The pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes

                                                      Adaptive Response

As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis. The pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

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To Prepare

· Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

· Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

· Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

· Review the Application Assignment Rubric found under Course Information

To Complete

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

· For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.

· Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

  • Chapter 6, “Innate Immunity:      Inflammation and Wound Healing”

This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound healing process.

  • Chapter 7, “Adaptive      Immunity”

This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.

  • Chapter 8, “Infection and      Defects in Mechanism of Defense”

This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder—HIV/AIDS.

  • Chapter 9, “Stress and      Disease”

This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.

  • Chapter 10, “Biology of      Cancer”

This chapter explores the developmental process of cancer and factors that impact the onset of cancer at the cellular level. It also describes various treatment options.

  • Chapter 11, “Cancer      Epidemiology”

This chapter reviews genetic, environmental, behavioral, and diet-related risk factors for cancer. It also examines types of cancers that result from risk factors.

  • Chapter 12, “Cancer in      Children and Adolescents”

This chapter focuses on the presentation and prognosis of childhood cancers. It examines the impact of genetic and environmental factors on these cancers.

  • Chapter 38, “Structure and      Function of the Musculoskeletal System”

This chapter covers the structure and function of bones, joints, and skeletal muscle. It also explores effects of aging on the musculoskeletal system.

  • Chapter 39, “Alterations of      Musculoskeletal Function”

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of bone, joints, and skeletal muscle disorders. Additionally, it explores musculoskeletal tumors, osteoarthritis, and rheumatoid arthritis. The pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes

  • Chapter 40, “Alterations of      Musculoskeletal Function in Children”

This chapter includes musculoskeletal disorders that affect children, such as congenital defects, bone infection, juvenile idiopathic arthritis, muscular dystrophy, musculoskeletal tumors, and nonaccidental trauma.

  • Chapter 41, “Structure,      Function, and Disorders of the Integument”

This chapter begins with an overview of the structure and function of skin. It then covers effects of aging on skin, as well as disorders of the skin, hair, and nails.

  • Chapter 42, “Alterations of      Integument in Children”

This chapter covers alterations of the integument that affect children. These include acne vulgaris, dermatitis, infections of the skin, insect bites and parasites, vascular disorders, and other skin disorders.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

  • Chapter 3, “Disorders of the      Immune System”

This chapter explores the anatomy and physiology of the immune system. It also explores the pathophysiology of various immune disorders such as primary immunodeficiency diseases and AIDS.

  • Chapter 8, “Diseases of the      Skin”

This chapter begins with an overview of the anatomy and physiology of skin. It also explores the pathophysiology of various types of skin lesions and inflammatory skin diseases.

  • Chapter 24, “Inflammatory      Rheumatic Disease”

This chapter explores the pathogenesis of inflammation and its role in rheumatic diseases. It also examines the clinical presentation, etiology, pathophysiology, and clinical manifestations of rheumatic diseases such as gout and rheumatoid arthritis.

Required Media

Zimbron, J.  (2008). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://www.medmaps.co.uk/beta/

Gastro-oesophageal reflux disease. [Image]. Used with permission of MedMaps.

This media provides examples of mind maps for dementia, endocarditis, and gastro-oesophageal reflux disease (GERD).

Optional Resources

Arthritis Foundation. (2012). Retrieved from http://www.arthritis.org/ 

Lupus Foundation of America. (2012). Retrieved from http://www.lupus.org/newsite/index.html 

Pharmacology Case Study- Prescribed Drugs With CAMs

No Plagiarism please, assignment will be checked with Turnitin. 

Will need 5 full pages, double spaced all throughout the page for the case study, APA Style, Times New Roman, font 12, Title Page and a Reference page. 

Case Study: Prescribed Drugs with CAMs

A 35-year-old male, Mr. NX, presents to your clinic today with complaints of back pain and “just not feeling good.” Regarding his back, he states that his back pain is a chronic condition that he has suffered with for about the last 10 years. He has not suffered any specific injury to his back. He denies weakness of the lower extremities, denies bowel or bladder changes or dysfunction, and denies radiation of pain to the lower extremities and no numbness or tingling of the lower extremities. He describes the pain as a constant dull ache and tightness across the low back Pharmacology Case Study- Prescribed Drugs With CAMs.

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He states he started a workout program about 3 weeks ago.

He states he is working out with a friend who is a body builder.

He states his friend suggested taking Creatine to help build muscle and Coenzyme Q10 as an antioxidant so he started those medications at the same time he began working out. 

