In completing the case study, students will be addressing the following learning objectives:

Identify common medical conditions that can have accompanying psychiatric complications or symptoms. Describe general nursing implications for clients experiencing psychiatric disorders that are intertwined with other nonpsychiatric illnesses.

1. Carla, a 27-year-old white single mother of two preschool-age children, is in the psychiatric hospital for treatment of anxiety and depression.   Carla has a cardiac condition that requires surgery.  Carla is concerned over the financial cost of the surgery and caretakers for her children while she is in the hospital and undergoing rehabilitation. Carla is also worried that she may be unable to continue in her present employment as a salesperson due to the physical demands of this position.  Carla’s case is representative of many patients with medical conditions who develop psychiatric symptoms. Medical Illnesses

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(Learning Objectives: 1, 2)

a. What are some prevalent medical conditions that can also be accompanied by psychiatric symptoms or complications?

b.What are some nursing implications for Carla that address both the psychiatric and nonpsychiatric illnesses?

Write a 1,000- to 1,400-word paper that addresses the following: Please include headers for each section below to ensure everything is explained in detail. 

• Why is accountability important in the health care industry?
• How is an employee’s accountability measured in the health care industry?
• How does accountability apply to ethical considerations in leadership and management?
• What does a checks-and-balances process look like in a successful organization?
• How does accountability affect an organization’s working culture?
• How can you maintain a positive working culture and avoid a working culture of blame?

Cite a minimum of 4 references.

Format your paper according to APA guidelines .Medical Illnesses

Analyze the health status of a specific minority group. Select a minority group that is represented in the United States (examples include: American Indian/Alaskan Native, Asian American, Black or African American, Hispanic or Latino, Native Hawaiian, or Pacific Islander.)

In an essay of 750-1,000 words, compare and contrast the health status of the minority group you have selected to the national average. Consider the cultural, socioeconomic, and sociopolitical barriers to health. How do race, ethnicity, socioeconomic status, and education influence health for the minority group you have selected? Address the following in your essay: HEALTH ANALYSIS

1. What is the current health status of this minority group?
2. How is health promotion defined by the group?
3. What health disparities exist for this group?
4. Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.

Cite a minimum of three references in the paper.

You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:

1. Minority Health: http://www.cdc.gov/minorityhealth/index.html
2. Racial and Ethnic Approaches to Community Health (REACH): http://www.cdc.gov/chronicdisease/resources/publications/aag/reach.htm
3. Racial and Ethnic Minority Populations: http://www.samhsa.gov/specific-populations/racial-ethnic-minority

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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 Success Center HEALTH ANALYSIS

Question 1 A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered

A) phytoestrogens.

B) monotherapy.

C) taboo.

D) inappropriate

Question 2 A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to

A) the mother regarding why the boy needs to take the medications.

B) both the boy and his mother regarding all medication issued NURSING EXAM.

C) the boy by telling him not to worry about the medications and to take them as directed

D) The mother and be sure to reinforce the need to force the medications, if her sondoes not want to take them

Question 3 A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather’s antidepressant to improve his mood. After immediately phoning the boy’s stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem?

A) Cardiac dysrhythmia
B) Hypertensive crisis
C) Nephrotoxicity
D) Hypokalemia

Question 4 A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should

A) cool the medication prior to administration.
B) use sterile technique when applying the medication.
C) allow the child to apply the medication if possible.
D) use clean technique only when applying the medication.

Question 5 A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is

A) a hepatotoxic response.
B) an idiosyncratic response.
C) a paradoxical response.
D) an allergic response.

Question 6 A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the

A) deltoid muscle.
B) rectus femoris muscle.
C) ventrogluteal muscle.
D) dorsogluteal muscle.

Question 7 A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects

A) breast cancer

B) PMS

C) pain in the heart

D) cancerous breast tenderness

Question 8 A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of

A) alcohol.
B) trans fat.
C) caffeine.
D) grapefruit juice.

Question 9 A nurse is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate?

A) Renal function
B) Hepatic function
C) Respiratory function
D) Cardiac function

Question 10 A 21-year-old female has a history of irregular menses. She recently became sexually active, and would like to begin taking oral contraceptives (OCs). The nurse practitioner recognizes that most likely this patient would benefit from taking which category of OCs.

A) Monophasic

B) Triphasic OC

C) Ortho Tri-Cyclen

D) Biphasic OC

Question 11 A nurse who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem?

A) Anxiety
B) Respiratory depression
C) Obesity
D) ADHD

Question 12 A nurse working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using

A) body surface area.
B) weight.
C) age in months.
D) age in years.

Question 13 A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect?

A) Decreased myocardial contraction
B) Decreased heart rate
C) Increased cardiac conduction
D) Increased intranodal conduction time

Question 14 A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug?

