Mr. JD is a 24-year-old who presents to Urgent Care with a 2-week history of cough and congestion. He says it started out as a “normal cold” and it will not go away. He has a productive cough for green mucous and has green nasal discharge. He says he has had a low-grade temperature for the past 2 days. John reports an intermittent frontal headache with this cold. He is otherwise healthy, with no known allergies.
In his assessment it is found that his vital signs are stable, temperature is 99.9 degrees F, tympanic membranes (TMs) are clear bilaterally, pharynx is erythematous with no exudate; there is greenish postnasal drainage; turbinates are swollen and red; frontal sinus tenderness; no cervical adenopathy, and lungs are clear bilaterally.
- Is there any additional subjective or objective information you need for this client? Explain.
In addition to what we have been told there are several things that may be identified. On first glance it would be important to assess the patients skin color, assess if they were sweating or were cold. It would be necessary to ask about allergies and see if he has been exposed to any possible allergens or irritants. It would need to be determined if this was the first time this has happened or has been a common occurrence. Assessing any recent traumatic injuries, headaches, or nose bleeds may help the clinician determine the root cause of the problem. Family history, patients past medical history, social history, and any current medications is a definite must. His vitals are stable besides the climb in temperature, so you could ask how he was sleeping and if he was getting enough fluid intake.
- Would you treat Mr. JDs cold? Why or why not?
I would definitely treat JD’s symptoms. He has been down and out for two weeks and his condition is not getting any better. His temperature is increasing, and he is symptomatic with tender mucous membranes, post nasal drip, and erythema. These are signs of an infection that should be treated. Not only is he at risk for getting worse but he could potentially expose others to his current illness. Clinical diagnosis of acute bacterial sinusitis requires prolonged, nonspecific upper respiratory signs such as rhinosinusitis and cough without improvement for more than 10 days, and symptoms such as fever, facial swelling, or facial pain (Woo & Robinson, 2016).
What would you prescribe and for how many days? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.
Many times, antibiotics are prescribed too quickly and often times will not be effective if it is a viral infection. Based on the assessment findings and the little we know about the patient; the patient could have possible sinusitis. The first-line treatment for sinusitis in adults is amoxicillin/clavulanate (875 mg amoxicillin/125 mg clavulanate) for 5 to 7 days (Woo & Robinson, 2016). This medication has a half-life of 1-1.3 hours, is metabolized by the liver and eliminated in the urine. It usually takes 30 minutes to be effective and peaks in 1-2 hours. This medication is an oral antibacterial combination that consist of the semisynthetic antibiotic amoxicillin and the β-lactamase inhibitor (FDA, n.d.). This bactericidal hinders bacterial growth by inhibiting the biosynthesis of bacterial cell wall mucopeptide (Woo & Robinson, 2016). For JD, it would be necessary to check a comprehensive metabolic panel to assess liver and kidney function. There is not a black box warning and usually does not have any side effects other than a possible rash. It is usually safe during pregnancy however before prescribing it would be necessary to assess allergies and inform the patient about potential side effects like a rash.
Would this treatment vary if Mr. JD was a 10 year-old 78 lb child? Include the class of the medication, mechanism of action, dosing, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings
Amoxicillin is first-line therapy for sinusitis in children (Woo & Robinson, 2016). If the child has not recently been on antibiotics, they should be on a dose of 25-50mg/kg/d in divided doses. This bactericidal medication is an aminopenicillin that is taken orally, has a half-life of 1.3hrs, is metabolized in the liver and excreted in the urine, and works by inhibiting the bacterial cell wall mucopeptide (Woo & Robinson, 2016). As stated before, it does not have any black box warnings and patients kidney and liver functioning is a concern before use.
What health maintenance or preventive education is important for this client based on your choice medication/treatment?
I would instruct this patient to take the medication until it is gone; not stop it early. In addition, if they failure to respond within 3 to 5 days he should prompt notify his PCP and a change in therapy should be considered (Woo & Robinson, 2016). I would instruct the patient to get plenty of sleep, increase fluid intake, and take a probiotic once they are done with their regimen. Antibiotics have been known to kill of not only the bad bacteria in the gut but the good as well. Preventing side effects like diarrhea should be taken prophylactically. They should be taken on an empty stomach, 1 hour before a meal or 2 hours after meals (Woo & Robinson, 2016). For additional resources, I would tell the patient the pharmacist is a great tool for resource if they had questions when they picked up the medication but to always call the PCP for further questioning.
