Newman pointed out that, “nurse client relationships often begin during periods of disruption, uncertainty, and unpredictability in patient’s lives” (Smith & Parker, 2015, p. 288).

Explore what she means by this statement. Then, reflect on a patient that you cared for that you could apply her theory to. Provide details of the interaction and outcomes.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook

the theorist referred to here is Betty Newman

 

The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials:

1. Key Features of the Affordable Care Act
2. Health Care Transformation: the Affordable Care Act and More

What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

 WEEK 3 discussion

Tam……

Breathing, Heart, and Lungs

An anxious patient is having rapid and shallow breathing. After a few moments, he complains of a tingling sensation.

1)What could be the causes of this tingling sensation?

Anxiety can increase in those patients that are already having rapid and shallow breathing. Hyperventilation added to this can cause the tingling sensation due to a decrease in C02.

2)What are the various patterns of respiration and their significance?

Normal respirations are 10-20 is also called sigh rate, depth is 500-800ml “air moving in and out with each respiration, pattern is even”. (Jarvis 2016 pg. 442). “These values increase as a normal response to exercise, fear, or fever”. (Jarvis 2016 pg. 442).

Tachypnea Hyperventilation Rapid is shallow breathing. Has an increased rate greater than 24 per minute. This rate can increase with respiratory insufficiency, alkalosis, pleurisy, pneumonia, pleurisy, diabetic ketoacidosis, salicylate overdose, hepatic coma and lesions of the midbrain and alteration in blood gas concentration, but it a normal response to fever, fear, or exercise.

Bradypnea Hypoventilation: Slow breathing. Is a decreased but regular rate less than 10 per minute. Can be caused by drugs, increased intracranial pressure and diabetic coma.

 “An irregular shallow pattern caused by an overdose of narcotics or anesthetics” (Jarvis 2016 pg. 442). It may also occur with conscious splinting of the chest to avoid respiratory pain and with prolonged bed rest.

Cheyne-Stokes Respiration: “respirations gradually wax and wane in a regular pattern, increasing in rate and depth and then decreasing”. (Jarvis 2016 pg. 442). Breathing periods are 30-45 seconds with about 20 second period of apnea. Common causes are severe heart failure, renal failure, meningitis, drug overdose, and increased intracranial pressure.

Biot Respiration is similar to Cheyne-Stokes respiration, except that the pattern is irregular and seen with head trauma, brain abscess, heat stroke, spinal meningitis, and encephalitis.

3)Ethnicity and culture influence risk factors for heart disease. Do you agree? Why or why not?

Heart disease knows no ethnic/culture. Some risk factors that cause heart disease is obesity, tobacco use and high cholesterol. These are modifiable. In other words, most of these can be prevented. High blood pressure is mainly in the Africa American culture and for some of them, blood pressure can be prevented or at least controlled. If not controlled, it can lead to heart disease.

4)What is the technique of percussion and palpation of the chest wall for tenderness, symmetry, bulges, fremitus, and thoracic expansion? Explain.

To palpate the chest wall, place your hands on the anterolateral wall with your thumbs along the coast margins with hands pointing toward the xiphoid process. You ask the patient to take a deep breath while watching your thumbs move apart symmetrically and take note of the smooth chest expansion with your fingers. “Any limitation in thoracic expansion is easier to detect on the anterior chest because greater range of motion exists with breathing here” (Jarvis 2016 pg. 432).

To assess tactile fremitus, began palpating over the lung apices in the supraclavicular areas comparing vibrations from one side to the other as the person repeats the words ninety-nine.

You then palpate the anterior chest wall looking for tenderness or detect any superficial lumps or masses. Note the skin mobility, turgor, temperature and moisture.

With percussion of the chest, you start at the apices in the supraclavicular area, going to the interspaces, comparing one side with the other, going in a downward motion, down the anterior chest.

5)Would you anticipate hearing hyper-resonance on a patient with a history of tobacco use?  Why or why not?

Yes. Hyperresonance is found when too much air is present like in emphysema which is caused from tobacco use.

6)What are the mechanics of breathing with reference to lung borders and the anatomical structure of the lungs and diaphragm?

Inspiration is the breathing in air into the lungs, the chest wall increases in size. When it is expelled it is caused expiration. This is the mechanical action of breathing. Expansion and contraction. There are four major functions of the respiratory system. Supplying oxygen to the body for energy production, removing carbon dioxide as a waste product of energy reactions, maintaining homeostasis of arterial blood and maintain heat exchange.

 

• Type of paper Essay (Any Type)
   
• Subject Nursing
   
• Number of pages 7
   
• Format of citation APA
   
• Number of cited resources  3
   
• Type of service  Writing
   

Write a paper  (2,000-2,500 words) in which you apply the concepts of epidemiology and  nursing research to a communicable disease. Refer to ″Communicable  Disease Chain,″ ″Chain of Infection,″ and the CDC website for assistance  completing this assignment.  Communicable Disease Selection  Choose one communicable disease from the following list:  Chickenpox Tuberculosis Influenza Mononucleosis Hepatitis B HIV Ebola Measles Polio Influenza Epidemiology Paper Requirements  Address the following:  Describe the communicable disease (causes, symptoms, mode of  transmission, complications, treatment) and the demographic of interest  (mortality, morbidity, incidence, and prevalence). Is this a reportable  disease? If so, provide details about reporting time, whom to report to,  etc. Describe the determinants of health and explain how those factors  contribute to the development of this disease. Discuss the epidemiologic triangle as it relates to the communicable  disease you have selected. Include the host factors, agent factors  (presence or absence), and environmental factors. (The textbook  describes each element of the epidemiologic triangle). Are there any  special considerations or notifications for the community, schools, or  general population? Explain the role of the community health nurse (case finding, reporting,  data collecting, data analysis, and follow-up). Identify at least one national agency or organization that addresses the  communicable disease chosen and describe how the organization(s)  contributes to resolving or reducing the impact of disease. Discuss a global implication of the disease. How is this addressed in  other countries or cultures? Is this disease endemic to a particular  area? Provide an example. A minimum of three peer-reviewed or professional references is required.

Discussion: Pharmacotherapy for Hematologic Disorders

In the 1970s, the average lifespan for patients diagnosed with sickle cell disease was 14 years. Today, the average lifespan has increased to 50 years and beyond (TriHealth, 2012). The patient prognosis for many other hematologic disorders such as hemophilia and cancer continue to improve as well. This can be attributed to advancements in medical care—specifically drug therapy and treatment. When managing drug therapies for patients, it is essential to continuously examine current treatments and evaluate the impact of patient factors on drug effectiveness. To prepare for your role as an advanced practice nurse, you must become familiar with common drug treatments for various hematologic disorders seen in clinical settings.

To prepare:

• Select one of the following hematologic disorders: anemia, hemophilia, cancer, sickle cell anemia, thalassemia, thrombolytic disorders, or white blood cell disorders. Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.
• Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

Post a description of the hematologic disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.