Category: Nursing

“Don’t Mess with Auntie Jean”

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Read the attached document: “Don’t Mess with Auntie Jeans”.
Create an outline of the story and then answer the following questions:
1. What is the main purpose of Smiths narrative? In what ways, does this story shape her understanding of herself and her family?
2. How does Smith create a mental picture of the scene in the roller rink? Which sensory details are particularly effective in helping the reader feel present at the standoff between O.L. Underwood and Auntie Jean?
3. Smith writes, History is written by the victors. What does she mean by this? How can this old adage be applied to the story of her Auntie Jeans confrontation in the roller rink?
4. How would you describe the authors style in this narrative? What factors lead you to that characterization? How does the authors conversational style impact the readers understanding and appreciation of the narrative?

Role of Complementary and Alternative Medicine (CAM) in Chronic Conditions: A Case Study Analysis

Posted on | by Kelvin

 

Introduction

More and more patients want options for alternative treatments that can be used alone or in conjunction with conventional treatments. Patients with chronic conditions will often seek out some form of complementary and alternative medicine (CAM). It is important that nurses have an understanding of the types of CAM so that they can make recommendations and safely advise their patients.

Case Study

Mr. Yakisoma is a 55-year-old Asian male with numerous chronic illnesses, including the following:

Chronic lower back pain
Diabetes mellitus
Hypertension
Dyslipidemia
BPH
Depression
He takes the following prescription medications for his conditions:

Tramadol: 100 mg Q 45 hrs.
Lisinopril: 40 mg DQ
Hydrochlorothiazide (HCTZ): 25 mg QD
Metformin: XR 2 G day
Sitagliptin: 100 mg DQ
Simvastatin: 40 mg HS
Sertraline: 50 mg QD
ASA EC: 81 mg QD
Other important information about Mr. Yakisoma is as follows:

His vital signs in the clinic today are as follows:
145/90
P-75
R-20
O2 Sat 98% on RA
He rates his lower back pain an 8/10, saying It always hurts; I cant even play with my grandkids.
He reports that he does not sleep well at night.
He says, “I cannot exercise because my back hurts too much.
His diabetes is not well-controlled.
His A1C is currently at 8.0.
His cholesterol is not controlled, with the following lipid values:
Total cholesterol: 235 mg/dl
LDL: 110 mg/dl
HDL: 30 mg/dl
Trig: 450 mg/dl
He reports that he is often depressed about how many illnesses he has and how many medications he has to take, and says, I just want to enjoy my life again, decrease my pain, and be active.
You are working with a nurse practitioner in a busy primary care clinic. The nurse practitioner has only 20 minutes to spend with Mr. Yakisoma. She knows that you are studying complementary and alternative medicine (CAM) and asks you to give some recommendations for CAM that would be safe and therapeutic for this patient. Mr. Yakisoma has a strong interest in alternative treatments. He says, I dont want to take all of those prescription medications, and they are bad for you!

Mr. Yakisoma, the case study patient, has multiple chronic diseases, including pain. Your first task is to identify 1 mindbody technique (e.g., yoga, meditation, hypnotherapy, guided imagery, dreamwork, intuition, music therapy, biofeedback, or animal-assistive therapy) that could be applied to this patient’s case. Conduct a literature review, and use evidence-based research to support or refute the recommended CAM treatment. You should utilize at least 3 research articles to support your assertions about the type of mindbody technique that you choose.

You should review each of the 3 research articles and present the following in a document of 46 pages, excluding title page and reference page:

State the therapy you selected.
State what condition the case study patient could use this for.
Report what the research has to say on this therapy.
Report what each of the 3 studies was about.
State how each of the 3 studies was conducted.
What were the results of each of the 3 studies?
Explain to the nurse practitioner how she can use this study for this patient’s case.

Cognitive Behavioral Therapy (CBT) and Its Effectiveness in Treating Depression

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search symptom Media platform and review the Psychotherapy/Cognitive Therapy film. How does Cognitive Behavioral Therapy (CBT) address the cognitive distortions commonly associated with depression, and what evidence supports its effectiveness compared to other therapeutic approaches for treating this condition?

 

 

The Importance of De-Prescribing: Safe Transitioning in Patient Medication Management

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What is the importance of de-prescribing? How might you assist a patient to taper from a medication safely or transition to a new medication?

In this Assignment, you will use the following patient examples to write a 5- to 6-page paper on considerations you have for how you might de-prescribe. Support your answers with five (5) evidence-based, peer-reviewed scholarly literature resources outside of Required Learning Resources in this course.

 

 

Characteristics of Effective Policy in Nursing Leadership

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https://westcoastuniversity.h5p.com/content/1291875035167319468As a future APN leader, you may be involved in developing policies that regulate your workplace.Watch Episode 6 Links to an external site.of Practice and Principle.In a 1 paper, discuss the characteristics of an effective policy. As a nurse leader, what could you do to ensure that policies are effective, ethical, and well-received by communities of interest?Please use reference within 5 years.

