Mrs. J. (age 42) has been married for 20 years to a TV newscaster. She has two 16-year-old twins who are in high school. She's coming in for a routine physical because she said over the phone that she has no energy and has lost some weight. She also thinks she has had a temperature for several days.

CC: "I can't stand sweating at night and think I'm too young for menopause. Besides, I still get my period."

Physical exam:

·        Temperature, 101°F    

·        Weight loss of 10 lbs. since her previous visit last year

·        Flu-like symptoms     

·        Nonproductive cough       

·        Bilateral lymphadenopathy in cervical and supraclavicular nodes    

·        Decreased breath sounds in bilateral bases  

·        White hair-like growth on tongue

Questions:

5. What are the differential diagnoses and your primary diagnosis with rationales?

6. Are there any legal/ethical considerations?

7. What is your plan of care? Always include pharmaceutical and nonpharmaceutical treatments, diagnostic tests, patient/family education, and follow-up plan.

8. Are there any Healthy People 2020 objectives that you should consider?

explain the important of personal cleanliness to the healthcare workers in a healthcare facility include your thoughts on why this is named Displaying Good Grooming personal Hygiene and Cleanliness

In what ways do particular political positions you have heard or read about, either in favor of or in opposition to the Patient Protection and Affordable Care Act (ACA), reflect any of the five frameworks of social justice?

Assignment 2: Developing your Leadership Philosophy.

Hello Students!

As aspiring nursing leaders and managers it is pivotal to have a leadership philosophy. Carter (2020) suggested that a leadership philosophy is essentially a belief system that guides your decision-making. It consists of your core principles, perspectives, and values. When you define what they are, and use them to shape a leadership philosophy statement, your behaviors and decisions will remain consistent.

For this assignment, choose a leader in Africa, using the assignment description below, discuss your philosophy of leadership following the steps outlined.  

Step 1: Select an admirable historic leader from.

1. Identify what you admire about this leader. Be specific.
2. What traits make them stand out?
3. What have they done or are doing to be an admirable, respected leader?
4. What type of working relationships have they built?
5. What are their exceptional leadership attributes and imperfections?

Step 2: Define your theory, attitude, principles, and behavior

think through 3 to 5 leadership elements you believe to be true in your heart and soul. For you, these elements are irrefutable right here, right now. Based on your experiences to date, you believe these 3 to 5 elements to be critical to leading effectively and productively. By belief I mean, these are elements you believe to be true about people, culture, and community.

Liam is a 17-year-old male who is being seen by his family physician for his annual physical examination. Liam’s sexual maturation rating is estimated to be 3. He weighs 114 lbs and stands 5’6” tall.

When he was 16 y.o., his height was 5’5” and weight was 106 lbs.  

At 15 y.o., Liam was 5’3” tall and weighed 98lbs.  

During the visit, Liam reports that he has been experimenting with a vegan diet since his visit last year. He explains that he thinks it is a healthier way to eat and states that he avoids milk, beef, and pork eats poultry or fish once every two weeks and eats cheese 3-4x/wk. Breakfast is usually cold cereal with almond milk because he heard that was a healthy milk alternative. He likes pasta, pizza, and salad, which he eats almost every day.  

For exercise, he runs 3 miles 2x/wk, plays basketball with friends after school 3x/wk for an hour, and lifts weights in his garage for 45 min 5x/wk.  

He says he would like to gain muscle and grow taller.  

3. What clarifying questions would you like to ask Liam about his current behaviors? List 3.

4. If there is protein a concern in Liam’s diet, why? Estimate his RDA and use evidence to support your position.

5. Given Liam’s diet and exercise patterns, which dietary components may he be deficient in? For each dietary component, list possible food sources that are appropriate for his current eating pattern.

6. There are both health benefits and costs of eating mostly plants. How might his current way of eating affect Liam’s growth and maturation?

7. Is it necessary to assess Liam for the presence of an eating disorder? Provide support for your answer.

Use motivational interview strategy to convince a 35 year old computer engineer was complaint of breathlessness and palpitation. Display the interview questions between the nurse and the patient

For each case study, you must develop an appropriate exercise prescription.  Use the FITT recommendations from the ACSM guidelines. You will need to calculate a workload for the particular type of mode of cardiovascular exercise you choose utilizing the metabolic equations. Once you pick an appropriate intensity, use the VO2R equation to calculate the oxygen consumption. Then use that to solve for the workload on the treadmill or cycle, whichever you think is best. Don't forget to indicate frequency and duration as well.  Please note any special considerations or precautions for each of them.

John, a 32 year old executive, is a type II diabetic with a fasting glucose level of 140 mg/dL. John currently weighs 220 pounds. He wants to begin an exercise program and has hired you as his trainer. Prior to developing diabetes John was somewhat active. He walked regularly and enjoyed gardening. His doctor informed him that he needs to participate in cardiovascular activity along with changing his diet in order to reduce his blood sugar. There are times when experience hypoglycemia and is concerned about exercising because of this issue. As a complication of diabetes, John has been experiencing neuropathy in both feet. He was given a GXT and his VO2max was estimated at 40ml/kg/mn.

