Assignment: Case Study Analysis

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as racial and ethnic variables can play a role.

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

You will be assigned to a specific case study scenario for this Case Study Assignment.

Assignment (2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

· Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.

· Any racial/ethnic variables that may impact physiological functioning.

· How these processes interact to affect the patient?

Case Study:

A 58-year-old obese white male presents to ED with a chief complaint of fever, chills, pain, and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg PO q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 6.7 mg/dl.

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!

Research Paper Help

Research Paper Help

Research Paper Help

Week 2 Lit review Directions with Rubric

Submission: Week 2 Paper – Scientific Perspective of Inquiry

The purpose of a literature review is to get your reader up to speed on any relevant information so they can understand the purpose of the research. This includes background information on the topic and often background information on techniques used. This particular assignment requires 5-7 pages for full credit. Be aware that if you do only the minimum for each section you will not reach the required 15 for the entire paper.

· Lit review or Executive Summary: 5-7 pagers

Writing Style

This is a formal paper which means it needs to be written in the passive voice. It is intended to be read by scholars, not the general public. This is not story time, a blog or a “how to pamphlet.”

You will not:

· Use I, we, your, our, should, anyway, society, anyhow, us, so in your writing

· Use the following phrases or words

· All in all

· When it comes to

· In the long run

· Never the less

· With that being said

· Of major concern

· Worrisome

· Overall health

· Human beings (it is just humans)

· On the other hand

· In today’s society

· Thing

· Being (as a verb)

· In the long run (over time)

· A lot

· Good

· Whopping

· People (they are consumers, patients, victims etc.)

· Huge (large or significant)

· More and more (increasing amounts)

· At the end of the day

· It (Name what IT is)

· Ask the reader questions (this is forbidden)

· Use “according to” (sometimes this is okay but it annoys me so don’t overdo it)

· Excessive use of quotations (this also annoys me)

· Be vague and unscientific

· Have incomplete or run on sentences

· Have grammar mistakes

· Make too large of a leap with information and lack evidence to support your claim

· Have missing or incorrect citations

· Have incorrect information

· Lack fluidity and have illogical sequencing of information

· Use .coms, blogs or Wikipedia as a source

Command of topic

· Using more than one source in a paragraph

· Using one demonstrates you know how to paraphrase and regurgitate someone else’s work

· Using introductory sentence in each paragraph

· Using summarizing sentences in each paragraph

· Using transition sentences that link one concept to another

· All points that are introduced are elaborated on and concluded

· Using examples to support a claim (then cite them)

· Has substance

Citations

In a literature review the writer is contributing very little. They are simply reporting on the literature that already exists. That means that the majority of the paper is comprised of information that is not their own and must be cited. In this section of the paper almost every sentence is cited. The only exceptions are

· Introductory sentences – preview of more detailed information to come and then followed by cited evidence

· Summary sentences – a recap of previously introduced information

This paper requires a minimum of 12 reliable sources.

Fluidity and Logical Sequencing

The presentation of the information must be logical in the paper as a whole and within in each paragraph. The most general information is written first in the form of introductory sentences and then followed by more detailed and related evidence. Transitions between paragraphs and within paragraphs must also have fluidity. Using choppy sentence structure and not employing transition sentences makes the paper unpleasant to read and comprehension difficult.

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!

General Awareness And Attitudes Scale

Each person has his or her own personal history; that is, his or her collected experiences. Everything you have ever seen, heard, felt, learned, or experienced has lead to the development of this personal history. Factors that affect this history include your gender, race, age, ethnicity, culture, education, native language, and religion, to name a few. Collectively, these factors create the sum total of who you are as a person. Bias occurs when a person has a tendency towards a particular perspective or ideology (i.e. your personal history); after all, you see the world through your own eyes. To some extent, every person has a natural bias. However, if or when your personal bias interferes with your ability to be unprejudiced or objective – especially in your nursing practice – your biases can become problematic. In this discussion, you will have the opportunity to determine how strong your biases are.You should post your original message by 23:59 PM Wednesday. You should also reply to posts by two of your peers by 23:59 PM, Saturday of Module 3.

