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APA Format 1 page 3 references 1 from walden university library due 8/9/18

 

In my clinical experiences in the past five years included many geriatric patients.  One patient, in particular, comes to mind when I reflect on the patient’s history and the pharmacokinetic and pharmacodynamic processes and how age and lifestyle choices were a factor.  Often, older patients take more medications than younger generations because of the likelihood of having numerous medical disorders.  Geriatric patients may have drugs that are a short or long-term prescription, but each one affects the patient.

Pharmacodynamics

M.M. was a 70 y.o. patient in our clinical setting that had a medical diagnosis of hypertension.  This patient was on metoprolol, a frequently used beta blocker.  M.M. was also a smoker with a half a pack a day 40-year history.  This patient reported attempts of smoking cessation a few times throughout the years but was not successful.  Throughout caring for this patient, he voiced understanding the importance of smoking cessation and was receptive to patient education concerning smoking cessation.

According to NSW Government (n.d.), medication levels can vary if a person smokes and interactions are caused by constituents of tobacco smoke inducing cytochrome P450 enzymes in the liver affecting absorption, distribution, metabolism, or elimination of the medication.  Beta blockers have a moderate effect on patients who use tobacco, therefore, may require a higher dose of the medication NSW Government (n.d.).  If the patient decides to quit smoking, they may experience possible bradycardia and hypotension, resulting in requiring a lower dose NSW Government (n.d.).  Beta blockers decrease blood pressure by blocking central and peripheral beta receptors, resulting in reduced cardiac output and sympathetic outflow (Arcangelo, Peterson Wilbur, & Reinhold, 2017).

Pharmacokinetics in Elderly Patients

Each of the body systems is affected by age.  The impact of aging on the pharmacokinetics of medications includes:

•    Absorptive changes such as decreased blood flow, increased gastric pH and delayed gastric emptying (Arcangelo et al., 2017).

•    Distribution changes including decreased albumin, decreased lean body mass and increased body fat (Arcangelo et al., 2017).

•    Metabolic changes such as decreased blood flow to the liver and reduced enzymatic activity (Arcangelo et al., 2017).

•    Excretion changes; examples include decreased glomerular filtration and decreased secretion (Arcangelo et al., 2017).

The pharmacokinetics of beta blockers can be affected by age, race, cigarette smoking and other drug therapies (Frishman & Alwarshetty, 2002).  Beta-1 receptors are located primarily in the heart and kidney.  These receptors are responsible for heart rate, renin release, and cardiac contractility (Arcangelo et al., 2017).  Beta blockers decrease blood pressure by blocking central and peripheral beta receptors, resulting in reduced cardiac output and sympathetic outflow (Arcangelo et al., 2017).

Plan of Care

As mentioned previously, M.M. was receptive to patient education on smoking cessation.  He did have support from his family to assist with this plan.  M.M. was able to participate in the plan of care as he voiced what did not work for him previously in his attempts to quit smoking.  He was open to ideas from the healthcare team and understood the benefits of smoking cessation on his health, lifestyle, and effect on his loved ones.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V. & Reinhold, J. A.  (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Frishman, W.H., & Alwarshetty, M. (2002).  Beta-adrenergic blockers in systemic hypertension: pharmacokinetic considerations related to current guidelines.  Clinical Pharmacokinetics, 41(7), 505-516.

NSW Government (n.d).  Medication interactions with smoking and smoking cessation.  Retrieved from http://www.health.nsw.gov.au/tobacco/Publications/tool-14-medication-intera.pdf.

PUBLIC HEALTH 4 PAGES NOT INCLUDING REFERENCE AND TITLE PAGE APA (Applying Theory To Practice and Research)

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DUE 3/9/18 7 P.M EST READ DIRECTIONS CAREFULLY

4 PAGES NOT INCLUDING TITLE AND REFERENCE PAGE (MIN 4 REF)

PUBLIC HEALTH CAMPAIGN (PRESCRIPTION DRUG OVERDOSE)

 

Assignment: Applying Theory to Practice and Research

There are four common theories often used in public health. They are: the Theory of Reasoned Action, the Health Belief Model, the Theory of Planned Behavior, and the Trans-theoretical Stages of Change. While these are not the only theories used in public health, they are most often utilized in the field. As a future public health leader, it is imperative to have a firm understanding of these four widely used theories so you can understand what motivates and influences people to change their behavior or attitudes related to public health issues. For this Application Assignment, select one article for each theory or one article that discusses all of the theories and summarize the information. Focus on how the theory was applied in practice and how this information may help guide you in the development of your public health campaign (Prescription Drug Overdose)

Submit the assignment (4 pages not including title and reference page)

· Select one article on each of the following theories: Theory of Reasoned Action, Health Belief Model, Theory of Planned Behavior, and Trans-theoretical Stages of Change or select one article that discusses all of the theories;

· Summarize how each theory is applied to practice;

· Explain two strengths of each theory;

· Explain at least two limitations of each of the theories;

· Select one theory you would like to use in the development of your public health campaign (PRESCRIPTION DRUG OVERDOSE) and justify your selection.

