Respiratory

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Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities, and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. Add questions to paper

CASE STUDY: 
Asthma

 

Patient Profile:

    Miss Winters, age 25, comes to the emergency department with severe wheezing, dyspnea, and anxiety. She was in the ED only 6 hours ago with an acute asthma attack, which resolved with nebulized albuteral treatments.

 

Subjective Data:

-Admits to use of albuterol inhaler several times weekly for the last few months 

-Asthma symptoms occasionally awaken her at night (about 3 times a week), and she has cancelled several outings with her family due to her symptoms

          -Can now only speak in one to three word sentences

          -Is allergic to cigarette smoke

-Began to experience increased shortness of breath and chest tightness when she returned home

-Used albuterol inhaler repeatedly at home without relief

-History of pruritic skin lesions that have come and gone since childhood.

 

Objective Data:

            Physical Examination:

                -Using accessory muscles to breath

             -Audible inspiratory and expiratory wheezing to auscultation with no air movement in lower lobes of l

                     lungs

             -HR = 126/min; Resp = 40/min

             -Areas of dry, scaling skin in antecubital areas bilaterally with evidence of scratching

            
Diagnostic Studies:

                        ABGs: PO2  = 80 mm Hg

                                    PCO2  = 35mm Hg

                                    HCO3  = 24 mEq/L

                                    pH = 7.48

                        PEFR: 150 L/min (Personal best: 400 L/min)

                        Continuous pulse oximetry: 82-85

 

CRITICAL THINKING QUESTIONS:

 

1. Why did Ms. W. return to the ED? Explain the pathophysiology of this second exacerbation of asthma.

 

2. Describe the progression of breath sounds auscultated from early in an asthma attack through very severe respiratory impairment. How do the sounds change as the patient improves?

 

3. What is the significance of her dry, scaling, pruritic skin lesions? What is your diagnosis (no nursing dx please)? How do these types of lesions relate to asthma? What is their physiologic cause ?

 

4. Analyze the ABG. What type of acid-base disorder is present? Why? Is there any compensation?

 

5. Discuss the four categories of asthma diagnosis advocated in the 
Guidelines for the Diagnosis and Management of Asthma from the National Heart, Lung, and Blood Institute of the National Institutes of Health. Which classification best describes Ms. W.'s asthma?

 

6. According to the asthma treatment guidelines from #5: the “Step up-Step down” approach, what is the recommended treatment strategy for a patient currently at Ms. W.’s classification level once this current exacerbation is controlled? When would it be appropriate to reevaluate the interventions and possibly adjust the medications?

 

7. She lost her Peak Flow meter during a recent house move. Why would you want to order a new one for her? How is it used and how can it help increase her ability to control her asthma? Explain the red, yellow, and green zones. What is the significance of her PEFR level on her return to the Emergency Room?

 

Chronic mental illness

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Analyze the potential effectiveness resulting from professional or nurse-provided social support versus enhancement of social support provided by personal relationship and social networks for parents of children with chronic mental illness.

Please include 400 words with two scholarly articles no later than 5 years old. 

No Plagiarism

Run rheumatoid arthritis

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I’ve attached a list of question asked by the patient please insert accordingly 

Peer responses

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Respond to two of your colleagues’ posts by offering suggestions/strategies for working with this database from your own experience, or offering ideas for using alternative resources.

See attachments for peer responses 

Requesting writing tutor

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Answer in 500 words

1. Find two articles (evidence-based) that discuss emerging trends in Nursing Informatics.

a. Conduct a literature review on emerging trends in nursing informatics. 

2. For your post, briefly summarize the important points and/or findings of the articles. 

3. State why your chosen articles are relevant to nursing. 

4. Answer the question: “How can I help my colleagues and patients embrace, understand, and use technologies to manage health?” 

5. Include references in APA format.

Introduction to Statistics

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It has long been a requirement for health care workers to take an Introduction to Statistics class. Why is it important for a person working in health care to understand statistical concepts? To answer this question, please provide two specific examples incorporating two different statistical terms from “Visual Learner Statistics,” located in the Topic 1 Resources. Do not use the same examples as those in a prior post. You may reference other articles in this topic or conduct your own scholarly research if more statistical terms are needed.

Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “HLT-362V Discussion Question Rubric” and “HLT-362V Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.

Health Assessment 10

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Geriatric Functional Assessment

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Module 11 Content

1.

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This assignment is due no later than Friday September 15th at 5:00pm-LATE SUBMISSION Wll NOT BE ACCEPTED


There are two parts to this assignment:

A.
 You will be conducting a geriatric functional assessment. This geriatric functional assessment tool is the 
Katz Index of Independence in Activities of Daily Living & depression screening tool

At the end of the geriatric functional assessment, you will be asked to document your findings & provide a brief summary of each of the six categories 

B. Answer the questions on the worksheet: 

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Nursing homework

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I need brief and concise answers to the assignment attached below. 

I will like to have it done in 24 hours.

Reflection 2

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One of  the key points of learning from experience is to reflect on what you  did. Reflect on the selection of your topic and question. Answer the  following questions in a document of between 250 and 500 words. Save  your response as a word document and include a 7th edition APA cover  page. Upload the document to complete the assignment. Do not cut and  paste from any document of quote from any source. This is a reflection  on your own experiences, so you should not need to do this.

A. What options do you have for finding literature?

B. How can you judge which literature is most credible?

C. Is your literature search complete? Yes my article search is complete as it has been approved by the Pamela Wright.

etre

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Create a PowerPoint slide show with notes pages discussing their PICOT question, literature review, and recommendations for change.

In a PowerPoint Presentation, address the following.

1.
Title Slide

2.
Introduction (1 slide): Slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered.

3.
Practice Issue (1-3 slides)
: Describe the area of interest and practice issue/problem related to NP practice selected in week 2. Explain why the issue/concern is important to nurse practitioner practice and its impact on health outcomes. Provide speaker notes. Provide scholarly references to support your ideas.

4.
PICOT Question (1 slide)
: Provide the PICOT question developed in week 2. Describe each element of your PICOT question in one or two sentences, being sure to address all the following:

1.
P-Population and problem – What is the nursing practice concern or problem and whom does it affect?

2.
I–Intervention – What evidence-based solution for the problem would you like to apply?

3.
C–Comparison – What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or alternative solutions.

4.
O–Outcome – Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome.

5.
T–Time frame – What is the Timeframe involved for the EBP initiative or the target date of completion?

5.
Literature review (2-4 slides):Summarize the literature review completed in week 5. Discuss themes and special concerns. Discuss any unique insight or perspective offered from the literature. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions presented.

6.
Recommendations (3 slides):

1. Slide 1: Identify the evidence-based recommendation for the identified practice change. Speaker’s notes should fully explain the recommended change and rationale for the change. Provide support from scholarly references to support the recommendation.

2. Slide 2: Identify the key stakeholders impacted by the recommended change. Speaker’s notes add detail.

3. Slide 3: Analyze the recommendation in terms of fit, feasibility, and appropriateness as discussed by Dang and Dearholt (2018), Ch. 8. Speaker’s notes add detail. *Note: information regarding stakeholders, fit, feasibility, and appropriateness may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.

7.
Conclusion: (1 slide)Slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.

8.
References: Reference elements provided in APA format, may use bullets. Hanging indents not required.