NSG 6101 2025

Please write a comment on this post. APA, citation and reference. prefer CDC, healthy people 2020. Mr. Barley is a 58-year-old well-developed male with a chief complaint of “a bad cough, mainly in the morning, last winter and this winter.” Cough produces “whitish phlegm”. The history of present illness includes no complaint of chest pain, weight loss, or fever. There is also no noted nausea, vomiting or diarrhea. Also, of note, the coughing is not precipitated by choking, trembling/shaking, palpitations, sweating or chills. Mr. Barley notes that he does have contact with chemicals on his farm, however, is cautious to use protective equipment. He also notes that he has a long (26 year) history of smoking up to two packs of cigarettes per day though recently he has cut back to a half a pack per day. Mr. Barley also notes that he has no known allergies, has not traveled or been exposed to tuberculosis. He also does not have leg swelling, orthopnea, or proximal nocturnal dyspnea (PND). Mr. Barley has no chronic illness noted in his past, only being seen for minor injuries, and has never been admitted to the hospital and only surgical history is a tonsillectomy at age 12. Mr. Barley takes no medications at this time. Mr. Barley’s social history includes being married for thirty-five years and has two adult daughters. He currently resides with his wife on their farm. Both of his daughters have families of their own. His past family history includes his mother whom he thinks has hypertension, and father who died of a stroke when he was seventy. His sisters and daughters have no known medical history. To complete a focused physical exam a differential diagnosis must first be established. There are several potential causes of acute dyspnea with a cough including asthma, acute bronchitis, and new onset chronic obstructive pulmonary disease (COPD), lung cancer, and congestive heart failure (CHF). (Buttaro, Trybulski, Polgar-Bailey, and Sandberg-Cook, 2017). It is unlikely that Mr. Barley has an active infection due to the lack of fever (current temp 98.9), chills, or change in color and consistency of the phlegm. At this time CHF may be set aside due to the lack of chest pain, edema in lower extremities, the absence of PND, and a blood pressure of 128/78. Therefore, a focused assessment relating to the respiratory system is warranted at this visit. According to Petty (2001), the National Lung Health Education Program (NLHEP) began a campaign to introduce early assessment, intervention, and diagnosis of chronic lung disease in individuals who smoke. It was recommended that individuals older than forty-five complete an in-office spirometry exam to indicate risk for chronic lung diseases such as asthma, chronic bronchitis, COPD, and lung cancers. A general physical exam will assess Mr. Barley’s general appearance, vital signs, head, eyes, ears, nose, throat, neck, lungs, heart, abdomen, and extremities. The focused assessment for COPD will include auscultation of breath sounds specifically looking for wheezing/end expiratory wheezing, assessment of anterior-posterior (AP) diameter of the chest, and prolonged expiratory phase and evidence of a change in the suprasternal notch. Mr. Barley is noted to have a laryngeal height of 2cm from the sternal notch, increased AP diameter, and diffuse end-expiratory wheezes in addition to self-admittance of long-term smoking. These findings are indicative of a COPD diagnosis. The GOLD standard for assessment of COPD is the use of spirometry to assess for airway obstruction. (Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2016). Buttaro, Trybulski, Polgar-Bailey, and Sandberg-Cook (2017) state that additional tests should include pulse oximetry, laboratory studies of complete blood count (CBC) with differential, arterial blood gas (ABG), and alpha 1 antitrypsin, and that imaging including a chest x-ray is suggested. Within the case study, pulmonary function testing (spirometry) is completed indicating that the diagnosis of COPD was accurate. At this time, I would also have completed baseline blood work including the suggested CBC, ABG, alpha 1 antitrypsin, and imaging of chest x-ray. Though the spirometry exam is the gold standard and indicative of COPD, identifying baseline images and laboratory information will provide information when an exacerbation occurs or the disease progresses. This diagnosis may be a shock for Mr. Barley and written information will need to be provided about COPD, what changes in symptoms will mean, and the addition of maintenance medications. Studies have shown that patient education and nonpharmacologic interventions are factors which decrease the incidence of COPD emergencies. (Lloyd and Garside, 2017). It is also necessary to discuss with Mr. Barley the need to quit smoking, assessment of his readiness to quit because smoking is the primary cause of chronic lung disease. (Lloyd and Garside, 2017). Mr. Barley should also be aware that smoking cessation will also decrease his current risk of premature morbidity related to COPD related illnesses. (Petty, 2001). At this point, it is necessary to support Mr. Barley emotionally as well. Information about support groups both in person and online should be provided. Resources for additional information about COPD should be supplied as well. Education on medications including the use of metered dose inhalers (MDI)/inhaled bronchodilators and corticosteroids should also be discussed. It is important to reinforce that no medication will reverse the disease process however, these medications will reduce the severity of the symptoms felt by Mr. Barley. (Buttaro, Trybulski, Polgar-Bailey, and Sandberg-Cook, 2017). An assessment of Mr. Barley’s current knowledge on how to use MDI’s and preferred learning style is necessary to determine the type of education utilized. The use of demonstration/ return demonstration was utilized within the case study and is a measurable way to assess assimilated knowledge from teaching. It is also important to discuss with Mr. Barley when to seek medical attention in the future relating to his COPD which includes changes in breathing quality (i.e. increased dyspnea) and productive cough with changes in phlegm amount, color or thickness. (Bostock-Cox, 2017). A preventative measure that Mr. Barley can take is to be sure to stay current on his immunizations including pertussis (DTaP), influenza, and pneumococcus. Seo, Hong, Kim, Choi, Baek, Lee, Song, Lee, Cheong, and Kim (2013) indicate that the influenza vaccine does decrease the risk of COPD exacerbations requiring hospitalization by 27 %. Follow up appointments should be set up to ascertain the effectiveness of the medications and further understanding of Mr. Barley’s diagnosis, perhaps to include his wife and or daughters. Follow up appointments also yield information about depression related to changes in health status as well as an opportunity to assess for weight gain related to corticosteroid use and assessment of smoking cessation.

