1. SGA case study

2. Submit report about following topics:

a. Densitometry (Body composition Assessment) Hydrostatic, or underwater weighing.

b. Air Displacement Plethysmography.

c. Neutron Activation Analysis.

d. Total Body Potassium.

Using a professional journal, the newspaper, or the web, locate an article that describes the development of a community partnership. Select a partnership that focuses on health and has at least three partners, if possible.

Text book population based nursing concepts and competencies for Advanced practice 2nd edition. ISBN: 9780826196132

J.S. is a 21-year-old male who was brought into the emergency room via ambulance after suffering a gunshot wound to the spine. At the accident scene, the paramedics noted J.S. had some movement of all his fingers and only his left leg. J.S. was not able to move his right foot.

Based upon the above situation:

1. What is the level of injury?
2. Is the cord injury complete or incomplete?
3. What type of lesion is he presenting (central cord, brown-sequard, anterior, conus medullaris, or cauda equina). Support your answer.

J.S.'s parents are present and ask you if he will every gain control of legs and feet.

4. Do you expect J.S. to eventually gain control of his legs and feet?

5. How would you explain primary and secondary injury in terms the parents will understand?
6. Compare and contrast cervical, thoracic, and sacral lesions.

Autonomic dysreflexia is an acute emergency.

7. What is autonomic dysreflexia?
8. What is the cause?
9. What are the manifestations?

J.S. is a 21-year-old male who was brought into the emergency room via ambulance after suffering a gunshot wound to the spine. At the accident scene, the paramedics noted J.S. had some movement of all his fingers and only his left leg. J.S. was not able to move his right foot.

Based upon the above situation:

J.S.'s parents are present and ask you if he will every gain control of legs and feet.

4. Do you expect J.S. to eventually gain control of his legs and feet?

5. How would you explain primary and secondary injury in terms the parents will understand?
6. Compare and contrast cervical, thoracic, and sacral lesions.

what are the barriers impeding advanced practice nurses from achieving their full scope of practice

Autonomic dysreflexia is an acute emergency.

7. What is autonomic dysreflexia?
8. What is the cause?
9. What are the manifestations?

TR is a 78-year-old female, who weighs 83.2kg (183 lbs. 6oz) and stands 152.4 cm (5 ft.). She states she lives with her spouse of 55 years and both are independent and active. Her code status is DNR and her Physician is Dr. Jon Doe. She states she wears glasses due to an eye injury when she was young and also has hearing aids but left them both of them at home.

Allergies: Ace inhibitors—unknown reaction, Actos—dizziness, throat swelling, Endocet—hives, Penicillin’s –hives, Tomatoes (raw) itching/rash

Past Medical History: per patient and husband: Hypertension, Kidney Infections, Stage III Chronic Kidney Disease, Heart murmur, Aortic stenosis, Congestive Heart Failure, Bronchitis, GERD, GI bleed, Endoscopy (February 2016)

TR states she was feeling “fine” the past 24 hours. She then began to have “flu-like” symptoms: headache, neck /jaw pain, mid-abdominal pain, weak and tired, loose stools, nausea, dizziness, poor balance, and decreased appetite. She was brought to the ER by her spouse, after talking to her FMD. Some blood work was drawn HGB 5.7—2 units of Packed Red Blood Cells ordered, INR 4.3----Vitamin K given. Coumadin put on hold. Gastroenterologists were consulted after blood was detected during a + (positive)Hemoccult test, indicating upper GI bleed. IV fluids were started, and it was decided she would be admitted.

On admission to the Medical-Surgical Unit, TR: She states she has a headache and some neck & jaw pain, mid abdominal pain, loose stools since yesterday, a little nausea that gets better with eating a few crackers, fatigue, dizziness especially after standing up after sitting for a while, poor balance, and decreased appetite. She states she does look a little pale compared to her usual tan self. TR denies vomiting, chest pain, shortness of breath, problems with urination and denies visible bloody stools. The patient was made NPO for further testing and was admitted to a Medical-Surgical/Telemetry unit. Her VS. are T- 99.8F oral, HR 96 and irregular, RR 18, BP 100/58, POX 96% on room air.

Later in the day after receiving the blood transfusion her Hgb was 6.8 HCT was 20.1, and another 2 units of PRBCs were ordered. After the second blood transfusion her repeat Hgb was 10.1, INR 3.1. Small bowel push enteroscopy was ordered. Prior to the test her assessment revealed: she is alert, oriented x3, dressed in a patient gown. Her speech was clear, and she was able to answer questions appropriately, skin slightly pale with delayed turgor, s1 s2 heart sounds, with a murmur noted at the mitral valve, lungs sounds were clear, no adventitious sounds, her lips appeared dry with a few cracks. She used the restroom and her urine was noted to be dark yellow in color and measured 100 mL. TR said “don’t worry about that its always that way”. Abdomen slightly round, symmetrical, hyperactive bowel sounds in all 4 quadrants, soft but slightly tender RUQ and tympanic throughout.

She returned to the unit: Results of her: Schatzki ring (narrowing of lower esophagus), small hiatus hernia (part of stomach pushed up through diaphragm) gastric melanosis (excess melanin) resulting in benign mucosa changes, single bleeding angioectasia (acquired lesion--bleeding) in the duodenum that was clipped with MRI compatible clips. She was able to ambulate to the bed with a slight imbalance and required 1 assist with a Gait belt. She requested examination of her right heel because it was “sore” and bothering her. She also stated her feet often get tingly and numb. Upon inspection it was noted she had a blister on her right heel and her right great toe appeared red and was also sore to the touch. Her pedal pulse was noted to be a +1 on the right and +2 on the left, bilateral sluggish capillary refill. +3 pitting edema in bilateral lower extremities was assessed, to which patient stated, “they get like that sometimes”.   She was started on clear liquids which she consumed 50% without difficulty and stated she continued to feel slightly nauseated. Patient asked if she could have some eye drops because her eyes feel dry. Upon inspection her eyes have no drainage, sclera is noted to be white, and conjunctiva is red and dry in appearance.

Complete a physical assessment on TR using the case study to break the assessment into the following: General Survey, Integumentary, HEENT, Sensory-Neurologic, Cardiovascular, Gastrointestinal, Genitourinary, and Musculoskeletal.

Future considerations for APN roles. There are three troublesome issues that have emerged in the advancement of APRN practice,.These issues in APRN include: 1) the clear role development and morphed to fill gaps in services; 2) the lack of clarity regarding role uniqueness; and 3) the dearth in nursing specific outcomes. From your readings, discuu one of the thrre questions Begin your discussion with the question you will addressing.
  
    1. why might the development and morphing of roles based on gasps in medicine be problematic for advancement of APRN's. What actions might a nurse take to reduce this
    2. In what ways can an APRN distinguish his or her role from other nursing roles and medical counterparts? Why might this be important?
How can APRN s encourage nursing-based outcome studies?

Provide an electronic media device that shows your interest in public health, then write a 5-sentence paragraph explaining the media device.

For example, a twitter or other social media account, or an infographic you took a picture of, or a public health ad that you found interesting and allowed you to enter the field.

When we speak of life in the sense of relationships, dreams, and expectations for the future, we are speaking of?