1. Clinical Standard of Practice Presentation (10% of Grade)

Students are expected to expand their use of resources for evidence-based practice beyond the required text, and explore nursing and related literature to improve their understanding and application of advanced interventions. Each student will present a Clinical Practice Presentation. The focus of the presentation must reflect current treatment recommendations from accepted professional organizations. Presentations will be evaluated related to the criteria listed. Presentations must be 8 slides in a PowerPoint format with a Reference List in APA format, will be no more than 15 minutes in length. Topic will be Current treatment recommendations for Asthma.

Grading Criteria .Criteria Points

 

1- Presents   the case including CC(chief complaint) ,  HPI(history of present illness), Hx(medical history), ROS(review of system) and PE findings concisely .10

 

2- List possible differential diagnosis with   supporting/excluding criteria. 10

 

3- What   labs or tests are typically ordered in relation to this condition? What   results should the NP   expects to see with this diagnosis? 20

 

4- What   medications are typically prescribed for this condition? List specific drugs,   starting doses, dose ranges, precautions to keep in mind when prescribing   these drugs. 20

 

5- What are   the outcomes expected or unexpected for this specific condition? And What   patient outcomes will trigger a referral?. 20

 

6- Provide   patient teaching materials specific to their condition. 20

 

Total 100

  

EPIDEMIOLOGY ASSIGNMENT

INSTRUCTIONS:

1. Go to http://www.healthypeople.gov/2020/default.aspx and review the Healthy People 2020 initiative. Pay close attention to the objectives, goals and the indicators.

2. Using your city or county public health department identify an epidemiological and surveillance data related to population based communicable illnesses described in table 5-1 page 72 of our class text book. Besides the illnesses describe you can also choose influenza or any other illnesses that are currently affecting your community.

3. Once you have chosen your topics you must send me an e-mail telling me what illnesses  you choose. 

4. Choose 3 population based communicable illness and prepare an analysis discussing how this 3-communicable illness affect your community and how they were identified and a plan of action to contained them base on healthy people 2020.

5. Presentation must be in APA format word document, Arial 12 font attach to the forum/thread in the assignment tab and turnitin with a minimum of 1000 words (excluding first and references page) with a minimum of 3 evidence based references (excluding the class textbook) no older than 5 years are required. The assignment must include the zip code of the city or county chosen. Follow the APA example paper that was sent to you at the beginning of the course for guidance. Make sure references are use according to APA guidelines and electronic references must be from reliable sources such as CDC. Once again, the assignment will be posted in turnitin under the tab epidemiology assignment to verify originality and on the discussion tab of the blackboard under forum/thread epidemiology assignment. You are posting the assignment twice but only you will receive one grade.

 

What causes the rapid change in the resting membrane potential to initiate an action potential?
Question 1 options:
                Potassium gates open and potassium rushes into the cell, changing the membrane potential from negative to positive
                Sodium gates open and sodium rushes into the cell, changing the membrane potential from negative to positive.
                Sodium gates close, allowing potassium into the cell to change the membrane potential from positive to negative.
                Potassium gates close, allowing sodium into the cell to change the membrane potential from positive to negative.
 

Question 2
 

What is a consequence of leakage of lysosomal enzymes during chemical injury?
Question 2 options:
                Enzymatic digestion of the nucleus and nucleolus occurs, halting deoxyribonucleic acid (DNA) synthesis.
                Influx of potassium ions into the mitochondria occurs, halting the adenosine triphosphate (ATP) production.
                Edema of the Golgi body occurs, preventing the transport of proteins out of the cell.
                Shift of calcium out of the plasma membrane occurs, destroying the cytoskeleton.
 

Question 3
 

In hypoxic injury, sodium enters the cell and causes swelling because:
Question 3 options:
                The cell membrane permeability increases for sodium during periods of hypoxia.
                Adenosine triphosphate (ATP) is insufficient to maintain the pump that keeps sodium out of the cell.
                The lactic acid produced by the hypoxia binds with sodium in the cell.
                Sodium cannot be transported to the cell membrane during hypoxia.
 