He states he also takes Kava Kava for his anxiety and garlic to help lower his blood pressure.

His historical diagnoses, currently under control, are:

Type II diabetes since age 27

High blood pressure

Recurrent DVTs

His prescribed medications include:

Glyburide 3 mg daily with breakfast

Lisinopril 20 mg daily

Coumadin 5 mg daily

Directions:

*****This Assignment may be submitted in an  APA formatted paper of no more than five (5) pages excluding title page and references.

Based on the above case study, address each section of the Unit 9 Assignment template. 

Be sure to first view the Unit 9 Assignment Grading Rubric and use it to guide your completion.

Be sure to read the Assignment description carefully (as displayed above);

  1. Download the Unit 9 Assignment template 
  2. Rename the downloaded template file as “FirstInitial+LastName_ MN553_Unit9.docx” (e.g., JDoe_MN553_Unit4.docx).
  3. Review the Assignment grading rubric.
  4. Complete the template, basing your responses on the case study above.
  5. Support your arguments with appropriate evidence from the literature, citing and referencing in APA 6th edition style. Pharmacology Case Study- Prescribed Drugs With CAMs

Using Variance Analysis In Decision Making

Having a budget is critical for the financial stability of an organization. Keeping track of how well the organization is actually adhering to the budget, and subsequent identification of why the budget numbers are being missed is equally important. Without this critical “why” piece, it is difficult to make the necessary adjustments to the budget or to organizational behavior that might be promoting overspending.

A good budget is built with thoughtful consideration of future costs and revenue. Though your budget is formulated with expected figures in mind, the actual resulting values may vary considerably. This variance–from projected to actual–can be a pleasant surprise or a fiscal nightmare and can make financial decision making difficult. Fortunately, variance analysis can enable management to determine why variance occurred and what can be done to mitigate its effects. Using Variance Analysis In Decision Making

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For those not comfortable with the use of Microsoft Excel, this week’s Optional Resources suggest several tutorials.

To prepare:

  • Review the information in this week’s Learning Resources dealing with variance analysis, how it is calculated, and how it can be used in decision making.
  • View the video  Week 8 Application Assignment Tutorial: Variance Analysis, provided in this week’s Learning Resources.
  • Use the Week 8 Application Assignment Template, provided in this week’s Learning Resources, to complete this assignment.   Carefully examine the information in each of the scenarios and provide the necessary calculations.  Using this information will help you answer the questions. 

Note:For those Assignments in this course that require you to perform calculations you must:
Use the Excel spreadsheet template for the Week 8 assignment
Show all your calculations and formulas in the spreadsheet.
Answer any questions included with the problems (as text in the Excel spreadsheet).

Salary Variance Scenario

For this Assignment run a variance analysis. Based on the information you obtain: assess the results of the analysis, suggest potential causes of the budget variances and an explanation for addressing the situation.

Using the following performance data calculate the volume adjusted labor rate variance and volume adjusted efficiency variance. Your Variable Expense Factor is 40% and your Volume Change Factor is 50%.

Note:Submit the Excel spreadsheet containing your Salary Variance Scenario calculations to the Assignment submission link.

In the past, students expressed confusion on which cells to complete on the week 8 assignment. To reassure you and perhaps, make it simpler, I have highlighted all cells that should have data in them on this assignment. That data may be simply transferred from data provided, or require you to complete a formula. I hope this helps.   

Week 8 highlighted template Weatherspoon.xls

On your Excel assignments with a narrative, I have a request. 

Please click on the narrative cell box (where you will write your answer; then look at the tool bar on top- click Wrap Text.  This will keep your narrative answer in a viewable box. Otherwise it runs off the screen. This is a big help to me as I can grade the assignment within the Blackboard system. If it is not done I have to download and expand that box (using wrap text) then reupload it again.  This prevents me from putting feedback directly into the grading tool on your assignment. Here is a screenshot: Using Variance Analysis In Decision Making

Thank you for your help with this on the week 8 and week 10 assignments! Dr  Deb

The highlighted areas are where you need to complete! Don’t forget to Wrap Text!