GUIDELINES

In the professional nursing practice, nurses must provide unbiased care, even in situations where the person/s being treated have different backgrounds (language, religion, culture, ethnicity, etc.) than you. The first step in overcoming and minimizing personal biases is to recognize them. In this discussion, you will assess your personal biases. Answer the questions honestly and to the best of your ability, noting that there are no right or wrong answers.

· Complete the General Awareness and Attitudes Scale 

o The General Awareness and Attitudes Scale is adapted from the Cultural Awareness Scale by Catterson, Cookston, Martinez, & Rew (1998). Answer the question as honestly as possible. There are no right or wrong answers.

· Once you complete and score the General Awareness and Attitudes Scale, answer the following questions:

· What does the scale say about you?

· How strong are your biases?

· NOTE: Do NOT post your individual scores. This discussion is not about how you score, but about personal discovery. In other words, the focus of this discussion is about what you learn about yourself. You also do NOT need to share your score with your academic coach.

· How can you address these personal biases in your professional nursing practice?

Your original post should consist of complete sentences and should be at least two complete paragraphs but no more than three paragraphs.

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!

PBHE215 Final Exam

PBHE215 Final Exam Questions

*Instructions and recommended answer length are included in each question*

*Answer the question in the space below the question*

1. This is a theoretical case taken from VHA Intensive Ethics Advisory Committee Training, 1998, as presented by Arthur R. Derse MD, JD. An 87-year-old woman widowed for six years, who is otherwise healthy, was visiting another city and abruptly became ill. She was seen in the emergency department of the local VA and admitted to the on-call physician. The on-call physician (who has not previously seen her) made the diagnosis of bowel obstruction arid made arrangements for a surgeon to evaluate her. The surgeon recommended surgery and obtained her consent for surgery. The surgeon expects an uneventful recovery. She is told that she will be on a ventilator for a short time after surgery. The patient tells the surgeon that is OK as long as it is for a short time. She tells the surgeon that she does not want to be dependent upon machines. She was asked upon admission whether she had an advance directive. She replied that she has a living will and a power of attorney for health care which names her daughter (who does not live in the area) as her health care agent. The patient undergoes surgery, which is successful in treating the underlying problem and does not show any malignant causes, but in the recovery room she has a cardiopulmonary arrest and is resuscitated. She is transferred to the ICU in the care of the on-call physician. The physician attempts to wean her gradually from the ventilator, but this is unsuccessful. Three days later, she has regained consciousness but is still intubated. Though she cannot speak because of the ventilator, she is able to write and asks that the tube be removed. The attending physician tells her that she is dependent upon the ventilator and the patient needs to remain on the ventilator until she can breathe on her own. She writes that she understands that she may die, but she does not want to be on machines. Her only children — a daughter and son — – have arrived. She repeats her wish to them that she wants the tube removed. She writes to her daughter that “I don’t want to die, but we all have to die sometime, and I don’t want to have to live on a machine. I know that whatever the outcome, God will take care of me.” Her daughter tells the physician that her mother is adamant that she be off of machines and she respects her mother’s wishes, even if she cannot breathe on her own. She says this is consistent with her previously expressed wishes and her religious beliefs. Her son tells the physician that he disagrees with his sister — since his mother does not have a terminal condition, he cannot see why she should not be forced to put up with the ventilator until she can be weaned from it. He feels that she is being shortsighted, and she will be thankful to have been kept on the ventilator when she is finally able to be weaned. Describe the criteria for giving “legal” consent. Were all elements met in this case? In other words, did the patient demonstrate decision-making capacity? Explain. (Minimum of 1 page including in-text citations and references in proper APA format)

