1. Read and familiarize yourself with all the manual therapy resources in Lesson 3 (Web links, Videos, Journal Articles, etc.)
2. Use the Internet to further explore manual therapy, and answer the following questions:
    
   1. Identify the actions you can take to safe-guard a patient’s right to manual therapy.
   2. Describe the role of educators, counselors, advocates, and change agents in manual therapy.
   3. List several cases of EBP (evidence-based practice) that support the use of manual therapy.
3. Your paper should be 4-6 pages, including: 
   • title page
   • reference page according to APA Writing Style 
   • spacing and margin settings (APA Style)

 

VINDICATES is a popular mnemonic device used to help determine all the possible diagnoses for any particular symptom. Select a symptom(Hyperglycemia) not used by another learner and create a list of at least one diagnoses per area. Include a question or test you can use to quickly rule in or rule out that diagnosis on your patient.

Vascular

Infection

Neoplasm

Drugs

Inflammatory/Idiopathic

Congenital

Autoimmune

Trauma

Endocrine/Metabolic

Social/Psych

 

Mrs. Thomas is a 54, year old African American widow, mother and grandmother, who lives with her daughter and four grandchildren (ages 12, 10, 7 and 5) in a 4 story walk up apartment. She is an active member of her church community and friends, comments that she had so much energy that she exhausted all of them just being around her. At age 51, she was diagnosed with non-Hodgkin’s lymphoma. Busy with raising her grandchildren, a little more than 3 years went by before she sought attention for her symptoms and was diagnosed. Despite aggressive treatments with chemotherapy and radiation, her diseased progressed and she was considering undergoing a bone marrow transplant. Climbing the stairs to the apartment one afternoon she became very short of breath and collapsed. Her twelve, year old granddaughter called 911. At the hospital she was minimally responsive and in severe respiratory distress. She was intubated and transferred to the ICU. A family meeting with the oncology and ICU team was called to discuss Mrs. Thomas’s advanced condition, the fact that she would probably not survive further treatment for the lymphoma and to develop a plan of care. Fifteen family members arrived, including her daughter, pre-teen granddaughters and grandson, three nieces, four nephews, several friends from her church and the minister. On being asked that only the immediate family participate in the meeting, the family and friends became angry and insisted that all of them be involved in this discussion.

1. The students should focus their thoughts on the dynamics of this family meeting. If you were the nurse in this situation, how would you address meeting? Here are some questions that may help your thinking. What is your impression regarding this scenario? What are some concerns you have with this case? What do you anticipate would happen? How would you handle all the family members and friends wanting to be included in the discussion? There is not right or wrong answer. But remember you need a professional journal to support the discussion. 

2. Now think about you being the patient. How would the situation be handle within your family? Have you thought about what kind of care you would want? Does someone know what you would want if you had a catastrophic event? Would family members support the decision maker’s decision for for you? 

Topic: Effect of Cholesterol in the Human Body 

 1. Based on the information collected in the Research Method, formulate the Results section of your selected topic. Do not forget that your Results section needs to provide a visual (table, graphic, figure, etc.) and a narrative paragraph that helps your reader understand the information presented in the visual. Please do not interpret the results!2. Post your Results.Attached is the research method I wrote and also the class notes for the results.  

Research method:

Effect of Cholesterol in the Human Body 

 For this study, a meta-analysis method was used to synthesize different results found among several studies. The researcher accessed the virtual library through the MRU home page. Then, the researcher accessed the EBSCOhost databases. Once there, the researcher selected both MEDLINE Complete and CINAHL Complete. An advanced search was performed, for which the following keywords were entered in the Boolean search: “Cholesterol”, “human body”, and “affects.” The search was limited to references providing full text, peer reviewed, and abstract available. A limitation was set for research published within the last five years, from 2016 to 2021. Additionally, researcher consulted only articles published in English. The search provided access to a total of 29,454 articles, of which only five (5) studies were selected based on their relevance with the topic; the other 29,449 were discarded. 

 

Literature Review/ Effect of Cholesterol in the Human Body

According to study done by (Jeong.et.al 2018), it was discovered that increased cholesterol levels were associated with high risk of contracting cardiovascular diseases (CVD) in young adults. Furthermore, it was discovered that young adults with decreased cholesterol levels had a reduced risk of contracting CVD. From this research study, there is a direct correlation between cholesterol levels and incidences of CVDs. The main inconsistency with this study is that it was mainly focused on young adults, thus excluding the older people who are the ones that are adversely affected by this disease. (Sonoda.et.al 2018) used the Friedewald equation as the standard method to evaluate the low-density lipoprotein cholesterol (LDL-C) levels. A constant value, five, was used although the study to come up with the ratios. The problem with this study was that the LDL-C levels obtained from Friedewald were not accurate. It was proposed that the researchers should use the novel method for LDL-C estimation as it gave more accurate results compared to Friedewald theory. There was no direct connection between the lipoprotein cholesterol levels and incidences of CVDs amongst the patients.

