walden nurs6501 week 1 quiz latest 2017 december

Question 1

A patient has a heart attack that leads to progressive cell injury that causes cell death with severe cell swelling and breakdown of organelles. What term would the nurse use to define this process?

Question 2

What is the diagnosis of a 13-year-old female who has a karyotype that reveals an absent homologous X chromosome with only a single X chromosome present? Her features include a short stature, widely spaced nipples, reduced carrying angle at the elbow, and sparse body hair.
 

HCA 330 DISCUSSION

Discuss why it is important for a Healthcare Administrator (HCA) to be aware of the need for patients to receive healthcare continuum services and what role you will play as a HCA in coordinating this type of care for your patients.

NSG6420 week 1 discussion December 2017

Week 1 Discussion Previous Next Discussion For this assignment, you will review the case study below and post a discussion for the class answering the noted questions.

You are evaluating a 78 year old white male who comes to your office today with unintentional weight loss of 10lb in the last year, self-reported exhaustion weakness based on grip strength, and slow walking speed, and low physical activity. Notes that he has been feeling worse over the past 6 months and just does not have the strength to do anything anymore.

The patient states they are not currently on any medications except a multivitamin. He notes that he lives alone and does not want to leave his house.

Answer the following questions with supportive rationale:

What questions should you as the patient/family to further assess?

What screening tools would be appropriate in this case?

Do you have concerns with fraility in this patient? If so why?

What referrals should be made if any on this patient?

HCA 322 FINAL PAPER

Scenario No. 2: DNR Project Assignment: Review your State Government’s website and search for its official Do Not Resuscitate (DNR) Form. Along with the form will be information and instructions regarding the form. In addition, research three area hospitals to determine if they provide separate DNR forms. Then, perform additional research regarding DNR and prepare your Final Paper by analyzing the issues through these steps: •Analyze the requirements of your State Government’s DNR. •Identify the requirements of the three hospital’s DNRs. •Examine the differences and similarities between the state’s and the three hospital’s DNR requirements, and address the following questions: •What are they? •Which one should you follow? •Explain how a DNR is applied if a patient is under hospice care and EMTs are called. Writing the Final Paper The Final Paper: •Must be eight to ten double-spaced pages in length, excluding title and reference pates, and formatted according to APA style as outlined in the Ashford Writing Center. •Must include a title page with the following: ?Title of paper ?Student’s name ?Course name and number ?Instructor’s name ?Date submitted •Must begin with an introductory paragraph that has a succinct thesis statement. •Must address the topic of the paper with critical thought. •Must end with a conclusion that reaffirms your thesis. •Must use at least eight scholarly sources that were published within the past five years, including a minimum of four from academic journals

Physical Exam

Vital signs: BP 138/88; HR 88 (regular), RR 18, T 98.8 height 5'7", weight 175 pounds 
General appearance: Thin and mildly dyspneic
Lungs: Mild end-expiratory wheezing. Pursed-lip breathing noted and has a prolonged expiratory phase. Heart: S1 and S2 RRR with distant heart tones. No murmurs
Abdomen: Soft, non-tender with positive bowel sounds. No abdominal bruits
Extremities: Full ROM of all extremities. No edema. All pulses 2+
Labs/diagnostics: Chest x-ray shows pulmonary hyperinflation, flattening of the diaphragm; Pulmonary function test: 
Prebronchodilation: FEV1/FVC ratio 53%, FEV1 50% of predicted value
Postbronchodilation with 2 puffs albuterol—FEV1/FVC ratio 0.60, FEV1 60% of predicted value

Discussion Questions Part Two:

Post your SOAP note for this patient's encounter.

Review the SOAP note format for the course. Summarize the history and results of the physical exam. Include one evidence-based journal article that supports your rationale for all diagnoses with ICD 10 codes and include a complete treatment plan that include medications, further diagnostics, patient education, referral and plan for follow-up. Each step of the plan must include an in-text citation to a scholarly source. Review the Reference Guidelines document in Course Resources.

hoose two issues or challenges that the leaders of today's health care organizations

Choose two issues or challenges that the leaders of today's health care organizations face. Select from among the following topics:

Staff Shortage (Physicians, Nurses, Allied Health Providers, Ancillary Services)

Reorganization in Response to Merger or Consolidation of Services Layoffs as a Result of Declining Revenues Influx of Registry, Part-Time, and Temporary Contract Staff

Poor Performance Outcomes Leading to a Reduction in Medicare Reimbursement Dollars Poor Job Satisfaction Rates Resulting in Turnover You are the manager of an ancillary service department at a large, 500+ bed hospital.

Develop a proposal (750-1,200 words) that is directed toward your staff, in which you address the following: Inform the staff of the two issues (from the topics provided) your organization is facing. Describe the impact of these issues on your department.

Describe how improved communication, collaboration, and teamwork can improve conditions in your department.

Identify at least two examples from the required or recommended readings of techniques found to foster inclusion and improve communication and collaboration.

A minimum of three academic references from credible sources are required for this assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide,

NR507 full course (all discussions+ midterm and final exam)

Week 1: Altered Immune System and Altered Inflammatory Response – Discussion Part One This week's graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

6 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1) 6 Distinguish risk factors associated with selected disease states.

(PO 1) 7 Explore age-specific and developmental alterations in physiologic and disease states.

(PO 1, 4) Discussion Discussion Part One (graded) John is a 19-year-old college football player who presents with sneezing, itchy eyes, and nasal congestion that worsens at night. He states that he has a history of asthma, eczema and allergies to pollen. There is also one other person on the football team that has similar symptoms. His vitals are BP 110/70, P 84, R 18, T 100 F. Write a differential of at least five (5) possible items from the most likely to less likely.