Based on this information, design an ExRx using VO2R method to choose an appropriate intensity range and include: FREQUENCY, TIME, and TYPE OF EXERCISE. Bases on this VO2R range, use the metabolic equations to help determine the workload. Follow ACSM guidelines for special populations for this ExRx.

this is all the information I got

F.J. is a 70-year-old white woman admitted to the hospital because of a fall at home during the night. She is scheduled for an open reduction with internal fixation (ORIF) of the right hip at 8:00 AM this morning. She has a history of type 2 diabetes mellitus that is well managed with metformin (Glucophage) 5 mg twice daily.

Subjective Data

• States pain is a level 7 on a scale of 1 to 10
• Last dose of metformin was at 6:00 PM the previous evening

Objective Data

Physical Examination

• Blood pressure 120/54, pulse 101, temperature 98° F, respirations 20
• Alert and oriented to person, place, and time
• Lungs clear to auscultation
• Heart rate and rhythm regular, no murmurs
• Height 5’2”, weight 150 pounds
• Bowel sounds active and present in all four quadrants
• Circulation and sensation to bilateral lower extremities intact
• Strength left lower extremity 5/5, right lower extremities not tested because of pain

Diagnostic Studies

• X-Ray reveals a break in the right hip
• Morning blood glucose level was 280 mg/dL

Preoperative Orders

• NPO after midnight
• Type and crossmatch 2 units of packed red blood cells
• Start an IV of lactated Ringer's at 75 mL/hr
• Place in Buck’s traction
• Ensure that surgical consent form is signed and placed in the chart
• Administer ceftriaxone sodium (Rocephin) 1 gram IV when called to OR

1.Name 3 nursing diagnosis, 3 interventions for each diagnosis and patient education

Case Study 1.

Andrew, a 22-year-old male, was involved in a head-on collision. He was not wearing his

seatbelt at the time of the accident. When emergency crews reached the scene of the accident

they found Andrew wedged against the steering wheel. Following a difficult extraction from his

vehicle, Andrew is exhibiting the following symptoms:

- Semiconscious

- Dyspnea

- Inward movement of the left anterior portion of his thorax during inhalation

- Pain in his left thorax and upper left abdomen

- Pale and cyanotic mucous membranes and cyanotic areas around his upper lip and nail beds

- BP 83/51

- CBC HgB 10.1, HcT 30%

- Blood chemistry abnormalities Arterial PO2 65mmHg, Arterial PCO2 55mmHg, Arterial pH 7.27

- Urinalysis: pH 4.0

1. What is the most likely cause of Andrew’s symptoms?

2. Flail chest is a condition which occurs when one section of the ribcage moves inward while

the rest of the thoracic wall moves outward during inhalation. What might be the cause of this

condition?

3. How might this condition affect the breathing process?

4. Why does Andrew have cyanotic mucous membranes?

For each case study, you must develop an appropriate exercise prescription.  Use the FITT recommendations from the ACSM guidelines. You will need to calculate a workload for the particular type of mode of cardiovascular exercise you choose utilizing the metabolic equations. Once you pick an appropriate intensity, use the VO2R equation to calculate the oxygen consumption. Then use that to solve for the workload on the treadmill or cycle, whichever you think is best. Don't forget to indicate frequency and duration as well.  Please note any special considerations or precautions for each of them.

Maria, a 68 year old recently diagnosed with Osteoporosis has been referred to you to help with an exercise program designed to slow the progression of bone loss. Her current weight is 130 pounds. Due to this condition, she has already fractured four ribs and broken her right ankle. She complains of fatigue and weakness most of the time. The results of her GXT showed a maximal VO2 of 25ml/kg/mn.

Based on this information, design an ExRx using VO2R method to choose an appropriate intensity range and include FREQUENCY, TIME and TYPE OF EXERCISE. Based on this VO2R range, use the metabolic equations to help determine the workload. Follow ACSM guidelines for special populations for this ExRx.

This section will discuss the differences between legal and illegal drugs

Read the article that discusses the differences between legal and illegal drugs http://www.differencebetween.com/difference-between-legal-and-vs-illegal-drugs/ First, list as many legal drugs as you can, next list as many illegal drugs as you can

Research in the media examples of the common drugs that are used. Write a brief description (paragraph) of your findings (legal or illegal) Answer the following questions:

What causes substance abuse addition? Why do people avoid seeking substance abuse treatment?

What is substance abuse treatment?

Discuss the various types of treatment programs and the levels of care?

and What is involved in the recovery process?

Discuss and analyze the benefits of Medication Reconciliation and SBAR for improving Quality in systemic, patient safety programs and compliance by health care providers.

information on Health behavior change affecting a vulnerable population