2. Based on case study above: Is this patient requesting to be euthanized or for her physician to assist in her suicide (PAS)? In your answer describe how the two terms differ. (Minimum of 2 paragraphs including in-text citations and references in proper APA format)

3. A managed care group may want to market their organization as being “the best” or “a leader” in providing certain services/ treatment. How can this type or marketing effect quality of care and utilization of services, hence costs? (Minimum of 2 paragraphs including in-text citations and references in proper APA format)

4. According to Darr, MCO enrollees can be described as either light/moderate users or heavy users. What are some of the strategies that management uses to turn “heavy” users into light/ moderate users? In your personal opinion, what positives or negatives may result? (Minimum of 2 paragraphs including in-text citations and references in proper APA format)

5. Describe the constraints/challenges that physicians experience as being service providers affiliated with a Managed Care Organization. (Minimum 2 paragraphs including in-text citations and references in proper APA format)

6. Give a very brief “real-life” example/instance where drugs/ medical treatment/services were microallocated. And give a “real-life” example of macroallocation. (Do not include the examples provided in the text.) (Minimum 1 paragraph including in-text citations and references in proper APA format)

7. Read the case of Karen Ann Quinlan (p. 248-249). Explain why this is a case involving medical futility. (Include in your answer the definition of medical futility). Darr (2011, p. 218) writes, “[the] futility theory has quantitative and qualitative aspects.” What is meant by these terms? Present arguments for each as it relates to this case. (Minimum 2 paragraphs including in-text citations and references in proper APA format)

8. Having just completed this class, what do you now know that you did not know before?

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!

Concept Analysis Paper Assignment Instructions

Concept Analysis Paper Assignment Instructions

Purpose and Process

You will choose this concept for analysis: SUSCESSFUL AGING

The concepts you will choose from are related to nursing practice, education, and/or administration. For example, if you are planning to be a Family nurse practitioner, you might choose the concept of family support. (Note: I am planning to be a Mental Health nurse practitioner, so you could also search topics related to Alzheimer’s, dementia, war veterans suffering from PTSD, etc.). In the concept analysis assignment, you will review the literature related to the study of your concept from different disciplines. Doing so will help illuminate the meaning of the concept for you. View it as helping you build the foundation for your nursing research proposal in NU 630, Advanced Nursing Research, and adding to your body of knowledge. For example, a former student, who planned to specialize in women’s health, chose the concept of post-partum depression for her concept analysis for an NU601 course. For NU630, she focused her research proposal on the same concept.

Paper Guidelines

1. Introduction (5 points): In this section, you inform the reader of the purpose of your paper. Sometimes, students start writing their papers without stating the focus of their paper. In addition, You should also explain what a concept analysis is according to the literature. Then, you should describe why you chose your concept and its application to nursing research and another area in nursing, such as nursing administration, nursing practice, or nursing education.

2. Review of the Literature (15 points): This is the main section of your paper where you should identify all uses of the concept. First, you begin with the dictionary and lay sources, then you move to academic literature. You should review the nursing literature related your topic, as well as two other disciplines, such as biology, psychology, or law. The selected literature should mainly be scholarly peer-reviewed journal articles and textbooks. You should provide a brief summary of each of these articles and connect them together as a synthesis. For example, for post-partum depression, you would review the literature in nursing, and two other possible disciplines you would include would be psychology and social work. Generally, references that have been published within the last five years should be used, unless there is a landmark piece of literature (for example, Peplau’s theory of interpersonal relationships). Use at least three scholarly articles from each discipline. Write a synthesis of these articles (for example, compare and contrast focus and/or findings). For more information, examine Nursing: How to Write a Literature Review.

