Religion And Morality

One thing is for sure: religions certainly play a major role in how people think about morality. In fact, religion undergirds such a vast portion of human society that it’s difficult to even imagine how we’d formulate our questions about ethics outside of religious frameworks. (Even modern secular cultures are still deeply informed by Christian language and themes.) Thorny questions like the relationship of religion and morality do accomplish one thing, though: they show that we need to understand religion if we want to understand ourselves, including our moral behavior.

Review these 15 common principles found in nearly all religions and focus on five (5) of these that relate back to the moral/ethical concepts described in your readings. Write a one paragraph response to how each of the 5 principles you’ve chosen to write about has influenced the formation of moral reasoning. There should be 5 paragraphs written for this assignment.

 
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Religion And America

One of the more common arguments I hear when discussing ethics, morals, and values is that in the United States is that they are founded in religious, primarily Christian, teachings. If this is true are we discounting the teachings of Buddhism, Islam, Judaism, Confucianism, Hinduism, and the Baha’i faith? If we profess to be a moral civilization and derive our ethics from the teachings of the Christian faith are these teachings valid and reliable concepts from which ethics are derived, or are ethics relative to the religious teachings of a that religion?

Building on the previous assignment related to religion and morality, in a 2-3 page paper compare and contrast the two articles below for this assignment. Specifically, identify where you stand in regard to these two competing points of view. In addition, include an opinion of how these competing points of view might impact poverty and access to health care.

Read article 1 – 

America is not a Christian Nation Click for more options

Read article 2 – 

America is a Christian Nation but does religion make us a moral nation? Click for more options  

 
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Replies Db Breast

 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 cancerPatients 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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Replies 19460303

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.

2-MV

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 This Discussion

 Please,reply this post

 The difference between research utilization and evidence-based practice

            Research utilization is basically conducted to process the research and to obtain more data for the research that was conducted earlier. It is a method of incorporating and applying research based intervention practically. Results of a certain study are implemented into a practice that are not related to the study, this is referred to as research utilization. It focuses specifically on applying scientific research findings in nursing practices. Research utilization is used to alter the impact on the practice of nursing. It includes application of opinions from the experts and patients’ reports, which can be applied in the treatment process (Schaffer, Sandau & Diedrick, 2014).

Evidence based practice involves the practice and performance of care and the treatment process which has already been implemented successfully or given positive results. Evidence based practice enhances the nursing practices in healthcare and ensures the quality of the care given to the patients is improved. Hence, implementing evidence based research in nursing practices helps to increase knowledge and elevate the nursing care standards. Evidence based practice implements the best current evidences to come up with better decisions on health care. It is very useful to researches related to nursing since it supports the hypothesis of the nursing research and scientific literature, which helps in the clinical trials (LoBiondo-Wood & Haber, 2017).

Evidence based practice is research utilization that employs other considerations specific to the problem that is being solved. Evidence based practice uses the present evidences to make better decisions regarding the patients while research utilization aims to put in practice the implementation of the research study.

 
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Replies 19460301

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.

2-MV

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 Theory Db4 Week 7

Refer attachment 

 
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Renal Case Study

  

Renal Case Study

 

Tea-Colored Urine 

  

Case Scenario:

       Carmelita Gomez, age 8, is brought to the Children’s Clinic by her mother because she is nauseated and has vomited three times in the past 24 hours. Her urine has turned “tea colored”. Carmelita is lethargic and she is complaining of diffuse abdominal pain. Ten days ago she had a sore throat and fever and stayed home from school for two days. She was not seen by a health care provider at that time. Upon questioning, Carmelita cannot remember needing to urinate in the past 12 hours. On exam, Carmelita is irritable and listless. She has slight periorbital edema. Carmelita has active bowel sounds with no palpable abdominal masses, but she is tender in all four quadrants. Carmelita is given a presumptive diagnosis of poststreptococcal glomerulonephritis (PSGN), pending laboratory tests.

Her laboratory values are:

Serum creatinine: 2.3 mg/dL

BUN 26.1 mg/dL

Serum sodium: 142 mEq/L

Potassium 4.2mEq

Specific gravity 1.025

Phosphorous: 6.3 mEq/dL

Calcium: 7 mEq/dL

UA: hematuria 4+, red cell casts

Antistreptococcal antibody titre: 800U

POINTS TO PONDER:

  1. Which lab values are abnormal?
  2. What clinical manifestations      correspond to the abnormal values?
  3. Describe the changes      (pathophysiology) in the body causing each abnormal value and link the      value to a clinical manifestation present in the patient?
  4. Which values are within normal      limits?
  5. What nursing care needs to be      implemented?
  6. Provide one nursing      diagnosis appropriate to this patient.

Reading 

  1. Urinalysis p.1146 (Leeuwen, pg.      546-552)
  2. Culture p.230
  3. Kidney      stone analysis p.696 (Leeuwen, pg. 61,265,426,444)

   

Case    Study Rubric

 

Criteria

 

Abnormal Values

What do the labs indicate specific to   this patient

 

values and signs and   symptoms

The relationship between the abnormal   Signs & Symptoms and lab values is clearly demonstrated. **Must be   specific**

 

Pathophysiology used to demonstrate connections between lab results, manifestations and disease process.