References:
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Anorexia Power Point
/in Uncategorized /by developerAnorexia
1-Definition
2-Epidemiology in united states
2-Symptoms and signs
3-Diagnosis Criteria
4-Differential diagnosis
5-Treatment
6-Criteria for hospitalization
7-Other diseases related with inadequate calories intake
8-Underweight and growth failure definition
At least 15 slides. APA format.turtinitin report
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Anp Role
/in Uncategorized /by developerBased on your selected MSN program, write your first section of your ROLE paper using the following criteria:
For this assignment, you will research an advanced nursing practice role and summarize your findings in a 3 page paper (excluding the title page and references):
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Anp Week 3 Discussion
/in Uncategorized /by developerThe Invisible Patients (2016) ( https://www.imdb.com/title/tt5592140/ ), will demonstrate the many professional issues and ethical dilemmas that exist for one APRN. Her journey could be your journey one day. Consider the concept of Nurse Practitioners being Disruptive Innovators. What does that mean?
Ethical Dilemma
After reviewing The Invisible Patients documentary, define/describe in detail an ethical dilemma that was experienced by the NP. Please note, there are several ethical issues, so there should be diversity in the responses. Explain how you would have handled the situation.
Remember there is no right or wrong answer for this ethical question. Suggested reference Look at the Nuremburg Code (US Department of Health & Human Services, 2005; Washington, 2012) as it was the major start of ethics in research and that can carry over to nursing practice.
US Department of Health & Human Services. (2005). The Nuremberg code.
Retrieved from http://www.hhs.gov/ohrp/archive/nurcode.html
least two posts by the end of the week.
2-3 PAGES IN APA FORMAT WITH 2-3 REFERENCES.
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Anp Week 2 Discussion
/in Uncategorized /by developerFaculty will assign you either DQ 1 or DQ 2. Please answer all parts of the DQ.
Discussion Question Response: By, post your complete response to one of the discussion questions in the appropriate threads in the Discussion Area by due date assigned.
Guidelines: Support your responses with scholarly academic references using APA style format. Assigned course readings and online library resources are preferred. Weekly lecture notes are designed as overviews to the topic for the respective week and should not serve as a citation or reference.
In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples that demonstrate a clear connection to the readings.
In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extend meaningful discussion by building on previous postings.
Discussion Question 1
Answer the following:
Coaching and mentoring should be a core competency of nurses prepared at the graduate level. Do you agree or disagree with this statement? Defend your response.
Based on your graduate specialization, identify one coaching activity that you can do in this advanced practice role. What strategies would you employ for this activity?
Describe one mentoring activity you might complete with a mentor that would help you to acclimate to your new advance practice role. Should this activity be structured or unstructured?
Discussion Question 2
Consultation is a core competency of graduate nursing. Answer the following:
Differentiate consultation from supervision?
Are consultation and collaboration synonymous? Defend your response.
Give an example on how you have seen the consultation competency practiced in your current nursing area. Explain if the practice followed the graduate competency criteria.
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Answer 19078649
/in Uncategorized /by developerDescribe the common history in allergic rhinitis.
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Answer 3 Questions 19475803
/in Uncategorized /by developerWatch the “Diary of Medical Mission Trip” videos dealing with the catastrophic earthquake in Haiti in 2010. Reflect on this natural disaster by answering the following questions:
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Answer A Discussion Post
/in Uncategorized /by developerMr. JD is a 24-year-old who presents to Urgent Care with a 2-week history of cough and congestion. He says it started out as a “normal cold” and it will not go away. He has a productive cough for green mucous and has green nasal discharge. He says he has had a low-grade temperature for the past 2 days. John reports an intermittent frontal headache with this cold. He is otherwise healthy, with no known allergies.
