2023 Opioid use during pregnancy comes with many risks to the mother and fetus In utero there

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Nursing 2023 reply hollie db prenatal

Opioid use during pregnancy comes with many risks to the mother and fetus In utero there 2023 Assignment

Opioid use during pregnancy comes with many risks to the mother and fetus. In utero, there is a risk of preeclampsia, premature labor and rupture of membranes, placental insufficiency, abruptio placentae, intrauterine growth retardation, and intrauterine death (Ross, Graham, Money, & Stanwood, 2014). While in utero, opioids can also cross the placenta and lead to abnormal growth and development, birth defects, and opioid uptake (Yazdy, Desai, & Brogly, 2015). Neonatal abstinence syndrome (NAS) is a condition in which opioid exposed infants experience drug withdrawal symptoms shortly after birth (Krans & Patrick, 2016).

NAS is characterized by central nervous system hyperirritability, autonomic nervous system dysfunction, and gastrointestinal disturbances (Stover & Davis, 2015). Observed symptoms may include: irritability, excessive crying, poor sleep, increased muscle tone, tremors, hyperthermia, loose stools, excessive movements, yawning, sweating, sneezing, and nasal stuffiness (Stover & Davis, 2015). Some infants may also experience seizures (Stover & Davis, 2015). Neonates with NAS typically require prolonged hospitalization and pharmacotherapy with morphine or methadone (Yazdy et al., 2015).

In this scenario, it is also going to be important for the mother to get clean. Opioid withdrawal is not recommended during pregnancy, however, medication assisted treatment can be started while pregnant (Krans & Patrick, 2016). Mental health assessments and counseling will also be important for this mother. For women that are undergoing medication assisted treatment with methadone or buprenorphine, the AAP and ACOG both encourage breastfeeding (Stover & Davis, 2015). In these cases, breastfeeding is associated with a decrease in the incidence and severity of NAS (Stover & Davis, 2015).  

The long-term consequences of opioid exposure in utero and NAS have been difficult to determine (Stover & Davis, 2015). This is due to small study sizes and issues differentiating the effects of in utero exposures versus postnatal treatments versus environmental influences (Stover & Davis, 2015). Although, studies have found that in general, children with opioid exposures are more likely to have psychiatric issues, attention deficit disorders, and disruptive behaviors (Stover & Davis, 2015). Other effects may also include smaller brains, a thinner cortex, and reduced cognitive abilities (Stover & Davis, 2015).

References

Krans, E. E., & Patrick, S. W. (2016). Opioid use disorder in pregnancy: Health policy and practice in the midst of an epidemic. Obstetrics and Gynecology, 128(1), 4-10. https://dx.doi.org/10.1097%2FAOG.0000000000001446

Ross, E. J., Graham, D. L., Money, K. M., & Stanwood, G. D. (2014). Developmental consequences of fetal exposure to drugs: What we know and what we still must learn. Official Publication of the American College of Neuropsychopharmacology, 40(1), 61-87. https://dx.doi.org/10.1038%2Fnpp.2014.147

Stover, M. W., & Davis, J. M. (2015). Opioids in pregnancy and neonatal abstinence syndrome. Seminars in Perinatology, 39(7), 561-565. https://dx.doi.org/10.1053%2Fj.semperi.2015.08.013

Yazdy, M. M., Desai, R. J., & Brogly, S. B. (2015). Prescription opioids in pregnancy and birth outcomes: A review of the literature. Journal of Pediatric Genetics, 4(2), 56-70. https://dx.doi.org/10.1055%2Fs-0035-1556740

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2023 Need responses to my peers done in 12 hours Please respond to my classmates

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Nursing 2023 Nursing post responses, NEED in 12 hours.

Need responses to my peers done in 12 hours Please respond to my classmates 2023 Assignment

Need responses to my peers done in 12 hours. Please respond to my classmates post as if it were me. 