Dr Deb

c

Expense forecasting is one of the preeminent tools that financial managers can use to prepare their organizations for future fiscal turbulence


Throughout this course, you’ve examined the importance of anticipating financial fluctuations that may impact your organization’s ability to provide services. While financial managers have no time machines or crystal balls, they do have expense forecasts. Expense forecasting is one of the preeminent tools that financial managers can use to prepare their organizations for future fiscal turbulence. In this Assignment, you will examine a scenario and generate a corresponding expense forecast in Excel. Expense forecasting is one of the preeminent tools that financial managers can use to prepare their organizations for future fiscal turbulence

Before pursuing an opportunity or making a major purchase, financial decision makers must first ascertain if the expenditures are justified. Determining whether a new process, system, or purchase will yield worthwhile returns is no easy task. However, managers have a variety of tools to help them decide whether the new expenditure is warranted. Analyzing a venture’s benefit/cost ratio, marginal profit and loss statement, and break-even points enable nurse managers to make educated decisions about how they choose to commit their funds.

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Note: For those Assignments in this course that require you to perform calculations you must:Use the Excel spreadsheet template for the Week 3 assignment
Show all your calculations and formulas in the spreadsheet.
Answer any questions included with the problems (as text in the Excel spreadsheet).

Expense Forecasting

In this Application Assignment you calculate scenarios focusing on benefit/cost ratio analysis, marginal profit and loss statements, and break-even analysis. For these scenarios, you will utilize the provided figures to perform calculations and then make recommendations about the viability of the investment opportunities 

Expense Forecasting Scenario

Your department has performed 20,000 procedures during the first six months (January–June) of 20X1. Spending during that period of time was $210,000 for fixed expense items and $1,200,000 for variable expense items. Of those amounts, $50,000 of fixed expense money was spent on preparing for a Joint Commission survey. Volume is anticipated to be 10% higher in the second half of the year. On November 1st, two new procedure technicians will begin work. The salary and fringe benefit costs for each are $96,000/year. Based on the information provided, prepare an expense forecast for 20X1.

Annualization for Fixed:  (Adjusted Total for Year to Date Expense/6) * 12 =Total Annualized Amounts

Annualization for Variable (Adjusted Total for Year to Date Expense/ 20,000) * 40,000 =Total Annualized Amounts.

Financial Analysis Cycle

Marginal Profit and Loss Statement Scenario

You are examining a proposal for a new business opportunity – a new procedure for which demand is expected to be 1,400 units the first year, growing by 600 units a year thereafter. The price charged per procedure is $1,000. The collection rate is anticipated to be 80%. Each procedure consumes $300 of supplies. Salary cost is estimated to cost $540,000 each year, fringe benefits are 25% of salaries, rent for the facility is $55,000/yr and operating cost are $120,000/yr.

Questions:

  1. Develop a marginal profit and loss statement for this business opportunity.Based on that analysis, should this opportunity be pursued?

Break-Even Analysis Scenario

You can charge $1,075 for a new service. Demand is anticipated to be 8,000 units a year. Your business is able to handle up to 16,500 units annually, so capacity should not be a problem. The average collection rate is 80%. The new service has annual fixed costs of $4,700,000. Variable cost per unit of service is $420.

Question: Use break-even analysis to determine if this new service is financially viable. If the business is not financially viable, what steps could you take to make a case to proceed with implementation?  Explain your decision Expense forecasting is one of the preeminent tools that financial managers can use to prepare their organizations for future fiscal turbulence.

Benefit/Cost Ratio Analysis Scenario

You are considering the acquisition of a new piece of equipment with a useful life of five years. This new technology will make your clinical operation more efficient and allow for a reduction of 10 FTEs. The equipment purchase price is $4,500,000 plus 10% installation fee. The purchase price includes service for the first year, an item that has an annual cost of $10,000. There is a potential for additional volume of 150,000 units in the first year, growing by 30,000 each year thereafter. The price charged per unit is $15.00 with a 50% collection rate. The staff being eliminated are paid $12.50 per hour. The fringe benefits rate is 20%. The hurdle rate is 7.5%.

Questions: After reviewing Dr. Ward’s Video and the calculations below, please answer the following questions:

  • What is meant by  benefit/cost ratio, average payback period and ROI  and why are the all  important to understand when purchasing new equipment?
  • Based on this information, would you pursue this opportunity?
  • Explain your decision  in 250-500 words in the text box below.

References:

Baker, J. J., Baker, R. W., & Dworkin, N. R.  (2018). Health care finance: Basic  tools for nonfinancial managers (5th ed.). Burlington, MA: Jones and  Bartlett Learning.