Question 4
 

What mechanisms occur in the liver cells as a result of lipid accumulation?
Question 4 options:
                Obstruction of the common bile duct, preventing the flow of bile from the liver to the gallbladder
                Increased synthesis of triglycerides from fatty acids and decreased synthesis of apoproteins
                Increased binding of lipids with apoproteins to form lipoproteins
                Increased conversion of fatty acids to phospholipids
 

Question 5
 

Which solution is best to use when cleaning a wound that is healing by 101. During an Immunoglobulin E (IgE)-mediated hypersensitivity reaction, the degranulation of mast cells is a result of which receptor action?
Question 5 options:
                Histamine bound to H2
                Chemotactic factor binding to the receptor
                Epinephrine bound to mast cells
                Acetylcholine bound to mast cells
 

Question 6
 

What is the mechanism that results in type II hypersensitivity reactions?
Question 6 options:
                Antibodies coat mast cells by binding to receptors that signal its degranulation, followed by a discharge of preformed mediators.
                Antibodies bind to soluble antigens that were released into body fluids, and the immune complexes are then deposited in the tissues.
                Cytotoxic T (Tc) lymphocytes or lymphokine-producing helper T 1 (Th1) cells directly attack and destroy cellular targets.
                Antibodies bind to the antigens on the cell surface.
 

Question 7
 

Type III hypersensitivity reactions are a result of which of the following?
Question 7 options:
                Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators
                Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
                Cytotoxic T (Tc) cells or lymphokine-producing helper T 1 (Th1) cells directly attacking and destroying cellular targets
                Antibodies binding to the antigen on the cell surface
 

Question 8
 

Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host deoxyribonucleic acid (DNA) is the cause of which disease?
Question 8 options:
                Hemolytic anemia
                Pernicious anemia
                Systemic lupus erythematosus
                Myasthenia gravis
 

Question 9
 

Why does tissue damage occur in acute rejection after organ transplantation?
Question 9 options:
                Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T (Tc) cells directly attack the endothelial cells of the transplanted tissue.
                Circulating immune complexes are deposited in the endothelial cells of transplanted tissue, where the complement cascade lyses tissue.
                Receptors on natural killer (NK) cells recognize antigens on the cell surface of the transplanted tissue, which releases lysosomal enzymes that destroy tissue.
                Antibodies coat the surface of the transplanted tissue to which mast cells bind and liberate preformed chemical mediators that destroy tissue.
 

Question 10
 

Oncogenes are genes that are capable of:
Question 10 options:
                Undergoing mutation that directs the synthesis of proteins to accelerate the rate of tissue proliferation
                Directing synthesis of proteins to regulate growth and to provide necessary replacement of tissue
                Encoding proteins that negatively regulate the synthesis of proteins to slow or halt the replacement of tissue
                Undergoing mutation that directs malignant tissue toward blood vessels and lymph nodes for metastasis
 

Question 11
 

After the baroreceptor reflex is stimulated, the resulting impulse is transmitted from the carotid artery by which sequence of events?
Question 11 options:
                From the vagus nerve to the medulla to increase parasympathetic activity and to decrease sympathetic activity
                From the glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase sympathetic activity and to decrease parasympathetic activity
                From the glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase parasympathetic activity and to decrease sympathetic activity
                From the glossopharyngeal cranial nerve through the vagus nerve to the hypothalamus to increase parasympathetic activity and to decrease sympathetic activity
 

Question 12
 

Regarding the endothelium, what is the difference between healthy vessel walls and those that promote clot formation?
Question 12 options:
                Inflammation and roughening of the endothelium of the artery
                Hypertrophy and vasoconstriction of the endothelium of the artery
                Excessive clot formation and lipid accumulation in the endothelium of the artery
                Evidence of age-related changes that weaken the endothelium of the artery
 

