Renal

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. 

Renal Failure

Patient Profile:

J.M. is a 37-year-old woman transferred to a large medical center from a small rural hospital for further evaluation of lower abdominal pain, nausea, vomiting, and progressive deterioration of urinary output.

Subjective Data:

-Long history of ETOH Abuse with a drinking binge two days ago

-Arthritis with heavy use of ibuprofen

-HTN for three years, treated with hydrochlorothiazide and a calcium channel blocker

-Borderline NIDDM for three years, does not want to take medications and has been trying

to lose weight and “watch her sugar intake.”

Objective Data:

B/P: 160/110 K: 6.3 mEq/L Urinary output: <15ml/hr Na: 149 mEq/L Lethargic Hgb A1C: 9.2%

Creatinine: 9.6 mg/dL BUN: 121 mg/dL

CRITICAL THINKING QUESTIONS…

1. Address how the various factors in her past medical history could have contributed to her present renal problem.

2. Is her acute renal failure likely to be prerenal, intrarenal, postrenal, or a combination? Why?

3. Discuss each of the laboratory values and how they reflect the pathophysiology that occurs in renal failure. What is the significance of her Hgb A1C level?

4. What are the specific priorities of treatment for J.M.?

5. Explain the types of dialysis available, their indications, and their advantages/ disadvantages. What type of dialysis will most likely be used for J.M?

6. After two weeks of intensive support and dialysis, J.M’s urinary output returns. Explain the diuretic phase of recovery in Acute Renal Failure, and what complications can occur.

7. Do you think she needs intervention for her diabetes? What guidelines did you consult? How would you start in treating a patient with newly diagnosed Type 2 diabetes? Which medication(s) might you want to start first? What patient education issues would you emphasize in the initial period?

Conc of Pathophys week 3 discussion

Week 3 Discussion: Myocardial Infarction (MI) (USLOs 1, 2, 3, 4)

You are the nurse caring for a 48-year Leslie Collins, retired army officer for the United States military, He arrives to the emergency department after experiencing chest pain and shortness of breath.  His EKG indicated he had a myocardial infarction (MI). He has a history of hypertension and high cholesterol. He states he used to smoke about 15 years ago, he has no other reported risk factors.

Based on this information, your prior knowledge of this client (refer to medical card from the Collins-Kim family tree interactive), and your knowledge of the pathophysiology of myocardial infarction (MI), respond to the following prompts:

1.

1. Thoroughly explain the pathophysiology of myocardial infarction (MI). Use a 
scholarly or 
authoritative source to support your answer.

2. Examine each of the following three factors related to this disease process. 
Support all three with a scholarly source.
cultural
financial
environmental implications

3. Identify 3-5 priority nursing interventions for the client while in the 
emergency department.

4. Describe labs and diagnostic testing you would want to include in client’s plan of care and why. What are critical indicators? 
Support with a scholarly source.

5. What members of the interdisciplinary team need to be included for holistic patient-centered care? 
Provide a rationale and support with a scholarly source.

see below

see below

SOAP note CKD

SOAP note follow up chronic kidney disease stage 2

Unit 12 Discussion Impulsivity and Compulsivity. 800w. 4 references. Due 11-13-23.

Unit 12 Discussion Impulsivity and Compulsivity. 800w. 4 references. Due 11-13-23.

1. Please describe the role of the mesolimbic dopamine pathway in the development or continuation of impulsive/compulsive behaviors. 

2. Please provide two examples of current research on interventions to reduce or eliminate compulsive/impulsive behavior related to addiction. 

3. Summarize the following article “Behavioral Functions of the Mesolimbic Dopaminergic System: an Affective Neuroethological Perspective” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2238694/

