Write a 500-750-word essay on the Stages-of-Life and the influence of age in health care from a patient’s perspective. Interview a friend or family member about that person’s experiences with the health care system. You may develop your own list of questions.

Suggested questions:

1. Do you feel that your stage-of-life had any effect on your interaction with health care professionals?
2. Which areas of the hospital or clinic were most concerned with your well-being and feelings?
3. Was your family with you during this hospital stay or outpatient visit?
4. Was your family included in your treatment, such as post-procedure instructions?

 

Patient A.B. a 69-year-old White mail visited his local clinic for a checkup as lately he was feeling lethargic and has gained 22 lbs in the past year. He also has episodes of nocturia. He has being diagnosed with Type 2 diabetes for 5 years. However, he was diagnosed with Borderline diabetes since 1997, but never took it seriously and made no lifestyle changes. He has symptoms of hyperglycemia for the past 2 years. He does not check his glucose daily. He has never had a foot examination.

AB carbohydrate intake daily most times consists of eating at least three slices of bread with each meal and eating pasta meals at least 3 times a week. He likes his wife to cook Italian meals no less than 3-4 times a week. He drinks a glass of red wine with dinner every day. He stopped smoking 10 years ago. He exercises on occasion, maybe once or twice a month.

A.B. takes Atorvastatin 10mg daily. Glyburide 2.5mg daily. However, he reports he stopped taking the Glyburide about 6 months ago as it was making him feel dizzy whenever he took it. He has not notified his PCP about not taking the Glyburide.

Physical Examination

Constitutional: Alert and oriented to person, place, time and situation. He is well groomed.  He is 5 feet 2 inches and weighs 178 pounds.

Eyes: Pupils round, reactive to light. EOM intact. Fundi clear.

Hearing: No deficit noted

Mouth: Mucosa moist. Upper and lower dentures.

Heart: Rate and rhythm regular. No murmur.

Lungs: Clear to auscultation

Neurological assessment: Diminished vibrating sense to the forefoot, absent ankle reflexes. Monofilament felt only above the ankle.

Vascular: No carotid bruits. Femoral, popliteal and dorsalis pedalis pulses 2+ bilaterally.

His Immunization is updated. He has erectile dysfunction and takes Sildenafil.

Vital signs: BP= 150/87, P= 88, RR= 20, T= 97.8, Oxygen Sat= 98%

Laboratory Results:

Glucose (fasting) = 178mg/dl

Creatinine = 1.0mg/dl

Blood Urea Nitrogen = 18mg/dl

Sodium = 141 mg/dl

Potassium = 4.3 mg/dl

Total Cholesterol = 162 mg/dl

HDL Chol = 43mg/dl

LDL Chol = 84 mg/dl

Triglycerides = 177 mg/dl

AST = 14 IU/L

ALT = 19 IU/L

Alkaline Phosphatase = 56 IU/L

A1C = 8.1%

a) Nursing Plan for A.B.

b) No less than three nursing diagnoses

c) Fully developed care plan

d) What is the priority nursing education this patient needs with rationale?

e) Nursing interventions

Remember no less than 2 references.

 

The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to caregivers.

Create a 10-12 slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end.

In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored.

Include the following in your presentation:

1. Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants.
2. Create a health promotion plan that can be presented to caregivers to address the environmental factor and improve the overall health and well-being of infants.
3. Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.
4. Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly resources are required. Two of the three resources must be peer-reviewed and no more than 6 years old.
5. Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

Refer to the resource, “Loom,” located in the Student Success Center, for additional guidance on recording your presentation.

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.

 

Metabolism — Metabolism is defined as the sum of all chemical reactions required to support cellular functions in the body. Answer one or more of these. Provide 3 full evidence-based APA citations.

~ Explain what catabolism is and give a couple of good examples of catabolism in the body. Describe how energy is involved in catabolism. Briefly describe how ATP energy molecules are extracted from the chemical bond energy in glucose.

~ Explain what anabolism is and give a couple of good examples of anabolism in the body. Describe how energy is involved in anabolism. What kinds of molecular and tissue structure are assembled through anabolism?

~ Explain what a metabolic pathway is. Describe what substrates are. Describe what intermediate are. Describe what end products are. Describe the roles of enzymes in metabolic pathways.

~ Describe the role of the citric acid cycle in glucose metabolism.

 Based on this case study answer the questions below in APA Style, more than 300 words, and please cite 3 or more references .

“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks. The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status. One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life. The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families. She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some time with the patient. One of the things that the nurse did to coordinate care was to meet with the family to see what times worked best for them; then she posted family time on the patient’s activity schedule outside her cubicle to communicate the plan to others involved in Mrs. Walsh’s care. When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done in this unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They turned down the lights, closed the doors, and put music on; the nurse, the patient’s daughter, and the patient’s son all cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter should be sharing this time alone with their mother. Then she realized that they really wanted her to be there with them. This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines” Critical thinking activities 1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011). 2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care? 3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice