David is a 47 years old male who has recently been diagnosed with hypertension

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Length: 400 words, excluding references

Task: Refer to the following case and answer the associated questions.

Case: David is a 47 years old male who has recently been diagnosed with hypertension. He has been prescribed metoprolol.

Questions: 1. How will metoprolol help to reduce the patient’s blood pressure? (Hint: mechanism of action).

2. What adverse reactions should the patient be aware of? Link the adverse reactions to the mechanism of action.

3. Metoprolol is a negative chronotrope. Explain what this means and link this to the mode of action of metoprolol.

4. David remains on metoprolol, but is later also prescribed a calcium-channel blocker. Explain what could possibly go wrong with this combination of medications (hint: what are the possible drug-drug interactions with these two medications).

Please use referenced evidence to support your answer.

Overall Presentation (including formatting and grammar) Presentation of work is excellent, grammatically correct with highly commandable writing skills.

Proper use of Literature  Critical analysis of a wide range of relevant literature. 5-10 external sources of information and included and well-integrated into a report. Reference list complete and well-formatted according to  APA 7th guidelines.

Demonstration of comprehension, knowledge and analysis  Analytical content demonstrates excellent critical thinking skills, knowledge and comprehension, able to synthesise learning and apply it to the field of study . Demonstrate ability to critically evaluate.

Interpretation and application Able to critically evaluate and make judgements, which are realistic, creative and original.

Vision of Nursing

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Vision of Nursing

What is your vision for the future of nursing? How does your vision fit with the recommendations in the IOM report? What two action steps do you plan to take to promote this vision?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA 7ed style with support from at least 2 academic sources. Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
  • All replies must be constructive and use literature where possible
  • Resources:

 

Online Materials & Resources

variety of vulnerable populations

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variety of vulnerable populations

Within my community there are a variety of vulnerable populations.  Some of the most vulnerable are the elderly, behavioral and mental health, and homelessness.  Luckily in my community, we have great resources available for all of them.  When it comes to the elderly, we have many neighborhoods that are for ages 55 and older, assisted living facilities, and skilled nursing facilities.  When an individual is admitted to the hospital, the case managers will assist with placing individuals who need it into the appropriate facility for them.  They will also report any cases of abuse towards the elderly.

Some forms of abuse may include physical, emotional, and financial.  For individuals that are not admitted into a hospital, cases of abuse can also be reported to the Department of Elder Affairs.  They can be reported either online, by phone, or by fax (Department of Elder Affairs, n.d.).  If an elderly individual needs to be placed in a facility for long term care, a family member or physician can assist the individual with the process of finding a location that will suit the patient best.

Another vulnerable population is the behavioral and mental health population.  In my community we have an inpatient facility right down the street called South County Mental Health Center.  This facility is a state-chartered, nonprofit health care organization.  They deliver high quality care for behavioral health as well as substance abuse disorders to people of all ages and income regardless of their ability to pay (South County Mental Health Center, 2020).  Individuals can be placed there either voluntary or involuntary.  Those that are involuntary are placed there because they were baker acted, while those that are voluntary can call the facility and asked to be placed there either by themselves or a family member if they are a minor.

Vulnerable Populations

Homelessness while it is not a huge population in my community, it does exist.  There are many services available to them.  Some services include Boca Helping Hands and Gateway Community Outreach.  Boca Helping Hands provides food. Medical and financial assistance to help with the basic needs of individuals.  They also provide education and job-training for individuals to be self-sufficient (Boca Helping Hands, 2017).  Gateway Community Outreach provides assistance to those who are struggling and are about to become homeless.  They provide intensive case management, food, housing assistance. And referrals to those in need of emergency aid (Gateway Community Outreach, 2021).

While there are services available within my community, they are not advertised for individuals.  Some ways that they can improve on is placing information in areas like bus stops, convenient stores, hospitals, clinics, fire stations, and advertisements on television.  Police offers and healthcare providers would also be a good resource.  If they have the proper information for all of the resources available to these individuals, when they come across someone that needs assistance, they can pass the information along.

