In a hypothetical case-control study, researchers are interested in exploring the activities and behaviors of individuals at Northwestern University that may be associated with increased risk for testing positive for COVID-19.
a. What inclusion and exclusion criteria would you use? Why?
b. Define who is considered a case. How might you identify cases?
c. Carefully define who is in the control group. How might you accurately identify control individuals?
d. For the case-control study, how would you collect information on activities and behaviors?
e. Discuss how cases and controls in your study might differ, besides disease status, and how this might bias the results.
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Values in the table below are approximate. Use these to answer the following questions and to compare health impact of the two diseases.
|
R-naught |
Incubation period |
Contagious Period |
|
|
COVID-19 |
2.5 |
10 days |
2-3 days before symptoms to 10 days after |
|
Rabies |
1.5 |
Several months |
From symptoms to 10 days after symptoms |
Recall that R-naught is the average number of additional cases that directly result from a single person bringing it into a fully susceptible community.
Below, compare in the impact between the two diseases for each of these disease characteristics on public health. For each question, use only the information provided in the table.
a. What does the R-naught suggest about the relative public health risk for the two diseases?
b. What do the differences in the incubation period suggest about potential challenges in clinical and public health responses to the two diseases?
c. What do the differences in the contagious period suggest about potential challenges in clinical and public health responses to the two diseases?
d-e. What are two other important aspects of the disease, besides access to vaccination, that would contribute to different health risks for these diseases?
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A hypothetical study investigated periodontal disease and oral hygiene behavior. The outcome of interest was the presence or absence of periodontal disease, and the exposure was current oral hygiene practices such as frequency of brushing and use of dental floss. Participants were enrolled during a regular dental visit where they were given a full dental screen and then completed a short questionnaire.
a. What type of a study design is this?
b. What are the advantages of using this design to study this question?
b. What is the major limitation of this design for showing that poor dental hygiene causes periodontal disease?
c. How might the patient’s knowledge of having periodontal disease bias the results?
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Nurses interact with technology on a daily basis. For this discussion, please address each of the following aspects of the discussion:
Describe a situation from your professional experience that backs up your viewpoint and discuss the social, moral, political and economic factors impacting your position.
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Case Study
Colleen, a psychiatric mental health RN, is leading a
therapeutic group for inpatients who have a history of alcohol
abuse. The group is in the orientation phase, and members are still
getting to know one another. Even at this early stage, however,
Colleen recognizes behavior and personality traits of two members,
in particular, that could pose potential problems in the group. One
member, Howard, comes across as extremely negative and fairly
aggressive. At times, he directly criticizes and belittles other
members. When one group member discusses his wife’s disapproval of
his drinking, Howard replies in disgust, “I don’t understand
spineless guys like you who let women run your life. No wonder you
can’t quit drinking.” When not confronting members directly, Howard
makes dismissive and disparaging sounds or gestures. Other members
seem offended by his behavior. Another member of the group, Fatima,
has not spoken at all, except when directly asked a yes-or-no
question. She does not seem unpleasant or unhappy to be in the
group, but she keeps her eyes down, as though she’s afraid to be
“called on.”
What term describes the type of group behavior Howard
is demonstrating? How might Colleen address this behavior most
effectively?
Fatima is what type of group member? How is this best
addressed? Should Colleen leave Fatima alone since she is not
disrupting the group or causing any trouble? Or should Colleen be
more proactive with this member?
The members of Colleen’s group are inpatients. What
bearing, if any, should this have on your suggestions above for
Colleen in addressing member behavior? How might this affect
Colleen’s overall leadership style for this group?
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1. Select the accurate statement that describes the
benefit of long-term therapy for Tuberculosis (TB)?
A) It eradicates tubercle bacilli and provides a cure for the
infection
B) It decreases drug toxicity and better patient tolerance
C) It decreases the likelihood of active infection in latent TB
2. Your patient is on metformin, glipizide, and pioglitazone for his DM II. His last 3 morning FBG are < 60mg/dl, which medication should be discontinued to avoid the risk of hypoglycemia?
A) Metformin
B) Pioglitazone
C) Glipizide
3. All of the followings accurately describes prochlorperazine (Compazine), EXCEPT:
A) It blocks acetylcholine receptors in chemoreceptor trigger zone
B) Can be co-administer with morphine to prevent nausea
C) It is indicated for nausea associated with opioids or anesthesia
4. A patient ℅ tinnitus after starting many new medications. Which of the following is most likely the cause of this ototoxicity effect?
A) Ondansetron (zofran)
B) Metformin
C) Pantoprazole
Gentamycin
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How does bacterial pneumonia lead to hypoxemia? (Describe the pathophysiology).
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1. A current IV drug use patient develops endocarditis. Which type of pathogens is most likely the cause of this infection?