A) That the infant’s skin has greater permeability than that of an adult
B) That there is less body surface area to be concerned about
C) That there is decreased absorption rates of topical drugs in infants
D) That there is a lower concentration of water in an infant’s body compared with an adult

Question 15 A nurse is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?

A) “I walk two blocks to school every day.”
B) “I am on the middle school track team.”
C) “We live in a two-story house.”
D) “My mother is going to give me my insulin.”

Question 16 A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to

A) the inability of infants and children and describe symptoms of adverse drug reactions.
B) increased body surface area relative to body volume in infants and children.
C) increased heart rate and subsequently rapid drug distribution among infants and children.
D) immature liver and kidney function in infants and children.

Question 17 A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication

A) for 20 days.

B) once a day.

C) every day until the infection is gone.

D) for 30 days.

Question 18 To which of the following patients would a medication nurse most likely administer caffeine as part of the treatment plan?

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A) A preterm neonate who has apnea
B) A 34-year-old woman with a diagnosis of gastric ulcerations
C) A school-age child with severe ADHD
D) A 52-year-old man with narcolepsy

Question 19 A nurse works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine? NURSING EXAM

A) A 38-year-old Caucasian woman with glaucoma
B) A 60-year-old African-American man who experiences angina
C) A 48-year-old Caucasian man who has adult-onset diabetes
D) A 28-year-old African-American woman with hyperthyroidism

Question 20 A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should

A) teach the boy about the fact that he will feel much better after he takes his medications.
B) have the mother hold the child firmly and sooth him while the drugs are administered.
C) offer a choice between liquid and chewable medications, if possible.
D) insert a central intravenous line.

Question 21 The recommended treatment for trichomoniasis is

A) Flagyl.

B) Diflucan.

C) Meclizine.

D) Amoxicillan

Question 22 A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide?

A) “Most people don’t know that marijuana can be just as addictive as heroin or cocaine over time.”
B) “Marijuana can easily interact with other drugs and cause potentially fatal reactions.”
C) “Every year, thousands of Americans end up in emergency departments with marijuana overdoses.”
D) “Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes.”

Question 23 A nurse is going to administer medication to an infant using a medicine dropper. The best method is to open the child’s mouth by gently squeezing the cheeks and placing the drops

A) at the back of the mouth.
B) in the buccal pouch.
C) under the tongue.
D) on top of the tongue.

Question 24 A nurse is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an

A) electrocardiogram (ECG).
B) electromyelogram (EMG).
C) electroencephalogram (EEG).
D) electrophysiologic study (EPS).

Question 25 A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse’s priority assessment would be

A) height and weight.
B) Vision.
C) body temperature.
D) blood pressure.

Question 26 A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause

A) orange-tinged urine.
B) staining of permanent teeth.
C) sleep deprivation.
D) deep muscle pain NURSING EXAM.

Question 27 A nurse is administering drugs to a 10-year-old child who has multiple health problems.The child is underweight and is on a special diet. Which of the following will the nurse consider when planning for the best absorption of the prescribed drugs? (Select all that apply.)

A) Age
B) Weight
C) Disease process
D) Diet
E) Route of administration

ACDE

Question 28 The clinical nurse educator who oversees the emergency department in a children’s hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?

A) Having nurses check their math calculations with a colleague before administering a drug.
B) Ensuring that a full assessment takes place no more than 30 minutes before giving a drug.
C) Recording drug administration in both the nurse’s notes and the medication administration record (MAR)
D) Avoiding intravenous administration of drugs whenever possible.

Question 29 A 15-year-old boy has been diagnosed with bone cancer after several months of fatigue and pain. What question should the nurse include in an assessment when trying to minimize the potential for adverse drug reactions?

A) “Do you ever use alcohol or drugs?”
B) “How much do you weigh?”
C) “On a scale of zero to ten, what level of pain is acceptable to you?”
D) “Did Tylenol or other over-the-counter pain remedies ever relieve your pain?”

Question 30 A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient’s childbearing potential. The nurse will inform the patient that during sibutramine therapy she should

A) abstain from sex.
B) obtain a pap smear .
C) use adequate contraception.
D) take a pregnancy test every month.

Question 31 A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient?

A) Take the drug on a full stomach
B) Avoid high noise levels
C) Take the drug for one full week before coming in contact with allergens
D) Drink plenty of fluids.

Question 32 A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis.The nurse practitioner is aware that

A) trichomoniasis is an incurable disease.

B) trichomoniasis discharge is typically thin and clear.

C) asymptomatic women are diagnosed with trichomoniasis by a routine pap smear.

D) it is unusual to have an odor with trichomoniasis

Question 33 A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse’s assessment?