In his assessment it is found that his vital signs are stable, temperature is 99.9 degrees F, tympanic membranes (TMs) are clear bilaterally, pharynx is erythematous with no exudate; there is greenish postnasal drainage; turbinates are swollen and red; frontal sinus tenderness; no cervical adenopathy, and lungs are clear bilaterally.
In addition to what we have been told there are several things that may be identified. On first glance it would be important to assess the patients skin color, assess if they were sweating or were cold. It would be necessary to ask about allergies and see if he has been exposed to any possible allergens or irritants. It would need to be determined if this was the first time this has happened or has been a common occurrence. Assessing any recent traumatic injuries, headaches, or nose bleeds may help the clinician determine the root cause of the problem. Family history, patients past medical history, social history, and any current medications is a definite must. His vitals are stable besides the climb in temperature, so you could ask how he was sleeping and if he was getting enough fluid intake.
I would definitely treat JD’s symptoms. He has been down and out for two weeks and his condition is not getting any better. His temperature is increasing, and he is symptomatic with tender mucous membranes, post nasal drip, and erythema. These are signs of an infection that should be treated. Not only is he at risk for getting worse but he could potentially expose others to his current illness. Clinical diagnosis of acute bacterial sinusitis requires prolonged, nonspecific upper respiratory signs such as rhinosinusitis and cough without improvement for more than 10 days, and symptoms such as fever, facial swelling, or facial pain (Woo & Robinson, 2016).
What would you prescribe and for how many days? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.
Many times, antibiotics are prescribed too quickly and often times will not be effective if it is a viral infection. Based on the assessment findings and the little we know about the patient; the patient could have possible sinusitis. The first-line treatment for sinusitis in adults is amoxicillin/clavulanate (875 mg amoxicillin/125 mg clavulanate) for 5 to 7 days (Woo & Robinson, 2016). This medication has a half-life of 1-1.3 hours, is metabolized by the liver and eliminated in the urine. It usually takes 30 minutes to be effective and peaks in 1-2 hours. This medication is an oral antibacterial combination that consist of the semisynthetic antibiotic amoxicillin and the β-lactamase inhibitor (FDA, n.d.). This bactericidal hinders bacterial growth by inhibiting the biosynthesis of bacterial cell wall mucopeptide (Woo & Robinson, 2016). For JD, it would be necessary to check a comprehensive metabolic panel to assess liver and kidney function. There is not a black box warning and usually does not have any side effects other than a possible rash. It is usually safe during pregnancy however before prescribing it would be necessary to assess allergies and inform the patient about potential side effects like a rash.
Would this treatment vary if Mr. JD was a 10 year-old 78 lb child? Include the class of the medication, mechanism of action, dosing, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings
Amoxicillin is first-line therapy for sinusitis in children (Woo & Robinson, 2016). If the child has not recently been on antibiotics, they should be on a dose of 25-50mg/kg/d in divided doses. This bactericidal medication is an aminopenicillin that is taken orally, has a half-life of 1.3hrs, is metabolized in the liver and excreted in the urine, and works by inhibiting the bacterial cell wall mucopeptide (Woo & Robinson, 2016). As stated before, it does not have any black box warnings and patients kidney and liver functioning is a concern before use.
What health maintenance or preventive education is important for this client based on your choice medication/treatment?
I would instruct this patient to take the medication until it is gone; not stop it early. In addition, if they failure to respond within 3 to 5 days he should prompt notify his PCP and a change in therapy should be considered (Woo & Robinson, 2016). I would instruct the patient to get plenty of sleep, increase fluid intake, and take a probiotic once they are done with their regimen. Antibiotics have been known to kill of not only the bad bacteria in the gut but the good as well. Preventing side effects like diarrhea should be taken prophylactically. They should be taken on an empty stomach, 1 hour before a meal or 2 hours after meals (Woo & Robinson, 2016). For additional resources, I would tell the patient the pharmacist is a great tool for resource if they had questions when they picked up the medication but to always call the PCP for further questioning.
References:
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Answer Based On These Answers You Must Answer It As They Are Listed One By One Apa Form No Less Than 250 Word And Your Answer Must Be Substantial 18893243
/in Uncategorized /by developer4-Conveinience sampling IS a less reliable type of sampling. Like the name, it it used for conveinience for the researcher. It does not give a broader population of participants, narrowing down to a smaller group, or groups more than likely to answer similiarly.
