Nursing  nursing

Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.Mr. DMr. D is a 90-year-old man admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction. Mr. D has a long history of comorbidities, including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest. Mr. D tells the physician that he wants all actions taken to save his life.Imagine that you are the nurse assigned to provide care to Mr. D, and address the following:Considering Mr. D’s advanced age, what are the benefits/risks associated with providing life-sustaining measures?What factors should you consider based on Mr. D’s age and health history?If Mr. D were your family member, how would you respond to his decision?You must use proper APA format and provide at least one credible reference within your initial post.

 
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Nursing  100 positive reply due tomorrow 1/20/21 due at 10 am with three references

pharm week 8 discussion postAttention-deficet/hyperactivity disorder is a neuropsychiatric disorder affecting 5-11% of children with boys being two to three times more likely to diagnosed (Rosenthal DNP ACNP, Laura & Burchum DNSc APRN BC, Jacqueline, 2020). A diagnosed with ADHD can be made if the symptoms began before the age of seven and have to have been exhibited for at least six months (Rosenthal DNP ACNP, Laura & Burchum DNSc APRN BC, Jacqueline, 2020). There is thought to be a genetic component to ADHD to which I fully agree as my son has ADHD and while I do not have a formal diagnoses of it I have most definitely diagnosed my self and my father. Children typically respond to the medication based on the mechanism of action meaning that it will either cause a release or blockage of norepinephrine, dopamine, and serotonin.In the scenario we were told that it is an eight-year-old girl whose parents were told by her teacher that she felt that she might have ADHD and now the parents have sought out professional help in determining if she does and if so what the corse of treatment would be. We are then asked to choose what medication we feel she should be started on (wellbutrin, intuniv, or ritalin) and I feel she should be started on Ritalin 10mg in the am. During her next follow up it is noted that the teacher feels that her attention has improved for the first part of the day however by the afternoon she is back to being unable to concentrate. It was also noted during the appointment that her pulse was elevated. At this point I felt that it was necessary to change her medication to Ritalin LA and to monitor her heart rate as it is a side effect of taking a stimulant. At her next follow up it was noted that she has been able to remain attentive during the entire school day and that her heart rate has returned to a normal rate. From this point I feel it would be acceptable to continue with the current regimen.Ritalin or methylphenidate works by increasing the release of norepinephrine and dopamine while also preventing the reuptake of the same neurotransmitters. A study was conducted regarding how to properly dose Ritalin and what they noted was that it should be started at 5mg not the 10mg that the scenario suggested and should be given twice a day with increased increments of 5-10mg based on the effectiveness of the medication(Childress et al., 2016). This same study also concluded that children tend to do better and are more compliant with the extended release Ritalin because they do not require a second dose while at school (Childress et al., 2016). It should also be noted that the goal of any medication should be to be on the lowest possible dose while achieving the desired affect. There are times when adding a second medication to the treatment can enhance the affect of Ritalin on in particular is memantine (namenda) a medication that is typically used to treat Alzheimer. What one study found is that memantine is able to improve the symptoms associated with ADHD without adding any adverse side effects (Riahi et al., 2020).ADHD is a condition that can be treated in a multitude of ways with multiple differed medication options and combinations that can be tailored to fit the needs of each individual patients. It is important to make sure that the child is not only on the correct medication but also that they are taking the lowest possible dose. Educating the family regarding dietary restrictions and when the medication should be given is also extremely important.

 
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Nursing  week 1 discussion

We begin our journey into discovering the new world of research and evidence-based practice (EBP) by exploring our past. After completing the required readings and lesson, answer the following:Explain how research has evolved since the Florence Nightingale era.Discuss how research and EBP are different; include how you believe research supports EBP for nursing.Describe one past/historical unethical breach of research conduct; then, share how you would ensure care of a study participant using one ethical or legal research consideration (guideline/principle).

 
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Nursing  Class 7 Unit 3 Assignment

see attach

 
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Nursing  Discussion Week 8 _Assessing Musculoskeletal Pain

Please review the complete instructions on attached document. Use the provided template to complete the assignment

 
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Nursing  Pediatric – Week 7 Discussion 2nd REPLY