Requirements:

Min of 150 words per post response— EACH  

1 Scholarly source ( no older than 5 years)—EACH

APA format

POST 1 

Diabetic Ketoacidosis (DKA) is a very serious and common complication of type 1 diabetes, but can also occur in individuals with type 2 diabetes. According to Misra and Oliver (2015) DKA has a mortality rate of 3-5%, and 6% of DKA cases are the initial presentation of diabetes in an individual.

DKA most often occurs due to an illness, such as an infection, “when there is an absolute or relative deficiency of insulin and an increase in the levels of insulin counterregulatory hormones” (McCance et al., 2013, p. 744). The increase of these hormones, along with the deficiency of insulin, cause the body to go into a state in which there is “decreased glucose uptake, increased fat mobilization with release of fatty acids, and accelerated gluconeogenesis and ketogenesis” (McCance et al., p. 744). Additionally, increased ketone concentrations are caused, which then causes a loss of bicarbonate, and leads to the development of a metabolic acidosis.

Hallmark signs of DKA include polyuria, polydipsia, lethargy, nausea, vomiting, altered mental status, Kussmaul respirations, and sweet-smelling (acetone) breath.

In the case of Ms. Blake, the following are all abnormal lab results: Sodium 156; Chloride 115; ABG pH 7.30, PO2 70 and HCO3 20. The ABG values show a metabolic acidosis as well as a low blood oxygen saturation. The sodium may be elevated in this case due to severe dehydration, which can also cause other dangerous electrolyte abnormalities.

For patients with all types of diabetes, it is important to ensure that they understand the many complications that are associated with their diagnosis. For Ms. Blake, it is important to ensure that she understands the severity of her DKA diagnosis, and how it may have been prevented. Education should also be reinforced in regard to the home monitoring of glucose and ketone levels. Additionally, it is important to find out if she has family or friends that are available to check in with her frequently, especially when she if feeling unwell, so that she can be seen by a physician sooner rather than later.

POST 2

Week five case study involves a three-month-old infant diagnosed with pyloric stenosis. The etiology behind pyloric stenosis is unknown at this time but it is thought to have a connection to genetics and environmental factors.  The pathophysiology behind pyloric stenosis involved a thickening of antropyloric portion of the stomach which the lumen has edematous mucosa which cause an obstruction (Hernanz-Schulman, 2018). The hyperplasia and hypertrophy of the muscle literally blocks of the pylorus which inhibits the passage of food to be digested.  The gastric outlet obstruction then causes food to not be able to pass and thus leads to forcefully vomiting.  This typically occurs in infants three to five weeks old (Hernanz-Schulman, 2018).  The classic signs that are hallmark include vomiting, persistent hunger, changes in bowel movements, dehydration, and decreased weight (Hernanz-Schulman, 2018). This case study described that the infant was having frequent episodes of vomiting after eating, swollen belly, fussiness due to being hungry, and decreased weight because the body was not being able absorb any food because it was being blocked from small intestine. 

                Complications from pyloric stenosis include failure to grow, jaundice due to bilirubin buildup, stomach irritation and dehydration (Hernanz-Schulman, 2018).  On assessment a provider may be able to palpate and fill an olive like lump that indicates an enlarge pylorus. They may order follow up ultrasound testing as well. The only treatment for pyloric stenosis is surgical intervention. The surgical intervention known as pyloromyotomy will help open up the pylorus enable food to be able to pass through. Post pyloromyotomy the patient will be able to have gastric emptying which will allow for proper digestion. It would be important to teach the parents on what exactly is happening with the anatomy of the child and why they are presenting with these signs and symptoms. The provider will need to educate them that they will need to immediately see a gastroenterologist or pediatrician for immediate surgery to fix this problem. It is important to let them know these procedures can be done laparoscopic ally and is minimally invasive through the naval.  Once the procedure is completed the provider should let the family know they may still have some vomiting post opt and will be able to eat normally within twenty-four hours. Additionally, it is important to educate them on fluids post opt.  The main thing to stress to these parents is how essential surgical intervention is so the child can eat, grow, and absorb nutrient adequately.