Chapter 14, “Trend Analysis, Common Sizing, and Forecasted Data” (pp. 149-160)
The focus of this chapter is the use of trend analysis and forecasting to develop future budgets and make financial decisions about capital purchases, programs, and personnel.
Chapter 15, “Using Comparative Data” (pp. 161-173)
In this chapter, you are introduced to the criteria for identifying other health care organizations that are comparable to your own. Data from these organizations can then be used to evaluate your own organizational performance.
Chapter 19, “Estimates, Benchmarking, and Other Measurement Tools” (pp. 223-231)
In this chapter, you continue exploring the concept of financial benchmarking. The chapter focuses on the importance of benchmarking for identifying performance gaps.

Zelman, W., McCue, M., & Glick, N. (2009). Financial management of health care organizations: An introduction to fundamental tools, concepts, and applications (3rd ed.). Hoboken, NJ: Jossey-Bass.
Retrieved from the Walden Library databases.
Chapter 5, “Working Capital Management” (pp. 187–231)
This chapter examines the concept of working capital. The authors explore the specifics of current assets and the management of the working capital cycle.
Chapter 11, “Responsibility Accounting” (pp. 468–497)
Review: This chapter explores the trend toward the decentralization of health care organizations and the challenges this presents. This chapter also describes responsibility centers, or organizational units intended to achieve specific tasks.

Mulva, S., & Dai, J. (2009) Health care facility benchmarking. HERD, 3(1), 28–37.
Reprinted by permission of Sage Publications via the Copyright Clearance Center.

This article describes a national health care facility’s benchmarking program. It is designed to compare measures of capital project performance.

Agency for Healthcare Research and Quality. (2013). Measuring and benchmarking clinical performance. Retrieved from www.ahrq.gov

Ettorchi-Tardy, A., Levif, M., & Michel, P. (2012). Benchmarking: A Method for Continuous Quality Improvement in Health. Healthcare Policy, e101-e119. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359088/

Regardless of clients’ reasons for presenting for therapy, to reach these clients and effectively treat them, you must be able to break down barriers, establish relationships, and help them see the benefits of this therapeutic approach.


Report Issue

                                      Group Therapy for Addiction

Consider the following scenario:

The psychiatric mental health nurse practitioner is working for a community health clinic that offers state mandated “intensive outpatient rehabilitation” services for individuals who face incarceration for driving while under the influence. Mr. Smith, a 24-year-old male patient, shows up for his initial intake appointment and says, “Look, this sounds like it’s going to be an AA meeting. Can’t I just go there? I only had a couple of drinks. I don’t know why the judge was such a jerk.”

Clients with addictive disorders may present for therapy for various reasons. Some, like Mr. Smith, attend because it is court mandated. Some attend because family or friends have pushed them to do so, while others may attend because life has become unmanageable. Regardless of clients’ reasons for presenting for therapy, to reach these clients and effectively treat them, you must be able to break down barriers, establish relationships, and help them see the benefits of this therapeutic approach.

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PLEASE REMEMBER TO REVIEW THE ATTACHED 7 VIDEO TRANSCRIPTS BEFORE DOING THE ASSIGNMENT, and to include a title page, introduction, summary, and references

                                                              The Assignment

In a 2- to 3-page paper, address the following:

· Identify the psychotherapeutic approach that the group facilitator is using and 

   explain why she might be using this approach Regardless of clients’ reasons for presenting for therapy, to reach these clients and effectively treat them, you must be able to break down barriers, establish relationships, and help them see the benefits of this therapeutic approach..

· Determine whether or not you would use the same psychotherapeutic approach 

   if you were the counselor facilitating this group and justify your decision.

· Identify an alternative approach to group therapy for addiction and explain why 

  it is an appropriate option.

· Support your position with evidence-based literature.

                                                                    Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

  • Chapter      16, “Psychotherapeutic Approaches for Addictions and Related Disorders”      (pp. 565–596)

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

  • Chapter 13, “Problem Group Members” (pp. 391–427)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Gamble, J., & O’ Lawrence, H. (2016). An overview of the efficacy of the 12-step group therapy for substance abuse treatment. Journal of Health & Human Services Administration, 39(1), 142–160. Retrieved from http://jhhsa.spaef.org/

Kim, J. W., Choi, Y. S., Shin, K. C., Kim, O. H., Lee, D. Y., Jung, M. H., … Choi, I. (2012). The effectiveness of continuing group psychotherapy for outpatients with alcohol dependence: 77-month outcomes. Alcoholism: Clinical & Experimental Research, 36(4), 686–692. doi:10.1111/j.1530-0277.2011. 01643.x

Required Media

Allyn & Bacon (Producer). (2000). Motivational interviewing [Video file]. Mill Valley, CA: Psychotherapy.net.

