According to Huether and McCance (2017), Addison’s disease is an auto-immune disorder marked by adrenal insufficiency and is more common in white women than all ethnicities of men. Relatively rare, this disease most often occurs between the ages of 30-60 (Huether &McCance, 2017). Addison’s disease is an inherited disorder, however, research on the pathway of genetic inheritability has been limited because the genotype of a patient does not always predict their phenotype and the rarity of disease inhibits large scale genetic analysis (Mitchell & Pearce, 2012).  According to Mitchell and Pearce (2012), it is a progressive disease with symptoms developing over months or years. Initial clinical manifestations of disease will appear in the increase of adrenocorticotropic hormone and renin well before adrenal failure develops (Mitchell & Pearce, 2012). 

     Pathological changes of the adrenal glands (including adrenal atrophy) are combined with fatigue, hypotension, weight loss and hyper skin pigmentation (Mitchell & Pearce, 2012). The steroidogenic enzymes in the adrenal cortex of the patient with Addison’s disease become targets for the immune system to attack (Mitchell & Pearce, 2012). The presence of circulating steroid 21-hydroxylase antibodies is a reliable predictor of Addison’s Disease, this is normally located on the smooth endoplasmic reticulum of intact cells (Mitchell & Pearce, 2012).  This can lead to other autoimmune responses in the body, metastatic malignancy, amyloidosis, hemorrhage, infections, adrenoleuko dystrophy, or sarcoidosis. Other clinical manifestations include low levels of cortisol in serum and urine tests, increased ACTH levels, BUN increases (due to dehydration), Eosinophil and lymphocyte elevations, hyperkalemia and mild alkalosis (Huether & McCance, 2017). Treatment involves glucocorticoid and mineralocorticoid replacement for life as well as increases in sodium intake if patient experiences excessive sweating and diarrhea.

References

Huether, S. E., & McCance, K. L. (2017). Understanding Pathophysiology(6th ed.). St. Louis, 

MO: Mosby.

Mitchell, A. L., & Pearce, S. H. S. (2012). Autoimmune Addison disease: pathophysiology and 

genetic complexity. Nature Reviews. Endocrinology, 8(5), 306–316. https://doi-org.ezp.waldenulibrary.org/10.1038/nrendo.2011.245

Write a 700-word paper that evaluates any recommendations you received, and those you did not.

Consider the following:

• Who did you reach out to and what is their relation to you?
• Who responded and what did they have to say?
• Was there anything in the recommendation you felt was missing?
• Who did not respond?Is there a reason why they might not have responded?
• What did this assignment teach you about your professional relationships with current or previous employers or supervisors?
• What can you do to strengthen weak professional relationships?

Transition into Adulthood

The transition into adulthood may differ depending on cultural traditions and rites of passage from adolescence to adulthood. The transition into adulthood is also a time for relationships and romance from a normative perspective.

• Describe at least two unique rites of passage to adulthood on the basis of ethnic or cultural variations.
• Explain the concepts of pluralism and assimilation and describe how they affect the rites of passage of individuals.
• Describe different attachment styles.
• Explain the attachment style you feel would be most effective in forming lasting relationships.
• Describe the different types of attraction.
• Explain the type of attraction you feel would be most effective in establishing lasting relationships.

Instructions

You have recently been promoted to Health Services Manager at Three Mountains Regional Hospital, a small hospital located in a mid-size city in the Midwest. Three Mountains is a general medical and surgical facility with 400 beds. Last year there were approximately 62,000 emergency visits and 15,000 admissions. More than 6,000 outpatient and 10,000 inpatient surgeries were performed.

After the first series of training, your CEO decided that employees would benefit from an online self-check after completing the training. You are tasked with developing a PowerPoint presentation with a list of questions that ask about liability protections for the physicians and the facility. Correct answers should be provided in the notes so that employees can check their responses.

Please prepare a PowerPoint presentation (or feel free to use other shareable Webware/software that you prefer) with questions that check employee understanding about the liability protections for physicians and the facility.

1. The PowerPoint presentation should be a minimum of 8 slides and a maximum of 12.
2. On each slide, provide a question that can be utilized to ascertain basic understanding. Open-ended questions are preferable.
3. Use the notes area on each slide to provide the answer with a thorough explanation of why that answer is correct.
4. Include a slide that provides links to 3-5 resources for employees who want more information.
5. Your final slide should be the reference page for sources cited in the Notes.