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2023 1 What is the impact to the nursing profession and to the public related to the projected nursing shortage

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Nursing 2023 DQs

1 What is the impact to the nursing profession and to the public related to the projected nursing shortage 2023 Assignment

#1:

 

What is the impact to the nursing profession and to the public related to the projected nursing shortage? Discuss at least one way that the nursing profession is working toward a resolution of this problem.

#2: What is the role of health care reform in shifting the focus from a disease-oriented health care system toward one of wellness and prevention, and how does nursing fit into this shift? 

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2023 Instructions Pick one 1 of the following topics Then address the corresponding questions prompts for your selected topic Use

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Nursing 2023 Week 7 Case Study

Instructions Pick one 1 of the following topics Then address the corresponding questions prompts for your selected topic Use 2023 Assignment

 Instructions
Pick one (1) of the following topics. Then, address the corresponding questions/prompts for your selected topic. Use at least one (1) documented example of the corresponding primary source in your writing.

Option 1: McCarthyism and Anti-Communist Campaigns
The Cold War brought about an irrational fear of communism and communist activities in the United States. As we are learning this week, one of the most vocal instigators of this paranoia was Senator Joseph McCarthy. McCarthy delivered a speech about the imminent threat of communism on February 9, 1950. Perform a search on the internet and locate and read Joseph McCarthy’s speech given in Wheeling, West Virginia on February 9, 1950. Copy and paste the following keywords into your Google search bar: “Joseph McCarthy, Wheeling, West Virginia.” The speech is also referred to as “Enemies from Within.”

Construct the case study by responding to the following prompts:

  • Explain how Senator Joseph McCarthy defined communist nations within the speech. What specific threats did these nations pose?
  • Assess if Senator Joseph McCarthy charges were accurate.
  • Analyze anti-communist sentiments during the Cold War era, were these sentiments valid. If so, how? If not, why not?
  • Explain if there are other examples of events similar to the Red Scare that have occurred throughout history and modern day.
  • Examine what happened to people who invoked the Fifth Amendment, refused to appear or were found in violation of the law as defined by the Congressional Committee.

Option 2: The Civil Rights Movement
Using the Internet, locate and read Martin Luther King Jr’s “I Have a Dream” speech given in Washington D.C., August 1963. Copy and paste the following keywords into your Google search bar: “I Have a Dream by Martin Luther King, Jr.” Feel free also to locate and incorporate additional scholarly sources to respond to this case study, including information on the Civil Rights Movement.

Construct the case study by responding to the following prompts:

  • Explain if the Civil Rights Movement of the 1960s effectively changed the nation.
  • What effect would the Civil Rights Acts have across the continent on minority groups?
  • Do you think that the tactics and strategies that civil rights activists used in the 1960s would apply to today’s racial and ethnic conflicts? Why or why not?
  • Do the ideas of the 1960s still have relevance today? If so how? If not, why not?
  • Analyze how the Civil Rights Movement would impact diversity in America today.

Option 3: American Domestic and Foreign Policies (1953-1991)
Complete a search either in the Chamberlain Library or internet for domestic and foreign polices of four (4) of the following Presidents. Please incorporate at least one primary source of either a policy or act that you have chosen to write about.

  • Eisenhower
  • Kennedy
  • Johnson
  • Nixon
  • Ford
  • Carter
  • Reagan

Then, compare domestic and foreign polices of your four (4) presidents by answering the following prompts:

  • Explain how your selected presidents worked to improve the United States economically and socially. Give at least one example of each president.
  • Assess if the policies of your choice of presidents strengthen or weaken the United States.
  • Explain how you see your choice of presidents served the public interest and further the cause of democracy.
  • Determine if it is constitutional for the United States to fight preemptive wars.
  • Determine if human rights and morality should be the cornerstones of United State foreign policy.