Note: You will access this media from the ATTACHED TRANSCRIPT. The approximate length of this media piece is 102 minutes.

Laureate Education (Producer). (2013d). Levy family: Sessions 1-7 [Video file]. Baltimore, MD; Author. 

The basic structural unit in compact bone

1. Question : What term is used to describe a hernial protrusion of a saclike cyst that contains meninges, spinal fluid, and a portion of the spinal cord through a defect in a posterior arch of a vertebra? 

2. Question : What provides the best estimate of the functioning of renal tissue?

3. Question : Where are Langerhans cells found?

4. Question : Where in the lung does gas exchange occur?

5. Question : The tonic neck reflex observed in a newborn should no longer be obtainable by:

6. Question : When renin is released, it is capable of which action?

7. Question : The portion of the antigen that is configured for recognition and binding is referred to as what type of determinant? The basic structural unit in compact bone

8. Question : Which sexually transmitted infection frequently coexists with gonorrhea?

9. Question : How is the effectiveness of vitamin B12 therapy measured?

10. Question : Carcinoma refers to abnormal cell proliferation originating from which tissue origin?

11. Question : Which type of microorganism reproduces on the skin?

12. Question : An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. A wide fixed splitting of the second heart sound is also found. These clinical findings are consistent with which congenital heart defect?

13. Question : An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?

14. Question : What is the function of erythrocytes?

15. Question : Which terms represent the correct nomenclature for benign and malignant tumors of adipose tissue, respectively?

16. Question : What is the chance with each pregnancy that a child born to two parents with the sickle trait will have sickle cell disease (SCD)?

17. Question : What pulmonary defense mechanism propels a mucous blanket that entraps particles moving toward the oropharynx?

18. Question : The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland?

19. Question : Why is the herpes virus inaccessible to antibodies after the initial infection?

20. Question : Which renal change is found in older adults?

21. Question : Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions?

22. Question : Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?

23. Question : Which statement is true regarding maternal antibodies provided to the neonate?

24. Question : The function of the tumor cell marker is to:

25. Question : Which statement is true concerning a fungal infection?

26. Question : Which change is a result of puberty and defends the vagina from infection?

27. Question : The number of persons living with a specific disease at a specific point in time is referred to by which term?

28. Question : Which risk factor for hypertension is influenced by genetic factors and lifestyle?

29. Question : Having ejected a mature ovum, the ovarian follicle develops into a(n):

30. Question : The failure of bones to ossify, resulting in soft bones and skeletal deformity, characterizes which disorder? The basic structural unit in compact bone

31. Question : What is the term that denotes the duration of time or the intensity of pain that a person will endure before outwardly responding?

32. Question : Aldosterone directly increases the reabsorption of:

33. Question : Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?

34. Question : Which clinical manifestations are associated with fibromyalgia?

35. Question : Prolonged high environmental temperatures that produce dehydration, decreased plasma volumes, hypotension, decreased cardiac output, and tachycardia cause which disorder of temperature regulation?

36. Question : What is the leading cause of infertility in women?

37. Question : Which substance is a water-soluble protein hormone?

38. Question : What is the target tissue for prolactin-releasing factor?

39. Question : What is the cause of familial hypercholesterolemia (FH)?

40. Question : Regarding type 2 diabetes, obesity is considered to be what type of risk?

41. Question : Which four-step process correctly describes muscle contraction?

42. Question : Adoption studies have shown that the offspring of an alcoholic parent when raised by nonalcoholic parents have what amount of an increased risk of developing alcoholism?

43. Question : Which hormone stimulates gonads to produce both male and female hormones?

44. Question : A person with 47, XXY karyotype has the genetic disorder resulting in which syndrome?

45. Question : Which would be considered a positive symptom of schizophrenia?

46. Question : What term describes the loss of the comprehension or production of language?

47. Question : Consanguinity refers to the mating of persons:

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48. Question : The major sleep center is located in which section of the brain?

49. Question : Which type of ion directly controls the contraction of muscles?

50. Question : Bacteria gain access to the female urinary tract by which means?

51. Question : A criterion for a diagnosis of generalized anxiety disorder (GAD) is a period of excessive worrying that lasts for at least how many months?