            A more dynamic approach was used by (Soran.et.al 2018) which involved the administering cholesterol lowering medication on its patients. A sample size of 100 was used for patients who had undergone 10 years treatment on the cholesterol lowering drugs. It was discovered that patients with reduced cholesterol level concentration were less likely to contract CVDs. The major problem arising from this study is that the patients had to undergo treatment for a period of not less than 10 years before being considered as suitable candidates for this study. Research done by (Wahid.et.al 2016) revealed that general body wellness is associated with the shift from inactivity to small amounts of activity. This conclusion provides a direct correlation between physical fitness and incidences of CVDs. It was discovered that people who engaged in physical activity were less likely to contract CVDs while those that were inactive were at a high risk of contracting CVDs. This research finding is perhaps the most accurate because a large sample size of 3439874 participants in 179393 events over a period of 12.3 years was used. It was concluded that a shift from being inactive to engaging in physical activity levels of about 150 minutes of moderate-intensity aerobic session per week was associated with reduced CVD mortality by 23% and a decrease in CVDs incidences by 17%.

            Study done by (Estruch.et.al 2018) revealed that CVD risk can be reduced by taking Mediterranean diet supplemented with extra-virgin oil or nuts opposed to taking a reduced-fat diet. This came as a shocker to many people who followed the popular belief that taking foods with the least amount of fats would prevent them from contracting CVDs. Of all the dietary measures used in this study, the Mediterranean diet proved to be the most effective in lowering attack by CVDs.

References. 

Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M. I., Corella, D., Arós, F., … & Martínez-González, M. A. (2018). Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. New England journal of medicine, 378(25), e34. 

Jeong, S. M., Choi, S., Kim, K., Kim, S. M., Lee, G., Park, S. Y., … & Park, S. M. (2018). Effect of change in total cholesterol levels on cardiovascular disease among young adults. Journal of the American Heart Association, 7(12), e008819. 

Sonoda, T., Takumi, T., Miyata, M., Kanda, D., Kosedo, I., Yoshino, S., & Ohishi, M. (2018). Validity of a novel method for estimating low-density lipoprotein cholesterol levels in cardiovascular disease patients treated with statins. Journal of atherosclerosis and thrombosis, 44396. 

Soran, H., Adam, S., & Durrington, P. N. (2018). Optimizing treatment of hyperlipidemia: Quantitative evaluation of UK, USA and European guidelines taking account of both LDL cholesterol levels and cardiovascular disease risk. Atherosclerosis, 278, 135-142. 

Wahid, A., Manek, N., Nichols, M., Kelly, P., Foster, C., Webster, P., … & Scarborough, P. (2016). Quantifying the association between physical activity and cardiovascular disease and diabetes: a systematic review and meta‐analysis. Journal of the American Heart Association, 5(9), e002495.

Research Method for Effect of Cholesterol in the Human Body

For this study, a meta-analysis method was used to synthesize different results found among several studies. The researcher accessed the virtual library through the MRU home page. Then, the researcher accessed the EBSCOhost databases. Once there, the researcher selected both MEDLINE Complete and CINAHL Complete. An advanced search was performed, for which the following keywords were entered in the Boolean search: “Cholesterol”, “human body”, and “affects.” The search was limited to references providing full text, peer reviewed, and abstract available. A limitation was set for research published within the last five years, from 2016 to 2021. Additionally, researcher consulted only articles published in English. The search provided access to a total of 29,454 articles, of which only five (5) studies were selected based on their relevance with the topic; the other 29,449 were discarded. 

• Determine your states practice environment color – green, yellow, or red.
• Discuss how your states is an independent practice or practice restricted state.
• Describe the prescriptive authority for your state.
• (For California Students) Review the CA Standardize Procedures requirement of NPs and discussion the meaning of Standardize Procedures (California BRN – Standardized Procedures Guideline) .
• (For States other than California Students) Identify one (1) barrier to practice and a strategy to address the removal of the identified barrier.
• Review the American Association for Nurse Practitioners ‘State Practice Environment’ Map and determine your states color – green, yellow, or red.
  Review a second time the Nurse Practice Act in your State for Advanced Practice to assist you in answering the questions in the discussion.
  Due: 3/12/21
• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA from within the last 5 years