A) GM+ cocci
B) Candidas
C) GM- bacilli
D) Pseudomonas
2. What is the most common pathogen for pyelonephritis? (An upper UTI infection)
A) E. Coli
B) Nisseria gonorrhea
C) MRSA
D) Extended spectrum beta-lactamase (ESBL) bacteria
3. What is the main benefit for intermitten chemotherapy?
A. It is more cost effective
B. It allows patient to receive chemo treatment at home
C. The successive dosing reduces cancer cell resistance
D. Allow host cells to recover and reduce injury after each dose
4. What are two examples of clinical consequences of AIDS?
A) Decreased adaptive immunity resulting in loss of fever response
B) Virus inhibits bone marrow function resulting in pancytopenia
C) Severe loss of macrophages and natural killer cells as shown by CD4 count < 200
D) Prone to severe, systemic fungal infection that is normally suppressed by healthy immune system
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A shipment of a radiopharmaceutical is received by your facility and the survey measurement you take at one meter is 108 mR / hr. How should you label and handle this shipment?
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Disorders of the endocrine system affect many
individuals. Providing multidimensional patient care can be
challenging for patients experiencing these disorders. Ensuring the
plan of care meets the patient and family needs is important in
order to increase adherence to proper medical treatment following
discharge.
What does it mean to provide a multidimensional
approach? Provide at least three examples of how the care team can
meet the patient and the family’s needs? List at least three care
team members and how are they involved in providing
multidimensional care?
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1) Which of the following drugs may cause reddish color urine?
A) Vancomycin
B) Methotrexate (Rheumatrex)
C) Doxorubicin (Adriamycin)
D) Cyclophosphamide (Cytoxan)
2) A patient is presented to ED in hyperosmolar hyperglycemia state. His O2 saturation is 90% and BP is 90/55. His K is low. Prioritize the following interventions in the correct order of administration based on patients condition.
1) Insulin 10 units IV
2) Normal Saline IV fluids
3) Oxygen therapy
4) KCL IV replacement dose
A) B,C,A,D
B) C,A,D,B
C) C,B,D,A
3. Which of the following medication absorption maybe affected by antacid administration?
A) Vitamin C
B) Vitamin D
C) Iron supplement
4) Which of the following is NOT regarded as GI defensive factor?
A) Pepsin
B) GI mucosa
C) Bicarbonate
D) Prostaglandin
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Read the case study, then answer the questions that follow.
Case study (questions 7-9)
Mrs Hampshire has now been in the facility for 10 weeks. During this time, Mrs Hampshire has gradually improved in her health status. Regular physiotherapy sessions have maintained the muscle tone of the affected side of her body and she has been able use an electric wheelchair, which has increased her level of social interaction and physical mobility.
On admission, communication was noted to be a problem for Mrs Hampshire and was also contributing to her depression and isolation. A communication board was used and Mrs Hampshire also communicated via written words on a notepad, though this was difficult as she was previously left-handed.
Improvement in her speech through regular speech therapy sessions has also meant that Mrs Hampshire is able to communicate her needs more easily.
Mrs Hampshire still requires a special diet. By recording how much Mrs Hampshire is eating and drinking, it is found that she is not taking adequate fluids. After discussion with the supervisor and Mrs Hampshire’s daughter, a plan is made for Mrs Hampshire’s daughter to give her extra fluid after lunch each day. Her daughter also remembers that her mother doesn’t like coffee or tea but prefers chocolate milk. Mrs Hampshire’s fluid is changed to chocolate milk and the fluid intake increases to a healthy level.
What problem-solving activity did the support worker take to assist with fluid intake to improve urinary system functioning? (Approx. 50 words).
Identify the health issues that Mrs Hampshire had and may experience. Explain how each problem affects other systems of the body in supporting healthy functioning. You are required to identify and explain eight health issues (or potential issues) in your answer. (Approx. 160 words).
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Case Studies, Chapter 40, Fluid, Electrolyte, and Acid--Base Balance
You are a nurse who frequently cares for postsurgical patients in your hospital unit. Most of the medical-surgical patients have IV fluids infusing during their admission. Due to the frequent use of IV fluids on your floor, understanding fluid balance and electrolyte function is primary to your nursing practice. (Learning Objectives 1, 6, and 7)
What conditions might lead to the development of hypovolemia?
How would the amount of patient fluid loss be determined?
Describe how hypovolemia and third-space fluid shift correlate.
Outline the major difference between hypovolemia and third-space fluid shift.
Which conditions can result in third-space fluid shift?
You are a nurse in a nonsurgical cardiac unit caring for a 92-year-old patient who has two sons, 15 grandchildren, and 49 great-grandchildren. She lives in assisted living and has a history of congestive heart failure (CHF). She consistently struggles with balancing her fluids and electrolytes and has an affinity for dill pickles and sauerkraut. While hospitalized, she remains on a fluid restriction---much to her chagrin, as she loves ice cream.
What within her history would indicate she was at risk for hypervolemia?
How would dill pickles and sauerkraut impact her fluid volume?
What body areas offer observational evidence of excessive interstitial extracellular fluid (ECF)?
Why would your patient be on a strict fluid restriction while hospitalized?
Outline nursing interventions used while a patient is on fluid restriction.
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