Writing Requirements (APA format)

  • Length: 4-5 pages (not including title page and references page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page
  • In-text citations that correspond with your end reference

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2023 SOAP NOTE SAMPLE FORMAT FOR MRC Name LP Date Time 1315 Age 30 Sex F SUBJECTIVE CC

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Nursing 2023 Soap Hypertension and Depressive Disorder

SOAP NOTE SAMPLE FORMAT FOR MRC Name LP Date Time 1315 Age 30 Sex F SUBJECTIVE CC 2023 Assignment

  

SOAP NOTE SAMPLE FORMAT FOR MRC

  

Name:  LP

Date: 

Time: 1315

 

Age: 30

Sex: F

 

SUBJECTIVE

 

CC:  

“I am having vaginal itching and pain in   my lower abdomen.”

 

HPI:  

Pt is a   30y/o AA female, who is a new patient that has recently moved to Miami. She seeks treatment today after   unsuccessful self-treatment of vaginal itching, burning upon urination, and   lower abdominal pain. She is concerned   for the presence of a vaginal or bladder infection, or an STD. Pt denies fever. She reports the itching and burning with   urination has been present for 3 weeks, and the abdominal pain has been   intermittent since months ago. Pt has   tried OTC products for the itching, including Monistat and Vagisil. She denies any other urinary symptoms,   including urgency or frequency. She   describes the abdominal pain as either sharp or dull. The pain level goes as high as 8 out of 10   at times. 200mg of PO Advil PRN   reduces the pain to a 7/10. Pt denies   any aggravating factors for the pain. Pt reports that she did start her menstrual cycle this morning, but   denies any other discharge other that light bleeding beginning today. Pt denies douching or the use of any   vaginal irritants. She reports that   she is in a stable sexual relationship, and denies any new sexual partners in   the last 90 days. She denies any   recent or historic known exposure to STDs. She reports the use of condoms with every coital experience, as well   as this being her only form of contraceptive. She reports normal monthly menstrual cycles that last 3-4 days. She reports dysmenorrhea, which she also   takes Advil for. She reports her last   PAP smear was in 7/2016, was normal, and reports never having an abnormal PAP   smear result. Pt denies any hx of   pregnancies. Other medical hx includes   GERD. She reports that she has an Rx   for Protonix, but she does not take it every day. Her family hx includes the presence of DM   and HTN. 

 

Current Medications: 

Protonix   40mg PO Daily for GERD

MTV OTC   PO Daily

Advil   200mg OTC PO PRN for pain

 

PMHx:

Allergies:  

NKA & NKDA

Medication Intolerances: 

Denies

Chronic Illnesses/Major traumas

GERD

Hospitalizations/Surgeries

Denies

 

Family History

Father-   DM & HTN; Mother- HTN; Older sister- DM & HTN; Maternal and paternal   grandparents without known medical issues; 1 brother and 3 other sisters   without known medical issues; No children.

 

Social History

Lives   alone. Currently in a stable sexual   relationship with one man. Works for   DEFACS. Reports occasional alcohol   use, but denies tobacco or illicit drug use.

 

ROS

 

General 

Denies   weight change, fatigue, fever, night sweats

Cardiovascular

Denies   chest pain and edema. Reports rare palpitations that are relieved by drinking   water

 

Skin

Denies   any wounds, rashes, bruising, bleeding or skin discolorations, any changes in   lesions

Respiratory

Denies   cough. Reports dyspnea that accompanies the rare palpitations and is also   relieved by drinking water

 

Eyes

Denies corrective   lenses, blurring, visual changes of any kind

Gastrointestinal

Abdominal   pain (see HPI) and Hx of GERD. Denies   N/V/D, constipation, appetite changes

 

Ears

Denies   Ear pain, hearing loss, ringing in ears

Genitourinary/Gynecological

Reports   burning with urination, but denies frequency or urgency. Contraceptive and STD prevention includes   condoms with every coital event. Current stable sexual relationship with one man. Denies known historic or recent STD   exposure. Last PAP was 7/2016 and normal. Regular monthly menstrual cycle   lasting 3-4 days. 

