microbial agent? Describe the morphology (shape, arrangement, gram reaction) and cultural properties (O2 requirement, biochemical requirements, motility, etc.) for this microbe.
2. Explain the spread or the occurrence for this infection (cause and transmission) and pathogenicity (virulent factors) of this agent relevant to this case study.
3. Describe the diagnoses (source of specimen, lab tests, and results that confirm your microbe) and treatment (name of Rx, what it targets, why/how does it work against this microbe) also include the general management of this patient.

A 13-year old girl is brought to hospital by her mother. She is reported to have a sudden onset of fever (103⁰ F), lightheadedness, nausea, vomiting and watery diarrhea. Physical examination reveals a desquamating rash of her palms and soles. She has no sick contact and there is no evidence of food poisoning. Upon questioning the patient says she started menstruating (menarche) a little over a month ago and she currently just finished her periods. It is Staphylococcus aureus.

1. Explain the spread or the occurrence for this infection (cause and transmission) and pathogenicity (virulent factors) of this agent relevant to this case study.
2. Describe the diagnoses (source of specimen, lab tests, and results that confirm your microbe) and treatment (name of Rx, what it targets, why/how does it work against this microbe) also include the general management of this patient.

• Discuss the importance of organizational theory in health care

SELECT THE RIGHT ANSWER :

QUES :

The patient underwent a surgical debridement during the day shift to remove a large amount of nonviable tissue from a complex abdominal wound. The nurse caring for the patient on the evening shift notices that the patient is tachycardic and febrile. Which action is the most appropriate nursing intervention?

Select one:

a. Notify the practitioner and express concern regarding infection.

b. Encourage the patient to take deep breaths to reduce anxiety.

c. Medicate the patient for pain and anxiety.

d. Document the finding as an expected outcome.

QUES :

The practitioner performed conservative sharp debridement at the bedside and removed a layer of eschar. There are orders for daily dressing changes using an enzymatic debriding agent. When assessing the periwound skin, the nurse notices tissue maceration. Which action should the nurse take?

Select one:

a. Wrap the area with a protective pad to maintain moisture in the dressing.

b. Increase the frequency of dressing changes.

c. Apply a barrier film to the periwound and request twice-daily dressing changes.

d. Reinforce the secondary dressing with more gauze.

QUES :

During an assessment, the nurse notices that the patient’s abdominal wound contains a small to moderate amount of loosely adherent yellow slough. If the practitioner decides to treat the wound using autolytic debridement, the nurse would expect an order for which step?

Select one:

a. Moisture-retentive dressing such as foam

b. Preparation for surgical intervention

c. Larval therapy every few days

d. Moist-to-dry dressing changes twice a day

Discuss jaundice signs & symptoms in New Born and explain rationales for therapy.

Discuss the dialogue you would use to teach a new mother about physiologic jaundice.

Include why the time of onset of the jaundice is important and how to treat jaundice.

Please include references.

1. MLO5 What are the concerns about the use of each of the following in food production?
   1. Hormones
   2. Antibiotics
   3. Pesticides
   4. GMO’s

What are the importance of patient reassessment in the hospital?

Discuss the purpose and at the same time demonstrate how you perform physical examination of head, face, eyes, ears, nose, mouth, throat, neck vessel, breast, regional lymphatics, thorax and lungs, heart, abdomen, and peripheral vascular system in order. Your discussion should includes the reason why we perform physical exam in each system or what abnormalities do we have to assess during physical examination of those systems.

1- Describe five elements to include in discharge teaching for a pediatric patient going home following a concussion.

2- Describe the six levels of consciousness in the pediatric patient.

3- describe a coup and contra coup head injury.

4- Differentiate between a generalized seizure and partial (focal) seizure. List the priority interventions for a padiatric patient having a seizure.

5- What is hydrocephalus and how is it managed?

Give an example of a Liposomal Amphotericin preparation.