52. Question : What is the first indication of nephrotic syndrome in children?

53. Question : An amniocentesis indicates a neural tube defect when an increase in which protein is evident?

54. Question : What is the risk for the recurrence of autosomal dominant diseases?

55. Question : Which term is used to identify the temporary displacement of two bones causing the bone surfaces to partially lose contact?

56. Question : The tear in a ligament is referred to as a:

57. Question : Why is prolonged diarrhea more severe in children than it is in adults?

58. Question : The BRCA1 and BRCA2 mutations increase the risk of which cancer in women?

59. Question : Insulin transports which electrolyte in the cell?

60. Question : What term is used to identify an interlacing bundle of dense, white fibrous tissue that is richly supplied with nerves, blood vessels, and lymphatic vessels?

61. Question : Which of the following is a lipid-soluble hormone?

62. Question : The mucosal secretions of the cervix secrete which immunoglobulin?

63. Question : The sudden apparent arousal in which a child expresses intense fear or another strong emotion while still in a sleep state characterizes which sleep disorder?

64. Question : What is the basic structural unit in compact bone?

65. Question : Parkinson disease is a degenerative disorder of the brain’s:

66. Question : Which pain theory proposes that a balance of impulses conducted from the spinal cord to the higher centers in the central nervous system (CNS) modulates the transmission of pain?

67. Question : Saliva contains which immunoglobulin (Ig)?

68. Question : What type of fracture occurs at a site of a preexisting bone abnormality and is a result of a force that would not normally cause a fracture?

69. Question : An infant suddenly develops abdominal pain, becomes irritable (colicky), and draws up the knees. Vomiting occurs soon afterward. The mother reports that the infant passed a normal stool, followed by one that looked like currant jelly. Based on these data, which disorder does the nurse suspect?

70. Question : In 95% of children of delayed puberty, the problem is caused by:

71. Question : Which characteristic is true of type II (white fast-motor) muscle fibers?

72. Question : Neurofibrillary tangles characterize which neurologic disorder?

73. Question : Which hormone triggers uterine contractions?

74. Question : How does the release (increase) of epinephrine raise body temperature?

75. Question : Which hormone is linked to an increase in appetite during puberty? The basic structural unit in compact bone

Describe the determinants of health and explain how those factors contribute to the development of this disease.


RUBRIC:

1-Comprehensive Description of a Communicable Disease and the Demographic of Interest: Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.

2-Determinants of Health and Explanation of How Determinants Contribute to Disease Development:Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.

3-Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors):The communicable disease is described thoroughly, accurately, and clearly within an epidemiological model. A visual description of the model and how the components of the model interact is included.

4-Role of the Community Health Nurse:Discussion of the role of the community health nurse is clear, comprehensive, and inclusive of the community nurse’s responsibilities to primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow up.

5-National Agency or Organization That Works to Addresses Communicable Disease:An agency or organization is identified. A clear and accurate description of efforts to address communicable disease is offered.

6-Thesis Development and Purpose:Thesis is comprehensive, contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

7-Paragraph Development and Transitions:There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless Describe the determinants of health and explain how those factors contribute to the development of this disease..

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8-Mechanics of Writing (includes spelling, punctuation, grammar, language use):Writer is clearly in command of standard, written, academic English.

9-Global Implication:A discussion of the global implication of the disease is clear, comprehensive, and inclusive with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.

10-Paper Format:All format elements are correct.

11-Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment):In-text citations and a reference page are complete. The documentation of cited sources is free of error.

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance completing this assignment.

Communicable Disease Selection

Choose one communicable disease from the following list:

  1. Chickenpox
  2. Tuberculosis
  3. Influenza
  4. Mononucleosis
  5. Hepatitis B
  6. HIV
  7. Ebola
  8. Measles
  9. Polio
  10. Influenza

Epidemiology Paper Requirements

Address the following:

  1. Describe the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
  2. Describe the determinants of health and explain how those factors contribute to the development of this disease.
  3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. (The textbook describes each element of the epidemiologic triangle). Are there any special considerations or notifications for the community, schools, or general population?
  4. Explain the role of the community health nurse (case finding, reporting, data collecting, data analysis, and follow-up). Describe the determinants of health and explain how those factors contribute to the development of this disease.
  5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organization(s) contributes to resolving or reducing the impact of disease.
  6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Succes

How would Maslow’s hierarchy of needs affect a person’s readiness to learn

  Discussion Question 1-1

1. Complete the Learning Styles Inventory found at:

http://www.educationplanner.org/students/self-assessments/learning-styles.shtml.