For each disease include information about the epidemiology, pathophysiology and briefly argue why this disease fits the presentation and why it might not fit the presentation Week 1: Altered Immune System and Altered Inflammatory Response – Discussion

B.J., a 70-year-old black female has been seen in the clinic several times. The last time she was in for a check-up was 6 months ago to get her prescriptions refilled. She has returned to the clinic today because she “ran out of blood pressure medicine” and would like to get her prescriptions renewed. She has not taken any prescription medicine in approximately 6 months

Background:

The patient indicates that she has noticed shortness of breath, especially when she is playing with her grandchildren. But, it goes away once she sits down to rest. She reports that she is also bothered by shortness of breath that wakes her up at night, but it resolves after sitting upright on 3 pillows. She also tells you that “I noticed over the last week that my legs and ankles have been swollen”. She also indicates that she often feels light headed and faint while going up the stairs, but it subsides after sitting down to rest.

PMH:

Hypertension

Previous history of MI in 2010

Current medications:

Coreg 6.25 mg PO BID

Colace 100 mg PO BID

K-dur 20 mEq PO QD

Furosemide 40 mg PO QD

Surgeries:

2010-Left Anterior Descending (LAD) cardiac stent placement

Allergies: Amoxicillin

Vaccination History:

She receives an annual flu shot. Last flu shot was this year

Has never had a Pneumovax

Has not had a Td in over 20 years

Has not had the herpes zoster vaccine

Other:

Last colorectal screening was 11 years ago

Last mammogram was 5 years ago

Has never had a DEXA/Bone Density Test

Last dilated eye exam was 4 years ago

Labs from last year’s visit: Hgb 12.2, Hct 37%, K+ 4.2,

Na+140 Cholesterol 186, Triglycerides 188, HDL 37, LDL 190, TSH 3.7

Blood pressure on day of visit: 150/90

Social history:

She graduated from high school, and thought about college, but got married right away and then had kids a short time later. Her son lives in another state,

Family history:

Both parents are deceased. Father died of a heart attack; mother died of natural causes. She had one brother who died of a heart attack 20 years ago at the age of 52.

Habits:

She drinks one 4-ounce glass of red wine daily. She is a former smoker that stopped 20 years ago.

Discussion Part One:

• Summarize the important data from the patient's history and reason for the visit today. 
• Provide a minimum of three differential diagnoses (DD) with rationale for the chief complaint.
• Include OLDCARTS and additional ROS questions needed to develop DD.
• Based on the LDL level above, indicate if you need to order a statin for this patient? Provide a rationale for your decision based on evidence based clinical guidelines.
• What other patient risk factors put the patient at risk for arteriosclerotic coronary vascular disease (ASCVD)? Reference the guidelines in your response. 
• Based on the patient data provided, choose two geriatric assessment tools that would be appropriate to use in conducting a thorough geriatric assessment. Provide a rationale on why you are choosing these particular tools.

Week 2: Discussion Part Two8 8 unread replies. 34 34 replies.Physical examination:
Vital Signs
Height: 5 feet 2 inches Weight: 163 pounds BMI: 29.8 BP 150/86 T 98.0 po P 100 R 22, non-labored
HEENT: normocephalic, symmetric. Bilateral cataracts; PERRLA, EOMI; Upper and lower dentures in place a fitting well. No tinnitus
NECK: Neck supple; non-palpable lymph nodes; no carotid bruits. Thyroid non-palpable
LUNGS: inspiratory crackles
HEART: Normal S1 with S2 split during expiration. An S4 is noted at the apex; systolic murmur noted at the right upper sternal border without radiation to the carotids.
ABDOMEN: Normal contour; active bowel sounds all four quadrants; no palpable masses.
PV: Pulses are 2+ in upper extremities and 1+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally
GENITOURINARY: no CVA tenderness; not examined
MUSCULOSKELETAL: Heberden’s nodes at the DIP joints of all fingers and crepitus of the bilateral knees on flexion and extension with tenderness to palpation medially at both knees. Kyphosis and gait slow, but steady.
PSYCH: normal affect; her Mini-Cog Score is 3. Her PHQ-9 score is 22.
SKIN: Sparse hair noted on lower legs and feet bilaterally with dry skin on her ankles and feet.

Discussion Questions Part Two:
Post your SOAP note for this patient's encounter.

Review the SOAP note format for the course. Summarize the history and results of the physical exam. Include one evidence-based journal article that supports your rationale for all diagnoses with ICD 10 codes and include a complete treatment plan that include medications, further diagnostics, patient education, referral and plan for follow-up. Each step of the plan must include an in-text citation to a scholarly source. Review the Reference Guidelines document in Course Resources.

Week 1 Discussion 1 Research Philosophies Methodologies

Week 1 Discussion 2 Ethical Considerations in Practice

Week 2 Assignment Conducting a Literature Review on a Research Problem – Phenomenon

Week 2 Discussion Critical Analysis in a Literature Review

Week 3 Assignment Conducting a Literature Review on a Theoretical Conceptual Framework

Week 3 Discussion The Importance of Theoretical Conceptual Framework in Research

Week 4 Assignment Revised Problem Statement

Week 4 Discussion Peer Critique of Revised Problem Statements

Week 5 Assignment Draft Quantitative Prospectus

Week 5 Discussion Alignment Within Quantitative Studies

Week 6 Assignment Draft Qualitative Prospectus

Week 6 Discussion Alignment Within Qualitative Studies

Week 7 Assignment Draft Doctoral Study Prospectus

Week 7 Discussion Understanding the Research Process

Week 8 Discussion 1 Judging Research Quality

Week 8 Discussion 2 Use and Misuse of Research Studies for Social Change