HOMEWORK :

The overall goal of the Session Long Project is to examine health care delivery in the United States from a strategic perspective.

The Patient Protection and Affordable Care Act, or in short Affordable Care Act, changed the landscape of the health care industry. For this assignment, read the article “Information asymmetries and risk management in healthcare markets: The U.S. Affordable Care Act (ACA) in retrospect” by Mendoza, and write a paper to respond to the following questions:

1. Discuss the “moral theory” contained in this article.

2. Explain whether you agree or disagree with the author that the ACA was an answer to health care accessibility.

3. Explain whether you believe or do not believe that ACA will improve patient care.

4. Discuss what you think President Trump should do with the ACA.

5. Discuss what strategies you would recommend to deal with economic realities of health care based on your own research.

Length: Submit a 3-page paper, not including the cover page and the reference list.

Minimum of 250 words with at least 2 peer review reference in apa 6th edition style

History: A 35 year old nurse complained of nervousness, mood swings, weakness, and palpitations with exertion for the past 6 months. Recently, she noticed excessive sweating and wanted to sleep with fewer blankets than her husband. She used oral contraceptives and her menstrual periods were regular.

Physical examination: Pulse was 92/minute and BP was 130/60. She appeared anxious, with a smooth, warm, and moist skin, a fine tremor, a bounding cardiac apical impulse, and she couldn’t rise from a deep knee bend without aid. Her thyroid was diffusely enlarged, soft, mobile, without nodularity and there was no lymphadenopathy. Her eyes were not prominent (proptotic) and she had no focal skin thickening.

Laboratory studies: Serum T4=15.6 ug/dl and serum T3=210 ng/dl.

1. What is the level of thyroid function in this patient? Are additional diagnostic tests necessary to define the level of thyroid function and if so which one(s)?
2. What is the most likely cause of this patient’s illness? What tests are necessary to confirm its cause? Are antithyroid antibodies helpful?
3. What are the treatment options?

• While many companies are hiring chief compliance or chief ethical officers, other companies are lumping ethical concerns under the umbrella of the chief financial officer, because the Sarbanes-Oxley Act requires the CFO to abide by a set of ethical standards. 

1. Do you believe that the CFO is the right person to protect a company’s ethical standards? 
2. Why or why not? 
3. Who else in a company would be better positioned to protect its ethical standards? 

In recent years, hormone replacement therapy has become a controversial issue. When prescribing therapies, advanced practice nurses must weigh the strengths and limitations of the prescribed supplemental hormones. If advanced practice nurses determine that the limitations outweigh the strengths, then they might suggest alternative treatment options such as herbs or other natural remedies, changes in diet, and increase in exercise.

Consider the following scenario:

• As an advanced practice nurse at a      community health clinic, you often treat female (and sometimes male      patients) with hormone deficiencies. One of your patients requests that      you prescribe supplemental hormones. This poses the questions: How will      you determine what kind of treatment to suggest? What patient factors      should you consider? Are supplemental hormones the best option for the      patient, or would they benefit from alternative treatments?

To prepare:

• Review Chapter 56 of the Arcangelo      and Peterson text, as well as the Holloway and Makinen and Huhtaniemi      articles in the Learning Resources.
• Review the provided scenario and      reflect on whether or not you would support hormone replacement therapy.
• Locate and review additional articles      about research on hormone replacement therapy for women and/or men.      Consider the strengths and limitations of hormone replacement therapy.
• Based on your research of the      strengths and limitations, again reflect on whether or not you would      support hormone replacement therapy.
• Consider whether you would prescribe      supplemental hormones or recommend alternative treatments to patients with      hormone deficiencies.

With these thoughts in mind:

Post a description of the strengths and limitations of hormone replacement therapy. Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy. Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why.

This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2012 and up)

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

Required Readings

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

• Chapter 33, “Prostatic      Disorders and Erectile Dysfunction” (pp. 527-544)
       This chapter examines the causes, pathophysiology, and drug treatment of      four disorders: prostatitis, benign prostatic hyperplasia, prostate      cancer, and erectile dysfunction. It also explores the importance of      monitoring patient response and patient education.
• Chapter 34, “Overactive      Bladder” (pp. 545-564)
       This chapter describes the causes, pathophysiology, diagnostic criteria,      and evaluation of overactive bladder. It also outlines the process of      initiating, administering, and managing drug treatment for this disorder.
• Chapter 55, “Contraception”      (pp. 959-970)
       This chapter examines various methods of contraception and covers drug      interactions, selecting the most appropriate agent, and monitoring patient      response to contraceptions.
• Chapter 56, “Menopause” (pp.      971-994)
       This chapter presents various options for menopausal hormone therapy and      examines the strengths and limitations of each form of therapy.
• Chapter 57, “Osteoporosis” (pp.      985-994)
       This chapter covers various options for treating osteoporosis. It also      describes proper dosages, potential adverse reactions, and special      considerations of each drug.
• Chapter 58, “Vaginitis” (pp. 995-1006)
       This chapter examines various causes of vaginitis and explores the      diagnostic criteria and methods of treatment for the disorder.

Holloway, D. (2010). Clinical update on hormone replacement therapy. British Journal of Nursing, 19(8), 496–504

This article examines the purpose, components, and administration of hormone replacement therapy (HRT). It also presents benefits, risks, potential side effects, and alternative treatment options of HRT.

Mäkinen, J. I., & Huhtaniemi, I. (2011). Androgen replacement therapy in late-onset hypogonadism: Current concepts and controversies—A mini-review. Gerontology, 57(3), 193–202. 

This article examines the role of testosterone levels in the development of hypogonadism. It also explores health issues that are impacted by testosterone levels and the role of testosterone replacement therapy.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

U.S. Preventive Services Task Force. (2014). The Guide to Clinical Preventive Services: Section 2. Recommendations for Adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, 

Evidence-based treatment for the Hispanic diabetic patient include the following medications: pioglitazone hydrochloride (a thiazolidinedione, 30 mg/d); irbesartan (an angiotensin receptor blocker, 150 mg/d titrated to 300 mg/d); hydrochlorothiazide (an antikaliuretic agent, 12.5 mg/d); and aspirin (325 mg/d).

            Therapy also includes a low-protein diet and walking program.  Taking note of cultural considerations, the evidence-based strategies that take into account blood pressure, creatinine clearance rate, and urine albumin level while improving peripheral vascular disease and diabetic peripheral neuropathy, must include lifestyle changes.  Diet, lifestyle modification and mental attitude are key factors in caring for the Hispanic diabetic patient.

Hispanics are more likely than the general population to develop diabetes; therefore, nutrition intervention is important for the Hispanic patient in managing existing diabetes, and preventing, or at least slowing, the rate of development of diabetes complications. It is, therefore, important at all levels of diabetes prevention.  Lifestyle changes are also an integral component of diabetes promotion education.  Evidence-based recommendations are based on the American Diabetes Association and offer guidelines to prevent overweight and obesity since they are closely linked to diabetes and particular attention is paid to medication management.

References

Crawford, U., & Hyatt, B. (2017).  Evidence-based strategies to address chronic conditions in the Hispanic community. American Journal of Public Health; 25(12): 157-169.

Urteaga, I.; Olef, Y. (2016). Hispanics and diabetes: Risks and prevention. Journal of Community Health; 19(21): 129-138.