Question 13
 

What is the expected electrocardiogram (ECG) pattern when a thrombus in a coronary artery permanently lodges in the vessel and the infarction extends through the myocardium from the endocardium to the epicardium?
Question 13 options:
                Prolonged QT interval
                ST elevation myocardial infarction (STEMI)
                ST depression myocardial infarction (STDMI)
                Non-ST elevation myocardial infarction (non-STEMI)
 

Question 14
 

A patient reports sudden onset of severe chest pain that radiates to the back and worsens with respiratory movement and when the patient is lying down. These clinical manifestations describe:
Question 14 options:
                Myocardial infarction (MI)
                Pericardial effusion
                Restrictive pericarditis
                Acute pericarditis
 

Question 15
 

Respirations that are characterized by alternating periods of deep and shallow breathing are a result of which respiratory mechanism?
Question 15 options:
                Decreased blood flow to the medulla oblongata
                Increased partial pressure of arterial carbon dioxide (PaCO2), decreased acid-base balance (pH), and decreased partial pressure of arterial oxygen (PaO2)
                Stimulation of stretch or J-receptors
                Fatigue of the intercostal muscles and diaphragm
 

Question 16
 

Which cytokines activated in childhood asthma produce an allergic response?
Question 16 options:
                IL-1, IL-2, and interferon-alpha (IFN-α)
                L-8, IL-12, and tumor necrosis factor–alpha (TNF-α)
                IL-4, IL-10, and colony-stimulating factor (CSF)
                IL-4, IL-5, and IL-13
 

Question 17
 

Which statement accurately describes childhood asthma?
Question 17 options:
                An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
                A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest X-ray imaging
                A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, the pancreas, the sweat ducts, and the vas deferens
                An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency
                Improvement on a trial of asthma medication
 

Question 18
 

Which statement best describes cystic fibrosis?
Question 18 options:
                Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
                Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest X-ray imaging
                A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that obstructs the airways, the pancreas, the sweat ducts, and the vas deferens
                A pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency
 

Question 19
 

What are the abnormalities in cytokines found in children with cystic fibrosis?
Question 19 options:
                A deficit of IL-1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α)
                A deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)
                A deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α
                A deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)
 

Question 20
 

Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?
Question 20 options:
                Retropharyngeal abscess
                Laryngospasms
                Rupturing of the tonsils
                Gagging induced aspiration
 

Question 21
 

Free radicals play a major role in the initiation and progression of which diseases?
Question 21 options:
                Cardiovascular diseases, such as hypertension and ischemic heart disease
                Renal diseases, such as acute tubular necrosis and glomerulonephritis
                Gastrointestinal diseases, such as peptic ulcer disease and Crohn disease
                Muscular diseases, such as muscular dystrophy and fibromyalgia
 

Question 22
 

What is a consequence of plasma membrane damage to the mitochondria?
Question 22 options:
                 Enzymatic digestion halts deoxyribonucleic acid (DNA) synthesis.
                Influx of calcium ions halts adenosine triphosphate (ATP) production.
                Edema from an influx in sodium causes a reduction in ATP production.
                Potassium shifts out of the mitochondria, which destroys the infrastructure.
 

Question 23
 

In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces?
Question 23 options:
                Oncotic pressure
                Buffering
                Net filtration
                Hydrostatic pressure
 

Question 24
 

Venous obstruction is a cause of edema because of an increase in which pressure?
Question 24 options:
                Capillary hydrostatic
                Interstitial hydrostatic
                Capillary oncotic
                Interstitial oncotic
 

Question 25
 

At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because:
Question 25 options:
                The interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure.
                The capillary hydrostatic pressure is higher than the capillary oncotic pressure.
                The interstitial oncotic pressure is higher than the interstitial hydrostatic pressure.
                The capillary oncotic pressure is lower than the interstitial hydrostatic pressure.
 