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

1. Role of the mesolimbic dopamine pathway in the development or continuation of impulsive/compulsive behaviors. The mesolimbic pathway is the dopamine pathway. This pathway extends from the “VTA of the brainstem (mesencephalon) to the nucleus accumbens in the ventral striatum which is part of the limbic system (Stahl, 2021, p. 90). This pathway is important as it is involved in the regulating motivation and reward. Hyperactivity of the mesolimbic pathway called hyperdopaminergia, is significant in the display of positive symptoms seen in psychosis, schizophrenia, and depression and can result in impulse, agitation, hostile, and aggressive symptoms. In addition, the hyperactivity of the DA pathway can be because of various psychostimulants. Such as, cocaine and methamphetamine (Stahl, 2021, p.90). In terms of impulsivity and compulsivity Stahl (2020, p.541) states, “Impulsivity can be thought of as the inability to stop the initiation of actions and involves a brain circuit centered on the ventral striatum, linked to the thalamus (T), to the ventromedial prefrontal cortex (VMPFC), and to the anterior cingulate cortex (ACC). Compulsivity can be thought of as the inability to terminate ongoing actions and hypothetically is centered on a different brain circuit, namely the dorsal striatum, thalamus (T), and orbitofrontal cortex (OFC). Impulsive acts such as drug use, gambling, and obesity can eventually become compulsive due to neuroplastic changes that engage the dorsal habit system and theoretically cause impulses in the ventral loop to migrate to the dorsal loop.” 2. Two examples of current research on interventions to reduce or eliminate compulsive/impulsive behavior related to addiction. According to Hartney (2021), compulsions are considered obsessions with repeated thoughts that create a feeling of distress (Hartley, 2021). The person’s behavior reduces anxiety and fear. An example to consider is obsessive compulsive disorder. In this disorder, the obsession revolves around the need to wash their hands. In the case of addiction, the desire to use will far outweigh the reality that there may be negative consequences. Such as financial strains, health issues, social problems, legal problems and/or decreased self-esteem (Hartney, 2021). Hartney (2021), suggests for treatment of the OCD behavior should include antidepressant medications like serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). These medications may be augmented with antipsychotics at the discretion of the provider. In terms of impulsivity, Kozak and her colleagues (2018) denote there are strong overlaps in the neural circuitry and functional mechanisms between impulsivity traits and addiction, which has directed treatment approaches. Therefore, it has been recommended, SUD treatment should include subjective and objective data and target the pharmacological, behavioral, and neurophysiological areas to individualize the patient’s care (Kozak et al., 2018). This study source was downloaded by 100000769192234 from CourseHero.com on 10-22-2023 17:11:39 GMT -05:00 https://www.coursehero.com/file/139195954/Discussion-12-ImpulsivityCompulsivitydocx/ For example: Alcohol use disorder – Naltrexone, Aripiprazole, and Topiramate were successful in decreasing impulsivity behaviors and Problem gambling – paroxetine was found to be successful in impulsivity (Kozak et al., 2018). References: Hartney, E. (2021). The difference between an addiction and a compulsion. Retrieved on March 30, 2022, from https://www.verywellmind.com/the-difference-between-an-addiction-and-acompulsion-22240 Kozak, K., Lucatch, A. M., Lowe, D., Balodis, I. M., MacKillop, J., & George, T. P. (2019). The neurobiology of impulsivity and substance use disorders: implications for treatment. Annals of the New York Academy of Sciences, 1451(1), 71–91. https://doi.org/10.1111/nyas.13977 Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.). p. 90 & 54, Cambridge: Cambridge University Press.

Nursing

The interpretation of research in health care is essentia

The interpretation of research in health care is essential to decision-making. By understanding research, health care providers can identify risk factors, trends, outcomes for treatment, health care costs, and best practices. To be effective in evaluating and interpreting research, the reader must first understand how to interpret the findings.

assist wk 1

Assignment: Articulate the Development of Quality Models and Associated Theoretical Frameworks

Using your reading assignments in your textbook as a starting point, you will conduct additional research on the early aspects of quality assessment, improvement, and management. Your Research Report must include an
introduction, body of discussion, and a summary. You will discuss the following quality models in-depth and the experts responsible for developing the models and frameworks for quality improvement and management. 

1. PDSA Cycle

2. Total Quality Management model

3. Lean Six Sigma model

4. Toyota Production System Lean Manufacturing

5. Donabedian Quality Framework 

In your summary paragraph, you will discuss the connection between the development of the Donabedian Quality Framework and its application in healthcare quality measurement.

In addition to your narrative, you will create a table that contains a timeline in chronological order for the introduction of the quality models you discussed in your research paper. Your table will be an
appendix to your research report and the entries will include the name of the quality model, the year it was introduced, and its purpose. The purpose will be a synopsis from your findings and may be presented using bullet points. Be sure to follow APA standards for the use of appendices.

Here is an example of the table. Add rows to complete your timeline. Download the table from your Weekly Resources.   

Year

Quality Model Name

Quality Model Purpose

 

 

 

 

 

 

 

 

 

Length: A minimum of 3 pages, not including the title page, reference page, and Appendix page.

Assess 2

Nursing

Leadership is an integral element in any job, regardless of the work title. However, it is important to recognize that leadership is not just one single skill; instead, success in leadership depends on a broad range of skills, among them are decision making, collaboration, and communication.

Develop a 3–4 page professional response to the supervisor in which you analyze your leadership skills and how you would use them to lead a project requiring group collaboration using the Letter Template which has two main components. In your response:

  • Identify the qualities of a successful leader and compare them to your own leadership characteristics.
  • Make recommendations on how to lead and foster teamwork.

This Book Must be used for at-least 1 reference – New Leadership for Today’s Health Care Professionals, 2nd Edition

& 2-3 other current sources below

Your assessment should also meet the following requirements:

  • Written communication:
    • Express your main points, arguments, and conclusions coherently.
    • Use correct grammar and mechanics.
    • Proofread your writing.
  • Length: 3–4 double-spaced pages.
  • Font and font size: Times New Roman, 12 point.
  • References: Support your claims, arguments, and conclusions with credible evidence from 2–3 current, scholarly or professional sources.
  • APA format: Apply current APA formatting to all in-text citations and reference