 

Case Study Analysis: Bertha’s Hepatitis C Management

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case study

Bertha, a 58 – year – old Hispanic female, presents to the primary care clinic to establish care. She states that in 1985 she received a blood transfusion after sustained an MVA. She had tested positive for hepatitis C virus ( HCV ) in the past, but ignored any advice regarding treatment options. She brings a previous lab result with her today that shows :(ALT) level of 85 IU/mL (range 8 35 IU/mL). The lab form also states, HCV antibody is positive by enzyme immunoassay confirmation is suggested.

Past medical h story: Hypertension, dyslipidemia, hepatitis C.

Family history: Unremarkable

Social history: She works as a case manager of an HMO and is married with 2 children. Denies use of illegal drugs, denies alcohol abuse, and has no tattoos.

Medications: HCTZ, 12,5 mg daily; Atorvastatin 20 mg daily.

Allergies: No known drug or food allergies.

OBJECTIVE General a ppearance: 58 – year – old female; pleasant, in no acute distress; good eye contact. Vital signs: T: 96.8; P: 76; RR: 25; SaO 2 : 91; BP: 138/80. Her weight is 174 lb, and her height is 63 inches.

HEENT : Negative. Neck: Thyroid nonpalpable. No lymphadenopathy.

Cardiovascular: Regular rate and rhythm. Apical Pulse (PMI) is at 5th intercostal space, left sternal border. Pulses + 2 all extremities.

Respiratory: Lungs clear to auscultation, No wheezes; no crackles.

Abdomen: Mild tenderness in right upper quadrant. BS x 4 no bruits. Nondistended, soft. No organomegaly. No ascites.

Neurological: A & O 4, CN II XII grossly intact.

Depression scale: negative. Musculoskeletal: Full ROM. No deformities. Muscle strength is 5/5.

CRITICAL THINKING

Which diagnostic or imaging studies should be considered confirm the

diagnosis?

What is the most likely differential diagnosis?

What is your plan of treatment?

Are there any emergent referrals needed?

COVID-19 Data Analysis Report

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Since the COVID tracking project has discontinued, there is no single federal database with all covid data. However, the Center for Disease Control (CDC) COVID Data Tracker contains links out to covid data for states and counties.

Use the links provided by the CDC COVID data tracker to find the covid data for your state:
Sort the data by state and then by submission date. Copy all of the data for your state to a new sheet.
Create a new column AR in the database labeled % positive. The formula to calculate % positive should be = AD1/AP1. Format the cell for percentage. Copy the cell down the column for all dates of your state.
Using the data, develop a linear regression time series analysis for deaths (column D), % tested, and % positive. Answer the following questions:
What is the null and alternative hypothesis for each variable?
What was the r squared for each variable? What does this mean?
What was the p-value of each test? What does this mean?
For those tests which were significant, use the model to predict the value of the variable seven days after the end of the workshop.
Write a short report (1 to 2 pages for each variable) that includes the results of your analysis. Present the results and discuss the implications of your findings. Include whatever graphs or statistical output you may have generated in answering these questions along with a short explanation of your analysis. What conclusions concerning COVID19 may you draw from your analysis?

 

 

 

 

Understanding Lateral Epicondylitis in an Undocumented Worker

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A 41-year-old male patient presents at the community walk-in clinic with complaints of severe elbow pain radiating into the forearm. His 13-year-old daughter is serving as a translator because her father is unable to speak English and understands only a few words in English. The daughter explains that he has been taking Tylenol to manage pain, but the pain is getting worse and is keeping him from working. You ask the daughter to describe the type of work her father does, and you notice she is hesitant to respond, first checking with her father. He responds, and she translates that he works in construction. Based on the response and the apparent concern, you suspect that the patient may be an undocumented worker. Further conversation reveals that several members of the family are working with the same local construction company.

You suspect the pain reported as coming from the elbow and radiating down the forearm is caused by repetitive motions, perhaps indicating lateral epicondylitis. What can you do to confirm this diagnosis?
While performing the physical examination, you ask the patient, through his daughter, if he has reported this injury to his employer, because the injury is most likely work-related. The daughter responded without consulting her father that this is an old injury that happened before he started working at his current place of employment. You could tell that she was becoming more distressed. What is the most likely explanation for her concern?
Visual inspection reveals erythema around the affected area with no evidence of overlying skin lesions, scars, or deformities. What other assessments should you perform?
How is lateral epicondylitis treated?
When discussing possible treatment approaches, you notice that the patient is very worried and seems to suggest to his daughter that they should leave. The daughter begins trying to explain why they have to leave right away. What would you tell the patient and his daughter to help them feel comfortable staying for treatment?

Understanding Rural Challenges in Monroe County, Florida

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Explore some of the websites listed below. Based on what you learn, explain how Monroe County Florida qualifies as “rural”, what this means for funding and human resources, and how the health of the population may suffer as a result of the geographic location. Think about food, water, specialty care, evidence-based practice, etc. If you had unlimited funding, what would your highest priority for the region be and why?

 

Vulnerable Groups and Support Services in Your Geographic Area

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Examine health statistics and demographic data in your geographic area to determine which vulnerable groups are predominant. Identify & list agencies you think provide services to these vulnerable groups. If the agency has a web page, post a link to it, write about the target populations they serve, the types of services they provide, and how they are reimbursed for services. Based on your findings, identify gaps or overlaps in services provided to vulnerable groups in your community.