Radiographic evidence of osteoporosis

A 78-year-old female was out walking her small dog when her dog suddenly tried to chase a rabbit and made her fall. She attempted to try and break her fall by putting her hand out and she landed on her outstretched hand. She immediately felt severe pain in her right wrist and noticed her wrist looked deformed. Her neighbor saw the fall and brought the woman to the local ER for evaluation. Radiographs revealed a Colles’ fracture (distal radius with dorsal displacement of fragments) as well as radiographic evidence of osteoporosis. A closed reduction of the fracture was successful, and she was placed in a posterior splint with ace bandage wrap and instructed to see an orthopedist for follow-up.

Question:
Discuss what is osteoporosis and how does it develop pathologically?

Bilateral ulnar deviation

A 48-year-old woman presents with a five-month history of generalized joint pain, stiffness, and swelling, especially in her hands. She states that these symptoms have made it difficult to grasp objects and has made caring for her grandchildren problematic. She admits to increased fatigue, but she thought it was due to her stressful job.
FH: Grandmothers had “crippling” arthritis.
PE: remarkable for bilateral ulnar deviation of her hands as well as soft, boggy proximal interphalangeal joints. The metatarsals of both of her feet also exhibited swelling and warmth.
Diagnosis: rheumatoid arthritis.

Question:
The pt. had various symptoms, explain how these factors are associated with RA and what is the difference between RA and OA?

Optic neuritis

A 28-year-old obese, female presents today with complaints for several weeks of vision problems (blurry) and difficulty with concentration and focusing. She is an administrative para-legal for a law firm and notes her symptoms have become worse over the course of the addition of more attorneys and demands for work.

Today, she noticed that her symptoms were worse and were accompanied by some fine tremors in her hands. She has been having difficulty concentrating and has difficulty voiding. She went to the optometrist who recommended reading glasses with a small prism to correct double vision. She admits to some weaknesses as well. No other complaints of fevers, chills, URI, or UTI

PMH: non-contributory
PE: CN-IV palsy. The fundoscopic exam reveals edema of the right optic nerve causing optic neuritis. Positive nystagmus on positional maneuvers. There are left visual field deficits. There was short-term memory loss with a listing of familiar objects.

DIAGNOSIS: multiple sclerosis (MS).

Question:

Describe what is MS and how did it cause the above patient’s symptoms?

The current healthcare dynamics

Historical factors and the current healthcare dynamics leading to curriculum design, implementation, and evaluation.

Reflect upon the historical factors and the current healthcare dynamics that lead to curriculum design, implementation, and evaluation.

Write a 1500-2000 word essay addressing each of the following points/questions. Be sure to answer all the questions for each bullet point completely. There should be five sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you address in that section of your paper. Support your ideas with at least five (5) sources in your essay.
Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Reflect upon the historical factors and the current healthcare dynamics that lead to curriculum design, implementation, and evaluation.

1-)Conduct a literature search on EBSCO and/or CINAHL related to the history and evolution of nursing curricula.
2.)Summarize two key events. How do past, present, and future events frame curriculum?
3.)Compare and contrast the different types of curricula that prepare entry-level nurses.
4.)Describe two innovative curriculum and/or teaching strategies for implementing the curriculum.
5.)List one or two barriers to implementing a curriculum, identify strategies to overcome the barriers.

The government and health system

At our hospital, the government health facility gives free service to diabetics who are under age 18 and over age 64.

However with diabetes being so prevalent and chronic leading to kidney failure and other illnesses I want to propose that my country’s government give diabetics of all ages access to free diabetes medication and free clinic follow up with 2 free HBA1c lab tests per year and free glucose test strips for the glucose monitors.

Also, I want to propose the government strengthen the school health program to include monitoring Diabetes children while at school.

Can you see if any of the country’s or country’s government health systems provides free care for diabetes patients?

Do a Literature review of how the government healthcare system of a Caribbean country and another country (you can choose which country) has stepped in to ensure diabetics receive diabetes medication and follow-up care. This is to put together a proposal for the government and health system in my country to make diabetes care and follow-up accessible to all citizens no matter the economic status.

The discipline of Philosophy

Can we trust what we see, hear, and feel? Do our senses tell us how the world “really” is? Or is there a different reality that our senses cannot fully help us comprehend? Both Plato and Aristotle grappled with these questions, and each philosopher settled on his own theory. In this assignment, you will explore Plato’s theory of rationalism as well as Aristotle’s theory of empiricism. You will then connect one of these two theories with your own experience.

