Case Study

• Based on this case study how would the nurse actualize Parse's theory of Human Becoming?

The hospice nurse sat with Ann's husband, Ben. Ann was resting quietly as the increased dosage of IV pain medication gradually reached its therapeutic level. Ben turned his head and slowly turned, looking out the room's only window. As he glanced up, a small flicker of light caught his breath. It was a shooting star. A tear fell from the corner of his eye and he turned to Ann. The nurse sensed that something significant to Ann and Ben was unfolding. Shuffling to Ann's bedside, he took her small fragile hand in his. These hands had rocked cradles, burped babies, and groomed the horses she loved to ride. Gently holding her hand, he turned to the nurse. "She would ride like the wind was chasing her." Looking back to Ann his voice broke; choking back tears "Ann, Ann I saw Jessie…Jessie is calling." Ben turned "Jessie was our daughter. She died having a baby that was too big. When she died it was a pitch-black night. Cold, so cold, the baby died too, a little boy, named him Abe, Jr. after Jessie's husband. I took Ann outside so she could cry to God above and there in this dark sky we saw two falling stars…together…just falling. We knew it had to be Jessie and Abe…two angels to light up the night." Ben turned back as a deep sigh escaped from Ann's lips. A soft smile remained as she joined Jessie and Abe.

A. FP is a 66-year-old man hospitalized for surgical management of an enlarged prostate. His chart indicates that he has had Parkinson disease for 5 years prior to admission and has been managed with a dopamine precursor (levodopa/carbidopa). He also has a seizure history, having experienced a seizure about 20 years ago as a complication of a motor vehicle accident. He took an anticonvulsant medication for many years but stopped taking it about 3 years ago because he was “tired of taking it” and hadn’t had a seizure since the accident.

Discussion Questions

1. What types of motor difficulties would FP be expected to exhibit related to his Parkinson disease?

2. What is the rationale for managing Parkinson disease with a dopamine precursor?

3. What safety and activities-of-daily-living problems might FP have encountered while hospitalized?

4. If FP experiences seizure activity while in the hospital, what should be assessed during the seizure episode? How would his seizure be managed?

B. MG is an 8-year-old boy who has been brought to the emergency department by his parents with a fever of 104 °F, lethargy, headache, and stiff neck. Laboratory analysis of a spinal tap demonstrates increased white blood cells in the cerebrospinal fluid (CSF).

Discussion Questions

1.What is the most likely cause of MG’s signs and symptoms?

2.What is the origin and pathogenesis?

3.What other laboratory findings would be consistent with this etiology?

4.What are common complications of this disorder, and how would one assess for their occurrence?

5.What is the usual treatment for this disorder?

Below is the the number of hours of TV watched by boys and girls per week. Using the data on the number of hours of TV viewing, test the hypothesis that the number of hours of TV watched by girls is less than 7.4 hours per week at a 2% significance level.

State the null hypothesis, H₀ and the alternative hypothesis, H₁

Below is the the number of hours of TV watched by boys and girls per week. Using the data on the number of hours of TV viewing, test the hypothesis that the number of hours of TV watched by girls is less than 7.4 hours per week at a 2% significance level.

Determine the critical values that divide the rejection and nonrejection regions

Tony’s favorite memories of his childhood were the times he spent with his dad at camp. Tony was daydreaming of those days a bit as he and Suzie jogged along a nature trail and came across a wonderful piece of property for sale. He turned to Suzie and said, “I’ve always wanted to start a camp where families could get away and spend some quality time together. If we just had the money, I know this would be the perfect place.” On November 1, 2022, Great Adventures purchased the land by issuing a $540,000, 6%, 10-year installment note to the seller. Payments of $5,995 are required at the end of each month over the life of the 10-year loan. Each monthly payment of $5,995 includes both interest expense and principal payments (i.e., reduction of the loan amount).

Late that night Tony exclaimed, “We now have land for our new camp; this has to be the best news ever!” Suzie said, “There’s something else I need to tell you. I’m expecting!” They decided right then, if it was a boy, they would name him Venture.

Record the issuance of the long-term note payable for the purchase of land on November 1, 2022.

Record the first monthly payment on the long-term note payable, made on November 30, 2022.

Record the second monthly payment on the long-term note payable, made on December 31, 2022.

The 12 monthly payments in 2023 (following year) will reduce the note's balance by an additional $41,054. Record the reclassification of this amount from long-term notes payable to current notes payable.

Prepare the closing entry for revenue accounts.

Prepare the closing entry for expense and loss accounts.

What does the term “hypoglycemia” mean? What are the symptoms? What is the treatment?

3. Provide 6 reasons to support the statement “Breast is Best” for infants and mothers

4. Olivia is a healthy 4-month old baby. Olivia’s mother wants to replace Olivia’s infant formula with 2% cow’s milk. What advice would you give to Olivia’s mother concerning the appropriateness of making such a decision?

5. Discuss the term “iron deficiency anemia”. Include what it is, how it occurs, two symptoms of it, as well as the two stages of lifecycle most at risk for it.

6. You are a caregiver for Nancy, an 85 year old woman, who has dementia and is underweight. What strategies could you use to help increase her nutrition and energy intake?

7. Mrs Smith is getting very frustrated with her 2 year old because, in her words, he is a “picky eater”. What are some strategies Mrs Smith can use to help with feeding her son?