 

Nose/Mouth/Throat

Denies   sinus problems, dysphagia, nose bleeds or discharge

Musculoskeletal

Denies   back pain, joint swelling, stiffness or pain

 

Breast

Denies   SBE

Neurological

Denies   syncope, seizures, paralysis, weakness

 

Heme/Lymph/Endo

Denies   bruising, night sweats, swollen glands

Psychiatric

Denies   depression, anxiety, sleeping difficulties

 

OBJECTIVE

 

Weight   140lb 

Temp -97.7

BP 123/82

 

Height 5’4”

Pulse 74

Respiration 18

 

General Appearance

Healthy   appearing adult female in no acute distress. Alert and oriented; answers   questions appropriately. 

 

Skin

Skin is   normal color for ethnicity, warm, dry, clean and intact. No rashes or lesions   noted.

 

HEENT

Head is   norm cephalic, hair evenly distributed. Neck: Supple. Full ROM. Teeth are in   good repair.

 

Cardiovascular

S1, S2   with regular rate and rhythm. No extra heart sounds. 

 

Respiratory

Symmetric   chest walls. Respirations regular and easy; lungs clear to auscultation   bilaterally.

 

Gastrointestinal

Abdomen   flat; BS active in all 4 quadrants. Abdomen soft, suprapubic   tender. No hepatosplenomegaly.  

    

Genitourinary

Suprapubic   tenderness noted. Skin color normal   for ethnicity. Irritation noted at   labia majora, minora, and perineum. No ulcerated lesions noted. Lymph nodes   not palpable. Vagina pink and moist   without lesions. Discharge minimal,   thick, dark red, no odor. Cervix pink   without lesions. No CMT. Uterus normal size, shape, and consistency.  

 

Musculoskeletal

Full   ROM seen in all 4 extremities as patient moved about the exam room.

 

Neurological 

Speech   clear. Good tone. Posture erect. Balance stable; gait normal.

 

Psychiatric

Alert   and oriented. Dressed in clean clothes. Maintains eye contact. Answers   questions appropriately.

 

Lab Tests

Urinalysis   – blood noted (pt. on menstrual period), but results negative for infection

Urine   culture testing unavailable

Wet   prep – inconclusive 

STD   testing pending for gonorrhea, chlamydia, syphilis, HIV, HSV 1 & 2, Hep B   & C 

 

Special Tests- No ordered at this   time.

 

Diagnosis 

 

Differential Diagnoses

  • 1-Bacterial Vaginosis (N76.0)
  • 2- Malignant neoplasm of female genital organ,         unspecified. (C57.9)
  • 3-Gonococcal infection, unspecified. (A54.9)

Diagnosis

o Urinary   tract infection, site not specified. (N39.0) Candidiasis of vulva and vagina.   (B37.3) secondary to presenting symptoms (Colgan & Williams, 2011) &   (Hainer & Gibson, 2011). 

 

Plan/Therapeutics

 

  • Plan:  
    • Medication – 

§ Terconazole cream 1 vaginal application QHS for 7 days for   Vulvovaginal Candidiasis; 

§ Sulfamethoxazole/TMP DS 1 tablet PO twice daily for 3 days   for UTI (Woo & Wynne, 2012)

  • Education – 

§ Medications prescribed. 

§ UTI and Candidiasis symptoms, causes, risks, treatment,   prevention. Reasons to seek emergent care, including N/V, fever, or back   pain. 

§ STD risks and preventions. 

§ Ulcer prevention, including taking Protonix as prescribed,   not exceeding the recommended dose limit of NSAIDs, and not taking NSAIDs on   an empty stomach. 

  • Follow-up         – 

§ Pt will be contacted with results of STD studies. 

§ Return to clinic when finished the period for perform   pap-smear or if symptoms do not resolve with prescribed TX.