Question 26
 

Secretion of antidiuretic hormone (ADH) and the perception of thirst are stimulated by:
Question 26 options:
                A decrease in serum sodium
                An increase in plasma osmolality
                An increase in the glomerular filtration rate
                A decrease in osmoreceptor stimulation
 

Question 27
 

Some older adults have impaired inflammation and wound healing because of which problem?
Question 27 options:
                The circulatory system cannot adequately perfuse tissues.
                Complement and chemotaxis are deficient.
                Underlying chronic illnesses exist.
                The number of mast cells is insufficient.
 

Question 28
 

Lead poisoning affects the nervous system by:
Question 28 options:
                Interfering with the function of neurotransmitters
                Inhibiting the production of myelin around the nerves
                Increasing the resting membrane potential
                Altering the transport of potassium into the nerves
 

Question 29
 

Carbon monoxide causes tissue damage by:
Question 29 options:
                Competing with carbon dioxide so that it cannot be excreted
                Binding to hemoglobin so that it cannot carry oxygen
                Destroying the chemical bonds of hemoglobin so it cannot carry oxygen
                Removing iron from hemoglobin so it cannot carry oxygen
 

Question 30
 

Which statement is true regarding the difference between subdural hematoma and epidural hematoma?
Question 30 options:
                No difference exists, and these terms may be correctly used interchangeably.
                A subdural hematoma occurs above the dura, whereas an epidural hematoma occurs under the dura.
                A subdural hematoma is often the result of shaken baby syndrome, whereas an epidural hematoma rapidly forms as a result of a skull fracture.
                A subdural hematoma usually forms from bleeding within the skull, such as an aneurysm eruption, whereas an epidural hematoma occurs from trauma outside the skull, such as a blunt force trauma.
 

Question 31
 

What physiologic change occurs during heat exhaustion?
Question 31 options:
                Hemoconcentration occurs because of the loss of salt and water.
                Cramping of voluntary muscles occurs as a result of salt loss.
                Thermoregulation fails because of high core temperatures.
                Subcutaneous layers are damaged because of high core temperatures.
 

Question 32
 

Hemoprotein accumulations are a result of the excessive storage of:
Question 32 options:
                Iron, which is transferred from the cells to the bloodstream
                Hemoglobin, which is transferred from the bloodstream to the cells
                Albumin, which is transferred from the cells to the bloodstream
                Amino acids, which are transferred from the cells to the bloodstream
 

Question 33
 

Hemosiderosis results in what substance being stored in excess as hemosiderin in cells of many organs and tissues?
Question 33 options:
                Hemoglobin
                Ferritin
                Iron
                Transferrin
 

Question 34
 

What two types of hearing loss are associated with noise?
Question 34 options:
                Acoustic trauma and noise induced
                High frequency and low frequency
                High frequency and acoustic trauma
                Noise induced and low frequency
 

Question 35
 

What type of necrosis results from ischemia of neurons and glial cells?
Question 35 options:
                Coagulative
                Liquefactive
                Caseous
                Gangrene
 

Question 36
 

During cell injury caused by hypoxia, sodium and water move into the cell because:
Question 36 options:
                Potassium moves out of the cell, and potassium and sodium are inversely related.
                The pump that transports sodium out of the cell cannot function because of a decrease in adenosine triphosphate (ATP) levels.
                The osmotic pressure is increased, which pulls additional sodium across the cell membrane.
                Oxygen is not available to bind with sodium to maintain it outside of the cell.
 

Question 37
 

In decompression sickness, emboli are formed by bubbles of:
Question 37 options:
                Oxygen
                Nitrogen
                Carbon monoxide
                Hydrogen
 

Question 38
 

What is an example of compensatory hyperplasia?
Question 38 options:
                Hepatic cells increase cell division after part of the liver is excised.
                Skeletal muscle cells atrophy as a result of paralysis.
                The heart muscle enlarges as a result of hypertension.
                The size of the uterus increases during pregnancy.
 