Support your Application Assignment with specific references to all resources used in its preparation. You are to provide a reference list for all resources(MIN 4). Your written assignments must follow APA guidelines. Refer to the Publication Manual of the American Psychological Association to ensure your in-text citations and reference list are correct

Monumental Architecture and Sculpture

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Question 1: Monumental Architecture and Sculpture

The cultures we studied this week produced architecture and monumental sculpture, in addition to smaller works of art. Locate three examples of architecture or monumental sculpture from three different cultures listed here: India, China, Japan, Korea, or the Pacific Cultures.

First, completely identify each structure or sculpture you would like to discuss by listing its name, date, and location.

In a minimum of 3 well-developed paragraphs address the following questions:

  1. Who created each work of architecture or sculpture? Who commissioned its creation?
  2. What historical events or social or cultural influences affected the creation of each work?
  3. How do the visual characteristics of each work contribute to or enhance its message or meaning?
  4. How do the reasons these works were created compare with those of a more modern example of monumental art work, such as Mount Rushmore, the 9/11 Memorial, etc.?

Be sure to explain your ideas clearly and support them by discussing specific details about each work of architecture or monumental sculpture.

Question 2: The Function of Art Objects

Some of the art objects created by the cultures surveyed this week, whether African masks, Japanese tea bowls, or Micronesian navigational charts, served functional roles in their society. Locate three such objects, one each from the following: Asia, Africa, or the Pacific Cultures.

First, completely identify each object you would like to discuss by listing its name, date, and location.

In a minimum of 2 well-developed paragraphs discuss:

  1. What was the function of each object at the time of its creation?
  2. What historical events or social or cultural influences affected the creation of each work?
  3. How do the visual characteristics of each object contribute to or enhance our understanding of its meaning?

Be sure to explain your ideas clearly and support them by discussing specific details about each work.

Respond to both questions as thoroughly as possible, making sure to use information from the readings and the lectures. All responses should be in complete sentence form, using proper spelling and grammar.

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Case Study of Immunology I

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Good morning, I need to complete this work by 04/03/2018. I offer $ 20.

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    CASESTUDYIMMUNOLOGY.pdf

discussion -3

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please see the links . 300 to 400 words

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    discussion-3.docx
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    Tworesponds.

Medical Office Scenarios

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Please correct English, spelling and grammar. Sources must be cited in APA format. Your response should be four (4) double-spaced pages.

Please see attached. 4 Part Question and Answer.

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    Medicaloffice.docx

Max Points: 5.0 There is a tendency for novice researchers to develop their own instrument if they cannot readily find one. How might you respond to a peer or manager who asks you to help develop a new tool to collect patient data on anxiety prior to ca

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APA format, at least 300 words, references

Why Don’t We Have Enough Nurses?

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What is burnout?

What is reality shock?

Do you think they can be related, and if so, in what way?

Write a career plan that includes current activities, activities during the first year after graduation, after 3 years, and after 5 years.

APA style 12 font arial.  at least 300 words not including introduction, conclusion and 2 references.

the presentation should have an introduction, a body, and a conclusion.

Max Points: 5.0 Demographic data are collected for every study. What is the purpose of describing the demographic data?

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Max Points: 5.0

Demographic data are collected for every study. What is the purpose of describing the demographic data?

Time Travel

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Time Travel

Assume you have been given the ability to travel back in time, and you are about to set off on a trip to the nineteenth and twentieth centuries. The purpose of your trip is to visit artists in their studios and view firsthand the creation of some of their paintings and sculpture.

In your time travels, you will collect information on five different styles of nineteenth- and twentieth-century art, as represented by one artist from each style. Before you set out, decide which specific styles you would like to explore.

Select one style from each of the five categories listed below:

  • Late Nineteenth Century: Impressionism or Post Impressionism
  • Early Twentieth Century: Fauvism, Expressionism, or Futurism
  • Cubism: Analytic or Synthetic
  • Post-World War I Art: Dada or Surrealism
  • Post-World War II Art: Abstract Expressionism, Minimalism, or Pop Art

For each of your five selected styles, identify one artist who represents that style whose studio you will explore in your time travels. In your visits to each artist’s studio, plan to identify one work of art that best exemplifies the artist’s style.

When you return from your time travels, prepare a report that includes the following information for each of your five representative works of art:

  1. A photograph of the object
  2. Identifying information:
    1. Name of the artist
    2. Title of the work
    3. Date of the work
    4. Medium/materials used to create the work
  3. Identify the style of the work of art. Then, write a paragraph of 4-6 sentences that:
    1. Describes the visual characteristics that makes the object representative of its style
    2. Places the work within its social and historical context and explains why it is culturally significant

Finally, in a well-developed paragraph of 6-8 sentences, summarize what you have learned from your “time travels,” highlighting key similarities and distinctions between the artists you visited and their representative works of art.