Reference

Boca Helping Hands. (2017). Our Mission. Retrieved from: https://bocahelpinghands.org/Mission

Department of Elder Affairs. (n.d.). Elder Abuse Prevention Program. Retrieved from:http://elderaffairs.state.fl.us/doea/abuse_prevention.php

Gateway Community Outreach. (2021). Our Mission. Retrieved from: https://gcoflorida.org/about/

South County Mental Health Center. (2020). About SCMHC. Retrieved from: https://www.scmhcinc.org/

REPLY 2

Vulnerable Populations

Resources for vulnerable populations in my community include organizations dealing with drug and substance abuse among adolescents, establishments providing services for the elderly, community education programs, and elder abuse services, and child welfare programs.  Educational programs in my community are tasked to create awareness to prevent disease injury and improve community’s quality of life by creating awareness for individuals’ behavioral change, advocating for policy change, educating communities about their environments and its health, and partnering with governmental and non-governmental agencies to realize goals and objectives (Porteny et al., 2020).

In particular community-based educational programs contribute to the overall health and well-being of people in Florida’s communities. They are developed to target vulnerable pope outside of the regular healthcare settings such as institutions of higher learning and schools, community health concerns, worksites and whole communities. However, the effectiveness of these organizations is often suboptimal due to lack of adequate fiscal and human resources (Porteny et al., 2020).

Their impacting fails totrickle down to the community, especially when they fail to effectively engage the community and create long lasting partnerships that foster changeand enhance communities’ quality of life. Therefore, it is critical to establish an evidence-base for service delivery in community educational programs, utilize skilled human resource, and adopt policy interventions to improve impact.

Islam and Christian almsgiving comparison

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Islam and Christian almsgiving comparison

Almsgiving is the third pillar of Islam, often described by modern Muslims as the pillar of social action. Two main kinds of almsgiving exist in Islam, one compulsory and the other voluntary. Zakah is the duty of sharing one’s wealth with the poor, the needy, the debtor, the prisoner, the wayfarer, while the Qur’an is less concerned with the quantity and more with the quality of giving (Partridge, 2018). Having said that, there is another essential aspect to giving in the Islamic tradition, one that is centered on the idea of purification. Being charitable is a way of purifying the material deeds, thus never losing track of the most crucial goal, serving God, in this case, by serving fellow humans.

To both Muslims and Christians, caring for the poor is a duty offered upon believers. Both faiths stress the importance of donating to, praying for, and protecting the needy. Furthermore, in both Islam and Christianity, it is made clear that giving alms in private is favorable in the eyes of God, as opposed to donations made in an attempt to receive praise and acknowledgment. Islam emphasizes the importance of zakat. The zakat’s amount is not precise, but in general practice, one gives 2.5 percent of one’s wealth (Kailani & Slama, 2020). Similarly, in the Christian tradition, God commands each Christian to donate 10 percent of their earnings to the church, called tithes used to provide for the poor.

References

Kailani, N., & Slama, M. (2020). Accelerating Islamic charities in Indonesia: zakat, sedekah, and the immediacy of social media. South East Asia Research, 28(1), 70-86.

Partridge, C. (2018). A short introduction to world religions. Fortress Press

REPLY 2

Compare one of the Five Pillars of Islam to Christianity.

Christianity and Islam are religions that share common roots – the Abrahamic origin. Both religions have cultural similarities, even though they both differ in their belief systems and doctrines. Islam has Five Pillars of Faith: Declaration of Faith, Daily Prayer, Charitable Giving, Fast of Ramadan. And Pilgrimage to Mecca, which are the framework of the Muslim life. It is obligatory for Muslims to uphold these pillars.

Fasting, the fourth pillar of Islam is a ritual that is observed in the month of Ramadan on the Islamic lunar calendar, and is usually a month long. The month of Ramadan is regarded as a sacred month, and fasting usually starts with sighting of the new moon. The day’s fasting starts at daybreak and ends at sunset. So a Muslim would start the day’s fasting with an early meal and break at sunset at a family or congregational dinner after the evening prayers.