Question 39
 

Current research has determined that chemical-induced cellular injury:
Question 39 options:
                Affects the permeability of the plasma membrane
                Is often the result of the damage caused by reactive free radicals
                Is rarely influenced by lipid peroxidation
                Seldom involves the cell’s organelles
 

Question 40
 

What is the inflammatory effect of nitric oxide?
Question 40 options:
                It increases capillary permeability and causes pain.
                It increases neutrophil chemotaxis and platelet aggregation.
                It causes smooth muscle contraction and fever.
                It decreases mast cell function and decreases platelet aggregation. 

  

With so much attention focused on health care reform, it is important that nurses be given the opportunity to use high-quality technology tools. These tools can increase access to vital medical information, promote effective communication among health care professionals, and improve the patient experience. By actively seeking out and adopting these tools, nurses can greatly enhance the quality and safety of care that they provide.

This Discussion focuses on identifying quality technology tools that increase the ability of nurses to provide safe, effective care.

· Review the various technology tools described in this week’s Learning Resources.

· Identify a recently adopted information, education, or communication technology tool in your specialty area. Reflect on how it is used and how its use impacts the quality of care.

· Consider how your identified technology tool might impact nursing practice if it were more widely used. What are some barriers preventing increased usage? How could wider implementation be facilitated?

Post a description of a current or new information, education, or communication technology tool that is being used in your specialty area and assess its impact on the quality of care. Highlight the effect that increased use of this technology would have on nursing practice and discuss the barriers that are slowing or hindering its adoption. Summarize how adoption of the technology tool could be facilitated.

 

After reviewing the readings and overview, discuss the significance of understanding the following items in relation to clinical practice as an advanced practice nurse. Consider the following two situations in addressing your assigned roles:

• Patient A: A 32-year-old Asian American construction worker visits his primary care physician with a 2-inch cut on the anterior aspect of his right hand. He lacerated his hand while fixing a barbed-wire fence 5 days ago. He told his wife that he did not have time to go to his primary care provider for such a small cut. The primary care provider noted the wound bed to be erythemic, swollen, and with a small amount of purulent greenish drainage on the Band-Aid the wife had placed on cut. The patient had an oral temperature of 100°F. The primary care provider cleaned the wound, applied a clean dressing, administered Tdap, and called in a prescription for 10 day-courses of an antibiotic.
• Patient B: A 5-year old was playing on his family’s farm when he accidentally tripped over a fallen fence suffering a similar injury as the first patient. This child suffered a 2-inch cut to the anterior aspect of his right hand. His father cleaned the wound, covered the site, and made an appointment for the following week (about 3 days later) to see the pediatrician. The pediatrician examined the wound and noted the wound bed to be erythemic, swollen, and with a small amount of purulent drainage on the Band-Aid the father had placed on the cut. The patient had an oral temperature of 100°F. The primary care provider cleaned the wound, applied a clean dressing, administered dTAP, and called in a prescription for 10 day-course of an antibiotic.

In your post please answer these questions based on each of the patients above:

• 1. Identify some potential concerns based on the findings of the wounds for each patient and provide a rationale for the healthcare provider’s treatment choices. Include the mechanism of wounds healing in your discussion. 
• 2. In addition, briefly discuss each individual’s risk for shock and what type of shock he is at most risk for based on the information presented.
• Explain your rationale for your choices, citing resources from the literature.
• 3. What are further assessment findings that you would expect to find on inspection of each patient? Discuss the risk factors for the development of shock in this individual. 
• 4. What are the corresponding potential differential diagnoses that you would prioritize based upon these findings? Explain your rationale for selecting differential diagnoses, using evidence from the literature. 
• 5.Discuss the pathophysiology issues that must be addressed due to changes at the cellular level.

Discussion should be about 2 paragraphs for each question and ANSWER/address all the questions.