Religion, Culture and Nursing

Read chapter 13 of the class textbook and review the attached PowerPoint presentation, once done please write an essay comparing and contrasting two spiritual or religious beliefs about sickness causation and health.  Make sure that you include the following;

1.  Include the potential benefits of understanding spirituality too both health care providers and patients.
2. What health issues may be better addressed by a nursing care staff with knowledge about religious diversity?

INSTRUCTIONS:

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 13 discussion questions” and the SafeAssign exercise in the assignment tab of the blackboard(which is mandatory).  A minimum of 3 evidence-based references besides the class textbook no older than 5 years must be used and quoted according to APA guidelines and must be from a gerontology journal.  700 or 800 words except first page or references

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Write a 4–6-page analysis of key features of two of the major world religious traditions.

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Select two of the major world religious traditions. Summarize the key features of each and contrast them with each other and with the Greek philosophical tradition. Write a report in which you consider the following:

• What sensations, feelings, thoughts, and behaviors are expressed in religious rituals?
• How have religious traditions survived from their historical origins to the present day?
• What social and cultural differences make it difficult for people from distinct traditions to relate to each other productively?
• What power do these approaches have to transform individual lives?

Your report may well include reflection on the role of religious traditions in your own life, but develop your analysis of the issues independently of your own convictions.

Additional Requirements

• Written communication: Should be free of errors that detract from the overall message.
• APA formatting: Your paper should be formatted according to APA (6th edition) style and formatting.
• Length: 4–6 typed and double-spaced pages.
• Font and font size: Times New Roman, 12 point.sessment allows you to demonstrate your ability to summarize, contrast, and evaluate historical and contemporary elements of world religions.

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Chapter 41

A patient is admitted with renal calculi.

a.            What symptoms will the patient manifest if he is experiencing renal colic?

b.            How will the nurse best manage the renal colic?

c.             The nurse is straining the urine for presence of stones that the patient may have passed. What is the importance of this nursing action?

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1-AG 

                                                    Process and Regulations of Fast Track

    New pharmacological agents go a long way in clinical trials and approvals from the Food and Drug Administration before entering a wide market and becoming available to needy patients in the United States. At the same time, for promising drugs that can significantly improve the results of existing therapy or fill a missing niche, this process can be accelerated using the Fast Track protocol (Woo & Robinson, 2015). The latter provides for the filing of a special application by a pharmacological company at the FDA office, which the latter examine within 60 days. If the medicine acquires Fast Track status, manufacturers receive a number of concessions, such as the right to more frequent correspondence and meetings with representatives of this state regulatory body and the possibility of cooperation in conducting a clinical trial. If convincing positive results are obtained, it is possible to obtain FDA approval after a single phase 2 clinical trial (Papadimitriou & Butler, 2017). In addition, the verification process of such a pharmacological agent is significantly reduced from 10 to 6 months.

                                                                    Medical Conditions

    In order to be able to obtain faster approval via the Fast Track protocol, the drug agent must meet a number of requirements. Specific medical conditions are not indicated, but it is prescribed that the effect of the drug should be aimed at treating a life-threatening or dangerous disease, such as heart failure (Papadimitriou & Butler, 2017). A prerequisite is either to improve the outcome of existing treatment, such as a reduction in mortality or disability, or a significant reduction in the toxicity of therapy (Woo & Robinson, 2015). In addition, medical conditions that do not have developed a pharmacological treatment, such as some rare and orphan diseases, are also eligible for faster approval from the FDA via the Fast Track protocol. Therefore, due to this possibility, patients will more quickly gain access to the most modern therapy and increase the chances of a more favorable outcome of treatment.                                                   

                                                                           References

Papadimitriou, L., & Butler, J. (2017). “Fast Track” Development and Approval Process for Heart Failure Therapeutics. Clinical Pharmacology & Therapeutics, 102(2), 184-186.

Woo, T. M., & Robinson, M. V. (2015). Pharmacotherapeutics for advanced practice nurse prescribers. FA Davis.

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The FDA made it possible for critically needed medications to be introduced to the US market promptly using the “Fast Track” procedure.  “Fast Track” is a process designed to facilitate the development and expedite the review of drugs to treat serious conditions and fill an unmet medical need (Vaggelas & Seimetz, 2019).  With fast track, FDA is required by the statute to decide within 60 days of receipt of the request whether the conditions for fast track designation have been met (Vaggelas & Seimetz, 2019).  To be eligible for the fast track program, an applicant must submit a request with supporting documentation for fast track designation for the product and its proposed use (Darrow, Avorn, & Kesselheim, 2018).

The medical conditions that warrant “Fast Track” drugs are serious or life-threatening conditions and those conditions that result in unmet medical needs (Darrow et al., 2018).  Determining whether a condition is serious is a matter of judgment, but generally is based on whether the drug will have an impact on such factors as survival, day-to-day functioning, or the likelihood that the condition, if left untreated, will progress from a less severe condition to a more serious one.  Stroke, epilepsy, brain disorders, depression, AIDS, Alzheimer’s, heart failure, diabetes, and cancer are examples of serious conditions.  Filling an unmet medical need is defined as providing a therapy where none exists or providing a therapy which may be potentially better than available therapy (Darrow et al., 2018).