3. Defining attributes (15 points): From your literature review of uses of the concept (sources such as the dictionary and the thesaurus [lay sources] and academic), you should determine the defining attributes of your concept. In order to accomplish this part of your analysis, it is helpful if for each of your selected sources (academic journal articles, dictionaries, textbooks) that you (1) read through them entirely, (2) highlight or underline the definitions within each of these sources so you can keep track of the various definitions used to define your selected concept, and (3) extract the definitions from across the sources to put together a comprehensive list of the attributes that define your specific concept. Two or three defining attributes may exist for one type of concept, whereas for another concept, there could be seven or eight defining attributes. Do a comprehensive review of the literature within your selected sources prior to deciding on your final list of defining attributes, so you fully capture the “essence” or meaning of your concept.

4. Definition of the Concept (5 points): Write a definition that incorporates all the concept’s defining attributes. This definiti9on should be written in a one-to-two paragraph narrative.

5. Cases (35 points): Ensure your cases fit your designated case types. Also, be sure to provide a rationale for why your case meets that criterion. For example, model case: First describe what a model case is according to the literature, then describe your model case and why it meets that criterion. Be specific. You should follow this method with each of your cases.

a. Model Case: (15 points)

b. Borderline, Related, Contrary, Illegitimate, and Invented Cases. (Each section is worth 4 points; 20 points for this component.)

6. Antecedents and Consequences (10 points; antecedents 5 points, and consequences 5 points): Antecedents are the events/required elements that occur before the concept can happen. Consequences are the events/outcomes that take place after the concept occurs. Antecedents and consequences cannot be the same. They also cannot be the concept itself, but the events/required elements that take place before or after the concept is evident.

7. Empirical Referents (5 points): Here, you describe how the concept is measured. Look for two research tools on the concept. Describe the definition of the concept that the researcher used and the purpose and structure of the tool (that is, number of items), and then describe one study where the tool was used including its purpose, sample, method, and main findings. This information can come from your literature review.

8. Summary (5 points): Summarize your paper and do not provide new information. You should not leave the reader in suspense as if there will be a sequel.

9. Format (5 points): Your paper should use APA formatting for its all components and formal writing mechanics, and be free of spelling and grammar errors.

Other Requirements

· Your paper should be 10 to 12 pages long, typed in a Times New Roman 12-point font, and have 1-inch margins. The paper’s length does not include the title page and references list. Do not include appendices.

· You will have following three milestones for your Concept Analysis paper so that your instructor can provide you with feedback on its development:

1. Concept Analysis Outline: It includes the Introduction through Review of the Literature with at least four references styled in APA format. This outline is due in Week 3. (Counts as 10% of the Concept Analysis paper’s grade.)

2. Concept Analysis draft: A draft of entire paper is due in Week 5. (PLEASE, INCLUDE A DRAFT OF THE ASSIGNMENT). The Concept Analysis draft you submit in Week 5 should be a complete version of the paper. Each part of the final paper should be present, including references styled in proper APA format. The closer that your draft is to the final paper, the more specific feedback your NU601 faculty can provide to you to help improve your final submission (which will be submitted during Week 7). (This draft is worth 10% of the Concept Analysis paper grade.)

3. Final Paper: (The final paper is worth 80% of the Concept Analysis paper grade)

Helpful Hints

· Have easy access to your APA Manual. It will be of help in writing your paper.

· Use the headings of the paper guidelines to organize your paper. Subheadings might also be helpful, but use them judiciously.

· Reference all work that is not your own or common knowledge, such as “alcoholism is a serious problem”.

· For each section of your paper, you should define what each part means according to the literature, then provide your explanation. You will want to define what a concept analysis is, as well as the meaning of defining attributes, model cases, borderline cases, etc.

· You can combine your review of the literature pertaining to the three disciplines or present each separately.

· Do not use broad assumptions without data or evidence to support them.

· Write in your own words.

· Do not use colloquial statements or informal language, such as “Let’s take the car for a spin.”

· If you find a concept analysis of your concept, you may use it very judiciously. Your paper should be your own work!

· Review this example of a Concept Analysis paper: West, P., Abbott, P., & Probst, P. (2014). Alarm fatigue: A concept analysis. Online Journal of Nursing Informatics 18(2). It is not perfect, but it should help further your understanding in how to write your paper.