To prepare for this Discussion:

Complete Interactive Unit 2, Module 1, titled “The Meaning of Philosophy.” Pay particular attention to the pages in which Plato and Aristotle are discussed.
To complete this Discussion:

By Day 4
Post to the Discussion board the following:

A description of the philosophical approach of the Rationalists (represented by Plato) and the Empiricists (represented by Aristotle). As part of your descriptions, identify at least two ways in which these approaches differ from one another.
A paragraph in which you select either Rationalism or Empiricism as the approach that resonates most deeply with your personal experiences. Support your selection with an example from your own life.

UNIT 1, Module 1, “The Meaning of Philosophy.” Pay particular attention to the pages in which Plato ans Aristotle are discussed.

The Philosophical Perspective Introduction
Introduction

In this course, we will explore the discipline of Philosophy as the pursuit of wisdom. Throughout our lives, we all seek wisdom in different ways. In this course, we will focus on the quest for knowledge in our relationship with others, our contact with the objective world, and our relationship with ourselves.

These three fundamental ways of pursuing wisdom through relating to the world, to others, and to ourselves are known as the practice of “critique,” the practice of “dialogue,” and the practice of “self-examination,” respectively. Throughout the course, we will continually refer back to these fundamental practices to remind us of the meaning that philosophy has in all the various aspects of our lives.

The philosophical tradition that we will be studying began with the practice of dialogue in ancient Greece. The first texts we will encounter in this course are Plato’s dialogues — passages presented as a series of conversations between two partners who are seeking answers to tough questions of their day, such as the question, “What is justice?” Dialogue, however, as the ancient philosophers discovered, gives way to questions about the world around us.

All human beings, Aristotle says, seek knowledge. Since human beings are always seeking knowledge, we are also continually making claims about the world around us. The problem, however, is that everyone— by being human—has claimed about the world.

When engaging others in dialogue, we often run into the problem that others do not agree with our claims about the world. The task of philosophy beyond discussion, therefore, is to find out which claims about the world are true and which are false. This practice is known as critique—allowing examination of one’s claims and views about the world in light of the evidence, reason, and argument.

However, as both ancient and modern philosophers discovered, wonder about the world around us eventually come back to the inquiry of our role in the world—the question of ourselves. For, after all, if so many people disagree about the reality of the external world, how can I be sure that there exists an external world apart from my perception? Does the world live as I see it precisely, or is there something more to it? Is there an objective world apart from my limited understanding, or are my beliefs about the world all that matter? This problem is one that caused both Plato and Descartes to wonder. For both philosophers, this question led to the third sphere of philosophical practice: self-examination.

In this way, we will approach the study of philosophy in this course as a pursuit of wisdom in our encounters with others (dialogue), in our contacts with the external world (critique), and in our meeting with ourselves (self-examination).

At the end of this lesson, students will be able to:

Explain concepts central to philosophical inquiry.
Describe Western philosophical tradition and timelines.
Identify significant figures in the birth of philosophy in ancient Greece.
Describe critiques, opinions, arguments, and the Socratic Method.
Describe the building blocks of logic and the structure of an argument.
Explain how to classify and evaluate an argument.
Describe the traditional branches of philosophy.
Distinguish different forms of philosophical skepticism.
Describe the types of continental and analytic philosophy.

Gastrointestinal and Hepatobiliary Disorders

Quiz – Module 3 Knowledge Check
Knowledge Check: Gastrointestinal and Hepatobiliary Disorders• In this exercise, you will complete 5-essay-type questions in the Knowledge Check to gauge your understanding of this module’s content.

• Each question will hold one to two parts asked to be addressed and each part will need at least one citation, at least two citations if asked two parts to the question from the textbook and/or current peer-reviewed journals.
• Each question is worth 4 points. I would expect substantive paragraphs per answer (a paragraph would include 6-10 sentences).