A) The mother and grandmother’s understanding about the drugs
B) How clean the house is
C) The health status of the other children
D) Where the medications will be stored NURSING EXAM

Question 34 A nurse is having difficulty administering a bitter drug to a 5-year-old child. The nurse should

A) have the parent gently force the child’s mouth open.
B) give the drug in a pill form.
C) involve the child in a play therapy session, and then tell the child that the medicine is candy.
D) offer the child a flavored ice chip or ice pop prior to administering the drug.

Question 35 A 22-year-old woman has given birth to an infant who exhibits the signs and symptoms of maternal cocaine use during pregnancy.These signs and symptoms are a result of what pathophysiological effect of opioid use during pregnancy?

A) Changes in blood chemistry as a result of nephrotoxicity and hepatotoxicity
B) Impaired maternal nutrition as a result of drug use
C) Vasoconstriction leading to reduced placental blood flow
D) Hypoxia as a result of a prolonged second stage of labor

Question 36 A preterm neonate received caffeine for the treatment of apnea. The nurse should monitor the neonate for which of the following?

A) Bloody stools
B) Bradycardia
C) Constipation
D) Hypoglycemia

Question 37 A 30-year-old man with a BMI of 59 has recently been diagnosed with type 2 diabetes mellitus. In light of the man’s lack of success with weight loss programs in the past, his care provider has prescribed sibutramine (Meridia). What instructions should the nurse consequently provide to this patient?

A) “Take this drug once each day on an empty stomach.”
B) “It’s best to take a dose of sibutramine after each meal.”
C) “This drug will help you to lose weight without having to exercise or change your normal diet.”
D) “Take a dose when you feel like you are tempted to binge on food.”

Question 38 A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose?

A) 1000 mg

B) 2000 mg

C) 3000 mg

D) 4000 mg

Question 39 A nurse is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation?

A) A child has an erratic blood flow from an immature peripheral circulation, which increases drug absorption, causing an increase in adverse effects.
B) A child’s gastric pH is decreased, causing less of the drug to be absorbed from the subcutaneous skin, therefore producing more adverse effects.
C) A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects.
D) A child has a smaller body surface area, resulting in an increase in topical absorption, which can cause more adverse effects.

Question 40 An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis.Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation?

A) Caregiver Role Strain
B) Ineffective Family Therapeutic Regimen Management
C) Delayed Growth and Development
D) Knowledge Deficit NURSING EXAM

Case Study 1:

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:

• Atenolol 12.5 mg daily
• Doxazosin 8 mg daily
• Hydralazine 10 mg qid
• Sertraline 25 mg daily
• Simvastatin 80 mg daily OBESITY

Case Study 2:

Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following:

• Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun
• Aspirin 81 mg daily
• Metformin 1000 mg po bid
• Glyburide 10 mg bid
• Atenolol 100 mg po daily
• Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

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Case Study 3:

Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following:

• Glipizide 10 mg po daily
• HCTZ 25 mg daily
• Atenolol 25 mg po daily
• Hydralazine 25 mg qid
• Simvastatin 80 mg daily
• Verapamil 180 mg CD daily

To prepare:

• Review this week’s media presentation on hypertension and hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson text.
• Select one of the three case studies, as well as one the following factors: genetics, gender, ethnicity, age, or behavior factors.
• Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
• Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
• Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

With these thoughts in mind: OBESITY

Create a 6–8-slide PowerPoint presentation for a group of school nurses, which addresses the role of the school nurse in managing the unique health concerns of teenagers while adhering to privacy laws.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: Nursing Practice And School Health Privacy

Show Less  

• Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes.       
  • Explain the laws that relate to adolescent safety and health privacy in a school setting.
  • Explain how the privacy laws affect schools, students, and school nurses.
• Competency 3: Apply professional nursing ethical standards and principles to the decision-making process.       
  • Describe health and wellness issues specific to the adolescent population.
  • Recommend evidence-based ethical strategies relating to health and wellness privacy communication by the school nurse.
• Competency 4: Communicate in a manner that is consistent with expectations of nursing professionals.       
  • Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.
  • Correctly format citations and references using APA style.

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Role of the School Nurse

It is the position of the National Association of School Nurses that the professional registered school nurse is the leader in the school community to oversee school health policies and programs. The school nurse serves in a pivotal role to provide expertise and oversight for the provision of school health services and promotion of health education. Using clinical knowledge and judgment, the school nurse provides health care to students and staff, performs health screenings, and coordinates referrals to the medical home or private health care provider. The school nurse serves as a liaison between school personnel, family, community and healthcare providers to advocate for health care and a healthy school environment (American Nurses Association & National Association of School Nurses, 2011).

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

• What is FERPA?
• What is HIPAA?
• How do FERPA and HIPAA affect school health privacy?
• What unique health concerns might young people have that differentiate them from adults? Nursing Practice And School Health Privacy