8. Kathy has a pre-pregnancy BMI of 36.5 kg/m2. She was taking a folic acid supplement prior to pregnancy but is unsure of the dosage now that she is pregnant. How much weight would you recommend she gain during her pregnancy? (1 mark) And what dosage of folic acid supplement would you recommend she take? (1 mark)

10. Jerome is 10 year old boy with a BMI of 24. When you plot his BMI, it falls above the 95th percentile. Discuss two recommendation you would give to Jerome’s mother? .

1) Industry Research polled teenagers on sunscreen use. The survey revealed that 46% of teenage girls and 30% of teenage boys regularly use sunscreen before going out in the sun.  

identify the two populations
A. teenage girls and teenage boys who use sunscreen regularly
B. all teenagers
C. teenage girls and teenage boys
D. None of the above


identify the specified attribute
A. being a teenage girl or a teenage boy
B. being a teenager
C. uses sunscreen before going out in the sun
D. None of the above


are the proportions 0.46 (46%) and 0.30 (30%) population proportions or a sample proportions?
A. population proportions
B. sample proportions
C. None of the above

2) Select True or False from each pull-down menu, depending on whether the corresponding statement is true or false.

  ?    True    False      1. The number of degrees of freedom associated with the ?t test, when the data are gathered from a matched pairs experiment with 10 pairs, is 9.

  ?    True    False      2. The best estimator of the difference between two population means ?1−?2 is the difference between two sample means ?¯1−?¯2x

  ?    True    False      3. In testing the difference between two population means using two independent samples, the sampling distribution of the sample mean difference ?¯1−?¯2x is normal if the sample sizes are both greater than 30.

  ?    True    False      4. A political analyst in Iowa surveys a random sample of registered Democrats and compares the results with those obtained from a random sample of registered Republicans. This is an example of two independent samples.

Olivia is a 33 year old G3 P2 who just gave birth to her 8 lb. 9 oz. baby boy by cesarean section after 15 hours of labor for failure to progress. The baby’s Apgar scores: 1 minute: 8 5 minutes: 9. The baby was admitted to the newborn nursery for evaluation and transition. Olivia was transferred to the postpartum unit, where you are the nurse and have assumed care of Olivia. You introduce yourself, orient her to her room, call light and review safety precautions. You perform your first assessment on Olivia and VS are within normal limits, fundus is firm, incision is intact, small amount of vaginal bleeding, no blood clots, lower leg edema is 1+, Foley catheter is in place and draining to gravity. Olivia appears withdrawn and asks to rest while her baby is in the nursery. Her husband and family have left to get breakfast and to rest after spending time with her and the baby while she was in recovery. Her husband plans to return after lunch. Olivia admits to you that she is disappointed that she could not have her baby vaginally after all she had done to prepare for the birth of her baby. She states “this baby was way too big.”

1. What about the initial assessment and conversation with Olivia would you want to evaluate further?
2. Explain “baby blues” and postpartum depression.
3. Does Olivia show signs of “baby blues” or postpartum depression? If yes what would concern you?
4. What interventions would you as the nurse implement if you noticed signs of “baby blues” or postpartum depression?

Lavinia is 35 years old. She is married to Sebastian who is a year younger than Lavinia. Lavinia and Sebastian are thrilled to have two daughters. One is nine years old. The other is seven.

Lavinia and Sebastian were originally hoping to add a son to their family, but they had mostly given up hope because they hadn’t had any luck conceiving again after their youngest daughter was born. And, they had stopped trying when Sebastian lost his job because money is a bit tight.

Lavinia has recently discovered that she is pregnant. She and Sebastian are excited that she might be carrying the son they have wanted in their family, but they are also stressed at the thought of having another mouth to feed.

When Lavinia met with her physician, she explained that she and her husband still desperately want a boy. Indeed, she expressed that she wants to continue the pregnancy only if the physician can do tests and determine that the fetus she is carrying is male. She has made clear that she wants to terminate her pregnancy and that she will be requesting an abortion if the fetus is not male. She has made equally clear that she wants to terminate the pregnancy and that she will be requesting an abortion if her physician won’t do the tests to identify the sex of the fetus.

Explore the ethics of sex selection involving abortion in contrast to sex selection involving preimplantation genetic diagnosis (PGD) you are welcome to do this by considering whether it would make a difference, in the case study, if Lavinia were asking her physician to identify and implant only a male fetus to begin her pregnancy.

You are an EMT and are called to the home of Kevin, a 13 week old boy who has become listless and is having trouble breathing. The parents reported that Kevin used to smile, but lately he has not smiled, nor has he had other noticeable facial expressions in the last two days. Kevin’s eyes are open when you arrive, but he does not seem to be focusing. You place your outstretched finger under his fingers and he fails to grasp it. You lift his foot and it drops back to the mattress. The parents report that he has not had a bowel movement in three to four days.

1. What is your diagnosis (disease name and causative agent), based on Kevin’s symptoms and why? (5 pts)
2. If this is indeed the case, do you start treatment here at Kevin’s home, or should you transport him to the local hospital? Why? (2 pts)
3. What should be administered to Kevin at the earliest opportunity and why? (2 pts)
4. How do babies acquire this condition? (2 pts)
5. Although the diagnosis should be confirmed with laboratory tests, the tests should probably not be performed in the local hospital lab. Why not? (2 pts)
6. What virulence factor is solely responsible for the symptoms Kevin is experiencing? Explain in specific detail the mechanism of action of this virulence factor. (4 pts)
7. What is a related virulence factor, made by a related organism, which causes the exact opposite symptoms? Explain in specific detail the mechanism of action of this virulence factor and explain how it causes the opposite symptoms. Name the disease caused by this factor and the organism that makes this virulence factor. (5 pts