Answer In Base At Each Comments 18963119

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Comment 1

Smokers such as Mrs. J should benefit from evidence-based guidelines nicotine replacement therapy, bupropion SR, and/or varenicline as an effective alternative for smoking cessation therapy, especially when combined with behavioral interventions. Combination pharmacotherapy is indicated for highly nicotine-dependent smokers like this patient, since Mrs. J has failed with monotherapy for several years. An additional form of nicotine replacement therapy or an addition of a non-nicotine replacement therapy oral medication (bupropion or varenicline) may also be helpful. Thus,  rate of successful smoking cessation at 1 year will be about 3% to 5% when the patient simply tries to stop, 7% to 16% if the patient/smoker undergoes behavioral intervention, and up to 24% when receiving pharmacological treatment and behavioral support.

Comment 2

It is true that hypertension is a silent killer and can have deadly effects on the cardiovascular system. This week we are focsuing on heart conditions, but it is important to remember that uncontrolled hypertension can cause strokes as well (AHA, 2018) . When I worked on a neuro icu floor, there were many patients who suffered strokes and had no idea they were caused by high blood pressure. Many would have burst aneurysms as well and that would be there first sign of disease. They would have moerate to severe brain hemorraghing, sometimes irreversible and unfortunately did not recover or died. The families overwhelmingly thought that only the heart could be affected by hypertension, and not the brain. It is amazing how the vascualr system is all interconnected. We must stress the importance of brain health as well as heart health when teaching patients, the public, and family members about prevention. 

Comment 3

Many older adults end up with several pills to take at several different times per day. At a minimum this is often a hassle; at worst it becomes a serious drain on quality of life. Some older adults are unable to take all their medications properly. Depending on which medications are missed, this can cause serious effects on an older person’s health.

 
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Answer In Base At Each Comments 18967079

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Comment 1

Mucor reminds me of necrotizing fasciitis which is caused by a bacteria rather than a fungus.  In addition to surgical debridement and bronchoscopy it is recommended patients receive a MRI because they“can demonstrate soft tissue lesions better than CT scan(Mohammadi et al., 2014).  This will allow the healthcare team to monitor the progress of the treatment.

Comment 2

our post subject description covers multiple aspects of Mucus and immunocompromising conditions as the main risk factor for mucormycosis. You also indicated that patients with uncontrolled diabetes mellitus, especially those with ketoacidosis, are also at high risk. I will add that other risk-factors for the development of mucormycosis are ketoacidosis (diabetic or other), iatrogenic immunosuppression, use of corticosteroids or deferoxamine, disruption of mucocutaneous barriers by catheters and other devices, and exposure to bandages contaminated by these fungi. Mucus is a very dangerous virus, as it invades deep tissues via inhalation of airborne spores, percutaneous inoculation or ingestion. Probable diagnosis of mucormycosis requires the combination of various clinical data and the isolation in culture of the fungus from clinical samples; and treatment of mucormycosis requires a rapid diagnosis, correction of predisposing factors, surgical resection, debridement and appropriate antifungal therapy.

Comment 3

In the medscape article I noted I found that in most of the Mucor cases the patient had risk factors such as diabetic ketoacidosis  and neutropenia were present. Since that is our discussion I highlighted this. It was also interesting to look at pediatric cases of Mucor in a related article. In this article, “pediatric mucormycosis was reviewed, such as infection involving immunosuppressed children; this disease has also been observed in neonates (especially premature infants), patients with burns, and children with a history of incidental trauma.”  the article did not mention Diabetic ketoacidosis. (Varman, 2017)

 
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Answer In Base At Each Comments Reference From 2013 2018 Needed

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Comment 1

In completing research I also found a signifcance with IV drug use and mucor infections.

Cerebral mucormycosis is extremely rare but when it is
diagnosed, it is often found in IV drug users (Fungal Infections, 2018).  In a study published in Neurology, mucromycosis was associated with IV drug uses, most common heroin and cocaine (Lin, 2013).  Although the infection started in another
location, mucor had a predilection for the basal ganglia in 89% of those who were studied (Lin, 2013).

Comment 2

You mentioned people can get infected with mucormycosis from breathing spores in the air, through an open wound in the skin. I also learned that mucormycosis is considered rare but is actually the second most common fungal infection (Clinical Microbiology and Infection, 2013). Some symptoms that can help diagnose mucor are: diplopia, necrotic naso‐sinus eschars, pleuritic pain, necrotic cutaneous lesions. These may be present in other fungal infections, but aid in the initial diagnosis. Early idenitification and treatment are the keys to recovery. 