KC each essay needs a citation(s) and reference(s), if using textbook apply correct page(s)
Basic book citation format
The APA in-text citation for a book includes the author’s last name, the year, and (if relevant) a page number.
In the reference list, start with the author’s last name and initials, followed by the year. The book title is written in sentence case (only capitalize the first word and any proper nouns). Include any other contributors (e.g. editors and translators) and the edition if specified (e.g. “2nd ed.”).
Format Last name, Initials. (Year). Book title (Editor/translator initials, Last name, Ed. or Trans.) (Edition). Publisher.
Reference entry Anderson, B. (1983). Imagined communities: Reflections on the origins and spread of nationalism. Verso.
In-text citation (Anderson, 1983, p. 23)

Possible topics covered in this Knowledge Check include:
• Ulcers
• Hepatitis markers
• After HP shots
• Gastroesophageal Reflux Disease
• Pancreatitis
• Liver failure—acute and chronic
• Gall bladder disease
• Inflammatory bowel disease
• Diverticulitis
• Jaundice
• Bilirubin
• Gastrointestinal bleed – upper and lower
• Hepatic encephalopathy
• Intra-abdominal infections (e.g., appendicitis)
• Renal blood flow
• Glomerular filtration rate
• Kidney stones
• Infections – urinary tract infections, pyelonephritis
• Acute kidney injury
• Renal failure – acute and chronic

QUESTION 1
1. Scenario 1: Peptic Ulcer
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.
PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain
Family Hx-non contributary
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.
Breath test in the office revealed urease.
The healthcare provider suspects the client has peptic ulcer disease.
Questions:
1. Explain what contributed to the development from this patient’s history of PUD?

QUESTION 2
1. Scenario 1: Peptic Ulcer
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.
PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain
Family Hx-non contributary
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.
Breath test in the office revealed urease.
The healthcare provider suspects the client has peptic ulcer disease.
Question:
1. What is the pathophysiology of PUD/ formation of peptic ulcers?

Q

QUESTION 5
1. Scenario 4: Diverticulitis
A 54-year-old schoolteacher is seeing your today for complaints of passing bright red blood when she had a bowel movement this morning. She stated the first episode occurred last week. The episode today was accompanied by nausea, sweating, and weakness. She states she has had some LLQ pain for several weeks but described it as “coming and going”. She says she has had a fever and abdominal cramps that have worsened this morning.
Diagnosis is lower GI bleed secondary to diverticulitis.
Question:
1. What can cause diverticulitis in the lower GI tract?

Discuss the epidemiologic triangle

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

Chickenpox
Tuberculosis
Influenza
Mononucleosis
Hepatitis B
HIV
Ebola
Measles
Polio
Influenza
Epidemiology Paper Requirements

Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.

Describe the social determinants of health and explain how those factors contribute to the development of this disease.
Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?

Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.

Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of the disease.

Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area?

Explain the role of the community health nurse

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

Chickenpox
Tuberculosis
Influenza
Mononucleosis
Hepatitis B
HIV
Ebola
Measles
Polio
Influenza
Epidemiology Paper Requirements

Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.

Describe the social determinants of health and explain how those factors contribute to the development of this disease.
Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?

Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.

Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of the disease.

Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area?

Discuss the pathophysiology of acute renal failure

A 28-year-old male presents to the primary care office for evaluation of left calf pain, swelling, and redness. He reports that this started one day ago and worsened today. He ran a 27-mile marathon 2 days ago and traveled for 3 hours in a car today.

He reports slight pain on walking and a swollen red calf. He took Ibuprofen 600 mg twice today without relief. Patient reports being an experienced runner, running 3-5 miles daily. He trained for the marathon for 4 months. The patient also reports a history of exercise-induced asthma and uses albuterol sulfate HFA as needed.

On physical exam, the patient appears in good health T 99 P 68 R 18 BP 118/78 wt. 175 lb, height 72 in. BMI 23.1. Heart rate is regular without murmurs, rubs, or gallops. Lungs clear bilaterally. HEENT WNL. Strength lower extremities 5 and DTRs 2. Left calf erythematous, edematous, warm, and tender on palpation. Pulses 3

  • Two possible diagnoses were considered: deep vein thrombosis (DVT) and rhabdomyolysis.
  • ordered Stat ultrasound of left leg to rule out DVT  and read as normal
  • CBC WNL
  • Creatine Kinase (CK) 23,000 U/L (normal 24-170 U/L)
  • BUN and Creatinine WNL
  • A diagnosis of rhabdomyolysis was made.Discuss the pathophysiology of acute renal failure in rhabdomyolysis.