 

Expected care to be given for exhibited   s/s and lab values. Expected correction of lab values based on care given.   Patient education to prevent recurrence of abnormal lab values.

 

Quality

Grammar, spelling, APA…

   

 
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Reply Each 250 Words Min Similarities Less 10 Apa

Political actions in the healthcare sector are important to the LGBTQ community as the engagement of the nurses in political actions help improve their well-being. The nurses can actively participate in elections to put up to power the leaders they want or to bring down the leaders who do not fully satisfy their needs. The nurses can therefore engage in policy making by ensuring that manifesto of the leaders elected include the various policies they need. The nurses can ensure that the leaders being elected have the potential to listen to the various proposals of the nurses on the grounds of ensuring protection for the LGBTQ community (Amann, 2017). This will facilitate the incorporation of the recommendations of nurses in the policies. 

The nurses can stand to be elected as leaders into political position which is the most important as it pertains to LGBTQ and in all the patients. The nurses can act best in that position as they leaders can be able to implement the needed policies that will improve the healthcare sector. A nurse chairing a political position will have adequate knowledge on how policies will work in the healthcare sector and how LGBTQ community could be protected. The political position will facilitate the enhancement of the health care services for all the patients regardless of the category (Groenwald andEldridge, 2019). The political action will facilitate the improvement of the LGBTQ as awareness to the public reducing the stigma associated with them due to non-acceptance in the society.  

The nurses can also obtain training and be involved in city councils and committees where they can raise issues of concern within the industry. Participating in these trainings on political issues will facilitate the enhancement of the needed knowledge to the community on the LGBTQ. The participation in the committees will facilitate the enlighteningof the society on the healthcare delivery for all the patients (Kung and Rudner Lugo, 2015). The involvement will generate an opportunity for nurses to protect the LGBTQ from being denied some services and priorities.  

References 

Amann, C. A. (2017). Undergraduate Health Policy Education: Impacting the Future of Nursing. Groenwald, S. L., & Eldridge, C. (2019, August). Politics, power, and predictability of nursing care. In Nursing forum

Kung, Y. M., & Rudner Lugo, N. (2015). Political advocacy and practice barriers: A survey of Florida APRNs. Journal of the American Association of Nurse Practitioners, 27(3), 145-151. 

Role of Nurses in Influencing Policy Making
 Nurses as Political Actors

Nurses should see themselves as practitioners with the opportunity and obligation to impact current and future delivery systems of health care to be successful. The practice of nursing is based on human health science and caring psychology. This works from a context that holistically respects all people and aims to encourage and advance the health of people throughout their lives and throughout all levels of society (Lesbian, Gay, Bisexual, and Transgender Health, n.d).

A large number of the leading nursing associations encourage nurses to take part in the formulating of policies actively. For instance, the American Association of Colleges of Nursing underlines the job of nursing in strategy. It distinguishes, in its “Fundamentals” reports, the standard arrangement inclusion that ought to be tended to in instructive projects at the baccalaureate, master’s, and doctoral degrees of expert nursing. The National League for Nursing and the American Nurses Association additionally anticipate that medical caretakers should address the approach as a component of their expert job. Politically, nurses can play a significant role in influencing policies that influences the lives of lesbian, gay, bisexual, and transgender individuals (LGBT) (Burke, 2016). They include individuals from different ethnic and socioeconomic backgrounds, yet society has treated them as lesser beings. Nurses can influence policymaking concerning these groups in the following ways.

Lobbying political leaders; Through unique knowledge of their constituents ‘ needs, city and county officials have the power to implement policies and programs that protect LGBTQ people, improve community engagement, and open opportunities (Burke, 2016). Nursing leaders can, therefore, lobby political leaders to pass policies that favor LGBT.

Involvement in campaign groups; Many of these LGBT individuals face discrimination due to current policies in place. Nurses can join in their campaign and together fight for their rights. Sometimes, demonstrations are the only voice that the government hears and responds to.

Volunteer to engage in conferences or activities related to strategy. Prepare a fact sheet and help prepare a document to educate policymakers. Inform stakeholders regarding events that provide incentives for policymakers to tackle.

Conclusively, there is a need for changes to be effected on policies relating to LGBT rights to ensure they feel safe in society. As such, nurses should politically intervene with members of LGBT. They have the potential to have a profound global impact on politics. Nevertheless, it is nurses ‘ ethical and professional duty to intervene in policies they deem to be affecting their patients, LGBT notwithstanding.

References
Burke Sheila A. (2016). Influence through policy: Nurses have a unique role.Retrieved 29 October 2019, from https://www.reflectionsonnursingleadership.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role
Lesbian, Gay, Bisexual, and Transgender Health. (n.d). Retrieved 29 October 2019, from  https://www.cdc.gov/lgbthealth/

 
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Renal Calculi

 

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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