From daybreak, Muslims refrain from eating, drinking and sexual intercourse until after sunset as a way of building spiritual strength. And learning to empathize with people who do not have food to eat or are disadvantaged in life. Most times during the fasting period, people engage in charitable donation of food (presumably, food that would have been eaten, but for the fast). Even though fasting is obligatory, the sick. Traveler and pregnant women are given fast-exemptions, they would make up for missed fasting days on a later date.

Christian fast

On the other hand, the Christian fast is equally an act of abstaining from food for spiritual purposes but is a voluntary, personal and private matter, and does not have set parameters. Fasting is not mandated in Christianity, but it is expected of Christians to fast. Jesus advocated the privacy of fasting; “When you fast, do not look somber as the hypocrites do,… put oil on your head and wash your face, so that it will not be obvious to others that you are fasting, but only to your Father, who is unseen; and your Father, who sees what is done in secret, will reward you

complaint of severe pain of a left leg

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Case Study for SOAPIER Note.

Read the case study. Write a progress note using the SOAPIER format.

SJ came to the ER you are working at with complaint of severe pain in his left leg. When you asked him what happened, he said “I was sled riding in the snow with some friends. I lost control and went over the hill and hit a tree. My leg is killing me.”

You do an assessment. SJ is alert and oriented to person, place and time. He has no known allergies (NKA).Skin is warm and dry. Color appropriate for ethnicity. Neuro checks are normal. Denies hitting his head. Has full range of motion in both arm and right leg. EMS has a stabilizing splint on his right leg. Bilateral toes are pink and capillary refill is quick to return. Distal extremities pulses are strong and bounding. Bowel sounds are positive in all four quadrants.

Vital signs are 97.8 orally. Heart rate is 110 and regular. Heart sounds S1 and S2 heard. Respirations are 24 and unlabored. Lung sounds are clear. Blood pressure is 172/96. He asks “Please can you give me something for pain?” Rates his pain a “10” on the 0 -10 numeric scale. You give him 4 milligrams of morphine IV as prescribed by the physician.

The xray results come back and he has a complete fractured tibia. He is admitted to the medical/surgical unit and scheduled for surgery tomorrow. Report given to RN “Mary” on the medical/surgical unit.

Menstrual Cycle

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Menstrual Cycle

● A female reproductive years begin around 11 to 13 years of age at the onset of menses

and end around age 50, when menses ceases.

● The average menstrual cycle is approximately 28 years in length, beginning with the first

day of menstrual bleeding.

● Premenarche is the physiological status of pre puberty , the time before the onset of

menses.

● Menarche is the state after reaching puberty in which menses occur normally every 28

days.

● Menopause refers to the cessation of menses.

Follicular Development and Ovulation

● During the menarcheal years, an ovum is released once a month once a month by one of

the two ovaries.

● All ova begin development during embryonic life and remain in suspended animation

within pre-antral follicle as an immune oocyte until the onset of menarche.

● Each ovary contains approximately 200,000 oocytes at the time of birth.

● When a young girl reaches puberty, the hypothalamus begins the pulsatile release of

gonadotropin releasing hormones.

● Which stimulates the anterior pituitary gland to secrete varying levels of gonadotropin(

primarily follicle-stimulating hormone and luteinizing hormone).

● The luteinizing hormone level will typically increase rapidly 24 to 36 hours before

ovulation in a process known as LH surge.

● It is the LH surge, accompanied by a smaller FSH surge that triggers ovulation in day 14.

Menstrual Cycle

 

● After ovulation, the ovary enters the luteal phase. This phase begins with ovulation and is

14 days in length.

● During Luteal Phase, the cells in the lining of the rupture ovarian follicle begin to

multiply and create corpus luteum or yellow body.

● The corpus luteum immediately begins secreting progesterone.

● As progesterone levels decline, menstruation occurs and the cycle begins.

Anatomy and physiology of female pelvis

● Two approaches are used to sonographically evaluate the female pelvis: transabdominal

and endovaginal(transabdominal).