“Mucormycosis has a worse outcome than other invasive fungal infections such as candidiasis or aspergillosis. The higher degree of difficulty to cure this devastating infection is related to differences in host–fungus interactions, and pathogenetic mechanisms, as well as greater difficulties in early diagnosis when the ‘window’ of successful treatment is higher, and wider inadequacies of therapeutic options”(Clinical Microbiology and Infectio, 2013) .

Comment 3

I agree with checking glucose levels as part of the medical treatment for persons with pulmonary mucor. Apart from surgical and pharmaceutical interventions, treating underlying predisposing factors is important (Iqbal et al., 2017). Adding a sliding scale to treat high glucose levels would be optimal for the patient. The incidence of diabetes mellitus is rising, and it is causing an increase in mortality rates with pulmonary mucor (Iqbal et al., 2017).

 
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Answer In Base At Each Comments

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Comment 1

“Medication reconciliation is a critical piece of care coordination for all individuals who use prescription medications. 82% of all adults in the U.S. take at least one medication (prescription or nonprescription, vitamin/mineral, herbal/natural supplement); 29% take five or more” (Kantor, et al, 2015). It is easy to imagine with more than 75% of adults taking medication in the United States, that the risk of interactions among prescription and over the counter drugs, along with herbbal supplements, is greatly increased. Pharmacies are getting better about cross-referencing all drugs when new prescriptions come in, but that is only as good as the information provided to them. For example, if a patient uses more than one pharmacy to get their meds filled, and the systems do not “talk to each other” electronically, or the patient takes supplements and herbs and does not notify the physician or pharmacist, there is no way the database will have the information in it. 

Fortunately, there are tools available to patients and families to help with this process in case they omitted certain medications or supplements on their lists that the doctor has. There is virtual tool called “Drug Interaction Checker”, which is a system that cross references the medications the patient is on with any potential dangerous interactions. The patient can enter the names of all medications and supplements into the database for review. If any interactions appeat, they can call the pharmacist or their prescribing doctor to clarify if the medication should be stopped, changed, or continued. 

Comment 2

I agree.  Spiritual care would definitely be an asset in this situation.  Unfortunately, spiritual care is not front in center, at least in the organizations that I have been a part of.  Also, when I worked inpatient and would ask patients if they would like to speak with a chaplain, they used to think something was seriously wrong with them. Some of the cited reasons for lack of spiritual care in hospitals were not having an agreed definition on what spirituality is, what the nurses’ role is in addressing spirituality, the lack of time to meet a patient’s spiritual need, and a lack of training nurses have in spirituality (Rushton, 2014). 

Comment 3

I think this patient is definetly in need of teaching concerning her C-PAP machine for sleep apnea.  Most patients seem to rebel at wearing the mask. So in the first few days especially the nurse could assess whether she is having trouble wearing all through the night. Non-compliant patients need the continued encouragement until they realize how important it is for the progress of their health.  Myown husband for example had to be closely monitored for a year. He would rip it off in the middle of the night and unless I gentle put it back on him he didn’t wear it. and then I didn’t sleep.   Make sure your mask is a good fit. The most common problems with CPAP occur when the mask does not fit properly. So education about the C-PAP is a must for her.

 
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Answer Q 3

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look to files to chapter then answers , so each questions separate answers 

one page and half. 

  

1

Health care expenditures continue to rise in the USA. (a) Describe three of the factors that you think drive up health care costs and (b) Explain what do you think an individual can do to have and impact on personal and overall health care cost?

2

In your own words explain your understanding of clinical integration and explain why is it important in the current health care environment?

3

What type of PAC services are important for healthcare providers to include within their business now that the elderly community populations are more in need of them? Why? Select and explain two PAC services.

 
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Answer Instruct

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Thanks for your discussion on UTI. Women and older adults are at a higher risk for UTIs. Many people are prone to recurrent UTIs. Proper management and prevention is essential. UTI may be either cystitis (lower UTI) or pyelonephritis (upper UTI). The most common offending uropathogen in sporadic and recurrent UTIs is Escherichia coli or E. coli. Other bacteria that commonly are the offending organisms are Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis (Aydin, Ahmed, Zaman, Khan, & Dasgupta 2014). 

With recurrent UTIs, prophylaxis is often necessary. One particular prophylaxis treatment that may be recommended is consumption of cranberry juice or tablets. While some studies indicate that cranberry juice inhibits adherence of pathogens to the uroepithelial cells, effectiveness of cranberry juice as prevention of UTIs remains debated. With conflicting data regarding effectiveness among many studies, the provider will have to decide if recommending cranberry juice for prophylaxis will be a part of a patient’s treatment plan. What would be your recommendations for the patient with recurrent UTI & why?