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Yani_Res 2025

Please respond to this classmates post with a minimum of two paragraphs, cited and app style. Two references no more than 5yrs old. Post: Urinary tract infections (UTIs) are among the most common infectious diseases occurring in either the community or healthcare setting. Uncomplicated UTIs typically occur in the healthy adult non-pregnant woman, while complicated UTIs (cUTIs) may occur in all sexes and age groups and are frequently associated with either structural or functional urinary tract abnormalities. Examples include foreign bodies such as calculi (stones), indwelling catheters or other drainage devices, obstruction, immunosuppression, renal failure, renal transplantation and pregnancy. UTI in the elderly is almost always complicated in men with prostatic hypertrophy and in post-menopausal women who may have an increased post-void residual volume. A urinary tract infection is an infection anywhere in the urinary tract. These often cause inflammation of the urethra (urethritis), bladder (cystitis), or kidneys (pyelonephritis).The symptoms depend on the area affected. Typical symptoms of a lower UTI include frequency and dysuria without fever, chills or back pain whereas upper UTI usually presents with symptoms of pyelonephritis such as loin pain, flank tenderness, fever or other signs of a systemic inflammatory response. Urinary tract infection is diagnosed by examination of a urine culture. Further investigations using intravenous urography or ultrasound scanning may be necessary. Most urinary tract infections are treated with antibiotic drugs. Increasing fluid intake and taking preparations such as potassium citrate that make the urine less acidic can relieve the symptoms. Trimethoprim/ sulfamethoxazole (Bactrim) Antibiotics—trimethoprim/ sulfamethoxazole (Bactrim) remains the first choice for community-acquired UTI in most areas. Complicated UTI is caused by a wider spectrum of organisms, and recommendations for treatment differ. Guidelines on specific antibiotic treatment and duration of treatment are available, but with increasing antibiotic resistance (including of E. coli to Trimethoprim), local microbiological advice should be taken into account when choosing antibiotic treatment. Advantages: Cheap, Well tolerated, high concentrations in vaginal and peri-urethral fluid. Possible reduced risk of emergence of resistant strains. Disadvantages: Increasing rates of resistance, adverse reactions (e.g. rash) to sulphonamide component. The efficacy of antibiotics is not fully predictable from in vitro sensitivity testing, which is probably part of the reason why trimethoprim (with or without sulphamethoxazole) remains the first-line choice in many areas, despite an upward trend in resistance rates. References: Scottish Intercollegiate Guidelines Network (2016). SIGN 88: Management of suspected bacterial urinary tract infections in adults. Dai B, et al. (2013). Long-term antibiotics for the prevention of recurrent urinary tract infection in children: a systematic review and meta-analysis. Arch Dis Child, 95, 499–508. Wagenlehner FM, Naber KG, (2016). Treatment of bacterial urinary tract infections: presence and future. Eur Urol, 49, 235–44.[CrossRef] [Web of Science] [Medline]