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.JO Discussion:A 7-month-old boy presents with an erythematous, confluent, slightly raised, and scaly rash on his cheeks; and his extremities are also covered with a fine papular rash. The infant has had some scaling behind the ears and on the scalp since early infancy, but the symptoms have recently increased. The mother applies baby oil to the scalp to relieve scaliness. Except for some intermittent rhinorrhea, the infant has otherwise been well. Immunizations are deficient; he received only the first set when he was two months old. The family history is positive for bronchitis. The infant’s weight is at the 75th percentile, and the height is at the 50th percentile. Vital signs are normal. The physical examination is normal, except for the presence of the rash.What are the characteristics of papulosquamous eruptions? Be thorough and descriptive.The hallmark of papulosquamous eruptions is the existence of thin scaling to thick adherence scaling, erythematous raised lesions that range in size from small papules (1-3 mm) to large discoid copper-colored plaques (>10 cm in diameter) (Bellet, 2021).What are the common conditions associated with papulosquamous eruptions in children? List at least 3 common conditions and include the pathophysiology of each condition.The three most common conditions associated with papulosquamous eruptions in pediatric patients include: Tinea, pityriasis rosea, nummular eczema.Tinea are dermophytes responsible for causing superficial fungal infections within keratinized tissues and specifically rely on keratinized cells to reproduce (Sahoo & Mahajan, 2016). Dermophytes are categorized into three groups based on the area of the body the infection occurs. Microsporum, causes infections on the hair and skin; Trichophyton infects the skin, hair, and nails; Epidermophyton infects the nails and skin (Sahoo & Mahajan, 2016). Pityriasis rosea is a viral infection causing a papulosquamous disorder presenting with large erythematous scaly plaque called the “mother patch” on the trunk or neck, which is followed by the eruption of multiple secondary small erythematous scaly Christmas tree appearing lesions on the trunk and back (Mahajan et al., 2016). Eczema/atopic dermatitis is a disorder that results from a complex interaction between defects in environmental and infectious agents, immune dysregulation, and skin barrier function (Kapur et al., 2018).  Eczema presents with papulosquamous eruptions that are found to be erythematous, pruritic, scaly, crusty, dry-leathery patches on the face, scalp, neck, trunk, extensor surfaces of the extremities, and flexural surfaces (Kapur et al., 2018).What are the appropriate treatments for common papulosquamous eruptions? Why?The appropriate treatments for common papulosquamous eruptions depend on the triggering/offending agent. Tinea is best treated with the antifungal class Azoles, with the preferred method of administration being applied topically (Sahoo & Mahajan, 2016). Pityriasis rosea is typically a self-limiting disorder, however, patients may require the utilization of topical steroids, antihistamines, and emollients to reduce the severity of pruritis associated with the rash (Mahajan et al., 2016).  Treatment of eczema/atopic dermatitis is geared towards reestablishing the skin barrier by applying topical calcineurin inhibitors, or topical corticosteroids to reduce inflammation, itching, breakdown of skin, and restoring the overall dryness of the skin (Kapur et al., 2018).When should children with papulosquamous eruptions be referred to a dermatologist?Children suffering from unrelenting papulosquamous eruptions not responsive to treatment, should be referred to a dermatologist to assist in the identification process of the rash.  A dermatologist can perform a skin biopsy or scraping of the skin containing the rash, to identify the underlying etiology of the rash. Dermatologists have particular training allowing them to serve as exceedingly proficient medical detectives and natural collaborators with other healthcare specialists to better serve to dermatological needs of patients (Grimes, 2018).Define the following: a) confluent, b) papular, c) papulosquamous, and d) rhinorrheaConfluent is the joining of skin lesions that become merged forming a patch/lesion that is not separate or distinct from one another (Farlex, 2021). Papular consists of or is characterized by papules (small solid conical elevation of the skin (Merriam-Webster, 2021). Papulosquamous is characterized by well-demarcated areas of papules and scale, classically on an erythematous background (Griffith, 2020). Rhinorrhea is defined as excessive mucous secretion from the nose (Merriam-Webster, 2021).ReferencesBellet, J. (2021). Chapter 307: Papulosquamous diseases. Retrieved fromhttps://pediatriccare.solutions.aap.org/chapter.aspx?sectionid=137947447&bookid=1626Farlex Inc. (2021). Confluent. Retrieved fromhttps://medical-dictionary.thefreedictionary.com/confluentGriffiths, C. (2020). Papulosquamous disease. Retrieved from https://oxfordmedicine.com/view/10.1093/med/9780198746690.001.0001/med-9780198746690-chapter-554Grimes P. E. (2018). A closer look at the role of the dermatologist in championing total women’s health through the dermatology gateway. International journal of women’s dermatology, 4(4), 189–192. https://doi.org/10.1016/j.ijwd.2018.09.006Kapur, S., Watson, W., & Carr, S. (2018). Atopic dermatitis. Allergy, asthma, and clinical immunology: official journal of the Canadian Society of Allergy and Clinical Immunology, 14(Suppl 2), 52. https://doi.org/10.1186/s13223-018-0281-6Mahajan, K., Relhan, V., Relhan, A. K., & Garg, V. K. (2016). Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects. Indian journal of dermatology, 61(4), 375–384.https://doi.org/10.4103/0019-5154.185699Merriam-Webster. (2021). Papular. Retrieved fromhttps://www.merriam-webster.com/dictionary/papularMerriam-Webster. (2021). Rhinorrhea. Retrieved from https://www.merriam-webster.com/medical/rhinorrheaSahoo, A. K., & Mahajan, R. (2016). Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review. Indian dermatology online journal, 7(2), 77–86. https://doi.org/10.4103/2229-5178.178099

 
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Nursing  Evidence based article review

What methods can be used to assess nutritional status?

 
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Nursing  Holistic Nursing Learning Brochure

Create a 4-page brochure that provides information about integrative/holistic nursing services that can be provided to healthcare facilities. Select a type of facility for which you would like to design this brochure (Medical-Surgical floor at a busy hospital). Incorporate the modalities you have learned in this course (Healing touch, Acupuncture, aromatherapy, Tai-Chi, homeopathy… ect) Be creative!Attached is an example of a brochure to base this off of.

 
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Nursing  public health and policy

What are the roles of the federal government and state governments in the policy-making process? Describe the role of committees, and analyze similarities and differences between these roles. How does the composition of Congress and state legislatures influence the creation of public health policy? Consider party affiliation, racial and ethnic diversity, professional background of elected officials, etc. Use a specific example to demonstrate your point.

 
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Nursing  nursing

When you review various curricular plans, you may see a variety of terms. Some programs use the term “program outcomes” while others use the term “terminal objectives” for those actions that the student is expected to accomplish upon graduation. The same is true for individual courses. Some programs call the knowledge and skills that a student should master by the end of the course “course outcomes” while others use the term “course objectives.” All of the terms have a specified definition in literature and according to accreditation agencies. What are the similarities and differences between the terms according to the literature and to accrediting agencies? Select a program or course (other than GCU) and critique their use of these terms. Do they use them in a manner consistent with the literature and/or accreditation agencies or do they use them differently? Include your review of the program in your response to this discussion question. Support your response with literature. Your critique could be at the program level or at the course level. You do not need to do both levels. At least 400-500 words with at least 2-3 references.

 
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