Topic 1 DQ 2

The most interesting aspect of the topic readings that I have never heard of before, is metaethics which is the study of the nature of being right and wrong (Grand Canyon University, 2018). Instead of the basic foundation of what is right and wrong that is taught in elementary school, metaethics asks questions of right and wrong that are much deeper. Metaethics asks questions such as “does right and wrong even exist?” and “how can I know what is right and wrong”? (Grand Canyon University, 2018). A major controversy with metaethics is whether morality is objectively true (Grand Canyon University, 2018). The metaethicist is interested in understanding moral discourse as compared with other forms of speech and writing (Wilson, 2016).

My personal analysis of disease and healing within the readings is that the responsibility of a professional nurse is essential to support patients with the individual spiritual aid that they need throughout their healing process. It is important as a caregiver to provide cares with understanding and with non-judgmental attitude. The relationship between medicine and Christian ethics is ever present. Having a strong ethical foundation allows for the possibility of moral knowledge (Grand Canyon University, 2018)

Using 200-300 words APA format with at least references within five years.

 What aspects of the topic readings do you find the most interesting? What is your view of the analysis of disease and healing in the readings? Explain. 

 

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.

To Prepare:

• Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.
• Consider the elements of the psychiatric interview, history, and examination.
• Consider the assessment tool assigned to you by the Course Instructor.

By Day 3 of Week 2

Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

I was assigned PATIENT HEALTH QUESTIONAIRE (PHQ-9)
Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond to at least two of your colleagues on 2 different days by comparing your assessment tool to theirs.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Fluid and Electrolytes: Balance and Disturbance

1. Mrs. Dean is 75-year-old woman admitted to the hospital for a small bowel obstruction. Her medical history includes hypertension. Mrs. Dean is NPO. She has a nasogastric (NG) tube to low continuous suction. She has an IV of 0.9% NS at 83 mL/hr. Current medications include furosemide 20 mg daily and hydromorphone 0.2 mg every 4 hours, as needed for pain. The morning electrolytes reveal serum potassium of 3.2 mEq/L. (Learning Objective 4)

1. What are possible causes of a low potassium level?
2. What action should the nurse take in relation to the serum potassium level?
3. What clinical manifestations might the nurse assess in Mrs. Dean? 

2. Conrad Jackson is a 28-year-old man who presents to the emergency department with severe fatigue and dehydration secondary to a 4-day history of vomiting. During the interview, he describes attending a family reunion and states that perhaps he “ate something bad.” Upon admission his vital signs are a temperature of 102.7°F, heart rate of 116 bpm, respiratory rate of 18 breaths/min, and blood pressure of 86/54 mm Hg. The nurse also notes the patient has dry mucous membranes and tenting of skin. The physician orders an IV to be started with 0.45% normal saline, and orders a serum electrolytes and an arterial blood gas. (Learning Objective 7)

The following results are returned from the laboratory:

Sodium (Na+)  150

Potassium (K+)  5.5

Chloride (Cl¯)  110

BUN    42

Creatinine   0.8

Glucose   86

pH   7.32

PaCO2    35

HCO3¯    20

PaO2    90

O2 Sat    98%

1. What is your interpretation of this arterial blood gas sample?
2. Explain the high potassium in this patient.
3. Calculate the patient’s anion gap:
4. What is the interpretation of this anion gap? 

 

1. Detached Retina

Mr. Gray, a 65-year-old man, was in an automobile accident in which he suffered a concussion. Soon after he was released, he noticed what he described as a “gray spot” in his field of vision. At first he ignored it, thinking it would go away, but the spot seemed to darken and spread over his visual field. He didn’t report any pain with the problem. On calling his physician, he was advised to go to the nearest hospital immediately. A detached retina was diagnosed.

After treatment, he regained most of his normal sight back. Five years later, he began having problems again. The central area of his visual field was becoming blurred, and he was losing his depth perception. An initial eye examination revealed neovascularization in both eyes.

• Question 1:  Relate the patient history and circumstances of the injury and the signs and symptoms related to the pathophysiology of this condition.
• Question 2: Discuss the treatments available for the patient.
• Question 3: Relate the symptoms and signs to those of macular degeneration.
• Question 4: Discuss the treatment available and the prognosis for recovering his normal vision.

Resources to assist you:

https://www.youtube.com/watch?v=3m__6QS8U_8

https://www.youtube.com/watch?v=hZe7VxtuQB0

https://www.youtube.com/watch?v=ozZQIZ_52YY

1. Cardiovascular Accident

Mr. Quinn, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen. Now his speech is slurred, and his right arm and the right side of his face feel numb. He is very anxious and is transported to the hospital. Mr. Quinn has a history of smoking and arteriosclerosis, and there is family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 Hg mm. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery.

• Question 1:  Discuss the pathophysiology related to CVA due to thrombus vs. embolus. Describe the stages in the development of an atheroma.
• Question 2: Explain the predisposing factors in this case, and relate Mr. Quinn’s initial signs to the pathological changes.
• Question 3: Discuss the treatments available after first aid for stroke patients and the patient’s prognosis.

Resources to help you:

https://www.youtube.com/watch?v=QIAI6KOwKII&t=16s

https://www.youtube.com/watch?v=U8s427-tv58

https://www.youtube.com/watch?v=qCvV11R2lgg&t=7s

1. Parkinson Disease

Mr. Nimmo, age 66, has noticed excessive fatigue, muscle aches, and weakness in his legs for some time. His hands were shaking slightly, although his wife reported that the shaking appeared to stop when he fell asleep. Some unintentional head movements were also apparent. He remembers that his grandfather died in his mid-60s after suffering for years from a condition with similar symptoms. After several tests and the elimination of some other neuromuscular conditions, a diagnosis of Parkinson’s disease was made for Mr. Nimmo.

• Question 1: Discuss the pathophysiology of Parkinson’s disease and how it differs from other neuromuscular conditions affecting older adults.
• Question 2: Discuss the usual progression of the disease as the pathophysiology develops further. Indicate additional manifestations that will be noticeable.
• Question 3: Describe the complications that frequently develop, including the rationale for each and the early indications of each problem.
• Question 4: Discuss the treatments available to this patient.