· You may not use basic nursing resources (such as Registered Nurse Journal or American Journal of Nursing), nor basic nursing textbooks. You may use websites that are classified as .org or .edu websites. However, such websites should be used judiciously.

Page 2 of 2

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!

NUR-621-E3

Scenario: You are an administrator at a health care facility providing a training session for new employees.

Create a training plan using the “NUR-621 Health Care Reimbursement Training Plan” template provided that describes how Medicare, Medicaid, and private insurance reimburse health care organizations for their services.

Include two to three references, including your textbook.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!

8 HRS DEADLINE Topic: Health Care

#1774870 Topic: Health Care Number of Pages: 2 (Double Spaced) Number of sources: 2 Writing Style: APA Type of document: Essay Academic Level:Master Category: Nursing Language Style: English (U.S.) Order Instructions: Analyze a grand nursing theory. Utilize the format in the Theory Evaluation Exemplar on pages 109-112 of the textbook.

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!

Reflection Paper

The reflection paper will consist of minimum 300 words, doubled space, APA style (no references). As you write your paper reflect on the following topics. You can select one or two of the topics to complete the reflection paper.

1. Experience of virtual clinical: Keep and Changes

2. Take away from virtual clinical

3. How will you apply this learning experience in real life

4. Discuss concepts learned: Medical diagnosis, treatments, medications, patient education

Topics

Olivia Bailey (poor nursing/fussy/jaundice) i-Human

Ana Martinez (Hyperglycemia) i-Human

Alyssa Thomas SBE/Case Study-Normal Birth i human

Amber Rhodes SBE/Case Study- Preeclampsia with HELLP Syndrome I human

4/20MP

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!

Advanced Pharmacology

Advanced Pharmacology

Advanced Pharmacology

Advanced Pharmacology

Advanced Pharmacology

Advanced Pharmacology

Assignment: Pharmacotherapy for Cardiovascular

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:

· Atenolol 12.5 mg daily

· Doxazosin 8 mg daily

· Hydralazine 10 mg qid

· Sertraline 25 mg daily

· Simvastatin 80 mg daily

·

All other factors were purposely omitted from the case study.  As you read through your course materials, please feel free to add those factors that you’d like to further discuss that may affect the decisions that you will make for this patient.  For example, if you’d like to discuss how the factor age will affect your choices, include in your paper that your patient is a 86 year old male.  Or if you’d like to provide details of how gender plays a role in what treatment the patient will receive, include that your patient is a female. 

.heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

—Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from /orders/www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare

· Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.

· Review the case study assigned by your Instructor for this Assignment.

· Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.

· Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.

· Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.

· Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

Write a 2- to 3-page paper that addresses the following:

· Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.

· Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.

· Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Sample

 Case Study 

I chose the first case study patient AO has a history of obesity and has recently gained 9 pounds.  The patient has been diagnosed with hypertension and hyperlipidemia.  Drugs currently prescribed include the following:

· Atenolol 12.5 mg daily

· Doxazosin 8 mg daily

· Hydralazine 10mg QID

· Sertraline 25g daily

· Simvastatin 80 mg daily

Hyperlipidemia and Hypertension

The American Heart Association (2018) discussed that high blood pressure (HBP) can lead to heart attack, stroke, heart failure, and other serious life threats.  Nearly half of U.S. adults have high BP and approximately 45% of people who have  HBP do not have it controlled.   Hypertension is diagnosed with repeated elevated blood pressure exceeding 140/99 mm Hg (Buzkurt et al., 2016).  Age, obesity, and lifestyle are huge factors regarding hypertension.  Hypertension increases with age and affects all ethnic groups.  Hypertension is classified as primary or essential, secondary or idiopathic  (Arcangelo et al., 2017).  The goal of treatment of hypertension is to reduce the cardiovascular and renal morbidity and mortality.