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NSG 6101 2025

answer in 2 paragraph to this post. APA, reference and citation need it. The existing instrument used to address my research will be a numerical scale from 1 through 7. This is a measurement tool of assigning numbers to perception in general from bad perception to good perception. In my research study we are assigning the numbers as response choices for the nurses to determine their perception of the interprofessional nursing rounds. The description of this scale is that it will be a survey and include response choices of 1 is no benefit at all through 7 which would represent extremely beneficial. In other words, the response choices would be 1,2,3,4,5,6 or 7 with a choice to circle one number in each question. Descriptive statistical analysis using an excel spreadsheet with numbers and calculating percentages will be used to generate the data. According to our text this is an example of indirect measurement. This type of technique would be an example of an ordinal level of measurement since it constitutes a ranking system (Gray, Grove & Sutherland, 2017). My study will be formulated from the quantitative literature review titled, Intensive care nurses’ perceptions of inter specialty trauma nursing rounds to improve trauma patient care – A quality improvement project. The study used a survey technique that was handed out by an independent person in order not to draw bias and was an anonymous form. The evaluation was conducted with questions regarding nurses’ perception of the interprofessional rounds ranging with a response from one to seven (Jennings & Mitchell, 2017) . This study will provide the framework for my survey questions and data collection. References Gray, J., Grove, S. & Sutherland, S. (2017). Burns & Grove’s the Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence (8th ed.). St. Louis, MO: Elsevier. Jennings, F. & Mitchell, M. (2017). Intensive care nurses’ perceptions of inter specialty trauma nursing rounds to improve trauma patient care-A quality improvement project. Intensive and Critical Care Nursing, 40, 35-43. doi: http://dx.doi.org/10.1016/j.iccn.2017.01.002

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Please Do A Comment Base In These Comment. Write At Least 130 Words. Academic References Need. Write The References.In Each Comment Please Not Together. References Less Than 5 Years. Please Read Carefully The Comments 2025

Comment 1 The social determinants of health refer to the social and economic conditions that determine an individual’s health and medical well-being. Economic and social conditions are variedly distributed amongst people and they affect people’s working and living conditions differently. The social determinants of health affect an individual working and living conditions. Social determinants are informed by public policies that mirror the political ideologies of the people in authority. Economic conditions determine the social conditions of a community. People who live in affluent areas are more content with their lives and they are mentally and physically healthier than people who are not content with their social status. Poor people generally are less healthy and have shorter life expectancies as compared to rich people. This differences in health are social injustices and they illuminate powerful health determinants in the modern world. The differences have allowed an increased understanding of how remarkably sensitive health issues are in the social environment. Social determinants contribute to the development of diseases in that poor people are generally more exposed to pathogens than the rich. They eat and drink contaminated food and water, the share amenities and they have no easy access to medical attention. According to the epidemiologic triad model, the repeated interaction of a disease-causing agent on their host in a conducive environment results in the spread of infectious diseases (CDC, 2014). The pathogen leaves its host and enters another potential host through a relevant portal. The pathogen thrives and multiplies in its habitat in what is referred to as a chain of infection (WHO, 2014). Understanding the various transmission channels and exit portals enable a care provider to know the best cause of prevention and treatment. Control measures are typically employed in the section of the infection chain that allows easy intervention. For instance, in the treatment of a bacterial respiratory infection, a nurse can administer antibiotics to a patient. A nurse can also wear protective gear such as masks and gloves to protect them from getting infections by touching infected bodily fluids. Comment 2 The global health issue which I have chosen and has affected the international health community is Zika Virus. It is a virus, which is spread by mosquito popularly known as Aedes species of mosquito. The said species of mosquito can bite both during the day and night. An issue of concern about Zika virus is pregnancy. The virus can pass through placenta thereby leading to birth defects. Zika virus can also be spread through sexual intercourse or sexual acts (Salazar, 2016). Unfortunately, Zika virus does not have a vaccine. Some of the symptoms of Zika virus include headache, fever, joint pain, rash, muscle pain and red eyes. According to CDC, Zika virus symptoms can last for days or weeks. Death and hospitalization after Zika infection are very rare. After one is infected with Zika virus, immunity is built against infections in the future ((U.S.), 2018). Mosquitos, which spread Zika virus, can also spread chikungunya virus and dengue virus. In the US, Zika infections have been reported in Florida and Texas states. On a global level, Zika infections have been reported in each continent except Europe and Antarctica. CDC already issued travel notices for regions including Asian nations of Singapore and Maldives, African countries of Guinea-Bissau and Angola, regions in Central America, Caribbean and Mexican regions such as Costa Rica, Belize, Guatemala, El Salvador, Nicaragua, Honduras and Panama. The CDC also reported other regions affected though it did not issue travel notices especially in Asia and Africa ((U.S.), 2018). Health care delivery systems all over the world need to work together to address Zika virus especially by creating awareness and providing education on prevention of transmission to areas of risks. As said earlier, there is no vaccine for Zika Virus and they key here is the prevention of mosquito bites (Salazar, 2016). Travellers who are outside their home countries should be made aware of higher risk regions. There is also need for safe sex practices to prevent Zika infections. CDC suggests the use of both male and female condoms to reduce Zika transmission through sexual acts.

Nursing Assignment Help 2025