References

Darrow, J. J., Avorn, J., & Kesselheim, A. S. (2018). The FDA breakthrough-drug designation-four years of experience. N Engl J Med, 378(15), 1444-1453.

Vaggelas, A., & Seimetz, D. (2019). Expediting drug development: FDA’s new regenerative medicine advanced therapy designation. Therapeutic Innovation & Regulatory Science, 53(3), 364-373. doi: 10.1177/2168479018779373

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 Reply Cathy

Asking the patient about any breast changes including size change, dimpling, or nipple discharge would be helpful (Centers for Disease Control and Prevention, 2018). In addition, asking the patient about any family history of breast cancer and her menstrual cycle timing could be helpful. A  breast exam would be appropriate during this patient’s physical exam. The patient reported feeling a lump in the shower. By the provider doing their own exam, the patient’s technique and lump placement could be verified (Centers for Disease Control and Prevention, 2018). 

       Some possible differential diagnosis for this patient include breast cancer, a cyst, fibroadenoma, lipoma, mastitis, and breast injury (Mayo Clinic, 2018). Getting a full health history and ordering tests would be needed to know for sure. Some tests that may be ordered include imaging to see what the potential lump looks like and placement.  A mammogram is commonly used along with a biopsy to test the breast tissue cells to determine if they could be cancerous (Mayo Clinic, 2018).  

       Based on the results for this patient, it is possible that a referral could be necessary. This patient may need to see an oncologist or even a surgeon. If this patient has cancer, radiation or chemotherapy may be an necessary intervention (Mayo Clinic, 2018). Making sure this patient has access to information and support is also important when considering management of care.  

Reference
 

Centers for Disease Control and Prevention. (2018). “What Are the Symptoms of Breast Cancer”. Retrieved from:  (Links to an external site.)Links to an external site.https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm
 

Mayo Clinic. (2018). Breast lumps. Retrieved from https://www.mayoclinic.org/symptoms/breast-lumps/basics/causes/sym-20050619 (Links to an external site.)Links to an external site. 

 Reply Quiana

A 35-y.o. woman is seen in the office with a chief complaint of a breast mass. She states she found the lump when she was in the shower, and she is quite visibly distressed. Her medical history is unremarkable, although she reports that she has not had a mammogram. She takes no prescription medications.

What additional questions should you ask the patient and why?

• Additional questions to ask this patient would be if the lump is painful, pain in fibrocystic disease is bilateral and increases before the monthly menstruation.
• Has the lump changed in size or remained the same, has she ever noticed a lump before, is she menstruating. Cyst gets smaller and pain decreases when the menstrual cycle starts. If the patient is menstruating it is important to have her come back at the end of her menstrual period. This is because the breast cysts can fluctuate during the menstrual cycle (So you found a lump, now what? 2015).
• Does she have a nipple discharge? A nipple discharge that is unilateral, pink or bloody, non-milky or associated with a mass is an indicator of breast cancer.
• Ask at what age did she begin menstruating because early menarche increases the risk of breast cancer.
• Does she have a family history of breast cancer? If a mother or sister had breast cancer there is twice the risk and if both have it there is three times the risk of developing breast cancer.
• Does she have any children? Null parity increases your risk of breast cancer (Seller, & Symons, 2018).

What should be included in the physical examination at this visit?

            A complete breast exam should be included in this visit. The breast lump should be assessed to determine if it is firm, with indistinct borders and if it is attached to the skin. Assessment should include if there is any dimpling or nipple retraction, and unilateral nipple discharge, all of which are a signs of breast cancer. Benign lumps usually have well-defined borders and are mobile (Sellers, & Symons, 2018).

Possible differential diagnoses at this time are as follows:

• Breast cancer–Patients that develop breast cancer with no family history are normally older than 40 years.
• Fibrocystic breast disease-Patients have cyclic bilateral breast pain, especially near and during menstruation. The pain and tenderness worsen before menstruation.
• Fibroadenoma- Usually presents in patients 20-40 years. Usually, a solitary lump that is firm, mobile, smooth, and rubbery (Seller, & Symons, 2018).

What tests should you order and why?

            A mammogram is the first test to order. If the mammogram is inconclusive or the breast has dense tissue then a breast ultrasound should be ordered to differentiate between a cystic mass and a solid mass. If needed a needle aspiration breast biopsy should be ordered. In some cases an MRI can be ordered, especially in high-risk patients (Sellers, & Symons, 2018).

How should this patient be managed?

            If it is fibrocystic breast disease the patient should be advised to wear a firm bra even at night. Dietary restrictions will include coffee, chocolate, and tea. The patient should also take 400 IU of vitamin E daily. If the patient is experiencing pain or moderate to severe fibrocystic breast disease, the therapeutics to prescribe are oral contraceptives, NSAIDs and/or progestin. The patient should also be educated on the importance of conducting breast self-exams monthly even though the breasts may be lumpy (Dunphy, Winland-Brown, Porter, & Thomas, 2015).

References

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. A. (2015). Primary

care. The art and science of advanced practice nursing. (4th Ed.). Philadelphia, PA. F. A. Davis Company.

Seller, R. H., & Symons, A. B. (2018). Differential diagnosis of common complaints. (7th Ed.). Philadelphia, PA. Elsevier, Inc.

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