Hypertension and Hyperlipidemia go hand and hand because both conditions can be controlled by lifestyle changes and management with medication.  Hyperlipidemia is high levels of lipids in the blood and can lead to Coronary Artery Disease.  Modifying the patients diet, reducing stress, and encouraging the patient AO to help decrease her blood pressure and the decrease in the number of lipids in her blood. Hypertension and Hyperlipidemia can both be controlled by lifestyle changes including diet changes, stress relief, and daily exercise.  If these lifestyle changes are unsuccessful, medication management to reduce HPB and Hyperlipidemia are suggested.

Treatment

Acarangelo et al., (2017) discusses that the first line of treatment of stage 1 hypertention is a thiazide type diuretic.  If he desired outcome has not been met with this treatment, a beta blocker, Ace-inhibitor, angiotension receptor II blocker, or a calcium channel blocker.  Patient AO is on a beta blocker, Antenolol.  Arcangelo et al., (2017) suggests that stage II hypertension should be treated as the same as stage I with the addition of a vasodilator.  Patient AO is taking Doxazosin, which treats hypertension but has a bonus effect of relaxing smooth muscles which decreases BP and is associated with a decrease in LDL and cholesterol.  Patient AO has recently gained nine pounds, this could be a sign of fluid retention.  A diuretic such as Hydrocholorathiazide could be added to the regular regime to help rid the extra fluid.  The patient AO should see a reduction in excess fluid with will reduce her weight dramatically.  Patient AO is also taking an antidepressant, Sertraline, which will help with stress, which will also help to decrease HBP.

Conclusion

     Patient AO is on the right track of medication management of her hypertension, hyperlipidemia, and stress to help reduce both conditions.  In my opinion, adding a diuretic will help decrease her sudden weight gain of nine pounds and she will be able to take in consideration lifestyle changes to prolong her life and decrease the chances of her hypertension and hyperlipidemia to cause cardiovascular disease, stroke, or any cause of morbidity related to being obese, hypertensive, and the high content of lipids in her bloodstream.

References

Arcangelo, V. P., Peterson, A M., Wilbur, V., & Reinhold, J. A. (Eds.) (2017)  Pharmacotherapeutics for advance practice:  A practicle choice (4th ed.)

Amber, PA: Lipincott Williams, & Wilkens,  Retrieved from Waldne Univeristy Library Database.

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Bozkurt, B., Aguilar, D., Deswal, A., Dunbar, S. B., Francis, G. S., Horwich, T., … & Rosendorff, C. (2016). Contributory risk and management

of comorbidities of hypertension, obesity, diabetes mellitus, hyperlipidemia, and metabolic syndrome in chronic heart failure: a scientific statement

from the American Heart Association. Circulation, 134(23), e535-e578.   

Fulton, B., Wagstaff, A. J., & Sorkin, E. M. (1995). Doxazosin. Drugs, 49(2), 295-320.

Wiysonge, C. S., Bradley, H. A. Volmink, Mayosi B.M& Opie L. H.  (207).  Beta-blockers were

hypertension (Cochraned databse of sysemtic reviews, (1.) Retrieved form Walden University.

Cystic Fibrosis Case Study

1. The text mentions that CF affects all the exocrine functions in the body as well as lung complications, and can lead to death during the adult years. Using the cystic fibrosis foundation website ( www.cff.org (Links to an external site.)Links to an external site. ), list the major effects on the digestive alterations in the pancreas, liver and large intestine in those with CF.

2. Read the following case study and write what the dietary regimen Miriam follows.

MIRIAM – A Cystic Fibrosis Case Study

My niece, Miriam, was born in April 1996. At 6 pounds 12 ounces, she had difficulty putting weight on after she was born. In fact at one point it dropped to 6 pounds.

After a spell in hospital in December 1996, when she was suffering from bronchitis, it was thought that she had asthma but my sister-in-law was already beginning to suspect that Miriam had Cystic Fibrosis. There was no other explanation of the symptoms which Miriam had.