 
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Answer Question 18908493

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2 reference

1.Describe the importance of evidence-based nursing care,

2.Idendify barriers to the implementation of evidence based-nursinf practice.

3.Identify strategies for the implementation of evidence based nursing practice.

 
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Answer Question About Alternative Therapies In Nursing

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Complementary and Alternative Therapies for Nursing Practice. 

BOOK Fontaine,K.L (2014) .

 Chapter 4 – Traditional Chinese
Chapter 5 –  Ayurvedic Medicine 

Question(s):   

Discuss Ayurvedic medicine .

· What is Ayurvedic medicine? 

· Explain the meaning of the word Ayurvedic. 

· Do you see any value of Ayurvedic medicine in the United States now days? (Explain your answer). 

· Would you integrate any of the Ayurveda practices into your nursing practice while caring for patients.

Guidelines: 

Apa format Time New Roman Format 12 font.

The answer should be based on the knowledge obtained from reading the book, no just your opinion. 

If there are 4 questions in the discussion, you must answer the four of them.   

Complementary and Alternative Therapies for Nursing Practice. 

BOOK Fontaine,K.L (2014) .

 Chapter 4 – Traditional Chinese
Chapter 5 –  Ayurvedic Medicine 

Question(s):   

Discuss Ayurvedic medicine .

· What is Ayurvedic medicine? 

· Explain the meaning of the word Ayurvedic. 

· Do you see any value of Ayurvedic medicine in the United States now days? (Explain your answer). 

· Would you integrate any of the Ayurveda practices into your nursing practice while caring for patients.

Guidelines: 

Apa format Time New Roman Format 12 font.

The answer should be based on the knowledge obtained from reading the book, no just your opinion. 

If there are 4 questions in the discussion, you must answer the four of them.   

Complementary and Alternative Therapies for Nursing Practice. 

BOOK Fontaine,K.L (2014) .

 Chapter 4 – Traditional Chinese
Chapter 5 –  Ayurvedic Medicine 

Question(s):   

Discuss Ayurvedic medicine .

· What is Ayurvedic medicine? 

· Explain the meaning of the word Ayurvedic. 

· Do you see any value of Ayurvedic medicine in the United States now days? (Explain your answer). 

· Would you integrate any of the Ayurveda practices into your nursing practice while caring for patients.

Guidelines: 

Apa format Time New Roman Format 12 font.

The answer should be based on the knowledge obtained from reading the book, no just your opinion. 

If there are 4 questions in the discussion, you must answer the four of them. 

 
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Answer Question About Communitypublic Nursing And International Health Care

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Topic:     Nursing  and  Global Health

                                                      PART 1:

1. Define global health and discuss the relation with community/public health nursing.

2. How a new nurse can take to get involved in international health care.

3. Discuss how the disease affects the people globally and what nurses can do in global public health to address and its impact.

4. A minimum of 700 words is required. 

THE assignment in an APA format word document, Arial 12 .

Is Not allow plagiarism. If the originality exceeds 9 % the percentage of plagiarism allow by the University points IT will be “cero”.

A minimum of 3 evidence-based references besides the class textbook are required. 

Example: 

References…

1- evidence-based references

2- evidence-based references

3- evidence-based references

4- Book  Title:Transcultural Concepts in Nursing Care

Author: Joyceen S. Boyle; Margaret M. Andrews 

                                                               PART 2:

You must write two replies to 2 different peers regarding the same topic sustained with the proper references and make sure that the references that you use in your assignment are properly quoted in it. 

Minimum 200 words.

If you have any questions you can contact me via email.

Due date: Thursday 8th, August

 
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Answer Question About Crisis Intervention In Nursing

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Question for Discussion

Chapter 3 – The Intervention and Assessment Models
Chapter 4 – Tools of the Trade

Question(s): Case of Elizabeth.

Maria is a 48-year-old white female who is recently divorced. She is not doing well in her love life and comes to you to get some immediate help because she is depressed and thinking about suicide. She spends the first ten minutes weeping uncontrollably and has a hard time putting words together.  Of the nine intentional strategies depicted in your book, which ones are the most important ones in this situation (mention 3 in the order of priorities) and why (explain and justify your answer)?  

Guidelines: 500 words . Time New Roman, APA Format 12 font 

The answer should be based on the knowledge obtained from reading the book, no just your opinion. If there are 2 questions in the discussion, you must answer both of them. 

 First question: Mention the adequate strategy for this case scenario (50%). Second part of this question:  explain / justify your answer (50%). 

 
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