Need a response to the following: 

Therapy guidelines for H. Pylori Treatment

H. Pylori remains to be one of the most common chronic bacterial infection affecting humans. Research shows that H. Pylori is normally acquired during childhood, with most victims being those who are socially disadvantaged and people who have migrated to North America (Chey et al., 2017). Although currently, there are no new drugs that have been developed, treatment primarily depends on a mixture of antibiotics and anti-secretory agents. H. Pylori treatment regimens are such as triple therapy, sequential therapy, quadruple treatment, and levofloxacin-based triple therapy (De Francesco et al., 2017). In selecting the best treatment regimen, it’s important to consider previous antibiotic exposure, the rate of eradication, and regional antibiotic-resistance patterns as these can affect the successful treatment of the condition (Myran & Zarbock, 2018). Additionally, it can be noted that for a treatment to be effective and successful, then host factors such as allergies and patient adherence need to be considered (Fashner & Gitu, 2015).

           Recent treatment guidelines have recommended quadruple therapy, which consists of PPI and three antibiotics (metronidazole, clarithromycin, and amoxicillin), which are to be administered concurrently (Chey et al., 2017). According to Shiotani et al. (2017), the rationale for this treatment option is that it’s not evidence-based but “hope-based” because gastroenterologists do believe that the infection would be susceptible to metronidazole or clarithromycin. 

           Patient compliance is a key factor that would determine treatment success. To minimize cases of side effects, clinicians should talk to their patients to adhere to their treatment plans and also instruct their patients on the right time to take their doses in relation to their meal (Li et al., 2019). Patients should be informed that they should avoid taking alcohol with metronidazole, avoid cheese, soy beans, and soy sauce taken with furazolidone (Li et al., 2019). Finally, it’s important to advice the patient to maintain personal hygiene by taking clean water and avoid ingesting contaminated food.

The original work is below in case you needed:

GI Case Study:

Chief complaint: “I have recurrent H. Pylori infection”. 

HPI: M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms. 

PMH: 

H. Pylori infection gastritis

Diabetes Mellitus, type 2

Surgeries: None

Allergies: NKDA

Vaccination History: Up-to-date

Social history:

High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.

Family history:

Both parents are alive. Father has history of DM type 2, Tinea Pedis. Mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis. 

ROS:

Constitutional: Negative for fever. Negative for chills. 

Respiratory: No Shortness of breath. No Orthopnea. 

Cardiovascular: No edema. No palpitations. 

Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal

Assessment:

Primary Diagnosis: Recurrent H. Pylori infection gastritis

Secondary Diagnoses: Dyspepsia

Differential Diagnosis: Peptic Ulcer Disease

Previous medication plan: two months ago and failed.

1. Clarithromycin      500 mg po BID for 2 weeks
2. Omeprazole      40 mg po BID for 2 weeks and then po daily.
3. Cipro      500 mg po BID for 2 weeks

Plan: Tests

Pt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results. 

Urea breath test 8 weeks after treatment with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test. 

Labs: No new labs are needed.  

Referrals: may refer based on effect of medication therapy given for 2 weeks.

Follow up: return to office in 8 weeks to reevaluate symptoms.

As a future nurse practitioner, it is important that you determine the medications used for recurrent H. Pylori infection. 

Please discuss new therapy guidelines for H. Pylori treatment, and provide patient education.

 As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues. 

 

Post a response to each of the following:

1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.
2. Compare and contrast the actions of g couple proteins and ion gated channels.
3. Explain the role of epigenetics in pharmacologic action.
4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

ZERO PLAGIARISM

FOUR REFERENCES

Due 7/29 9 p.m EST

3 PAGES APA NOT INCLUDING MIN 4 REF

PUBLIC HEALTH (SELECT A COUNTRY)

 The dearth of disease surveillance in developing nations is an immediate opportunity for public health professionals to improve the health of underserved populations. As presented in the Chapter of your course text, implementing disease surveillance in developing nations requires that public health professionals acclimate to the variety of unique obstacles in each country. From insufficient lab diagnostics to a lack of personnel with necessary professional skills, there are many potential challenges to establishing surveillance systems in developing nations 

 

To complete this portion of your Scholar-Practitioner project, write a 3-page paper that provides an overview of your selected country and disease (H.I.V/AIDS)

 Be sure to address the following: include SUBHEADINGS)

• 1)Describe the condition/disease and the developing country.
• 2)Describe the current monitoring procedures used in the developing country.
• 3)Provide a rationale as to why the country would greatly benefit from a disease surveillance system.
• 4)Describe two additional special features that should be a part of surveillance systems in your chosen country.
• 5)Describe challenges public health officials face in establishing disease surveillance systems in this country.
• 6) Describe how you would address these challenges.

DUE 3/30/18 7 P.M EST

APA FORMAT MIN 2 REFERENCES

 

Health Literacy

The government has defined health literacy as “The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions” (Healthy People 2020, 2011). Scholars have demonstrated that health literacy skills are stronger predictors of health status than age, income, employment status, education level, and race or ethnicity. Individuals with inadequate health literacy often struggle with basic tasks when managing a chronic condition such as reading and comprehending prescription bottles, appointment slips, self-management instructions, and educational brochures. The problems are compounded when the individual has several conditions requiring different medications. Inadequate health literacy can be a barrier to controlling disease that can lead to medication errors, increased hospitalization, poor health outcomes, and greater health care costs.

Discussion:   

• *Provide an example that illustrates the difference between literacy and health literacy.
• *Describe one potential health-related consequence to low health literacy and a population at risk for this potential consequence, explaining why they are at risk.

Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low birth weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community, or a population in your community. Provide the link to the resource in your post.