Eventually, Miriam was given a “sweat test” and it was confirmed that she had Cystic Fibrosis. Both Tim & Sue are carriers – which is how they unknowingly passed on the faulty CF gene to Miriam.

No sooner had Miriam’s CF been diagnosed, shortly before she was one year old, than the medical support swung into action. The family had meetings with all members of the CF team – a doctor, a nurse, a social worker, a physiotherapist and a dietitian.

Miriam is now approaching five years old. Before she goes to school in the morning, she has around 30 minutes of inhalers and physiotherapy. With every meal she has to eat a number of “Creons”, mixed in with her food, which help her to digest her food. She has to eat a high fat and high calorie diet.

In the evening, she has another 40 minutes of inhalers, physiotherapy and nebulizers. She then has to take a variety of antibiotics, fluoride and vitamins.

Not surprisingly, all these medications have side effects – Miriam can be fairly hyperactive, she is always hot, and it takes her a long time to get to sleep each night.

Every nine weeks, Miriam is taken to the CF clinic. When Miriam has a particularly bad infection, it is necessary for her to go into hospital to receive a course of intra-venous antibiotics. The threat of infection is an ever-constant danger. To counter the risk of cross-infection, there are individual cubicles in the CF clinic and strict hygiene standards apply. Miriam cannot play or mix with other children with CF.

Inevitably all this has a major impact on the family. Every time they go on holiday – however short – all the drugs and equipment need to be taken with them. If they go out for the day, or when they are on holiday, Miriam’s daily routine of physio each morning and evening have to be fitted in – meaning no early starts, and no stopping out late.

(adapted from  http://people.exeter.ac.uk/ajohnson/miriam.htm) (Links to an external site.)Links to an external site.  (Links to an external site.)Links to an external site.

3. Using the information from Chapter 13 and the formula provided below, complete the question a-c.

Table: DRIs for Energy for Children (Available at:  http://books.nap.edu/openbook.php?record_id=10490&page=107 (Links to an external site.)Links to an external site. )

EER for Girls 9 Through 18 Years

EER = 135.3 – (30.8 ´ age [y]) + PA ´ (10.0 ´ weight [kg] + 934 ´ height [m]) + 25 kcal

PA = 1.00 if PAL is estimated to be ≥ 1.0 < 1.4 (sedentary)*

PA = 1.13 if PAL is estimated to be ≥ 1.4 < 1.6 (low active)

PA = 1.26 if PAL is estimated to be ≥ 1.6 < 1.9 (active)

PA = 1.42 if PAL is estimated to be ≥ 1.9 < 2.5 (very active)

a. Calculate the estimated nutritional requirements for a 10-year-old female with cystic fibrosis who weighs 62 pounds and is 51 inches tall and is considered low active.

b. The estimated calorie requirement for an individual with cystic fibrosis is two to four times the usual recommendation. How would one know the appropriate calorie level to recommend initially?

c. Research the nutrition recommendations for cystic fibrosis ( /orders/www.cff.org/Living-with-CF/Treatments-and-Therapies/Nutrition (Links to an external site.)Links to an external site.  or  /orders/medlineplus.gov/ency/article/002437.htm (Links to an external site.)Links to an external site. ) that can assist an individual with meeting her high calorie and protein requirements. What advice could you provide to a patient?

4. What have you learned about treatment for CF?

5. (Optional, one extra credit point) Read the paper, “ Caregiver Coping, Mental Health and Child Problem Behaviours in Cystic Fibrosis: A Cross-Sectional Study,”  Jane Sheehan, Int.J. Behav. Med. (2014) 21:211–220. The thesis of the paper is that the caregiver coping strategies is related to the health of the CF child.

a. Complete the table below defining the characteristics noted in the paper of a proactive or adaptive coping strategy and an avoidant or passive coping strategy.

b. What are the overarching outcomes of the two coping strategies in the health of the child?

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so that it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

Your assignment woes end here!