● Transabdominal requires a full bladder for acoustic windows. Requires the 3.5 to 5 MHz transducer for adequate penetration.

● An edovaginal examination is performed with empty bladder and uses a 7.5 to 10 MHz

transducer.

Theories Of The 1980’S And 1990’S.

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Create a PowerPoint presentation that addresses each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with at least two (2) sources and the textbook using APA citations throughout your presentation. Make sure to cite the sources using the APA writing style for the presentation. Include a slide for your references at the end. Follow best practices for PowerPoint presentations related to text size, color, images, effects, wordiness, and multimedia enhancements. Review the Signature Assignment rubric criteria for this assignment.

This week, you will develop a PowerPoint presentation reviewing the theories from each module. Please select one theory from each module (1-8) and answer the following questions. You should have 2-4 slides per theory with a total of 8 theories discussed.

  • Describe the theory
  • Provide 3 examples of how the theory applies to current practice
  • Provide 3 positive patient outcomes resulting from utilizing the theory
  • Explain 3 benefits to nursing satisfaction when utilizing the theory
  • Describe two barriers to using the theory in practice and at least one method for overcoming each barrier (support methods with sources)
  • Support from literature clearly noted throughout

The PowerPoint presentation should include at least two outside references and the textbook. The presentation should contain 2 to 4 slides per theory, for a total of 16 to 32 slides.

Total Point Value of Assignment: 500 points

Ankle Pain

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Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

SW, 46, F, Caucasian

S.

CC: Bilateral ankle pain

HPI: SW, 46-year-old Caucasian female presents with bilateral ankle pain that started three days ago. Pt states that her right ankle is more of a concern than her left. States she was playing soccer over the weekend when she heard a “pop.” Claims she was running to kick the soccer ball when she slipped on the grass and fell on top of her right foot. She thinks she “rolled” her foot inward.

States she is able to bear weight on both ankles, but the right is uncomfortable. Rates pain 7/10 in intensity for her right ankle, and 3/10 in intensity for her left ankle. She has been taking OTC 600mg ibuprofen every 8 hours for two days and has minor relief. States her right ankle pain is a 4/10 pain with ibuprofen, but only lasts a few hours. Confirms icing both ankles three times a day for the past three days. States walking, and standing is uncomfortable, and most movement makes the pain worse.

Current Medications: OTC 600mg Ibuprofen q 8 hours PRN pain

Allergies: NKA

PMHx: No chronic conditions; UTD on immunizations, last TdAp 2011, last influenza vaccine 10/2020.

Soc Hx: Lives at home with her husband, 11-year-old daughter, 13-year-old son, and 16-year-old son; works as stay at home for the past 16 years; lives in a multi-family home neighborhood with several friends in the neighborhood; negative tobacco use; consumes moderate alcohol, estimates 2-3 glasses of wine per week; exercises 4 days a week and plays soccer over the weekends with her 16-year-old to help him practice; denies cell phone use while driving; not currently on birth control and LMP was 2 /12 weeks ago; practices safe sex

Fam Hx: both parents still living; mother, 68-years-old, has history of hyperlipidemia; father, 70-years-old, has a history of HTN, hyperlipidemia, and CHF; paternal grandfather died at age 80 of pancreatic cancer; paternal grandmother died at age 83 of pneumonia; maternal grandfather, 89-years-old, has a history of COPD, HTN, and CHF; maternal grandmother, 86-years-old, has a history of kidney disease; 11-year-old daughter has a history of asthma; 13-year-old son has a history of anxiety, 16-year-old son is healthy; husband, 49-years-old suffers from HTN.

ROS:

GENERAL:  Right ankle pain, 7/10 pain; no weight loss, fever, chills, weakness or fatigue.

