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The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control with sodium restriction. He current works at a catalog telephone center.

Objective Data

  1. Height: 68 inches; Weight 134.5 kg
  2. BP: 172/96, HR 88, RR 26
  3. Fasting Blood Glucose: 146/mg/dL
  4. Total Cholesterol: 250mg/dL
  5. Triglycerides: 312 mg/dL
  6. HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

  1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL      PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
  2. Ranitidine (Zantac) 300 mg PO at bedtime.
  3. Sucralfate/Carafate 1 g or 10ml suspension (500mg /      5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

  1. Assess each of Mr. C.’s functional health patterns      using the information given. (Hint: Functional health patterns include      health-perception – health management, nutritional – metabolic,      elimination, activity-exercise, sleep-rest, cognitive-perceptual,      self-perception – self-concept, role-relationship, sexuality – reproductive,      coping – stress tolerance.)
  2. What actual or potential problems can you identify?      Describe at least five problems and provide the rationale for each.
 
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Use the image in “Discussion Question Resource: Chest X-Ray” to answer the following Critical Thinking Questions.

Examine the x-ray of a patient diagnosed with pneumonia due to infection with Mucor. Refer to the “Module 4 DQ Chest Xray” resource in order to complete the following questions.

Critical Thinking Questions

  1. Explain      what Mucor is and how a patient is likely to become infected with Mucor.      Describe the pathophysiologic progression of the infection into pneumonia      and at least two medical/nursing interventions that would be helpful in      treating the patient.
  2. Examine      the laboratory blood test results and arterial blood gases provided in      “Discussion Question Resource: Laboratory Blood Test Results.”      What laboratory values are considered abnormal? Explain each abnormality      and discuss the probable causes from a pathophysiologic perspective.
  3. What      medications and medical treatments are likely to be prescribed by the      attending physician on this case? List at least three medications and      three treatments. Provide rationale for each of the medications and      treatments you suggest.
 
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The American Cancer Society (ACS) is a nationwide, community-based, voluntary health organization dedicated to eliminating cancer as a major health problem. Together with its supporters, ACS is committed to helping people stay well and get well by finding cures and by fighting back.

Critical Thinking Questions:

1. Imagine that a family friend or colleague has just been diagnosed with cancer. Explain how the American Cancer Society might provide education and support. What ACS services would you recommend and why?

2. According to statistics published by the American Cancer Society, there will be an estimated 1.5 million new cancer cases diagnosed each year over the next decade. What factors contribute to the yearly incidence and mortality rates of various cancers in Americans? What changes in policy and practice are most likely to affect these figures over time

3. Select a research program from among those funded by the American Cancer Society. Describe the program and discuss what impact the research will have on the prevention or treatment of cancer.

 
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The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.

Subjective Data

  • Complains of pain and heaviness in her leg.
  • States she cannot bear weight on her leg and has been in bed for 3 days.
  • Lives alone and has not had anyone to help her with meals.

Objective Data

  • Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
  • Left leg red from knee to ankle
  • Calf measurement on left 3 in > than right
  • Temperature: 38.9 degrees C
  • Height: 160 cm; Weight: 83.7 kg

Laboratory Results

  • WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
  • Wound culture: Staphylococcus aureus

Critical Thinking Questions

  1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
  2. Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
  3. What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
  4. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

 
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Describe one internal and one external method for the dissemination of your EBP project results. For example, an internal method may be the hospital board, and an external method may be a professional nursing organization. Discuss why it is important to report your results to both of these groups. How will your communication strategies change for each group?

 
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After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects.

 
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 Submit a summary of six of your articles on the discussion board. Discuss one strength and one weakness to each of these six articles on why the article may or may not provide sufficient evidence for your practice change 

 
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Identify the educational preparation and role(s) of the clinical nurse leader (CNL) designation. Give an example of how the CNL influences direct patient care whether in a hospital or out in the community.

 
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Answer both of the following discussion questions for your discussion response. 

  1. Anemia of chronic disease is a common occurrence in elderly patients. What is the pathophysiological mechanism behind this disease process?
  2. Virchow’s triad refers to states that can produce hypercoagulability. What are the three categories? Give an example for each and explain the pathophysiological changes seen.

at least 250 words total. reference with no older than 5 years and intext citation

 
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Answer both of the following discussion questions for your discussion response. 

  1. What, in your opinion, is the most dangerous electrolyte imbalance and why? Explain the pathophysiology of the imbalance.
  2. Disease processes can cause an array of fluid and electrolyte imbalances. What does a nurse practitioner need to consider when treating various diseases? When a patient has hemodynamic instability associated with orthostatic hypotension, what treatment is considered to provide stability?

250 words with reference no older than 5 years and intext citation.

 
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