5-Cluster sampling is when the population is divided into sections, then a section is chosen, and every individual of that section is used. An example would be to use classrooms A, B, C, and D, then choose one of those classrooms as your sample in the study.
Convenience sampling is used to get results by the easiest of ways. An example is when the researcher uses subjects close at hand.
Systematic sampling is having a place to begin and then selecting (every other, for example) of that sample. For example, lining up a class of 10 th graders and picking every 3 rd person to be part of the sample.
Stratified sampling takes a population with the same characteristics and divide it into two separate groups and then take a sample from each group. An example could be taking soccer players with similar playing capabilities dividing that population into two groups and then selecting players from each of those groups. ”
6-Cluster sampling is when the population is divided into sections, then a section is chosen, and every individual of that section is used. An example would be to use classrooms A, B, C, and D, then choose one of those classrooms as your sample in the study.
Convenience sampling is used to get results by the easiest of ways. An example is when the researcher uses subjects close at hand.
Systematic sampling is having a place to begin and then selecting (every other, for example) of that sample. For example, lining up a class of 10 th graders and picking every 3 rd person to be part of the sample.
Stratified sampling takes a population with the same characteristics and divide it into two separate groups and then take a sample from each group. An example could be taking soccer players with similar playing capabilities dividing that population into two groups and then selecting players from each of those groups.
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Answer Based On These Answers You Must Answer It As They Are Listed One By One Apa Form No Less Than 250 Word And Your Answer Must Be Substantial
/in Uncategorized /by developer1-Great response. You brought up many points that I overlooked. I love the info on assessing the community. Of course you need to assess the community on their spiritual needs and reaction to the disaster. There could be people at risk of harming themselve or others. It is important to gauge the community members and provide them with the proper support they need. A community health nurse has a very important job when dealing with disasters.
2-What we call holistic care in nursing involves the mind, body and spirit. If we are required to care for our patients this way for them to be healed as a whole person, then it should be part of their health care. I think there should be reimbursement for it. Spiritual care is important in the care of patients.
3-During disasters, people suffer psychological and emotion stress. There are many types of disasters that cause emotional stress, like school shootings, mass shootings, bombings, and weather-related disasters. They witness some traumatizing events that may haunt them. They may question why God allowed this to happen. They may wonder about their beliefs of God. They may feel the need to push others away, so they do not get hurt. They may feel guilty or angry. They may question life and death and its purpose. The community will ask the same questions as well. Community leaders may feel overwhelmed while trying to care for their community members like when Las Vegas had the mass shooting during a country concert. The community of Las Vegas and country music came together to support the victims and the community. Health care worker, first responders, and the community, caring for the victims struggle to save lives and lose precious lives. They worked to save lives and to provide emotional support to the victims. After the day was over, the workers themselves were the ones that needed to be cared for emotionally and mentally. They are mentally drained and need counseling themselves.
A community nurse health nurse can assist with all aspects of nursing, triaging the injured, as well as population-based practices, rapid assessment of the community’s needs, handing out of preventative and treatments, education, providing shelter or resources for shelter, and staples to survive or resources to facilitate those staples (Association of Public Health Nurses, 2013). They also can provide the spiritual support that people need. They should offer spiritual support by offering spiritual care by being present and hospitality, nonjudgmental listening, providing no harm, and confidentiality. Encourage their faith to get them through the disaster, attempt to normalize and understand their situation. They should also be ready to provide spiritual resources and assistances (National Disaster Interfaith Network, n.d.). The community can assist her colleagues by listening to them and providing them with resources for spiritual support.
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Answer Case Question 19441687
/in Uncategorized /by developerNike, as many other companies like Tesla, Lyft, Airbnb, Starbucks, along with numerous tech giants have raised their voice related to political concerns. The information below offers some background and overviews of Nike’s controversial ad. After critically reflection on the sources, post your response to the following question: Is an organization taking a political stand an ethical dilemma? If so why, if not why not? Draw on course vocabulary to support your thoughts.
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