HEENT:

  • HEAD: denies headaches, dizziness, head injuries, or past head injuries
  • EYES: wears corrective lenses for about 20 years; denies any vision changes
  • EARS: denies any changes in hearing; no history of injuries; denies hearing aid use
  • NOSE: denies any changes in sense of smell; denies nasal discharge or swelling
  • THROAT: denies mouth sores or lesions; denies sore throat, dysphagia, or any injuries or surgeries to throat

SKIN: denies contact dermatitis or any other skin conditions; confirms bruising of right ankle

CARDIOVASCULAR:  denies chest pain, chest pressure or chest discomfort; denies palpitations or edema

RESPIRATORY:  denies shortness of breath, cough, or wheeze

GASTROINTESTINAL:  denies anorexia, nausea, vomiting or diarrhea; denies abdominal pain

NEUROLOGICAL: denies headaches, head injuries, dizziness, seizures, tremors, difficulty swallowing or speaking; denies gait disturbances

MUSCULOSKELETAL:  confirms right ankle pain near the right lateral malleolus; tenderness and swelling noted on right ankle; denies joint pain, stiffness, swelling, redness, or heat in upper extremities and left lower extremity; denies arthritis, hip dysplasia or scoliosis

https://quicknursinghelp.com/

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Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

Patient Initials: __TC_____ Age: ___15____ Gender: ___Male____

SUBJECTIVE DATA:

Chief Complaint (CC): Bilateral Knee Pain

History of Present Illness (HPI): TC is a 15-year-old African-American male high school student who is in 9th grade. He presents to the clinic today with complaints of dull bilateral knee pain. Pateint states that he’s experencing “a catching sensation under my kneecaps.” The patient states that this has been going on for weeks now. He said that his knees really bother him the most when playing basketball, but they still bother him even when he’s walking. He says the pain comes and goes and he rates the pain level as a 5 on a pain scale of 1-10 after taking 200mg of Ibuprofen. His last dose he stated was taken orally 45 minutes ago. He then stated that the pain without pain medicine is was 10/10 before. The patient states that resting and icing his knees helps to alleviate the pain also.

Medications:

Ibuprofen 200mg PO Q6-8hrs PRN pain

Multi-vitamin PO Daily

Allergies:

Sulfa drugs – Facial Swelling

Past Medical History (PMH):

No Past Medical Hx

Past Surgical History (PSH):

No Past Surgical Hx
Personal/Social History:

Patient is in high school. He enjoys playing basketball, football, and baseball. He lives at home with his parents and younger brother and sister.

Immunization History:

His immunizations are up to date.

Significant Family History:

P Grandmother- Diabetes

P Grandfather- HTN

M Grandmother- Diabetes, Heart Disease

© 2019 Walden University Page 1 of 4

M Grandfather- HTN, Hyperlipidemia

Review of Systems:

General: Denies weakness, no recent weight loss/gain, fever, and fatigue.

HEENT: The patient has no headache and no history of head injury. He denies blurred vision, double vision, and visual loss. no hearing loss. No sneezing, runny nose, and congestion. Patient denies a sore throat.

Respiratory: denies a cough and shortness of breath.

CV: Patient denies chest pain, and chest discomfort. Patient exhibits no palpitations or edema.

GI: Denies change in dietary patterns or bowel habits. He denies abdominal pain, nausea, and vomiting or diarrhea., stomach distress or blood in the stool

GU: Patient denies painful urination, frequency, and urgency

MS: Patient has bilateral knee pain for , Patient denies any other joint, muscle, or back pain. Denies any recent injury.

Psychopharmacologic Approaches

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Neurocognitive Disorder related to Alzheimer’s

  • Explain the diagnostic criteria for your assigned neurocognitive disorder.
  • Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned neurocognitive disorder.
  • Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks.
  • Support your rationale with references to the Learning Resources or other academic resource.

References

Oltra-Cucarella, J., Pérez-Elvira, R., Espert, R., & Sohn McCormick, A. (2016). Are cognitive interventions effective in Alzheimer’s disease? A controlled meta-analysis of the effects of bias. Neuropsychology, 30(5), 631–652. doi:10.1037/neu0000283

Hopkins, S. A. A., & Chan, D. (2016). Key emerging issues in frontotemporal dementia. Journal of Neurology, 263(2), 407–413.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 21, “Neurocognitive Disorders” (pp. 694–741)