This is a free tool that you can take called the Learning Styles Inventory. Once you have obtain your results by answering the 20 questions, you will then answer the following questions: What is your personal learning style? How did your results compare to what you already knew about your personal learning style? How do you think your learning style affects your teaching style?

Discussion Question 1-2

2. How would Maslow’s hierarchy of needs affect a person’s readiness to learn? Include an example from your selected area of education (academic, staff, or patient). Support your response with literature.

Assignment Benchmark – Learning Styles

As faculty members, you have been asked to design a 4-hour Leadership Strategies course that would accommodate the learning styles for a selected 10 students. The students have all completed a learning style inventory in which three of the students are determined visual learners, four are kinesthetic learners, and the rest are auditory learners How would Maslow’s hierarchy of needs affect a person’s readiness to learn.

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Note: The intended audience for the course can be either newly graduated nurses or experienced staff nurses as you choose.

Compose a 1,000-1,250-word paper which describes your plan to accommodate the learning styles of each student. This plan starts with defining course objectives; use the “A-B-C-D Method of Writing Objectives” resource as a guide. 

The objectives should incorporate Bloom’s taxonomy, be written at the appropriate level for the audience, and include at least two learning domains (cognitive, psychomotor, and affective). Make sure to include the following:

  1. An outline of the course content and agenda that will be covered. 
  2. Descriptions  of the learning activities and the rationale for the learning activities  selected
  3. Strategies  to assess learning, based on the learner objectives
  4. Use  at least three scholarly, peer-reviewed resources less than 5 years old in addition to the course materials.

An abstractis required.

Refer to “Learning Styles Rubric,” prior to beginning the assignment to become familiar with the expectations for successful completion.

NUR-647E-R-T6.docx NUR-647E-RS-A-B-C-DApproachtoObjectiveWriting.docx How would Maslow’s hierarchy of needs affect a person’s readiness to learn

Schizophrenia Spectrum and Other Psychotic Disorders

Assignment: “Captain of the Ship”Project

– Schizophrenia Spectrum and Other Psychotic Disorders

There are many disorders that result in the development of “positive” symptoms,

such as hallucinations and delusions, but not all of these conditions represent schizophrenia. When treating schizophrenia spectrum and other psychotic disorders, emphasis should be placed not only on treating the positive symptoms but the negative and residual symptoms as well.

This week, you will explore a wide variety of disorders along the schizophrenia spectrum as you become “captain of the ship” once again. You also will analyze issues involved with state practice agreements.

Assignment

In this assignment, you will become “captain of the ship” as you take full responsibility for a client with schizophrenia spectrum by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans.

Remember that there is an excellent example for ‘Captain of the Ship’ project attached with this ASSIGNMENT.

Instructions:  

To prepare for this Assignment

 Select an adult or older adult client with a schizophrenia spectrum and other psychotic disorder that you have seen in your practicum/clinical rotation site Schizophrenia Spectrum and Other Psychotic Disorders.

In 3-4 pages, write a treatment plan for your client. In which you do the following:

· Describe the history of the present illness (HPI) and clinical impression for the client.

· Recommend psychopharmacologic treatments based on evidence-based practice and describe specific and therapeutic end points for your psychopharmacologic agent. (This should relate to HPI and clinical impression.).

· Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.

· Identify medical management needs, including primary care needs, specific to this client.

· Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.

· Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

N: B. (1)The Captain of the Ship project needs to show that you are evaluating the patient, making a diagnosis, providing treatment plans and outcomes as well as collaborating with other providers. The project MUST meet all these requirements. (2) The choice of medications should be clear, and the medical management should be clear. (3) Consider using the bipolar disorder algorithm from  http://www.psychiatrictimes.com/bipolar-disorder/new-psychopharmacology-algorithms

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 7, “Schizophrenia Spectrum and other Psychotic Disorders” (pp. 300–346)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 8, “Early-Stage Schizophrenia”

Chapter 9, “Toward a Dimensional Understanding of Psychosis and Its Treatment”

Chapter 10, “Psychosocial Treatments for Chronic Psychosis”

Chapter 11, “Pharmacological Treatment of Psychosis”