            

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2023 I think the one issue I have struggled with regarding obesity is the nutritional aspect Healthy foods that

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Nursing 2023 post-instr

I think the one issue I have struggled with regarding obesity is the nutritional aspect Healthy foods that 2023 Assignment

I think the one issue I have struggled with regarding obesity is the nutritional aspect!  Healthy foods that could foster weight loss may or may not be available for these individuals and if they are available, they may be very expensive.  What strategies do you feel we can use to combat this issue?

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We give our students 100% satisfaction with their assignments, which is one of the most important reasons students prefer us to other helpers. Our professional group and planners have more than ten years of rich experience. The only reason is that we have successfully helped more than 100000 students with their assignments on our inception days. Our expert group has more than 2200 professionals in different topics, and that is not all; we get more than 300 jobs every day more than 90% of the assignment get the conversion for payment.

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2023 After reading the Brittany Maynard case create an original post that compares your professional and personal

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Nursing 2023 Discussion: Brittany Maynard Case

After reading the Brittany Maynard case create an original post that compares your professional and personal 2023 Assignment

 

After reading the Brittany Maynard case, create an original post that compares your professional and personal positions on the case. What are the code of ethics, professional regulations, and policies that support your professional position? Explain how to work through ideas when your professional and personal positions come into conflict.

In your responses to at least two peers, suggest codes of ethics, professional regulations, or policies that contradict the position proposed in their post.

Brittany Manyard Case Link

 https://time.com/3678199/brittany-maynard-death-with-dignity-legislation-california/ 

 This video contains a news story about 29-year-old Brittany Maynard and physician-assisted suicide. 

 https://www.youtube.com/watch?v=KcuRh-zQB6o 

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2023 Can you assist with the following questions 1 Define genetics and genomics What are the main differences between

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Nursing 2023 3 pages due Tuesday

Can you assist with the following questions 1 Define genetics and genomics What are the main differences between 2023 Assignment

 

Can you assist with the following questions?

1. Define genetics and genomics. What are the main differences between genetics and genomics? Provide examples-200 wrds

Your response must be at least 200 words in length.

2. Describe how genomics has shaped the dissemination of public health intervention in the community.

Your response must be at least 200 words in length.

3.Provide a brief history of genetics in public health.

Your response must be at least 200 words in length

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2023 Psychiatric Care and Mental Health in the Community Review the attached Power Point presentation Once done answer the

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Nursing 2023 community 14

Psychiatric Care and Mental Health in the Community Review the attached Power Point presentation Once done answer the 2023 Assignment

Psychiatric Care and Mental Health in the Community

Review the attached Power Point presentation.  Once done answer the following questions;

1.  What challenges have you encountered in working with patients with mental health issues? How do you feel these challenges will be different in a community health setting?  Would it be easier or more difficult and why?

2.  Discuss scenarios in which the community health nurses might encounter ethical issues related to mental health.  Give some examples and explain.

As stated in the syllabus present your assignment in an APA format, word document, Arial 12 font attached to the forum in the discussion tab of the discussion board title “week 14 discussion questions”.  You must used at least 2 evidence based references no older than 5 years besides the class textbook.  A minimum of 500 excluding the first and references page are required.

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2023 Well Said I like the part about speaking up if you see someone not washing their hands It

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Nursing 2023 DQ1WK2 ans Danielle

Well Said I like the part about speaking up if you see someone not washing their hands It 2023 Assignment

 

Well Said. I like the part about speaking up if you see someone not washing their hands. It happens too often and to be honest the majority of the time its the doctors who are guilty. Just last week I saw a Doc coming out of an isolation room and he did not wash his hand. Even worse he’s an infectious disease MD. not only did I say something to him but I also notified my nurse manager as I felt like that kind of behaviour is unacceptable.

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We give our students 100% satisfaction with their assignments, which is one of the most important reasons students prefer us to other helpers. Our professional group and planners have more than ten years of rich experience. The only reason is that we have successfully helped more than 100000 students with their assignments on our inception days. Our expert group has more than 2200 professionals in different topics, and that is not all; we get more than 300 jobs every day more than 90% of the assignment get the conversion for payment.

PLACE ORDER NOW