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

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“Schizophrenia Spectrum and other Psychotic Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Psychosis

alprazolam (adjunct)

amisulpride

aripiprazole

asenapine

blonanserin

carbamazepine (adjunct)

chlorpromazine

clonazepam (adjunct)

clozapine

cyamemazine

flupenthixol

fluphenazine

haloperidol

iloperidone

lamotrigine (adjunct)

lorazepam (adjunct)

loxapine

lurasidone

mesoridazine

molindone

olanzapine

paliperidone

perospirone

perphenazine

pimozide

pipothiazine

quetiapine

risperidone

sertindole

sulpiride

thioridazine

thiothixene

trifluoperazine

valproate (divalproex) (adjunct)

ziprasidone

zotepine

zuclopenthixol

Schizoaffective disorder

amisulpride

aripiprazole

asenapine

carbamazepine (adjunct)

chlorpromazine

clozapine

cyamemazine

flupenthixol

haloperidol

iloperidone

lamotrigine (adjunct)

l-methylfolate (adjunct)

loxapine

lurasidone

mesoridazine

molindone

olanzapine

paliperidone perospirone

perphenazine

pipothiazine

quetiapine

risperidone

sertindole

sulpiride

thioridazine

thiothixene

trifluoperazine

valproate (divalproex) (adjunct)

ziprasidone

zotepine

zuclopenthixol

Schizophrenia

amisulpride

aripiprazole

asenapine

carbamazepine (adjunct)

chlorpromazine

clozapine

cyamemazine

flupenthixol

haloperidol

iloperidone

lamotrigine (adjunct)

l-methylfolate (adjunct)

loxapine

lurasidone

mesoridazine

molindone

olanzapine

paliperidone

perospirone

perphenazine

pipothiazine

quetiapine

risperidone

sertindole

sulpiride

thioridazine

thiothixene

trifluoperazine

valproate (divalproex) (adjunct)

ziprasidone

zotepine

zuclopenthixol

Seasonal affective disorder

bupropion

Sedation-induction

hydroxyzine

midazolam

Cataplexy syndrome

clomipramine

imipramine

sodium oxybate

Catatonia

alprazolam

chlordiazepoxide

clonazepam

clorazepate

diazepam

estazolam

flunitrazepam

flurazepam

loflazepate

lorazepam

midazolam

oxazepam

quazepam

temazepam

triazolam

Extrapyramidal side effects

benztropine

diphenhydramine

trihexyphenidyl

Ferreira, C. D., de Souza, M. G. D., Fernández-Calvo, B., Machado-de-Sousa, J. P., Cecilio Hallak, J. E., & Torro-Alves, N. (2016). Neurocognitive functions in schizophrenia: A systematic review of the effects of typical and atypical antipsychotic drugs. Psychology & Neuroscience, 9(1), 12–31. doi:10.1037/pne0000045

Granholm, E., Holden, J., Link, P. C., & McQuaid, J. R. (2014). Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: Improvement in functioning and experiential negative symptoms. Journal of Consulting and Clinical Psychology, 82(6), 1173–1185. doi:10.1037/a0037098 Schizophrenia Spectrum and Other Psychotic Disorders

Required Media

Murphy, L. (2011, July 21). Types of schizophrenia – A day in the life (scary) [Video file]. Retrieved from https://www.youtube.com/watch?v=LWYwckFrksg

Social Determinants of Health

Social Determinants of Health

Answer one of the following questions:

· Increasingly, health policymakers are becoming aware of the social determinants of health and the role they play in prevention disease and promoting health and wellness. In the “Frameworks for Action in Policy and Politics” chapter, examine Box 1-1 (Political Aspects of the Social Determinants of Health) and Figure 1-6 (The Who, What, Where, When, and Why of Nursing’s Policy Influence). Then compare these with the story about Lilian Wald’s work in New York City. Reflect on the “what” of Wald’s strategies. In your opinion, which did she use effectively? Social Determinants of Health

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Looking further at the “what” in Figure 1-6 and answer any one of the following questions:

o Discuss at least three competencies/strategies that you have used effectively.

o Identify three competencies/strategies that you don’t currently use and discuss how you might incorporate them into your advocacy toolbox.

Review the four recommendations in the IOM report The Future of Nursing: Leading Change, Advancing Health and find your state’s action coalition(https://campaignforaction.org/our-network/state-action-coalitions/)USE THIS LINK OR WEBSITE TO ACCES THE STATE’S ACTION

· . Discuss your state’s action coalition’s work as it aligns with these four recommendations. Is each recommendation being addressed? Based on your analysis of the website, how would you describe your state’s progress toward meeting the IOM recommendations?APA FORMAT AND REFERENCES NEEDED. Social Determinants of Health